scholarly journals Does the reform of public hospitals' payment system increase the pay of medical personnel? A nationwide cross-sectional study

2021 ◽  
Author(s):  
Yong Dang ◽  
Yaxin Zhao ◽  
Hong Yan ◽  
Zhichao Wang ◽  
Zhongliang Zhou
Keyword(s):  
Scale Up ◽  
Control Level ◽  
Medical Personnel ◽  
Performance Pay ◽  
Payment System ◽  
Public Hospitals ◽  
Control Group ◽  
Cross Sectional ◽  
Study Results ◽  
The Government

Abstract Background The reform of public hospitals' payment system (RPHPS) is the focus of medical reform in China. The current medical personnel payment system was formulated under a framework including the whole public sector, and this cannot meet the demands of necessary reform. In 2017, the government piloted the RPHPS to raise the pay of medical personnel and mobilize their work enthusiasm. Here, we examine whether the RPHPS provides a way to influence the pay of medical personnel and examine the factors determining this pay. Methods This study used data from a cross-sectional survey of 699 public hospitals across 21 provinces of China in 2017, the China Public Hospitals Pay Reform Survey. We used a coarsened exact matching method and hierarchical linear analysis to enhance the comparability between groups. A total of 178,622 medical personnel were included in our study. Results We found that the RPHPS was significantly associated with total annual pay and annual performance pay. Those who worked in the treatment group had significantly higher total annual pay and annual performance pay than those in the control group. The pay of medical personnel was strongly associated with the average salary of an urban worker and the hospital type, and their gender, age, education status, work characteristics, position, professional titles, seniority in years and departments. Conclusion There was a strong relationship between the implementation of the RPHPS and the pay of medical personnel. From a policymaker perspective, this shows that there may be value in further promoting the development of the payment system in public hospitals. The government should scale up the piloted areas for RPHPS and increase the total salary and the total performance-based wage-control level of public hospitals to reflect the value of the technical and labor services provided by medical personnel.

A Human Resource Development Strategy for Primary Health Care: an Exploratory Study of Mixed Methods

2021 ◽  
Author(s):  
Huanhuan Jia ◽  
Hairui Jiang ◽  
Jianxing Yu ◽  
Jingru Zhang ◽  
Zhou Zheng ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Human Resource Development ◽  
Structural Equation ◽  
External Environment ◽  
Medical Personnel ◽  
Public Hospitals ◽  
Individual Development ◽  
Primary Health ◽  
The Government

Abstract Background: The serious shortage of primary health care (PHC) providers is a common issue in the health reforms worldwide, including in China. The government of China have proposed that encouraging and guiding qualified medical personnel to work in primary medical and health care institutions (PMHCIs) is an effective way to improve the overall quality and efficiency of PHC, but it has not produced good results. The problem of insufficient human resources of PHC has not been substantially ameliorated.Methods: Based on implicit theory and lexical approach, pre-investigation was conducted to collect the items that influence the medical personnel to seek employment at PMHCIs from the perspective of guided objects. Through a three-phase investigation of 1,160 doctors in 29 public hospitals in 9 cities, the items were categorized, and a structural equation model was established and verified to explore the interrelationship of influencing factors.Results: A total of 5 factors were rotated, including Sense of Gain (SG), Internal Organization Development (IOD), Remuneration and Development (RD), Condition of the City Where the PMHCI Is Located (CCPL), Job Responsibilities (JR) and Family Support (FS). The results of the model showed that IOD, RD, JR and FS had a significantly positive effect on the SG, whereas CCPL had no significant direct effect. In addition, the FS, RD and JR significantly mediated the relationship between the internal and external environment of the institution and the willing of medical personnel to seek employment at PMHCIs. The values of fit index indicated an acceptable-fitting model.Conclusion: Family, remuneration, individual development, and job responsibility are closely related with the willingness of medical personnel to seek employment at PMHCIs, and the internal and external environment of PMHCIs is also an important factor. Based on this, targeted measures can be proposed to promote the development of PHC providers.

scholarly journals Fetomaternal outcome in pregnancy with gestational thrombocytopenia: a cross sectional study

