scholarly journals Systems Capacity To Conduct Non-Communicable Disease Focused Implementation Research In The Malawian Health Sector: A National Needs Assessment

2021 ◽  
Author(s):  
Chimwemwe Kwanjo Banda ◽  
Mina C Hosseinipour ◽  
Johnstone Kumwenda ◽  
Ndaziona Peter Kwanjo Banda ◽  
Prosper Lutala ◽  
...  
Keyword(s):  
Needs Assessment ◽  
Implementation Research ◽  
Communicable Disease ◽  
Health Sector ◽  
Healthcare Services ◽  
Health Facilities ◽  
Hiv And Aids ◽  
Research Engagement ◽  
Research Activities ◽  
The Government

Abstract Background: Non-communicable diseases (NCDs) are significant causes of morbidity and mortality in Malawi and are the second leading cause of deaths in adults after HIV and AIDS. The purpose of this assessment was to identify human, infrastructural and systems requirements in implementation research to support the response to the NCD epidemic in the Malawian health sector.Methods: This national needs assessment was conducted using a concurrent triangulation mixed methods approach. Twenty-two health facilities providing tertiary (n =4), secondary (n =2) and primary (n = 16) care level were included in the assessment. Qualitative interviews with 72 participants from the health facilities, academic institutions, development partner organizations, Ministry of Health and the Central Medical Stores Trust from across the country were also conducted. Descriptive statistics were used to analyze the quantitative data from the facility assessment and thematic content analysis was done to identify themes from the qualitative data. Results: The qualitative and quantitative findings were merged and categorized into five thematic areas. Theme 1: Record keeping and surveillance for NCDs – which showed a high incidence of hypertension and diabetes at the facilities. Theme 2: Availability of NCD services- 15 (68%) facilities had an NCD clinic available. NCD clinics were reported available at 75% of the tertiary facilities, 100% of secondary facilities and 63% of the primary facilities. Theme 3: Perceived needs for improving NCD care – where key informants highlighted the need for more human resources, drugs, guidelines and diagnostic technologies. Theme 4: Limited NCD focused implementation research engagement. This was due to lack of funding and limited number of researchers conducting NCD focused research. Theme 5: Opportunities for improving NCD focused implementation research. Opportunities were available through the growing interest and focus on NCDs by the government and development partners.Conclusion: NCDs are a significant health burden in the Malawian healthcare services. A general lack of human, systems and material resources in the healthcare system negatively affects extent of coverage of NCD services and implementation research activities necessary for improving care.

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 Integrated Family Planning and Immunization Service Delivery at Health Facility and Community Sites in Dowa and Ntchisi Districts of Malawi: A Mixed Methods Process Evaluation

2020 ◽  
Vol 17 (12) ◽  
pp. 4530
Author(s):  
Chelsea M. Cooper ◽  
Jacqueline Wille ◽  
Steven Shire ◽  
Sheila Makoko ◽  
Asnakew Tsega ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Family Planning ◽  
Service Providers ◽  
Service Integration ◽  
Secondary Analysis ◽  
Health Sector ◽  
Health Facilities ◽  
Immunization Service ◽  
Mothers And Fathers ◽  
The Government

The Government of Malawi’s Health Sector Strategic Plan II highlights the importance of service integration; however, in practice, this has not been fully realized. We conducted a mixed methods evaluation of efforts to systematically implement integrated family planning and immunization services in all health facilities and associated community sites in Ntchisi and Dowa districts during June 2016–September 2017. Methods included secondary analysis of service statistics (pre- and postintervention), focus group discussions with mothers and fathers of children under age one, and in-depth interviews with service providers, supervisors, and managers. Results indicate statistically significant increases in family planning users and shifts in use of family planning services from health facilities to community sites. The intervention had no effect on immunization doses administered or dropout rates. According to mothers and fathers, benefits of service integration included time savings, convenience, and improved understanding of services. Provision and use of integrated services were affected by availability of human resources and commodities, community linkages, data collection procedures and availability, sociocultural barriers, organization of services, and supervision and commitment of health surveillance assistants. The integration approach was perceived to be feasible and beneficial by clients and providers.

