scholarly journals Assessment of linkage between Productive Safety Net Program and Health Services in Somali Region, Ethiopia: Lessons, Challenges and Missed Opportunities

Author(s):  
Olusola Oladeji ◽  
Abdifatah Elmi Farah ◽  
Ann Robins

Abstract Background: Ethiopia’s Productive Safety Net Programme (PSNP) which has been implemented since 2005 is a large-scale, social protection intervention aimed at improving food security. The fourth phase of the PSNP included a system of integrated health and nutrition service delivery for its categories of beneficiaries especially the creation of a temporary direct support(TDS) category for clients that are pregnant and lactating women (PLW) or caretakers of malnourished children, who are exempted from public work but expected to comply with co-responsibilities which counts towards their public works requirement aimed at improving utilization of health services.Methods: The study was a cross-sectional descriptive survey and used qualitative methods, in-depth interviews and focus group discussions (FGDs), conducted in two woredas( districts) (Gursum and Kebribayah) in Farfan zone of Somali region. The study population were key individuals involved in the linkages of PSNP with health services and the beneficiaries. The study assessed the implementation of the linkage between PSNP4 and health servicesResults: The study observed that the stakeholders have adequate knowledge and understood their roles in the linkages between PSNP and the health services, in addition the beneficiaries also are aware of their rights and the process for exemption from public work. However, the major issues identified included poor coordination among the implementing actors, poor knowledge , monitoring and compliance with the co-responsibilities by the stakeholders and the beneficiaries.Conclusion: Considering the size of the program in the region which is targeted to the poor, the Productive Safety net program being the main tool to help forward Ethiopia’s Social Protection Policy and Strategy, has the potential to improve access and utilization of health and nutrition services if more efforts are put to strengthen integration and linkages with the health sector and monitoring of compliance of co-responsibilities by the beneficiaries of the program.

2017 ◽  
Vol 1 (S1) ◽  
pp. 14-14
Author(s):  
William G. Adams ◽  
Michael Mendis ◽  
Shiby Thomas ◽  
David Center ◽  
Sara Curran

OBJECTIVES/SPECIFIC AIMS: The primary objective of this effort is to develop and distribute an easy to use i2b2 component that is capable of evaluating diverse complex relationships for a wide variety of exposures and outcomes over time. In this manner we are able to leverage the unique design of the i2b2 database to support health services research, comparative effectiveness, and quality improvement using a single tool. Furthermore, our novel database redesign has the potential to provide user-friendly access to individual and group CHC data for CER. METHODS/STUDY POPULATION: For this project we used software experts, clinical informatics specialists, and the existing i2b2 open-source software to convert our legacy HOME Cell into a web-client version. The tool will be used to study health outcomes within a network of Boston based Community Health Centers and the largest safety-net hospital in New England, Boston Medical Center. RESULTS/ANTICIPATED RESULTS: The new web-client HOME Cell will allow i2b2 users to model virtually any exposure (including therapeutic interventions such as medications or tests) in i2b2 against any outcome accounting for complex temporal relationships and other factors. In addition we plan to use our new Community Health Center views to enhance our community engagement activities by allowing direct access to their data for our partners. DISCUSSION/SIGNIFICANCE OF IMPACT: Our project addresses multiple national priorities related to data sharing, clinical research informatics, and comparative effectiveness. The web-client version of the HOME Cell substantially improves our community’s access to HOME Cell functionality and is a novel, sharable resource for use within the CTSA/NCATS community. Our approach provides a new way to perform large-scale collaborative research without the need to actually move patient-level data and has demonstrated that CER, health services research, and quality measurement can share a common framework. In addition, and as demonstrated in our earlier pilot work, the HOME Cell also has the potential to support large-scale multivariate analyses in a distributed manner that does not require sharing of patient-level data. We believe our approach has great promise for supporting the reuse of clinical data for rapid, transparent, health outcome assessments on a national scale. Our efforts support multiple strategic goals including: (1) support for building national clinical and translational research capacity by enhancing a broadly adopted informatics tool (i2b2); (2) enhanced consortium-wide collaborations by offering a tool that can be easily shared within the CTSA network to support multi-institutional collaboration; and (3) improving the health of our communities by offering a tool that has the potential to provide new insights into health care processes and outcomes that could drive innovation and improvement activities.


