scholarly journals Comparative Analysis: Cost of Two Community ARTDelivery ModelsIn the Urban Settings In Zambia

2021 ◽  
Vol 3 (1) ◽  
pp. 85-92
Author(s):  
Miniver Munkanta ◽  
◽  
Fredrick Mulenga Chitangala ◽  
Keyword(s):  
Standard Of Care ◽  
Cross Sectional Study ◽  
Models Of Care ◽  
Health Centers ◽  
Urban Centers ◽  
Community Based ◽  
Cross Sectional ◽  
Standard Facility ◽  
Personnel Costs ◽  
The Cost

In the quest to improve and address the bottle necks of ART services to the affected population, Zambia has implemented three models of delivering this service which are; Standard of Care, Door to Door and Adherence Clubs. The aim of this study was to identify and cost the provision of ART services using the three models. A quantitative retrospective cross-sectional study was done to compare the cost of delivering two models, adherence clubs and door to door in relation to the standard facility-based model. The 2018 costing data for ART was collected retrospectively in the Kanyama and Chipata Health Urban Centers in Lusaka, Zambia. A checklist and a data costing tool was developed to help identify and cost all the costs items attached to the provision of ART services in the two Health Centers. The study shows that the total cost of delivering ART services to 11,225 patients at Chipata Health center was 53,087,649.54 ZMW ($ 4,994,134.48) translating into 21,802.49 ($2,051.03) per patient. Furthermore, providing the same services at Kanyama to 12,293 clients costed 35,823,354.87 ZMW ($ 3,370,023.98) and cost per patient was 24989.65 ZMW ($2,350.86).The study concluded that it was more expensive to deliver ART through health facility model than community-based models. The major costs of ART services using three models of care were ARV drugs followed capital and personnel costs. In order to reduce barriers and costs ART services must be brought close to people as much as possible.

scholarly journals Counseling Quality of Dangerous Signs of Pregnancy Health in Work Region of Urban and Rural Puskesmas (Public Health Center) Jeneponto

2020 ◽  
Vol 8 (T2) ◽  
pp. 172-175
Author(s):  
Hafidah Amiruddin ◽  
Ansariadi Ansariadi ◽  
Sukri Palutturi ◽  
Wahidin M. Wahidin ◽  
Abdul Rahman Akmal ◽  
...  
Keyword(s):  
Public Health ◽  
Rural Areas ◽  
Standard Of Care ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Health Centers ◽  
Computer Application ◽  
Cross Sectional ◽  
Work Area

BACKGROUND: Quality healthcare is the standard of care received by citizens who are entitled to guarantee their health status due to the poor quality of health care that affect the high mortality. AIM: This study aimed to determine the difference in counseling quality of pregnancy dangerous signs at the public health centers of urban and rural areas in Jeneponto regency. METHODS: The type of study was analytical observation with a cross-sectional study design. The populations of this research are all pregnant women in Jeneponto regency in October 2015–May 2016 at the work area of Urban and Rural Public Health centers. There were 278 respondents obtained by proportionate stratified random sampling. Data analysis used computer application of SPSS examined with the Chi-square test. RESULTS: The results indicate that 85.3% of counseling quality of pregnancy dangerous signs in the work area of urban and rural Puskesmas are categorized bad. There is a difference of counseling quality of pregnancy dangerous sign component of vagina bleeding (p = 0.000), severe headache (p = 0.000), visual problems/blurred sight (p = 0.000), swelling on face and hand (p = 0.001), and severe abdominal pain (p = 0.000), fetus movement is lacking or not felt (p = 0.000) and fever (p = 0.000). CONCLUSION: There is no difference in counseling quality based on age, education, job, and parities.

scholarly journals Transfers of Care between Healthcare Professionals in Obstetric Units of Different Sizes across Spain and in a Hospital in Ireland: The MidconBirth Study

2020 ◽  
Vol 17 (22) ◽  
pp. 8394
Author(s):  
Anna Martín-Arribas ◽  
Rafael Vila-Candel ◽  
Rhona O’Connell ◽  
Martina Dillon ◽  
Inmaculada Vila-Bellido ◽  
...  
Keyword(s):  
Birth Outcomes ◽  
Cross Sectional Study ◽  
Models Of Care ◽  
Public Hospitals ◽  
Future Research ◽  
Cross Sectional ◽  
Skin Contact ◽  
Perineal Injury ◽  
Transfers Of Care ◽  
The Cost

