scholarly journals Barriers to mental health services at public health centers: Providers’ perspectives

2019 ◽  
Vol 7 (1) ◽  
pp. 66
Author(s):  
Putu Aryani ◽  
Pande Putu Januraga ◽  
Komang Ayu Kartika Sari ◽  
Lisanne Gerstel ◽  
Willem F Scholte
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Local Government ◽  
Health Workers ◽  
National Policy ◽  
Health Centers ◽  
Health Providers ◽  
The Government ◽  
Services Implementation ◽  
Depth Interviews

Background and purpose: The disparity between the increasing prevalence of mental health (MH) illness and the availability of treatment in Indonesia remains high, despite the campaign to provide MH services at public health centers (PHCs) initiated by the government in 2014. This study explored barriers to provide MH services at PHCs in Denpasar, Bali, Indonesia in order to identify priorities to improve the services.Methods: This qualitative study was conducted from March to December 2015 and employed in-depth interviews and focus group discussions (FGDs). In-depth interviews were conducted with the Head of Denpasar City Health Office to explore the barriers of MH services provision at PHCs in the scope of policy and services management. Interviews with general practitioners (GPs) from 4 PHCs in Denpasar were conducted in order to explore the experiences and barriers of MH services in the PHC clinics. To explore further the MH services implementation in the community, two FGDs were conducted with the MH program managers and community health workers (CHWs). The interviews and FGDs were recorded, and the verbatim transcripts were analyzed using a thematic framework analyses.Results: Barriers to MH service provision identified in our study are poor dissemination of the national policy to the local government and PHCs; low prioritization of MH issues; organization workforce issues; funding concerns; poor coordination and supervision; poor management and recording system; scarcity of ancillary facilities and other resources such as psychotropic medicines.Conclusion: The findings of this study highlight the importance of national policy dissemination and collaboration between local government, health providers and CHWs to overcome the barriers in providing MH services at PHC level.

Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Healthcare Provision ◽  
The Public ◽  
Public Health Sector ◽  
The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

scholarly journals Working conditions and health status of 6,317 front line public health workers across five provinces in China during the COVID-19 epidemic: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jinghua Li ◽  
Jingdong Xu ◽  
Huan Zhou ◽  
Hua You ◽  
Xiaohui Wang ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Health Status ◽  
Health Outcomes ◽  
Working Conditions ◽  
Health Workers ◽  
Front Line ◽  
Cross Sectional ◽  
Self Rated Health ◽  
Public Health Workers

ABSTRACT Background Public health workers at the Chinese Centre for Disease Control and Prevention (China CDC) and primary health care institutes (PHIs) were among the main workers who implemented prevention, control, and containment measures. However, their efforts and health status have not been well documented. We aimed to investigate the working conditions and health status of front line public health workers in China during the COVID-19 epidemic. Methods Between 18 February and 1 March 2020, we conducted an online cross-sectional survey of 2,313 CDC workers and 4,004 PHI workers in five provinces across China experiencing different scales of COVID-19 epidemic. We surveyed all participants about their work conditions, roles, burdens, perceptions, mental health, and self-rated health using a self-constructed questionnaire and standardised measurements (i.e., Patient Health Questionnaire and General Anxiety Disorder scale). To examine the independent associations between working conditions and health outcomes, we used multivariate regression models controlling for potential confounders. Results The prevalence of depression, anxiety, and poor self-rated health was 21.3, 19.0, and 9.8%, respectively, among public health workers (27.1, 20.6, and 15.0% among CDC workers and 17.5, 17.9, and 6.8% among PHI workers). The majority (71.6%) made immense efforts in both field and non-field work. Nearly 20.0% have worked all night for more than 3 days, and 45.3% had worked throughout the Chinese New Year holiday. Three risk factors and two protective factors were found to be independently associated with all three health outcomes in our final multivariate models: working all night for >3 days (multivariate odds ratio [ORm]=1.67~1.75, p<0.001), concerns about infection at work (ORm=1.46~1.89, p<0.001), perceived troubles at work (ORm=1.10~1.28, p<0.001), initiating COVID-19 prevention work after January 23 (ORm=0.78~0.82, p=0.002~0.008), and ability to persist for > 1 month at the current work intensity (ORm=0.44~0.55, p<0.001). Conclusions Chinese public health workers made immense efforts and personal sacrifices to control the COVID-19 epidemic and faced the risk of mental health problems. Efforts are needed to improve the working conditions and health status of public health workers and thus maintain their morale and effectiveness during the fight against COVID-19.

