scholarly journals Underlying factors and challenges of implementing the urban family physician program in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mohammad Hossein Mehrolhassani ◽  
Vahid Kohpeima Jahromi ◽  
Reza Dehnavieh ◽  
Mahla Iranmanesh
Keyword(s):  
Family Physician ◽  
Program Implementation ◽  
Rural Areas ◽  
Health Coverage ◽  
Policy Makers ◽  
International Pressure ◽  
Electronic File ◽  
The Family ◽  
Urban Family ◽  
Management Changes

Abstract Background The family physician program was launched in 2005 in rural areas of Iran and then piloted in 2012 in the cities of Fars and Mazandaran provinces due to insufficient health coverage in these cities. However, despite its pivotal role in the health system, this program has not progressed according to the policies. This study aimed to explain the underlying factors and challenges of implementing the urban family physician program in Iran. Methods This qualitative study was conducted on 44 policy-makers and managers at national and provincial levels selected via snowball and purposive sampling with maximum variation. The data were managed in MAXQDA 2020 and analyzed by directed content analysis. A triangulation method was adopted for this purpose. Results A total of 10 categories, 18 sub-categories, and 29 codes were formed. Most challenges related to underlying factors included precipitancy, economic sanctions, belief in traditional medicine, belief in the expertise of previous physicians, and global ranking of countries. For program implementation, most challenges included a diversity of insurance organizations, budget allocation, referral system, electronic file, educational system, and culture building. Conclusions The major challenges pertaining to underlying factors included international pressure for reforms and precipitancy in program implementation due to management changes. The challenges associated with program implementation included budget provision and interaction with insurance organizations. Therefore, to expand this program to other provinces in Iran, the identified factors should be carefully considered so that sufficient confidence and commitment can be guaranteed for all stakeholders.

scholarly journals Antibiotic Prescribing in Outpatient Before and After Implementation of the Urban Family Physician and Referral System

2021 ◽  
Vol 15 (6) ◽  
pp. 1749-1755
Author(s):  
Ehsan Nabovati ◽  
Hamed Mahmoudi ◽  
Reza Abbasi ◽  
Saeed Barzegari ◽  
Hossein Akbari ◽  
...  
Keyword(s):  
Health Services ◽  
Family Physician ◽  
Positive Impact ◽  
Referral System ◽  
Antibiotic Prescribing ◽  
Mazandaran Province ◽  
Medication Prescription ◽  
The Family ◽  
Before And After ◽  
Urban Family

Background The Family Physician and Referral System was piloted in Mazandaran and Fars provinces, Iran in 2012. The goal of this program was to improve the provision of health services including medication prescription. Objective This study aimed to determine the trends in antibiotic prescribing in outpatient before and after implementation of the Family Physician and Referral System in Babol, Iran from 2010 to 2018. Methods In this retrospective study, all prescriptions of urban family physicians in Babol, which were registered in the database of the Health Services Insurance Organization of Mazandaran province, were included. The trends of average number of items per prescription, percentage of antibiotics per prescription, frequency of antibiotic groups, and cost of antibiotics were calculated using SQL Server and IBM SPSS version 22. Results The average number of items per prescription was found to be 3.4±1.82, and 2.8±1.60, and percentage of antibiotics per prescription was 49% and 32% in 2010 and 2018, respectively. The most prescribed antibiotic groups were penicillin (54.8%) and cephalosporin (39.9%). Amoxicillin 500mg capsules (13.1%), metronidazole 250 mg (10.2%), and ciprofloxacin 500 mg (8.2%) were the most prescribed antibiotics. Also, the mean cost of prescriptions containing antibiotics compared to the total prescriptions had decreased from 22% in 2010 to 5.5% in 2018. Conclusion The pattern of medication prescription especially antibiotics, improved after the implementation of the Family Physician and Referral System. Due to the positive impact of the Family Physician and Referral System on medication prescription by physicians, we recommend the implementation of this program in low and middle-income countries. Keywords: Antibiotic, medication prescribing, Health system reform plan, Family physician, Trend

Setting Up Community Health Programmes in Low and Middle Income Countries, Fourth Edition, by Ted Lankester and Nathan Grills, Oxford University Press, May 2019

2020 ◽  
Vol 7 (2) ◽  
pp. 155-158
Author(s):  
Sundeep Manoth ◽  
Bethany Carr
Keyword(s):  
Global Health ◽  
Community Health ◽  
Rural Areas ◽  
Health Coverage ◽  
Middle Income ◽  
Policy Makers ◽  
Rural And Urban ◽  
Wide Range ◽  
Health And Development ◽  
Low And Middle Income

Universal health coverage is still out of reach for many people in the world and not surprisingly, it is those in rural areas made up of largely poor communities who are the most deprived. Setting Up Community Health and Development Programmes in Low and Middle-Income Settings is a practical tool to guide the process of starting, developing and maintaining a healthcare programme in these areas. Its purpose is to help stakeholders to empower communities to identify and solve their own problems so as to decrease inequality and inequity which remain serious issues in global health. This book also aims to assist academics, policy makers and planners to understand the realities of field-based development and progress. The book has a wide range of contributors with expertise in different areas and they address two main audiences. The first is those working in the field: programme managers, and practitioners from government and civil society involved in setting up or developing community health and development programmes, rural and urban. This book is also written for global health and other health care students, academics, policy makers and planners who wish to anchor their work in field-based situations.

