Perceptions of Non-Communicable Disease and War Injury Management in the Palestinian Health System: A Qualitative Study of Healthcare Providers Perspectives

Antecedentes: Las enfermedades crónicas no transmisibles, son la principal causa de morbimortalidad a nivel mundial. Comportamiento similar se presenta en Colombia al igual que en Santander. Las patologías cardiovasculares en el 2010 cobraron la vida de 1527 mujeres y 1634 hombres; seguido de las neoplasias, en especial las de localización de tumores malignos que causaron la muerte a 727 mujeres y 755 hombres, estos resultados se ven reflejados en los altos costos requeridos para la atención hospitalaria, ambulatoria y domiciliaria por lo que requiere dedicación, educación y cuidado individualizado. Métodos: Se realizó una búsqueda de artículos teniendo en cuenta tiempo de publicación y las palabras claves; en las bases de datos: MEDLINE, IME, LILACS, Centro Cochrane Iberoamericano, EMBASE, CINAHL, BDIE, en el primer semestre de 2013. Identificando 55 estudios potenciales, de los cuales se seleccionaron seis artículos del comportamiento de los costos de la atención a pacientes con enfermedades crónicas no transmisibles; cabe incluir que se obtuvo información directa por parte de algunas instituciones de Bucaramanga, la cual demuestra el comportamiento de los costos frente al cuidado de enfermería y a nivel interno de cada entidad no solo del sistema de salud sino de los pacientes y cuidadores familiares. Resultados: la enfermedad crónica genera la mayor parte de los costos al Sistema de Salud, situación a tener en cuenta; así como el cuidado efectivo para la atención de pacientes que ya han sido afectados. Conclusiones: el Sistema de Salud debe implementar estrategias preventivas para la aparición de las Enfermedades Crónicas No Trasmisibles (ECNT) y las complicaciones derivadas de ellas, que contemple un cuidado efectivo para la atención de los individuos.Palabras claves: Costos, Cuidado, Enfermedad Crónica no transmisible. Abstract Background: Chronic noncommunicable diseases are the leading cause of morbidity and mortality worldwide. Similar behavior occurs in Colombia as in Santander. Cardiovascular diseases in 2010 claimed the lives of 1527 women and 1634 men ; followed by neoplasms, especially the localization of malignant tumors that killed 727 women and 755 men, these results are reflected in the high cost required for inpatient , outpatient and home care so requires dedication , education and individualized care. Methods: A search of articles were given at time of publication and keyword; in databases: MEDLINE, IME, LILACS, Iberoamerican Cochrane Centre, EMBASE, CINAHL, BDIE in the first half of 2013. By identifying 55 potential studies, of which six articles of behavior of costs of care were selected patients with chronic non- communicable diseases; it should include direct information was obtained by some institutions Bucaramanga, which shows the behavior of costs compared to nursing care and internally each institution not only the health system but patients and family caregivers. Results: Chronic illness generates most of the costs the health system, a situation to consider; and effective care for the care of patients who have already been affected. Conclusions: Health System must implement preventive strategies for the appearance of Chronic Non Communicable (ECNT) and complications arising from them, by providing effective care for the care of individuals.Keywords: Costs, Care, Chronic Non-Communicable Disease.

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Exploring patient-provider interactions and the health system’s responsiveness to street-connected children and youth in Kenya: a qualitative study

BMC Health Services Research ◽

10.1186/s12913-021-06376-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Embleton Lonnie ◽

Shah Pooja ◽

Gayapersad Allison ◽

Kiptui Reuben ◽

Ayuku David ◽

...

Keyword(s):