scholarly journals An assessment of mental health programs at community health centers in north Minahasa, Indonesia

2021 ◽  
Vol 8 (12) ◽  
pp. 5707
Author(s):  
Jessica Gloria Mogi ◽  
Gustaaf A. E. Ratag
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Community Health Centers ◽  
Supported Employment ◽  
Health Workers ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Family Approach ◽  
Mental Health Programs

Background: The Indonesian government recognizes the importance of mental health issues as indicated by the inclusion of such issues as indicators in the national program, the Healthy Indonesian Program with Family Approach (PIS-PK). This program is enforced in community health centers (puskesmas) in every regency in the country. However, the continually increasing number of mental disorder cases and the intense stigmatization of people with these disorders indicate the need to re-evaluate the capacity and delivery of designated centers’ mental health programs.Methods: This community survey involved interviewing the program directors of four community health centers in north Minahasa using the WHO-AIMS 2.2 questionnaire.Results: Very little effort has been made to improve mental health facilities and programs. Examples of aspects of health facilities that are lacking include training for health workers, the provision of psychotropic drugs, and supported employment or occupational rehabilitation.Conclusions: Community health centers are primary healthcare facilities for society. Therefore, mental health services should be implemented as one of their main programs.

scholarly journals A QUALITATIVE ANALYSIS OF AWARENESS AND UTILIZATION OF SOCIAL SECURITY MEASURES AMONG THE ELDERLY IN KOCHI CORPORATION

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Charutha Retnakumar ◽  
Leyanna Susan George ◽  
Maya Chacko
Keyword(s):  
Social Security ◽  
Health Workers ◽  
The Elderly ◽  
Community Level ◽  
Financial Security ◽  
Security Measures ◽  
Effective Utilization ◽  
Public Health Workers ◽  
The Government ◽  
Depth Interviews

Background: As per Census 2011, nearly 104 million people in India are above the age of 60 years. While in Kerala, 12.6 % of the population is elderly. The government of India has launched various social security schemes and concessions for the elderly.  Hence, objective of this research is to study the awareness & utilization of social security measures. It also aimed to understand the motivators & barriers for utilization of social security measures among the elderly. Methodology: A qualitative study was carried out in 5 geriatric care centres in the 65th division of Kochi. 7 FGDs were conducted in each of the geriatric clubs and 7 In-depth interviews were conducted among the Anganwadi workers, medical officers, public health workers, and welfare officers. The data was translated, transcribed, Coded, thematically analysed and conclusions were drawn after data triangulation. Results: The awareness & utilization of various social security measures were found to be poor among the elderly. This was attributed to the lack of awareness among the community level workers regarding same. Pensions, railway concessions, and vayomitram project were the most popular schemes. Financial security among the pensioners through the schemes was a major motivator. While, the lack of awareness regarding the schemes and delay in processing the applications were the barriers identified. Conclusion: Proper channelization of knowledge is important for the awareness generation among elderly and community level workers. This can further lead to effective utilization of the benefits provided.

Increasing Trends in Physical and Mental Health Problems among US Workers in Different Job Sectors During the COVID-19 Pandemic

2021 ◽  
Vol 5 (2) ◽  
pp. 90-102
Author(s):  
Gopal K Singh ◽  
Hyunjung Lee ◽  
Romuladus E. Azuine
Keyword(s):  
Mental Health ◽  
Public Sector ◽  
Family Business ◽  
Mental Health Problems ◽  
Health Workers ◽  
Health Problems ◽  
The Self ◽  
Physical And Mental Health ◽  
Non Profit ◽  
The Government