Family Firms, Social Responsibility, and Non-Family Member Employees Identification

Think India ◽  
2013 ◽  
Vol 16 (3) ◽  
pp. 10-19
Author(s):  
Ang Bao
Keyword(s):  
Resource Allocation ◽  
Social Responsibility ◽  
Family Member ◽  
Program Implementation ◽  
Social Identity Theory ◽  
Family Firms ◽  
The Family ◽  
Corporate Social ◽  
The Relationship ◽  
Csr Engagement

The objective of this paper is to find the relationship between family firms’ CSR engagement and their non-family member employees’ organisational identification. Drawing upon the existing literature on social identity theory, corporate social responsibility and family firms, the author proposes that family firms engage actively in CSR programs in a balanced manner to increase non-family member employees’ organisational identification. The findings of the research suggest that by developing and implementing balanced CSR programs, and actively getting engaged in CSR activities, family firms may help their non-family member employees better identify themselves with the firms. The article points out that due to unbalanced CSR resource allocation, family firms face the problem of inefficient CSR program implementation, and are suggested to switch alternatively to an improved scheme. Family firms may be advised to take corresponding steps to select right employees, communicate better with non-family member employees, use resources better and handle firms’ succession problems efficiently. The paper extends employees’ identification and CSR research into the family firm research domain and points out some drawbacks in family firms’ CSR resource allocation while formerly were seldom noticed.

Information Practices of Baby Boomers as Caregivers

2013 ◽  
Author(s):  
Khuan Seow ◽  
Nadia Caidi
Keyword(s):  
Social Policy ◽  
Baby Boomers ◽  
Information Needs ◽  
Family Members ◽  
Age Groups ◽  
Maladie D’Alzheimer ◽  
Policy Makers ◽  
Age Related ◽  
The Family ◽  
Growing Age

Canada has an aging population with the fastest growing age groups (80 and 45-64 years old) vulnerable to age-related diseases such as Alzheimer’s disease. Caregiving responsibilities often fall to the family members of the afflicted without much attention and consideration being placed on the information needs of these caregivers. We call for a better understanding of these caregivers' information needs and uses by social policy makers as well as information providers.La population du Canada a tendance à vieillir considérablement, avec la hausse la plus rapide dans les groupes d’âge (80 et 45 à 64 ans). Les personnes âges sont très vulnérables à toute sorte de maladies, telles que la maladie d’Alzheimer. La responsabilité revient souvent aux membres de la famille qui doivent prendre soin des personnes atteintes de cette maladie. Or, nous ne connaissons que peu de chose sur les besoins en information des personnes qui prennent soin de ces malades de l’Alzheimer : qui sont-ils ? Quelles sont leurs sources... 

Socio-Economic Profile of Labour Households in Rural Punjab

2020 ◽  
pp. 306-311
Keyword(s):  
Rural Areas ◽  
Good Condition ◽  
Family Type ◽  
Age Group ◽  
Employment Opportunities ◽  
Nuclear Families ◽  
The Family ◽  
Working Age ◽  
Average Condition ◽  
Economic Profile

The present paper is an attempt to analyze the socio-economic profile of the labour households in rural Punjab. The study revealed that majority of rural labour households belonged to the scheduled caste category. As far as the distribution of sampled rural labour households according to the family type was concerned, it was found that 46.42 percent of the total rural labour households had nuclear families, while the remaining 53.58 percent have joint families. Majority of the rural labourers were living in semi-pucca houses. Further, if we look at the housing condition, 54.72 percent of rural labourers owned the houses of average condition, 40.19 percent owned good condition households and 5.09percent owned dilapidated houses. The analysis further showed that as many as 20.35percentof the sampled labour population was illiterate. A few persons from sampled labour households educated above matric. Although large majority of the sampled labour population were from the working-age group yet the ratio of dependents was high among rural labour households. This was due to lower employment opportunities in rural areas.