scholarly journals Non-communicable disease (NCD) corners in public sector health facilities in Bangladesh: a qualitative study assessing challenges and opportunities for improving NCD services at the primary healthcare level

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029562 ◽  
Author(s):  
Lal B Rawal ◽  
Kie Kanda ◽  
Tuhin Biswas ◽  
Md. Imtiaz Tanim ◽  
Prakash Poudel ◽  
...  
Keyword(s):  
News Media ◽  
Primary Healthcare ◽  
Communicable Disease ◽  
Qualitative Interviews ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Challenges And Opportunities ◽  
The Government ◽  
Non Communicable Disease ◽  
Management Services

ObjectiveTo explore healthcare providers’ perspective on non-communicable disease (NCD) prevention and management services provided through the NCD corners in Bangladesh and to examine challenges and opportunities for strengthening NCD services delivery at the primary healthcare level.DesignWe used a grounded theory approach involving in-depth qualitative interviews with healthcare providers. We also used a health facility observation checklist to assess the NCD corners’ service readiness. Furthermore, a stakeholder meeting with participants from the government, non-government organisations (NGOs), private sector, universities and news media was conducted.SettingTwelve subdistrict health facilities, locally known as upazila health complex (UHC), across four administrative divisions.ParticipantsParticipants for the in-depth qualitative interviews were health service providers, namely upazila health and family planning officers (n=4), resident medical officers (n=6), medical doctors (n=4) and civil surgeons (n=1). Participants for the stakeholder meeting were health policy makers, health programme managers, researchers, academicians, NGO workers, private health practitioners and news media reporters.ResultsParticipants reported that diabetes, hypertension and chronic obstructive pulmonary disease were the major NCD-related problems. All participants acknowledged the governments’ initiative to establish the NCD corners to support NCD service delivery. Participants thought the NCD corners have contributed substantially to increase NCD awareness, deliver NCD care and provide referral services. However, participants identified challenges including lack of specific guidelines and standard operating procedures; lack of trained human resources; inadequate laboratory facilities, logistics and medications; and poor recording and reporting systems.ConclusionThe initiative taken by the Government of Bangladesh to set up the NCD corners at the primary healthcare level is appreciative. However, the NCD corners are still at nascent stage to provide prevention and management services for common NCDs. These findings need to be taken into consideration while expanding the NCD corners in other UHCs throughout the country.

scholarly journals Assessment of staffing needs for physicians and nurses at Upazila health complexes in Bangladesh using WHO workload indicators of staffing need (WISN) method

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e035183
Author(s):  
Taufique Joarder ◽  
Samiun Nazrin Bente Kamal Tune ◽  
Md Nuruzzaman ◽  
Sabina Alam ◽  
Valeria de Oliveira Cruz ◽  
...  
Keyword(s):  
Health Workforce ◽  
Quantitative Methods ◽  
Service Providers ◽  
Workforce Planning ◽  
Healthcare Services ◽  
Health Facilities ◽  
Time Motion ◽  
High Workload ◽  
The Government ◽  
Staffing Needs

ObjectiveThis study aimed to assess the current workload and staffing need of physicians and nurses for delivering optimum healthcare services at the Upazila Health Complexes (UpHCs) in Bangladesh.DesignMixed-methods, combining qualitative (eg, document reviews, key informant interviews, in-depth interviews, observations) and quantitative methods (time-motion survey).SettingStudy was conducted in 24 health facilities of Bangladesh. However, UpHCs being the nucleus of primary healthcare in Bangladesh, this manuscript limits itself to reporting the findings from the providers at four UpHCs under this project.Participants18 physicians and 51 nurses, males and females.Primary outcome measuresWorkload components were defined based on inputs from five experts, refined by nine service providers. Using WHO Workload Indicator of Staffing Need (WISN) software, standard workload, category allowance factor, individual allowance factor, total required number of staff, WISN difference and WISN ratio were calculated.ResultsPhysicians have very high (WISN ratio 0.43) and nurse high (WISN ratio 0.69) workload pressure. 50% of nurses’ time are occupied with support activities, instead of nursing care. There are different workloads among the same staff category in different health facilities. If only the vacant posts are filled, the workload is reduced. In fact, sanctioned number of physicians and nurses is more than actual need.ConclusionsIt is evident that high workload pressures prevail for physicians and nurses at the UpHCs. This reveals high demand for these health workforces in the respective subdistricts. WISN method can aid the policy-makers in optimising utilisation of existing human resources. Therefore, the government should adopt flexible health workforce planning and recruitment policy to manage the patient load and disease burden. WISN should, thus, be incorporated as a planning tool for health managers. There should be a regular review of health workforce management decisions, and these should be amended based on periodic reviews.