Background: The COVID-19 pandemic has had a substantial adverse impact on workers’ employment and physical and mental health. However, job losses, job-related household income shocks, and their related physical and mental health problems have not been well-documented. Using temporal, nationally representative data, this study examines inequalities in job-related income losses and their resultant health impact among US workers aged 18-64 years in different job sectors during the pandemic. Methods: Using April, August, and December 2020 rounds of the US Census Bureau’s Household Pulse Survey (N=56,156, 82,173, and 51,500), job-related income losses among workers in various job sectors and associated impacts on self-assessed health, depression, anxiety, worry, and lack of interest were analyzed by multivariable logistic regression. Results: In December 2020, 64.0% of self-employed and 66.3% of unemployed adults reported that they or someone in their household experienced a loss of employment income since the start of the pandemic in March 2020. This percentage was the lowest for the public sector (35.2%) and non-profit-sector (45.0%) workers. Job/income losses increased by 26% between April and December for workers in the private and non-profit sectors. Prevalence of fair/poor overall health, serious depression, serious anxiety, serious worry, and serious lack of interest increased substantially during the pandemic for workers in all sectors, with the self-employed, those in the family business, and the unemployed experiencing the highest risk and those in the government/public and non-profit sectors experiencing the lowest risk of poor physical and mental health. Workers in all sectors reporting job-related income losses experienced approximately 2-to-4-fold higher odds of poor overall health, serious depression, serious anxiety, serious worry, and serious lack of interest, compared to public-sector workers with no job/income losses, controlling for covariates. Conclusion and Implications for Translation: Job-related income losses and prevalence of poor overall health and mental health among workers in all sectors increased markedly during the pandemic, with the self-employed, family business, and unemployed workers being especially vulnerable to poor health, depression, anxiety, and stress.   Copyright © 2021 Singh, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

Exploring Distrust in the Wait and See: Lessons for Vaccine Communication

2021 ◽  
pp. 000276422110628
Author(s):  
P. Christopher Palmedo ◽  
Lauren Rauh ◽  
Hannah Stuart Lathan ◽  
Scott C. Ratzan
Keyword(s):  
Public Health ◽  
Ethnically Diverse ◽  
Health Interventions ◽  
Lower Income ◽  
Future Health ◽  
Effective Delivery ◽  
The Media ◽  
Wait And See ◽  
The Government ◽  
Depth Interviews

We conducted in-depth interviews with survey respondents who were distrusting of government authorities and/or communications, and also undecided about accepting the COVID-19 vaccine. Our sample was racially and ethnically diverse, mostly lower income without a college degree. Participants were concerned about their own health and cared about public health, but expressed mistrust in the government and the media. They generally felt ignored by public and institutional systems and expressed a desire to be listened to. These attitudes all influenced lack of confidence in the vaccine. We identify specific opportunities for intervention and communication in vaccine promotion. We propose longer-term solutions for improving trust, which is essential for the effective delivery of future health interventions.

scholarly journals COVID-19 disease emergency operational instructions for Mental Health Departments issued by the Italian Society of Epidemiological Psychiatry

2020 ◽  
Vol 29 ◽  
Author(s):  
Fabrizio Starace ◽  
Maria Ferrara
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Chronic Conditions ◽  
Community Psychiatry ◽  
Italian Society ◽  
Decision Makers ◽  
Health Departments ◽  
Mental Health Providers ◽  
Health Providers ◽  
Vulnerable Subjects

Abstract During the current COVID-19 disease emergency, it is not only an ethical imperative but also a public health responsibility to keep the network of community psychiatry services operational, particularly for the most vulnerable subjects (those with mental illness, disability, and chronic conditions). At the same time, it is necessary to reduce the spread of the COVID-19 disease within the outpatient and inpatient services affiliated with Mental Health Departments. These instructions, first published online on 16 March 2020 in their original Italian version, provide a detailed description of actions, proposed by the Italian Society of Epidemiological Psychiatry, addressed to Italian Mental Health Departments during the current COVID-19 pandemic. The overall goal of the operational instructions is to guarantee, during the current health emergency, the provision of the best health care possible, taking into account both public health necessities and the safety of procedures. These instructions could represent a useful resource to mental health providers, and stakeholders to face the current pandemic for which most of Mental Health Departments worldwide are not prepared to. These instructions could provide guidance and offer practical tools which can enable professionals and decision makers to foresee challenges, like those already experienced in Italy, which in part can be avoided or minimised if timely planned. These strategies can be shared and adopted, with the appropriate adjustments, by Mental Health Departments in other countries.