Qualitative Study ◽

Health System ◽

Health Systems ◽

Cultural Context ◽

Healthcare Providers ◽

Children And Youth ◽

Economic Factors ◽

Health Coverage ◽

Socially Constructed ◽

Prompt Attention

Abstract Background In Kenya, street-connected children and youth (SCY) have poor health outcomes and die prematurely due to preventable causes. This suggests they are not accessing or receiving adequately responsive healthcare to prevent morbidity and mortality. We sought to gain insight into the health systems responsiveness to SCY in Kenya through an in-depth exploration of SCY’s and healthcare provider’s reflections on their interactions with each other. Methods This qualitative study was conducted across 5 counties in western Kenya between May 2017 and September 2018 using multiple methods to explore and describe the public perceptions of, and proposed and existing responses to, the phenomenon of SCY in Kenya. The present analysis focuses on a subset of data from focus group discussions and in-depth interviews concerning the delivery of healthcare to SCY, interactions between SCY and providers, and SCY’s experiences in the health system. We conducted a thematic analysis situated in a conceptual framework for health systems responsiveness. Results Through three themes, context, negative patient-provider interactions, and positive patient-provider interactions, we identified factors that shape health systems responsiveness to SCY in Kenya. Economic factors influenced and limited SCY’s interactions with the health system and shaped their experiences of dignity, quality of basic amenities, choice of provider, and prompt attention. The stigmatization and discrimination of SCY, a sociological process shaped by the social-cultural context in Kenya, resulted in experiences of indignity and a lack of prompt attention when interacting with the health system. Patient-provider interactions were highly influenced by healthcare providers’ adverse personal emotions and attitudes towards SCY, resulting in negative interactions and a lack of health systems responsiveness. Conclusions This study suggests that the health system in Kenya is inadequately responsive to SCY. Increasing public health expenditures and expanding universal health coverage may begin to address economic factors, such as the inability to pay for care, which influence SCY’s experiences of choice of provider, prompt attention, and dignity. The deeply embedded adverse emotional responses expressed by providers about SCY, associated with the socially constructed stigmatization of this population, need to be addressed to improve patient-provider interactions.

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A sustainable community based model of non-communicable disease risk factor surveillance: “SHRADDHA-JAGRITHI project” (Preprint)

10.2196/preprints.27299 ◽

2021 ◽

Author(s):

Jaideep Menon ◽

Mathews Numpeli ◽

Sajeev.P. Kunjan ◽

Beena.V. Karimbuvayilil ◽

Aswathy Sreedevi ◽

...

Keyword(s):

Public Health ◽

Health System ◽

Public Health System ◽

Health Workers ◽

Communicable Disease ◽

Community Based ◽

Frontline Health Workers ◽

The Individual ◽

Non Communicable Disease

UNSTRUCTURED Abstract: India has a massive non-communicable disease (NCD) burden at an enormous cost to the individual, family, society and health system at large, in spite of which prevention and surveillance is relatively neglected. Risk factors for atherosclerotic cardiovascular disease if diagnosed early and treated adequately would help decrease the mortality and morbidity burden. India is in a stage of rapid epidemiological transition with the state of Kerala being at the forefront, pointing us towards likely disease burden and outcomes for the rest of the country, in the future. A previous study done by the same investigators, in a population of >100,000, revealed poor awareness and treatment of NCDs and also poor adherence to medicines in individuals with CVD. The investigators are looking at a sustainable, community based model of surveillance for NCDs with corporate support wherein frontline health workers check all individuals in the target group ( > age 30 years) with further follow up and treatment planned in a “spoke and hub” model using the public health system of primary health centres (PHCs) as spokes to the hubs of Taluk or District hospitals. All data entry done by frontline health workers would be on a Tab PC ensuring rapid acquisition and transfer of participant health details to PHCs for further follow up and treatment. The model will be evaluated based on the utilisation rate of various services offered at all tier levels. The proportions of the target population screened, eligible individuals who reached the spoke or hub centres for risk stratification and care and community level control for hypertension and diabetes in annual surveys will be used as indicator variables. The model ensures diagnosis and follow up treatment at no cost to the individual entirely through the tiered public health system of the state and country.

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What influenced provision of non-communicable disease healthcare in the Syrian conflict, from policy to implementation? A qualitative study

Conflict and Health ◽

10.1186/s13031-018-0178-5 ◽

2018 ◽

Vol 12 (1) ◽

Cited By ~ 8

Author(s):

Sylvia Garry ◽

Francesco Checchi ◽

Beniamino Cislaghi

Keyword(s):

Qualitative Study ◽

Communicable Disease ◽

Syrian Conflict ◽

Non Communicable Disease

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Unraveling PBF effects beyond impact evaluation: results from a qualitative study in Cameroon