2020 ◽  
Vol 9 (7) ◽  
pp. 2751
Author(s):  
Devyani Misra ◽  
Mariyam Faruqi
Keyword(s):  
Birth Asphyxia ◽  
Admission Rate ◽  
Intrauterine Fetal Death ◽  
Control Group ◽  
Perinatal Complications ◽  
Third Trimester ◽  
Cross Sectional ◽  
Gestational Thrombocytopenia ◽  
Study Results ◽  
Nicu Admission

Background: Thrombocytopenia is second to anemia as the most common haematological abnormality during pregnancy. Objective of this study was to study the clinical profile, maternal and perinatal outcomes in thrombocytopenic antenatal patients.Methods: A prospective study was carried out in tertiary hospital, 280 pregnant women who attended the Antenatal clinic regularly were enrolled. All were screened for thrombocytopenia in third trimester (after 28 weeks), women with normal platelet (n=140) were taken in control group and those with low counts less than 150×109/L (n=140) were included in study group. Maternal and fetal outcome of thrombocytopenia in third trimester of pregnancy were studied.Results: Majority of women with gestational thrombocytopenia had mild thrombocytopenia (70.71%). 30.72% patients with thrombocytopenia had hemorrhagic manifestations. Maternal and perinatal complications like PPH (27.14%), puerperial sepsis (9.28%), placental abruption (5%), need for transfusion (20%), neonatal jaundice (20%), neonatal thrombocytopenia (12.14%), birth asphyxia (12.86%), NICU admission (12.14%), low Apgar (37.14%), need for resuscitation (30%), were more in patients with thrombocytopenia as compared to their age and parity matched controls.Conclusions: According to this study results, pregnancies with gestational thrombocytopenia, as compared to the control group, were at a higher risk of cesarean section, intrauterine fetal death, preterm delivery, low Apgar scores, more NICU admission rate, intracranial hemorrhage, neonatal death, or adverse maternal outcome.

scholarly journals Temporal response of canine flexor tendon to limb suspension

2010 ◽  
Vol 109 (6) ◽  
pp. 1762-1768 ◽  
Author(s):  
Yu-Long Sun ◽  
Andrew R. Thoreson ◽  
Stephen S. Cha ◽  
Chunfeng Zhao ◽  
Kai-Nan An ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Control Level ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Matrix Metalloproteinase 2 ◽  
Control Group ◽  
Temporal Response ◽  
Cross Sectional ◽  
Clinical Disorders ◽  
Catabolic Process ◽  
Timp1 Expression

Tendon disuse, or stress deprivation, frequently accompanies clinical disorders and treatments, yet the metabolism of tendons subject to stress deprivation has rarely been investigated systematically. The effects of stress deprivation on canine flexor tendon were investigated in this study. One adult canine forepaw was suspended for 21 or 42 days. Control forepaws were collected from dogs that had no intervention on their limbs and paws. The expression of collagen I and III was not significantly altered in the tendons disused for 21 days but was significantly decreased at 42 days ( P < 0.03). The expression of collagen II, aggrecan, decorin, and fibronectin was significantly decreased in the tendons in the suspended limbs at 21 days ( P < 0.002) and further reduced at 42 days. With stress deprivation, the expression of matrix metalloproteinase 2 (MMP2) was significantly increased ( P < 0.004) at 21 and 42 days. The expression of MMP3 was significantly decreased at 21 and 42 days ( P < 0.03). The expression of MMP13 was not altered with stress deprivation at 21 and 42 days. The expression of MMP14 was significantly increased at 21 days ( P = 0.0015) and returned to the control level at 42 days. Tissue inhibitor of metalloproteinase 1 (TIMP1) expression was decreased after the limbs were suspended for 42 days ( P = 0.0043), but not 21 days. However, TIMP2 expression was not significantly different from control at 21 or 42 days. Furthermore, the cross-sectional area of the stress-deprived tendons at 42 days was decreased compared with the control group ( P < 0.01). The intervention method in this study did not result in any alteration of stiffness of the tendon. Our study demonstrated that stress deprivation decreases the anabolic process and increases the catabolic process of extracellular matrix in flexor tendon.

scholarly journals Evaluating effectiveness of screening house eaves as a potential intervention for reducing indoor vector densities and malaria prevalence in Nyabondo, western Kenya