Author(s):  
Wonjung NOH ◽  
Heakyung MOON

Background: Sleep durations shorter or longer than 7 h are associated with cardiovascular diseases. We aimed to investigate the association among sleep duration, risk factors of hypertension, and cardiovascular disease in South Korea using data from a recent large-scale survey. Methods: Data produced by the Korea National Health and Nutrition Examination Survey (KNHANES) were subjected to multivariate logistic analysis. This cross-sectional, nationally representative survey was conducted from Jan 1 to Dec 31, 2011, by the Korean Center for Disease Control and Prevention. Overall, 6,466 participated. Data were analyzed using STATA version 13.0 (STATA Corp LP). Results: The participants’ socioeconomic, physical, and lifestyle factors were statistically different between the two age groups (<65 yr and ≥65 yr). Shorter sleep durations were associated with hypertension in individuals younger than 65 yr of age. On the other hand, in participants aged ≥65 yr, both shorter and longer sleep durations were associated with hypertension, while shorter sleep durations were associated with cardiovascular diseases. Conclusion: Unusual sleep durations are associated with an increased prevalence of cardiovascular disease among Korean adults. The effect of sleep duration appears to be more significant in individuals with hypertension, suggesting that the management of hypertension should be prioritized in patients older than 65 year.


Healthcare ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. 160
Author(s):  
Jinlin Liu ◽  
Ying Mao

National basic public health services (BPHSs) are important for promoting the health of rural populations. A better understanding of rural BPHSs from the viewpoint of residents utilizing the services can help health-related departments and primary health care (PHC) centers further improve rural BPHSs. By conducting a large-scale cross-sectional survey in 10 western provinces of China, the study depicts rural resident experiences with rural BPHSs. Of the 9019 participants, 59.33% and 66.48% did not receive services related to health examinations or health education in the six months prior to the survey, respectively. A total of 56.90% were satisfied with the rural BPHSs, and the mean overall satisfaction score was 3.61 ± 0.908 (out of a maximum of 5). The most satisfying domain for rural residents with BPHSs was the attitude of PHC workers, whereas rural residents with chronic diseases were the least satisfied with the health management. Satisfaction with the attitude of PHC workers was identified as the strongest determinant of rural residents’ overall satisfaction with BPHSs. This study could enlighten rural BPHSs management in China.


2019 ◽  
pp. 128-138 ◽  
Author(s):  
Delia Ortega Lenis ◽  
Fabián Méndez

Introduction: Colombian population is getting old in an accelerated manner, causing economic, social and health services effects. The Ministry of Health and Social Protection in the National System of Population Studies and Surveys for Health implemented the first health, well-being and aging survey- SABE-2015 Colombia- to know the living conditions of people 60 years of age or older. Objective: Describe the design of the method, statistical sampling and quality control of information from the SABE-2015 survey. Methods: A cross-sectional study, with quantitative and qualitative approaches, representative for the population in urban and rural areas aged 60 or over. Information was collected on socioeconomic variables, physical and social environment, behavior, cognition and affection, functionality, mental well-being, health conditions, and the use and access to health services. Results: 23,694 surveys were conducted, 17,189 in urban population (72.5%) and 6,505 in rural population. The percentage of effective national response was 66% in 244 municipalities. Supervision was made in 40% of the surveys and telephone re-contact in 25%. The consistency of 100% surveys was reviewed and double entry was developed in 5% of them. National estimates have a 5% margin error. Conclusion: The SABE Colombia 2015 survey is representative of the main indicators of health, well-being and aging in Colombia. The design allows regional comparisons, between large cities and urban and rural population.