BMJ Global Health ◽

10.1136/bmjgh-2017-000693 ◽

2018 ◽

Vol 3 (2) ◽

pp. e000693 ◽

Cited By ~ 18

Author(s):

Manuela De Allegri ◽

Maria Paola Bertone ◽

Shannon McMahon ◽

Idrissou Mounpe Chare ◽

Paul Jacob Robyn

Keyword(s):

Qualitative Study ◽

Health System ◽

Low Income ◽

Impact Evaluation ◽

Healthcare Providers ◽

Analytical Techniques ◽

Demand Side ◽

Middle Income ◽

Implementation Processes ◽

Heterogeneous Effects

IntroductionPerformance-based financing (PBF) has acquired increased prominence as a means of reforming health system purchasing structures in low-income and middle-income countries. A number of impact evaluations have noted that PBF often produces mixed and heterogeneous effects. Still, little systematic effort has been channelled towards understanding what causes such heterogeneity, including looking more closely at implementation processes.MethodsOur qualitative study aimed at closing this gap in knowledge by attempting to unpack the mixed and heterogeneous effects detected by the PBF impact evaluation in Cameroon to inform further implementation as the country scales up the PBF approach. We collected data at all levels of the health system (national, district, facility) and at the community level, using a mixture of in-depth interviews and focus group discussions. We combined deductive and inductive analytical techniques and applied analyst triangulation.ResultsOur findings indicate that heterogeneity in effects across facilities could be explained by pre-existing infrastructural weaknesses coupled with rigid administrative processes and implementation challenges, while heterogeneity across indicators could be explained by providers’ practices, privileging services where demand-side barriers were less substantive.ConclusionIn light of the country’s commitment to scaling up PBF, it follows that substantial efforts (particularly entrusting facilities with more financial autonomy) should be made to overcome infrastructural and demand-side barriers and to smooth implementation processes, thus, enabling healthcare providers to use PBF resources and management models to a fuller potential.

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Barriers to Integrate Physical Exercise Into the Ethiopian Healthcare System to Treat Non-Communicable Diseases

Global Journal of Health Science ◽

10.5539/gjhs.v10n10p123 ◽

2018 ◽

Vol 10 (10) ◽

pp. 123 ◽

Cited By ~ 1

Author(s):

Melkamu D. Kassa ◽

Jeanne Grace

Keyword(s):

Physical Exercise ◽

Built Environment ◽

Healthcare System ◽

Healthcare Professionals ◽

Communicable Disease ◽

Healthcare Providers ◽

Healthcare Organizations ◽

Exercise Participation ◽

Referral Hospitals ◽

Non Communicable Disease

Introduction: Physical exercise is recognized as one component of non-communicable disease prevention, but little attention has been devoted to integrating physical exercise into the Ethiopian healthcare system, with the barriers to its inclusion being unclear. Objectives: The present study explores the bottlenecks to integrate physical exercise into the Ethiopian healthcare system to treat non-communicable disease. Design: A mixed method sequential explanatory design. Setting: Public referral hospitals in Ethiopia. Methodology: Data was collected in two phases among 312 (195 males and 117 females) healthcare professionals. The participants were selected proportionately and randomly from 13 public referral hospitals. Results: Lack of: national coordination to promote physical exercise (t (311) = 69.20, p < .0005), trained physical exercise professionals (t (311) = 14.42, p < .0005); physical exercise guidelines (t (311) = 33.25, p < .0005); training how to prescribe physical exercise by healthcare providers (t (311) = 62.94, p < .0005); information on the health benefits of physical exercise to give to their patients (t (311) = 65.62, p < .0005); and built environment that encourages physical exercise participation (t (311) = 59.64, p < .0005) were identified as barriers. Additionally, built environment, policy, healthcare professionals' lifestyle, demography of healthcare professionals, health information coverage of physical exercise and the hospital physical building were also identified as barriers. Conclusions: Physical exercise appears marginalized from the Ethiopian healthcare system. Healthcare organizations and policy makers could take the cited barriers into consideration to plan, design and integrate physical exercise into the healthcare system to prevent NCDs in Ethiopia.

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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 ◽

10.1136/bmjopen-2019-029562 ◽

2019 ◽

Vol 9 (10) ◽

pp. e029562 ◽

Cited By ~ 5

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.

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