An Analysis of Users’ Perceptions on Health Facilities in Mumbai

2014 ◽  
Vol 1 (2) ◽  
Author(s):  
Hiral Sheth
Keyword(s):  
Health Services ◽  
Health Sector ◽  
Healthcare Services ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Public Health Services ◽  
Policy Objective ◽  
Private Health Sector ◽  
The Government ◽  
High Level

The new challenges of globalisation have made it essential to achieve and sustain a high level of efficiency in the provision of healthcare. Even though the Government of Maharashtra clearly views assuring efficiency and providing public health services to the people as an important policy objective, data reveals that the amount of resources spent on public healthcare especially public hospitals is very meagre as compared to the needs of the population. This study attempts to understand the shift from public to the private health sector by the users of health services in the city of Mumbai. This changing trend towards increasing use of private hospitals for healthcare services was analysed to understand the specific reasons behind the privatisation of health services in this metropolitan city. Using primary survey, the analysis revealed that majority of the users preferred private hospital services due to various reasons like cleanliness, better infrastructure, efficient and competent doctors and other staff. The results also indicated significant inefficiencies in the functioning of the public hospitals as noted from the responses of the users.

scholarly journals Investment Analysis of Startups Company PT. Zaps Teknologi Service Application of BPJS

2021 ◽  
Vol 8 (8) ◽  
pp. 504-509
Author(s):  
Zulham Wafiq ◽  
Edi Hamdi ◽  
Tantri Yanuar Rahmat Syah
Keyword(s):  
Real Time ◽  
Financial Analysis ◽  
Health Sector ◽  
Investment Decisions ◽  
Health Facilities ◽  
Investment Analysis ◽  
The Media ◽  
The Government ◽  
Service Application ◽  
A Company

Background – Health facilities and hospitals are government facilities in serving the community in the health sector, BPJS is one of the media used by the government in carrying out these services. PT. Zaps Teknologi is a company engaged in technology and information with the product of Dokter Tunggu (DOKU). This application was created to improve BPJS services in Hospitals and Health Facilities. The application has innovations in BPJS services where this application has features that are able to accommodate BPJS services. Online referrals, real time conditions from the Referral Hospital are some of the features embedded in this application, besides that in the next few years PT. Zaps Teknologi will improve services by adding features to this application. The addition of features requires detailed financial analysis and precise investment calculations Method - Investment analysis using NPV, ROI, PP and IRR. Result – This analysis shows the investment value for investors in making investment decisions. Keywords: Investment, BPJS, Financial Analysis.

How Does the Largely Unregulated Private Health Sector Impact the Indian Mass?

2019 ◽  
Vol 21 (3) ◽  
pp. 383-393
Author(s):  
Ranjit Kumar Dehury ◽  
Janmejaya Samal ◽  
Shawnn Coutinho ◽  
Parthsarathi Dehury
Keyword(s):  
Health Expenditure ◽  
Health Sector ◽  
Poverty Line ◽  
Healthcare Services ◽  
Private Hospitals ◽  
Ethical Concerns ◽  
The Poor ◽  
Private Health Sector ◽  
The Rich ◽  
The Government