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Peter Njoroge Ng’ang’a ◽  
Collins Okoyo ◽  
Charles Mbogo ◽  
Clifford Maina Mutero
Keyword(s):  
Malaria Parasite ◽  
Parasite Prevalence ◽  
Malaria Prevalence ◽  
Wire Mesh ◽  
Control Group ◽  
Light Traps ◽  
Cross Sectional ◽  
Western Kenya ◽  
Study Results

Abstract Background Mosquito-proofing of houses using wire mesh screens is gaining greater recognition as a practical intervention for reducing exposure to malaria transmitting mosquitoes. Screening potentially protects all persons sleeping inside the house against transmission of mosquito-borne diseases indoors. The study assessed the effectiveness of house eaves screening in reducing indoor vector densities and malaria prevalence in Nyabondo, western Kenya. Methods 160 houses were selected for the study, with half of them randomly chosen for eaves screening with fibre-glass coated wire mesh (experimental group) and the other half left without screening (control group). Randomization was carried out by use of computer-generated list in permuted blocks of ten houses and 16 village blocks, with half of them allocated treatment in a ratio of 1:1. Cross-sectional baseline entomological and parasitological data were collected before eave screening. After baseline data collection, series of sampling of indoor adult mosquitoes were conducted once a month in each village using CDC light traps. Three cross-sectional malaria parasitological surveys were conducted at three month intervals after installation of the screens. The primary outcome measures were indoor Anopheles mosquito density and malaria parasite prevalence. Results A total of 15,286 mosquitoes were collected over the two year period using CDC light traps in 160 houses distributed over 16 study villages (mean mosquitoes = 4.35, SD = 11.48). Of all mosquitoes collected, 2,872 (18.8%) were anophelines (2,869 Anopheles gambiae sensu lato, 1 Anopheles funestus and 2 other Anopheles spp). Overall, among An. gambiae collected, 92.6% were non-blood fed, 3.57% were blood fed and the remaining 0.47% were composed of gravid and half gravid females. More indoor adult mosquitoes were collected in the control than experimental arms of the study. Results from cross-sectional parasitological surveys showed that screened houses recorded relatively low malaria parasite prevalence rates compared to the control houses. Overall, malaria prevalence was 5.6% (95% CI: 4.2–7.5) n = 1,918, with baseline prevalence rate of 6.1% (95% CI: 3.9–9.4), n = 481 and 3rd follow-up survey prevalence of 3.6% (95% CI: 2.0–6.8) n = 494. At all the three parasitological follow-up survey points, house screening significantly reduced the malaria prevalence by 100% (p < 0.001), 63.6% (p = 0.026), and 100% (p < 0.001) in the 1st, 2nd and 3rd follow-up surveys respectively. Conclusions The study demonstrated that house eave screening has potential to reduce indoor vector densities and malaria prevalence in high transmission areas.

Medical Care under Social Security in France

1971 ◽  
Vol 1 (4) ◽  
pp. 331-341
Author(s):  
R. F. Bridgman
Keyword(s):  
Social Security ◽  
Medical Care ◽  
Local Governments ◽  
Social Insurance ◽  
Medical Profession ◽  
Great Influence ◽  
Payment System ◽  
Public Hospitals ◽  
Health Institutions ◽  
The Government

Social insurance was initiated in France on a national scale in 1930 and now covers about 98.5 per cent of the population. The coverage expanded the limits of traditional sickness insurance for curative medicine and had a growing impact on overall health and social policy. French social insurance is a public service run by organizations which retain the voluntary status of the old mutual funds. The social security budget is independent of that of the government, which contributes less than 20 per cent of the overall social budget of the nation. The relationships between the medical profession, private and public hospitals, preventive care organizations, social insurance funds, and central and local governments have become very complex. The huge social security organization has acquired competence in planning and in technical organizational matters and consequently has had a great influence on medical care patterns. Social security adopted the direct payment system in its relationships with the medical profession; therefore the latter has retained its independent status. But, for public and private hospitals, the payment system is indirect. A special branch was created in 1945 to deal with capital investments in hospitals and health institutions concerned with preventive medicine. Social insurance contributed greatly to facilitating access of patients to all kinds of medical care, either public or private, curative or preventive, and helped the government by participating in the construction of a complex network of health institutions for the benefit of the whole population. This task is not yet achieved, and greater coordination and additional resources are necessary. But there is no doubt that social insurance was and still is a powerful factor in the continuing improvement of the nation's health and living conditions.