2021 ◽  
pp. 1-5
Author(s):  
Sergej M. Ostojic

<b><i>Introduction:</i></b> Recent population-based studies reported an inadequate dietary intake of creatine, a conditionally essential nutrient that plays an important role in human metabolism. <b><i>Methods:</i></b> We analyzed here the nutritional profiles of US adults with low creatine consumption, using data from the 2017 to 2018 National Health and Nutrition Examination Survey (NHANES). <b><i>Results:</i></b> Among 4,004 NHANES adult participants that reported detailed dietary intake information, 2,611 (65.2%) were calculated to have dietary creatine intake below recommended levels of 1.00 g/day. The average daily creatine intake in this subpopulation was 0.52 ± 0.26 g (95% confidence interval, from 0.51 to 0.53). This was accompanied by a significantly lower dietary intake of meat-based protein, as compared to participants whose dietary creatine intake was equal to or above recommended levels (20.1 ± 10.2 g/day vs. 67.1 ± 30.4 g/day; <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> The large-scale rate of suboptimal dietary creatine intake found in this cross-sectional study warrants additional research, and calls for immediate public health measures fostering creatine-rich foods in human nutrition.


2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Lu Hao ◽  
Qiuyan Chen ◽  
Xi Chen ◽  
Qing Zhou

Introduction. Mildly increased bilirubin concentration has a protective effect on oxidative stress–related diseases. However, it remains unknown whether elevated circulating bilirubin is associated with longer telomere length. The aim of this cross-sectional study was to examine the association between total bilirubin concentration and telomere length. Methods. We used the data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. The multivariable linear regression model was used to examine the association between total bilirubin concentration and telomere length. The nonlinear relationship was analyzed using a generalized additive model with the smoothing plot. Results. A total of 7818 participants with a mean age of 49.20 ± 18.82 years were included. Compared with the lowest concentration of total bilirubin (Q1), the highest quartile of total bilirubin concentration was associated with longer telomere length in male ( β = 0.04 , 95 CI%: 0.00, 0.07, P = 0.024 ) and female ( β = 0.04 , 95 CI%: 0.02, 0.04, P = 0.002 ). Furthermore, an inverted U-shaped relationship between total bilirubin and telomere length was found. On the left of turning points ( total   bilirubin < 0.5   mg / dL ), total bilirubin concentration was positively associated with telomere length ( β = 0.23 , 95 CI%: 0.14, 0.32, P < 0.001 ). However, the association between total bilirubin concentration and telomere length was not significant ( β = 0.01 , 95% CI: -0.01, 0.04, P = 0.346 ) above the turning point. Conclusion. This is the first evidence based on a nationally representative survey demonstrating a positive and nonlinear association between total bilirubin concentration and telomere length. Future large-scale prospective studies are warranted to confirm our findings.


2020 ◽  
Vol 32 (Supplement_1) ◽  
pp. 75-83
Author(s):  
Gaston Arnolda ◽  
Teresa Winata ◽  
Hsuen P Ting ◽  
Robyn Clay-Williams ◽  
Natalie Taylor ◽  
...  

