Beyond COVID-19: Telehealth Equity Considerations to Improve Access to Care (Preprint)

2020 ◽  
Author(s):  
Hassanatu Blake

UNSTRUCTURED Telehealth is now a fundamental health approach to address the coronavirus pandemic (COVID-19) globally. Since the declaration of the pandemic by the World Health Organization (WHO) in March 2020, there has been an overrepresentation of African American deaths, a greater demand of health services on disadvantaged health facilities in rural and urban US, and growing infection rates in some African countries with fragile health systems. With broad mobile utilization, telehealth provides accessibility to quality health care that addresses both COVID-19 and other health inequities. Future health interventions should focus on securely expanding telehealth offline and via social media to minimize health disparities in vulnerable populations during pandemics and beyond.

2019 ◽  
Vol 17 (2) ◽  
pp. 269-284
Author(s):  
Stella Fatović-Ferenčić ◽  
Martin Kuhar

Recently, the World Health Organization launched its Universal Health Coverage initiative with the aim to improve access to quality health care on a global level, without causing financial hardship to the patients. In this paper, we will identify and analyze the ideological similarities between this influential initiative and the work of one of the founders of the WHO—Andrija Štampar (1888–1958)—whose social medicine was built of various normative, sociological and philosophical elements. Our aim is to demonstrate the crucial role of carefully erected and thought-out ideology for the success of public health programs.


2018 ◽  
Vol 150 (3) ◽  
pp. 240-245 ◽  
Author(s):  
Vincent Rusanganwa ◽  
Jean Bosco Gahutu ◽  
Innocent Nzabahimana ◽  
Jean Marie Vianney Ngendakabaniga ◽  
Anna-Karin Hurtig ◽  
...  

Abstract Objectives We investigated the quality system performance in Rwandan referral laboratories to determine their progress toward accreditation. Methods We conducted audits across five laboratories in 2017, using the Stepwise Laboratory Quality Improvement Process Towards Accreditation checklist. Laboratories were scored based on the World Health Organization grading scale (0-5 stars scale) and compared with earlier audits. Results Between 2012 and 2017, only one laboratory progressed (from four to five stars). Four of the five laboratories decreased to one (three laboratories) and zero (one laboratory) stars from four and three stars. Management reviews, evaluation, audits, documents, records, and identification of nonconformities showed a low performance. Conclusions Four of five laboratories are not moving toward accreditation. However, this target is still achievable by energizing responsibilities of stakeholders and monitoring and evaluation. This would be possible because of the ability that laboratories showed in earlier audits, coupled with existing health policy that enables sustainable quality health care in Rwanda.


2020 ◽  
Vol 14 (S 01) ◽  
pp. S105-S109
Author(s):  
Bianca Princeton ◽  
Preetha Santhakumar ◽  
Lavanya Prathap

Abstract Objectives Coronavirus disease is an infectious disease caused by a newly discovered coronavirus. This virus primarily spreads through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. This virus was named after its shape, which takes the form of a crown with protrusions around it. The World Health Organization has recommended personal protective equipments (PPE) to doctors and health care workers attending COVID-19 patients. PPE generally includes masks, goggles, respirators, gloves, face shields, and isolation gowns. The principle aim of this study is to create awareness among dental students about the preventive measures taken by health care professionals while attending patients affected with COVID-19. Materials & Methods A questionnaire comprising 15 questions was created using an online Google forms website and was circulated among 100 dental students. The survey was conducted within a week in the months of April to May 2020. The results and observations were recorded in the form of pie charts. Results Ninety-three percent of the participants have stated that health care professionals must clean their hands often, cover their nose and mouth, and maintain safe distance from everyone in order to prevent the virus from affecting them. Sixty-three percent of the participants are familiar with the term PPE. Majority assume that health care professionals are given enough safety precautions while treating a patient with coronavirus. Conclusion Hence, to conclude, health care professionals play a vital role in improving access and quality health care for the population, and hence, they must be protected as well. Since dental students treat patients, they are vulnerable to infection as well, and must take proper safety measures.


Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 4028
Author(s):  
Theodosia Adom ◽  
Anniza De Villiers ◽  
Thandi Puoane ◽  
André Pascal Kengne

To address the issue of obesity, the World Health Organization (WHO) recommends a set of comprehensive programmes aimed at changing the obesogenic environments to provide opportunities for healthy food options and increased physical activity in the school, home, and at the population level. The objectives of this study were to examine the nature and range of policies related to overweight and obesity prevention in Africa, and to assess how they align with international guidelines. An existing methodological framework was adapted for this scoping review. A search of publicly available national documents on overweight/obesity, general health, and non-communicable diseases (NCDs) was undertaken from relevant websites, including WHO, ministries, and Google Scholar. Additional requests were sent to key contacts at relevant ministries about existing policy documents. The documents were reviewed, and the policies were categorised, using the Analysis Grid for Environments Linked to Obesity (ANGELO) framework. The framework categorises the environmental drivers of obesity into four domains (physical, economic, legislative, and socio-cultural) and two scales: macro (national, regional, sectors, food industries, media, etc.) and micro (household, institutional, and community). This review included documents from 41 African countries. The policy initiatives to prevent overweight/obesity target the school, family and community settings, and macro environments, and broadly align with global recommendations. The NCD documents were in the majority, with only two on obesity. The majority of the documents detailed strategies and key interventions on unhealthy diets and physical inactivity. The physical, legislative, and sociocultural domains were largely featured, with less emphasis on the economic domain. Additionally, nutrition- and diet-related policies were in the majority. Overlaps and interactions of policies were observed in the application of the ANGELO framework. This study has provided information on national policies and programmes in Africa and can be useful as a first point of call for policymakers. The overlapping and interaction in the initiatives demonstrate the importance of multi-sectoral partnerships in providing supportive environments for healthy behaviours.