scholarly journals THE INFLUENCE OF FINANCIAL PLANNING ON THE RELATIONSHIP BETWEEN HOUSEHOLD INCOME AND LEVEL OF SAVING IN TANZANIA

2020 ◽  
Vol 8 (12) ◽  
pp. 622-634
Author(s):  
Warren Tibesigwa ◽  
◽  
Will Kaberuka ◽  
Joanina Ayebare ◽  
Ally Ndeshiuta Morris ◽  
...  
Keyword(s):  
Financial Planning ◽  
Household Income ◽  
Secondary Data ◽  
School Curriculum ◽  
Moderating Effect ◽  
Cross Sectional ◽  
Study Results ◽  
The Government ◽  
Financial Awareness ◽  
The Relationship

There are many studies on the relationship between household income and saving though very little is known about the influence of financial planning on the relationship between household income and saving.This paper examined the moderating effect of financial planning on the relationship between household income and saving in Tanzania.Based on cross-sectional secondary data (Finscope data,2017) that was collected using multistage sampling from 9457 respondents, descriptive, correlation, regression and moderation effect were performed to analyze the data.The findings indicate that household income and interaction effects have a positive relationship with level of saving. Finally, regression results show that household income and financial planning have a positive significant effect on household saving levels and that financial planning has a positive moderating effect on the relationship between household income and level of saving. From these study results,it is recommended that the government of Tanzania through the ministry of community development, gender and children in should introduce financial awareness programs to the communities in order for the people to realize the need of financial planning and hence improve their saving.Further more the government throughthe ministry of education and vocational training should introduce financial awareness in the school curriculum so that citizens learn how to plan for financial matters at early stages.

scholarly journals ENTREPRENEURIAL MONEY MANAGEMENT PRACTICES AND COMPETITIVE OUTCOMES OF SMALL AND MEDIUM ENTERPRISES

2021 ◽  
Vol 3 (2) ◽  
pp. 71-83
Author(s):  
Fred Gichana Atandi
Keyword(s):  
Management Practices ◽  
Small And Medium Enterprises ◽  
Money Management ◽  
Product Portfolio ◽  
Cross Sectional ◽  
Study Results ◽  
Competitive Outcomes ◽  
The Government ◽  
Medium Enterprises ◽  
Large Enterprises

This study aimed at determining the effect of entrepreneurial money management practices on competitive outcomes of small and medium enterprises. The specific objectives of the study were to; assess the entrepreneurial money management practices of small and medium enterprises, determine the competitive outcomes of small and medium enterprises and to determine the relationship between entrepreneurial money management practices and competitive outcomes of small and medium enterprises. The study used both descriptive, cross-sectional and correlation research designs. The target population was 324 SMEs trading in Trans Nzoia county out of which 179 were sampled to participate in this study. The sampling method used was stratified and simple random sampling. The research instruments reliability test had a Cronbach alpha value of 0.825 which was above the threshold. The study findings indicated that entrepreneurial money management practices among SMEs was moderately embraced affecting their competitive outcomes. The study results also indicated that competitive outcomes of SMEs were dismal affecting their graduation into large enterprises. It was also found that there existed a positive significant relationship between entrepreneurial money management practices and competitive outcomes of SMEs. The study concluded that for SMEs to realize their competitive outcomes of increasing their respective product portfolio and increased revenue, it’s imperative that they apply entrepreneurial money management practices of prioritized financing, budgeting and adequate working capital to graduate SMEs to large enterprises. The study recommended that SMEs to allocate the realized financial resource prudently to exploit opportunities available to them to remain competitive. The study also recommended that SMEs should prioritize on innovations to differentiate themselves in the overcrowded market by expanding their bundle of product portfolio and also the government to formulate workable SME policies which impart entrepreneurial money management practices to improve SME performance. Keywords: Entrepreneurial, Money Management Practices, Competitive Outcomes, Small  and Medium Enterprises.

scholarly journals Maternal factors associated with stillbirth among women in Marsabit County, Kenya