Abstract Healthcare organisations vary in the degree to which they implement quality and safety systems and strategies. Large-scale cross-sectional studies have been implemented to explore whether this variation is associated with outcomes relevant at the patient level. The Deepening our Understanding of Quality in Australia (DUQuA) study draws from earlier research of this type, to examine these issues in 32 Australian hospitals. This paper outlines the key implementation and analysis challenges faced by DUQuA. Many of the logistical difficulties of implementing DUQuA derived from compliance with the administratively complex and time-consuming Australian ethics and governance system designed principally to protect patients involved in clinical trials, rather than for low-risk health services research. The complexity of these processes is compounded by a lack of organizational capacity for multi-site health services research; research is expected to be undertaken in addition to usual work, not as part of it. These issues likely contributed to a relatively low recruitment rate for hospitals (41% of eligible hospitals). Both sets of issues need to be addressed by health services researchers, policymakers and healthcare administrators, if health services research is to flourish. Large-scale research also inevitably involves multiple measurements. The timing for applying these measures needs to be coherent, to maximise the likelihood of finding real relationships between quality and safety systems and strategies, and patient outcomes; this timing was less than ideal in DUQuA, in part due to administrative delays. Other issues that affected our study include low response rates for measures requiring recruitment of clinicians and patients, missing data and a design that necessarily included multiple statistical comparisons. We discuss how these were addressed. Successful completion of these projects relies on mutual and ongoing commitment, and two-way communication between the research team and hospital staff at all levels. This will help to ensure that enthusiasm and engagement are established and maintained.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043933
Author(s):  
Sabuj Kanti Mistry ◽  
Fahmida Akter ◽  
Uday Narayan Yadav ◽  
Md Belal Hossain ◽  
Amarynth Sichel ◽  
...  

IntroductionWith the acute shortage of human resources and infrastructure, mobile phones can be a critical tool for accessing health services and strengthening health systems in Bangladesh. Yet, there is a scarcity of evidence on the use of mobile phones in this context for accessing health services. In this study, we sought to explore the current use of mobile phones for accessing maternal and child healthcare and its determinants among recently delivered women in urban slums of Bangladesh.MethodsThe data were collected through interviewing 800 recently delivered women from eight slums of Dhaka city of Bangladesh during May and June 2018. The study followed a cross-sectional design and a two-stage cluster random sampling procedure was followed. A pretested structured questionnaire was employed to collect information. Chi square tests were performed for descriptive analyses and a multilevel binary logistic regression model was executed to explore the determinants of mobile phone usage for accessing maternal and childcare among the participants.ResultsOverall, 73.8% of study participants used mobile phones for accessing maternal and child healthcare. After adjusting for potential confounders, participants’ age, husband’s occupation, sex of household head, women’s ownership of mobile phones and household wealth status were found to be significantly associated with higher odds of using mobile phones to access maternal and child healthcare.ConclusionThe study highlighted the possibility of implementing large-scale mobile health (mHealth) interventions in slum settlements for accessing maternal and child healthcare and is a sustainable mitigation strategy for the acute health worker crisis in Bangladesh. The findings of this study are particularly crucial for policymakers and practitioners while they revise the health policy to incorporate mHealth interventions as highlighted in the recently initiated Digital Health Strategy of Bangladesh.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261347
Author(s):  
Yunjin Lee ◽  
Ji Soo Kim ◽  
Un Chul Park ◽  
Juwon Lim

The present study was conducted to investigate recent trends of refractive surgery rates and analyze subjects undergoing refractive surgery using large-scale population studies over the past 8 years. We used the dataset of the Korean National Health and Nutrition Examination Surveys, a nationwide population-based cross-sectional study which were performed from 2008 to 2015. Of the 21,415 participants aged 20 to 49 years, 1,621 had refractive surgeries. Seventy three percent of them were females and 81% of them were aged under 40 years old. Over the past 8 years, cumulative prevalence of refractive surgery rate increased more than 10%. Although young (< 40 years, odds ratio (OR) 0.31, P<0.001) women (OR 1.86, P<0.001) living in urban areas (OR 0.51, P<0.001) with high educational attainment (OR 2.67, P<0.001) and income levels (OR 3.16, P<0.001) accounted for a high proportion in refractive surgery group through all survey years, subgroup analyses revealed that gaps between genders (ORs 3.8 in 2008–2009, 2.1 in 2010–2012, and 1.5 in 2013–2015), educational level (ORs 3.0, 2.5, and 2.1, respectively), and highest/lowest quartiles of household income (ORs 5.2, 2.6, and 2.4, respectively) were decreasing over time. Overall, our study suggests that refractive surgery has reached an age where the majority accepts it, and indeed more and diverse people are undergoing refractive surgeries.


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