scholarly journals Morbidity profile of patients attending the centers for mental health service provided jointly by the Government of Nepal and Community mental health service of Community Mental Health and Counseling- Nepal (CMC-Nepal)

2013 ◽  
Vol 2 (1) ◽  
pp. 14-19 ◽  
Author(s):  
KD Upadhyaya ◽  
B Nakarmi ◽  
B Prajapati ◽  
M Timilsina
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Community Mental Health ◽  
Health Service ◽  
Health Services ◽  
Health Program ◽  
Health Workers ◽  
Mental Health Program ◽  
Community Mental Health Program ◽  
The Government

Introduction: Community mental health program initially conducted in Lalitpur district by UMN and later in the western region demonstrated the possibility of providing mental health services in the primary health care level if proper mental training is provided to different levels of health workers and the program is well supervised. Community Mental Health and Counseling- Nepal (CMC-Nepal) extended the same model of community mental health program to several other districts of the country after taking permission from the Ministry of Health and Population. The basic objective of the study was to prepare morbidity profile of patients attending the centers for mental health conducted jointly by the government of Nepal and Community Mental Health and Counseling- Nepal (CMC-Nepal). Material and method: Ten days block training in mental health for health assistant (HA) and Auxiliary Health Workers (AHW) was conducted by the CMC-Nepal. Senior psychiatrists, psychologists and psychiatric nurse were the trainers. Materials like mental health manual, audiovisuals, flip charts and case stories were used during training by the facilitators. An especially developed patient record card was used for case record, diagnosis and treatment. The study was carried out in between July 2010 to June 2011. A total of 6676 cases were studied during the study period. Results: Community mental health program identified 4761 total new cases in 12 months (July 2010 to June 2011), out of which 2821 were females (59%) and 1940 were males (41%). Similarly total old cases both females and males were 6676 registered in these centers for treatment. Out of all new cases patients with Anxiety Neurosis emerged as the largest group (50%) followed by Depression (24.88%). Other commonly diagnosed conditions were Epilepsy (7.5%), Psychosis (5.3%) and Conversion disorder (5.7%) and unspecified cases (6.5%). The implications of the results are discussed, in the current context. Conclusion: Mental health services need to be provided at the community so as to prevent cases of prolonged subjection to mental illness and also prevent cases of stigma and discrimination. DOI: http://dx.doi.org/10.3126/jpan.v2i1.8569 J Psychiatrists’ Association of Nepal Vol .2, No.1, 2013 14-19

Public health challenges during the COVID-19 outbreak in Nepal: a commentary

2020 ◽  
Vol 34 (4) ◽  
pp. 373-376 ◽  
Author(s):  
Sharmistha Sharma ◽  
Jeevan Bhatta
Keyword(s):  
Public Health ◽  
Design Methodology ◽  
Health Workers ◽  
Health Interventions ◽  
Content Type ◽  
The Public ◽  
Public Health Challenges ◽  
Current Scenario ◽  
Public Health Officials ◽  
The Government

PurposeThe purpose of this paper is to depict the current scenario of coronavirus diseases 2019 (COVID-19) in Nepal, how the government is tackling this pandemic as well as look at the public health challenges that Nepal is facing and might face in the future.Design/methodology/approachThis paper is a viewpoint of COVID-19 activities conducted in Nepal.FindingsNepal is vulnerable to COVID-19, as it shares borders with China and India. Cases have started to be seen in different parts of Nepal. Government of Nepal has started various measures to control the spread of the virus such as deploying health workers, information sharing via different mediums. However, there are still many challenges that the government and public health officials need to be concerned about as well.Originality/valueThis paper provides information about the situation of COVID-19 in Nepal, how the government is handling, and public health challenges that may arise. This paper can be beneficial for further public health interventions.

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