2021 ◽  
Vol 15 (1) ◽  
pp. 1-11
Author(s):  
Badane Amina Wako ◽  
Isabella Epiu ◽  
Samuel Otor
Keyword(s):  
Quantitative Data ◽  
Illicit Drugs ◽  
Public Hospitals ◽  
High Rate ◽  
Insurance Fund ◽  
Maternal Factors ◽  
Maternal Weight ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Government

Background/Aim Stillbirth refers to fetal death occurring at or after 28 weeks of gestation. Worldwide, 130 million babies are born every year and approximately 4 million are stillborn; more than 98% of these deaths occur in developing countries. The government of the Republic of Kenya has put in place several measures, such as the National Health Insurance Fund and Free Child Delivery Programmes for pregnant women, in order to meet the Sustainable Development Goals on health. However, the problem of stillbirth continues to prevail in the country. This study sought to determine maternal factors associated with occurrence of stillbirth in selected hospitals in Marsabit County, Kenya. Methods The study employed a cross-sectional descriptive study design, targeting 387 women who delivered in selected hospitals in Marsabit County, to collect qualitative and quantitative data. Quantitative data were analysed using the Statistical Package for Social Sciences version 24.0 while qualitative data were analysed using N-Vivo software version 11. Inferential statistics were calculated using Chi Square and Fisher's Exact Tests at 95% confidence interval and P<0.05 was considered significant. Results The rate of stillbirth occurrence was 5.9%. Maternal factors significantly associated with the occurrence of stillbirth included antenatal attendance (P=0.031), use of illicit drugs (P=0.041), low maternal weight (P=0.043) and tough domestic work (P=0.004). Conclusions The respondents from Marsabit County experienced relative high rates of stillbirth compared to the national figure. The outcome of delivery was significantly influenced by maternal factors. These results may help address the high rate of stillbirth across the country and improve the delivery outcomes of pregnancies among mothers delivering in public hospitals.

scholarly journals Evaluating effectiveness of screening house eaves as an intervention for integrated vector management for malaria control in Nyabondo, Western Kenya.

2019 ◽  
Author(s):  
Peter Njoroge Ng'ang'a ◽  
Collins Okoyo ◽  
Charles Mbogo ◽  
Clifford Maina Mutero
Keyword(s):  
Malaria Transmission ◽  
Malaria Prevalence ◽  
Wire Mesh ◽  
Control Group ◽  
Cross Sectional ◽  
Western Kenya ◽  
Study Results ◽  
Entry Points ◽  
Mosquito Entry

Abstract BackgroundMosquito-proofing of houses with appropriate screens fixed at potential mosquito entry points is gaining greater recognition as a practical intervention for reducing malaria transmission indoors. The study aimed at evaluating the effectiveness of house eaves screening in preventing mosquito entry and malaria prevalence in Nyabondo, western Kenya. Methods160 houses were selected for the study, with half of them randomly chosen for screening at the eaves with fibre-glass coated wire mesh (experimental group) and the other half left without screening (control group). Randomization was carried out by use of computer-generated list, in permuted blocks of ten houses and 16 village blocks in the study site, with treatments in the ratio of 1:1. Cross-sectional baseline entomological and malaria parasitological data were collected before house eave screening. After the baseline period, series of sampling of indoor adult mosquitoes were conducted once a month in each village using CDC light traps. Three cross-sectional malaria parasitological surveys were also conducted at three month intervals after installation of the screens. The primary outcome measures were indoor Anopheles mosquito density and malaria parasite prevalence. ResultsA total of 15,286 mosquitoes were collected over the two years period using CDC light trap in 160 houses distributed over 16 study villages (mean = 4.35, SD = 11.48). Of all mosquitoes collected, 2,872 were anophelines (2,869 An. gambiae s.l., 1 An. funestus and 2 other anopheles). Overall, among An. gambiae collected, 92.6% were non-blood fed, 3.57% were blood fed and the remaining 0.47% were composed of gravid and half gravid females. Overall more mosquitoes were collected in the control than experimental arms of the study. Results from four cross-sectional prevalence surveys showed that screened houses recorded relatively low malaria prevalence rates compared to the control houses. Overall, malaria prevalence was 5.6% (95%CI: 4.2-7.5) N=1,918, with baseline survey recording 6.1% prevalence (95%CI: 3.9-9.4), n=481 and third follow-up survey recording 3.6% prevalence (95%CI: 2.0-6.8) n=494. At all the three follow-up survey points, house screening significantly reduced the malaria prevalence by 100% (p<0.001), 63.6% (p=0.026), and 100% (p<0.001) for first, second and third follow-ups surveys respectively. The house screening significantly reduced malaria prevalence by 54% (OR = 0.46, 95%CI: 0.24-0.87, p = 0.017). ConclusionsThe study demonstrated that house eave screening has potential to reduce indoor vector densities and malaria transmission in high transmission areas in Kenya.