Empowerment of Rural Women through SHGs: A Study in Telangana

2017 ◽  
Vol 4 (36) ◽  
Author(s):  
Shankar Chatterjee
Keyword(s):  
Rural Women ◽  
Rural Areas ◽  
Poverty Line ◽  
Rural India ◽  
Group Approach ◽  
Research Article ◽  
Self Help ◽  
Rural Livelihood ◽  
The Family ◽  
Self Help Group

The self-help group (SHG) is a powerful instrument to empower economically backward women of rural India as the women members under the SHG not only can earn income but they feel empowered also. With the launching of Swarnajaynti Gram Swarozgar Yojana (SGSY) by the Ministry of Rural Development, Government of India from April 1999, subsequently rechristened as Deen Dayal Antyodaya Yojana–National Rural Livelihood Mission (DAY-NRLM) self-help group approach (SHG) has been given utmost importance in India for the development of rural women mainly focusing on below poverty line households. SHG concept is popular in many rural areas of India as through economic development and subsequently empowering, rural women have got a solid platform. This research article has discussed the how rural women after forming SHGs in Ranga Reddy district (R.R. District) of Telangana were not only earning and contributing to the family but felt empowered also. The study was carried out at Gandipet village of Gandipet Mandal, Ranga Reddy (R.R.) district in September 2017. The some women members of 10 different SHGs were contacted and few individual cases are presented here.

Developing and Validating a Scale of Tourism Gentrification in Rural Areas

2021 ◽  
pp. 109634802110149
Author(s):  
Chaohui Wang ◽  
Yumei Xu ◽  
Tingting (Christina) Zhang
Keyword(s):  
Rural Areas ◽  
Living Standards ◽  
Rural Tourism ◽  
Measurement Scale ◽  
Community Culture ◽  
Policy Makers ◽  
Qualitative And Quantitative ◽  
Cultural Appreciation ◽  
Great Progress ◽  
Development And Validation

In recent years, tourism gentrification has made great progress in rural areas and has had significant impacts on these areas’ development, specifically in the domains of the economy, living standards, community, culture, and environment. Tourists play a key role in developing tourism gentrification in rural areas, but research investigating tourism gentrification in rural areas from the tourist perspective is scarce. To fill this gap, we focus on tourism gentrification and develop a measurement scale from the tourist perspective through multiple qualitative and quantitative steps. Our findings confirm that tourism gentrification in rural areas from the tourist perspective comprises eight dimensions: economic growth, enhanced environment, enhanced living standards, individual civilization, improved communication, promoted social environment, cultural appreciation, and improved individual quality. Through development and validation of the scale, we hope to offer a comprehensive referencing index of tourism gentrification in rural areas to policy makers and rural tourism practitioners.

scholarly journals The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ramadhani Kigume ◽  
Stephen Maluka
Keyword(s):  
Health Insurance ◽  
Community Health ◽  
Rural Areas ◽  
Health Coverage ◽  
Access To Health Services ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Urban Districts ◽  
Health Fund ◽  
The Government

Abstract Background Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania. Methods A descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data. Results While TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community. Conclusions Similar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.

scholarly journals Changes in Tobacco Use Patterns during COVID-19 and Their Correlates among Older Adults in Bangladesh

2021 ◽  
Vol 18 (4) ◽  
pp. 1779
Author(s):  
Sabuj Kanti Mistry ◽  
Armm Mehrab Ali ◽  
Md. Ashfikur Rahman ◽  
Uday Narayan Yadav ◽  
Bhawna Gupta ◽  
...  
Keyword(s):  
Older Adults ◽  
Tobacco Use ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Policy Makers ◽  
Use Patterns ◽  
Telephone Interviews ◽  
Related Information ◽  
Structured Questionnaire

The present study explored the changes in tobacco use patterns during the COVID-19 pandemic and their correlates among older adults in Bangladesh. This cross-sectional study was conducted among 1032 older adults aged ≥60 years in Bangladesh through telephone interviews in October 2020. Participants’ characteristics and COVID-19-related information were gathered using a pretested semi-structured questionnaire. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic (6 months prior to the survey). Nearly half of the participants (45.6%) were current tobacco users, of whom 15.9% reported increased tobacco use during the COVID-19 pandemic and all others had no change in their tobacco use patterns. Tobacco use was significantly increased among the participants from rural areas, who had reduced communications during COVID-19 compared to pre-pandemic (OR = 2.76, 95%CI:1.51–5.03). Participants who were aged ≥70 years (OR = 0.33, 95% CI: 0.14–0.77), widowed (OR = 0.36, 95% CI: 0.13–1.00), had pre-existing, non-communicable, and/or chronic conditions (OR = 0.44, 95% CI: 0.25–0.78), and felt themselves at the highest risk of COVID-19 (OR = 0.31, 95% CI: 0.15–0.62), had significantly lower odds of increased tobacco use. Policy makers and practitioners need to focus on strengthening awareness and raising initiatives to avoid tobacco use during such a crisis period.

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