Background: In Europe, the majority of healthy women give birth at conventional obstetric units with the assistance of registered midwives. This study examines the relationships between the intrapartum transfer of care (TOC) from midwife to obstetrician-led maternity care, obstetric unit size (OUS) with different degrees of midwifery autonomy, intrapartum interventions and birth outcomes. Methods: A prospective, multicentre, cross-sectional study promoted by the COST Action IS1405 was carried out at eight public hospitals in Spain and Ireland between 2016–2019. The primary outcome was TOC. The secondary outcomes included type of onset of labour, oxytocin stimulation, epidural analgesia, type of birth, episiotomy/perineal injury, postpartum haemorrhage, early initiation of breastfeeding and early skin-to-skin contact. A logistic regression was performed to ascertain the effects of studied co-variables on the likelihood that participants had a TOC; Results: Out of a total of 2,126 low-risk women, those whose intrapartum care was initiated by a midwife (1772) were selected. There were statistically significant differences between TOC and OUS (S1 = 29.0%, S2 = 44.0%, S3 = 52.9%, S4 = 30.2%, p < 0.001). Statistically differences between OUS and onset of labour, oxytocin stimulation, type of birth and episiotomy or perineal injury were observed (p = 0.009, p < 0.001, p < 0.001, p < 0.001 respectively); Conclusions: Findings suggest that the model of care and OUS have a significant effect on the prevalence of intrapartum TOC and the birth outcomes. Future research should examine how models of care differ as a function of the OUS in a hospital, as well as the cost-effectiveness for the health care system.

scholarly journals A cross-sectional study of patients presenting for hospital-based screening for COVID-19: risk of disease, and healthcare access preferences

2020 ◽  
Author(s):  
Amanda Rojek ◽  
Martin Dutch ◽  
Daniel Peyton ◽  
Rachel Pelly ◽  
Mark Putland ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Healthcare Access ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Models Of Care ◽  
Sources Of Information ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional

AbstractIntroductionEarly during the SARS-CoV-2 pandemic, Australian emergency departments (EDs) have experienced an unprecedented surge in patients seeking screening for COVID-19. Understanding what proportion of these patients require screening, who can be safely screened in community based models of care, and who requires an emergency departments to care for them is critical for workforce and infrastructure planning across the healthcare system, as well as public messaging campaigns.MethodssIn this cross sectional survey, we screened patients presenting to a SARS-CoV-2 screening clinic in a tertiary hospital Emergency Department in Melbourne, Australia. We assessed the proportion of patients who met screening criteria; self-reported symptom severity; reasons why they came to the ED for screening; views on community-based models of care; and sources of information accessed about COVID-19.ResultsWe included findings from 1846 patients who presented to the Emergency Department (ED) for COVID-19 screening from 18th to 30th March 2020. Most patients (55.3%) did not meet criteria for screening and most (57.6%) had mild or no (13.4%) symptoms. The main reason for coming to the ED was being referred by a telephone health service (31.3%) and 136 (7.4%) said they tried to contact their GP but could not get an appointment. Only 47 (2.6%) said they thought the disease was too specialized for their GP to manage. Patients accessed numerous information sources, commonly government websites (68.4%) and other websites (51.3%) for COVID-19 information.Conclusionsif we are to ensure that emergency departments can cope with the likely surge in presentations requiring resuscitation or inpatient care COVID-19, we should strengthen access to alternative services to triage patients to prevent unnecessary presentations at health services, and to direct those who are well but require screening away from EDs.

Lipophilic Statin Use and Suicidal Ideation in a Sample of Adults With Mood Disorders

Crisis ◽  
2014 ◽  
Vol 35 (4) ◽  
pp. 278-282 ◽  
Author(s):  
Karen M. Davison ◽  
Bonnie J. Kaplan
Keyword(s):  
Suicidal Ideation ◽  
Mood Disorders ◽  
Prevalence Ratio ◽  
Cross Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Symptom Scores ◽  
Unit Increase ◽  
Predominantly Female ◽  
Lipophilic Statin

Background: Mood disorders are associated with a high risk of suicide. Statin therapy has been implicated in this relationship. Aims: To further clarify reported associations between suicide and cholesterol in mental health conditions, we conducted an analysis of dietary, clinical, and suicidal ideation measures in community-living adults with mood disorders. Method: Data were used from a cross-sectional study of a randomly selected community-based sample (> 18 years; n = 97) with verified mood disorders. Dietary (e.g., fat, iron, vitamin intakes), clinical (e.g., current depression and mania symptoms, medications), and sociodemographic (age, sex, and income) measures were analyzed using bivariate statistics and Poisson regression with robust variance. Results: Participants were predominantly female (71.1%) with bipolar disorder (59.8%); almost one-third (28.9%) were taking lipophilic statins. The prevalence of suicidal ideation was more than 2.5 times in those taking statins, PR = 2.59, 95% CI 1.27–5.31, p < .05. The prevalence ratio for suicidal ideation was 1.10, 95% CI 1.06–1.15, p < .001, for each unit increase in mania symptom scores. No associations between suicidal ideation and dietary intake measures were identified. Conclusion: Individuals with mood disorders may be susceptible to neuropsychiatric effects of cholesterol-lowering drugs, which warrants further research.