scholarly journals Sigi's Response to the Disaster Program: Nutrition, Sanitation, and Food Fulfillment

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Hilda Carmitha Panjaitan ◽  
Theresia Pratiwi Elingsetyo Sanubari ◽  
Fiane De Fretes
Keyword(s):  
Mixed Method ◽  
Government Programs ◽  
Design Data ◽  
Cross Sectional ◽  
Depth Interview ◽  
Study Results ◽  
The Government ◽  
Cross Sectional Design ◽  
One Year ◽  
Central Sulawesi

The earthquake occurring in Indonesia caused various problems, especially the decreased degree of human health caused by insufficient food availability. It makes victims of natural disasters need assistance from government programs. One case of a natural disaster in 2018 was an earthquake in Central Sulawesi. Unfortunately, disaster survival has the challenge to continue their living caused by program absences from the government in post-disaster. This study aimed to explore disaster survival's resilience after one year of the earthquake disaster in Sidera village, Sigi regency, in response to government programs, especially nutrition, sanitation, and food fulfillment response. This research used mixed-method approaches with a cross-sectional design. Data collection was done with questionnaires, in-depth interviews, and anthropometric measurements. The study was conducted from February to April 2020 with 30 refugees in the temporary shelter in Sidera village as respondents. The study results found that people still need to initiate countermeasures related to sanitation and fulfillment of food. Government programs in health services produce good conditions related to normal nutritional status at the age of 5 years (40%), 5–18 years (100%), and 18 years (41%). The conclusion is that the government program is not sustainable, which makes the community still need to initiate countermeasures related to sanitation and food fulfillment. The program recommendations are to ensure clean water availability and guide the community to fulfill their food need. TANGGAPAN SIGI TERHADAP PROGRAM BENCANA: GIZI, SANITASI, DAN PEMENUHAN PANGANGempa bumi yang terjadi di Indonesia menyebabkan berbagai masalah, secara khusus penurunan derajat kesehatan manusia dikarenakan oleh ketersediaan pangan yang tidak tercukupi. Hal tersebut membuat korban bencana alam membutuhkan bantuan dari program pemerintah. Salah satu kasus bencana alam tahun 2018 adalah gempa bumi di Sulawesi Tengah. Namun, hingga pascabencana, korban bencana alam masih tinggal di pengungsian tanpa program. Tujuan penelitian ini adalah mengeksplorasi daya lenting pengungsi pasca-satu tahun bencana gempa bumi di Desa Sidera, Kabupaten Sigi sebagai tanggapan dari program pemerintah khususnya gizi, air bersih, dan pemenuhan pangan. Penelitian ini menggunakan pendekatan mixed-method dengan desain cross-sectional. Teknik pengumpulan data dilakukan melalui pengisian kuesioner, in depth interview, serta pengukuran antropometri. Penelitian dilakukan pada 30 responden yang merupakan pengungsi di hunian sementara (huntara) Desa Sidera. Penelitian dilakukan selama bulan Februari hingga April 2020. Hasil penelitian menemukan bahwa masyarakat masih perlu melakukan inisiasi penanggulangan terkait air bersih dan pemenuhan pangan. Program pemerintah terkait pelayanan kesehatan menghasilkan kondisi yang baik terkait status gizi normal pada usia ≤5 tahun (40%), 5–18 tahun (100%), dan ≥18 tahun (41%). Simpulan dari penelitian ini adalah program pemerintah tidak memiliki keberlanjutan, hal tersebut membuat masyarakat masih perlu melakukan inisiasi penanggulangan terkait air bersih dan pemenuhan pangan. Rekomendasi program yang dapat diberikan adalah ketersediaan air bersih serta pemantauan program dalam membimbing masyarakat agar dapat memenuhi kebutuhan pangan.

Sign in / Sign up

Export Citation Format

Share Document