Private hospitals in India are least monitored by the government, which leads to violation of the roles and responsibility they have to offer for the community. Indeed, it is a more serious issue in a country like India where people are forced below poverty line (BPL) after every hospitalization. Of the four different models of health expenditure, India and, in fact, many developing countries follow the out-of-pocket (OOP) expenditure model rampantly. This is very evident from the recent working article (2015) published by NITI Aayog-Health Division, which reveals that OOP expenditures are high in India accounting for 69.5 per cent of total health expenditure. These are catastrophic economic damages for the poor and push an estimated 37 million into poverty each year. Furthermore, 66.4 per cent of the total expenditure is on medicines. A major part of these expenditures are invariably the money spent by a huge section of the community, both rich–poor and rural–urban, on healthcare services availed from the privately run corporate hospitals in India. The sector needs to be sensitive for an inclusive healthcare. However, the situation appears to be the opposite in India and the private health sector creates a divide in the society by virtue of which the rich get medical care and the poor stay sick or die. This article discusses various ethical concerns and remedial measures relating to the functionality of private hospitals which poses serious pressure on the community and marginalized sections of the society.

scholarly journals Status and Infrastructure of the Health Sector in Karnataka

2012 ◽  
Vol 11 (3) ◽  
pp. 15 ◽  
Author(s):  
Siddu V H ◽  
Keshava Murthy K D ◽  
R Revankar
Keyword(s):  
Health Status ◽  
Health Sector ◽  
Health Facilities ◽  
Good Service ◽  
The Public ◽  
Health Infrastructure ◽  
The Government ◽  
Basic Infrastructure ◽  
Regional Imbalance ◽  
Quality Infrastructure

Karnataka is closer to the average of India in case of health status and health facilities, but compared to the states like Kerala, it stands too low. The most striking problem, related to the health infrastructure and health status arises out of the regional imbalance. The study shows that the Gulbarga and Belgaum divisions of Karnataka show a poor status in health infrastructure and health status. Among these, the Gulbarga division (means Hyderabad Karnataka) lies in the lower position. It is well known that Hyderabad Karnataka is underdeveloped in most of the sectors compared to the rest of the regions. Lesser health infrastructure facilities in this region clearly indicate the neglect of the government intervention/ interest to develop basic infrastructure facilities in this region. For better health, health facilities should be improved. For better health facilities, public health expenditure is very important. At present, the Karnataka government is spending very less amount of money on health, which is about 2 per cent of the NSDP. This amount has to be increased. Increasing the public expenditure alone, cannot serve the purpose, unless it is properly used for delivering quality infrastructure and good service mechanization.Keywords: Health Sector, Health Infrastructure.

Social Enterpreneurs: Emerging Trend in Health Sector of Pakistan

2021 ◽  
pp. 23-35
Author(s):  
Sahar Qaiser ◽  
Ijlal Mansoor
Keyword(s):  
Health Sector ◽  
Healthcare Services ◽  
Health Improvement ◽  
Social Entrepreneurs ◽  
Quality Healthcare ◽  
Financial Variables ◽  
Emerging Trends ◽  
The People ◽  
The Government

The term Social Entrepreneurs is relatively new in the country like Pakistan. These groups try to overcome the existing social problems and derive sustainable social change in the economy through their innovative ideas and plans. The purpose of this study is to compare and explore the emerging trends of social entrepreneurs with the government in the health sector of Pakistan. This study tries to cover the research gap in the area of social entrepreneurship and highlight the growing role of social entrepreneurs in providing healthcare services to the people of Pakistan. For empirical evidence, three different healthcare institutions are selected. They include: Indus Hospital, Sindh Institute of Urology Transplantation and Shaukat Khanum Memorial Hospital. The services provided by these Healthcare Institutions are compared over the period of time. Trend analyses are carried out to study the role of these institutions by using various healthcare indicators and quantify the contribution of these organizations towards health improvement facilities in Pakistan. Some financial variables are also used to investigate resource mobilization in the sector. The result of the analysis revealed that these institutions are providing quality healthcare services to the people of Pakistan that are increasing with the passage of time.

Eliminating Hepatitis B from Bangladesh by the Year 2030

2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Health Workers ◽  
Health Sector ◽  
Public Health Problem ◽  
Integrated System ◽  
Hbv Infection ◽  
Diagnosis And Treatment ◽  
Major Public Health Problem ◽  
Medical Institutions ◽  
The Government

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149

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