Disposal Practices of Unused Medications Among Patients in Public Health Centers of Dessie Town, Northeast Ethiopia: A Cross-sectional Study

2020 ◽  
Vol 15 (2) ◽  
pp. 105-110
Author(s):  
Haile Kassahun ◽  
Dugessa Tesfaye
Keyword(s):  
Public Health ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Health Centers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Global Challenge ◽  
Northeast Ethiopia ◽  
Unused Medications ◽  
At Home

Background: Disposal of pharmaceutical waste among patients is a global challenge especially in developing countries like Ethiopia. Improper medication disposal can lead to health problems and environmental contaminations. Therefore, the present study aimed to assess disposal practices of unused medications among patients in public health centers of Dessie town, Northeast Ethiopia. Methods: A descriptive cross-sectional study was conducted among 263 patients in four public health centers of Dessie town, Ethiopia from March to June, 2019. Face-to-face interviews using structured questionnaires were used to collect data from each study subject. Results: The majority of the respondents, 224 (85.17%) had unused medications at their home during the study period. The most commonly reported disposal method in the present study was flushing down into a toilet 66 (25.09%). None of the respondents practiced returning unused medications to Pharmacy. Moreover, 85 (32.31%) of the respondents reported never disposing their medications and believed that it is acceptable to store medications at home for future use. Conclusion: In the present study, there was a high practice of keeping medications at home and most of the disposal practices were not recommended methods. In addition, most of the respondents did not get advice from pharmacists and other health care professionals on how to dispose off unused medications. Hence, there is a need for proper education and guidance of patients regarding disposal practices of unused medications.

Breastfeeding practices among mothers of infants in Peringara Panchayat in Pathanamthitta District

2018 ◽  
Vol 3 (01) ◽  
Author(s):  
Aswathy S. ◽  
Lakshmi M. K.
Keyword(s):  
Exclusive Breastfeeding ◽  
Cross Sectional Study ◽  
Community Based ◽  
Chi Square ◽  
Cross Sectional ◽  
Breastfeeding Practices ◽  
Chi Square Test ◽  
Type Of Delivery ◽  
Initiation Of Breastfeeding

The study was aimed to assess the breastfeeding practices among mothers of infants in Peringara Gramapanchayat in Kerala. Study was a community based cross-sectional study among mothers of infants in Peringara gramapanchayat using a pretested questionnaire. 142 breastfeeding mothers of infants in Peringara gramapanchayat were studied and mothers who were not present at home during the study were excluded from the study. Study period consisted of 18 days between December 2015 and January 2016. Study variables includes type of delivery, initiation of breastfeeding, breastfeeding practices and role of ASHAs in promoting good breastfeeding practices. Statistical analysis was done using Pearson’s Chi-square test and T test. The study found that exclusive breastfeeding has been done by 68.3% of mothers. There is no practice of giving pre-lacteal feed, 95.8% of mothers have given colostrum to the new born. Statistically significant association was found between the type of delivery and time of initiation of breastfeeding (p less than 0.05). Time of initiation of breastfeeding was prolonged in case of Caesarean section. 49.3% of mothers have breastfed the baby within one hour. 55.6% of mothers were informed about importance of breastfeeding by ASHAs and only 20.4% of mothers were informed about period of exclusive breastfeeding and period of complimentary feeding by ASHAs.

scholarly journals Difference in the general medicine in-training examination score between community-based hospitals and university hospitals: a cross-sectional study based on 15,188 Japanese resident physicians

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuji Nishizaki ◽  
Keigo Nozawa ◽  
Tomohiro Shinozaki ◽  
Taro Shimizu ◽  
Tomoya Okubo ◽  
...  
Keyword(s):  
Physical Examination ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Medical Interview ◽  
Sectional Study ◽  
University Hospitals ◽  
Community Based ◽  
Cross Sectional ◽  
Clinical Competencies ◽  
Clinical Procedures

Abstract Background The general medicine in-training examination (GM-ITE) is designed to objectively evaluate the postgraduate clinical competencies (PGY) 1 and 2 residents in Japan. Although the total GM-ITE scores tended to be lower in PGY-1 and PGY-2 residents in university hospitals than those in community-based hospitals, the most divergent areas of essential clinical competencies have not yet been revealed. Methods We conducted a nationwide, multicenter, cross-sectional study in Japan, using the GM-ITE to compare university and community-based hospitals in the four areas of basic clinical knowledge“. Specifically, “medical interview and professionalism,” “symptomatology and clinical reasoning,” “physical examination and clinical procedures,” and “disease knowledge” were assessed. Results We found no significant difference in “medical interview and professionalism” scores between the community-based and university hospital residents. However, significant differences were found in the remaining three areas. A 1.28-point difference (95% confidence interval: 0.96–1.59) in “physical examination and clinical procedures” in PGY-1 residents was found; this area alone accounts for approximately half of the difference in total score. Conclusions The standardization of junior residency programs and the general clinical education programs in Japan should be promoted and will improve the overall training that our residents receive. This is especially needed in categories where university hospitals have low scores, such as “physical examination and clinical procedures.”

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