2020 ◽  
pp. 101053952096846
Author(s):  
Kaixuan Hu

The purposes of this article are to explore the challenges the Chinese health care system will be facing in the next decade. The recent outbreak of coronavirus disease (COVID-19) having infected more than 90 000 persons in China (Source: World Health Organization, WHO Coronavirus Disease Dashboard) again reveals the weaknesses of the fragmental health care system. Over the past 3 decades, increasing out-of-pocket spending on health care, increasing mortality rate of chronic disease, growing disparities between rural and urban populations, the defectiveness of disease surveillance system, and disease outbreak response system have been pressing Chinese authorities for action. As this country has experienced an unprecedented economic growth along with an unparalleled development of health care system in the past 3 decades, the challenges ahead are unavoidably numerous and complex.


2019 ◽  
Vol 4 (2) ◽  
pp. 238146831989454
Author(s):  
Joe Brew ◽  
Christophe Sauboin

Background. The World Health Organization is planning a pilot introduction of a new malaria vaccine in three sub-Saharan African countries. To inform considerations about including a new vaccine in the vaccination program of those and other countries, estimates from the scientific literature of the incremental costs of doing so are important. Methods. A systematic review of scientific studies reporting the costs of recent vaccine programs in sub-Saharan countries was performed. The focus was to obtain from each study an estimate of the cost per dose of vaccine administered excluding the acquisition cost of the vaccine and wastage. Studies published between 2000 and 2018 and indexed on PubMed could be included and results were standardized to 2015 US dollars (US$). Results. After successive screening of 2119 titles, and 941 abstracts, 58 studies with 80 data points (combinations of country, vaccine type, and vaccination approach–routine v. campaign) were retained. Most studies used the so-called ingredients approach as costing method combining field data collection with documented unit prices per cost item. The categorization of cost items and the extent of detailed reporting varied widely. Across the studies, the mean and median cost per dose administered was US$1.68 and US$0.88 with an interquartile range of US$0.54 to US$2.31. Routine vaccination was more costly than campaigns, with mean cost per dose of US$1.99 and US$0.88, respectively. Conclusion. Across the studies, there was huge variation in the cost per dose delivered, between and within countries, even in studies using consistent data collection tools and analysis methods, and including many health facilities. For planning purposes, the interquartile range of US$0.54 to US$2.31 may be a sufficiently precise estimate.


2018 ◽  
Vol 147 ◽  
Author(s):  
D. P. O'Brien ◽  
I. Jeanne ◽  
K. Blasdell ◽  
M. Avumegah ◽  
E. Athan

AbstractMycobacterium ulceransis recognised as the third most common mycobacterial infection worldwide. It causes necrotising infections of skin and soft tissue and is classified as a neglected tropical disease by the World Health Organization (WHO). However, despite extensive research, the environmental reservoir of the organism and mode of transmission of the infection to humans remain unknown. This limits the ability to design and implement public health interventions to effectively and consistently prevent the spread and reduce the incidence of this disease. In recent years, the epidemiology of the disease has changed. In most endemic regions of the world, the number of cases reported to the WHO are reducing, with a 64% reduction in cases reported worldwide in the last 9 years. Conversely, in a smaller number of countries including Australia and Nigeria, reported cases are increasing at a rapid rate, new endemic areas continue to appear, and in Australia cases are becoming more severe. The reasons for this changing epidemiology are unknown. We review the epidemiology ofM. ulceransdisease worldwide, and document recent changes. We also outline and discuss the current state of knowledge on the ecology ofM. ulcerans, possible transmission mechanisms to humans and what may be enabling the spread ofM. ulceransinto new endemic areas.


2020 ◽  
Vol 26 (4) ◽  
pp. 2792-2810
Author(s):  
Md Rakibul Hoque ◽  
Mohammed Sajedur Rahman ◽  
Nymatul Jannat Nipa ◽  
Md Rashadul Hasan

This study reviews the quality of evidence reported in mobile health intervention literature in the context of developing countries. A systematic search of renowned databases was conducted to find studies related to mobile health applications published between a period of 2013 and 2018. After a methodological screening, a total of 31 studies were included for data extraction and synthesis. The mobile health Evidence Reporting and Assessment checklist developed by the World Health Organization was then used to evaluate the rigor and completeness in evidence reporting. We report several important and interesting findings. First, there is a very low level of familiarity with the mobile health Evidence Reporting and Assessment checklist among the researchers and mobile health intervention designers from developing countries. Second, most studies do not adequately meet the essential criteria of evidence reporting mentioned in the mobile health Evidence Reporting and Assessment checklist. Third, there is a dearth of application of design science–based methods and theory-based frameworks in developing mobile health interventions. Fourth, most of the mobile health interventions are not ready for interoperability and to be integrated into the existing health information systems. Based on these findings, we recommend for robust and inclusive study plans to deliver highly evidence-based reports by mobile health intervention studies that are conducted in the context of developing countries.


2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Robert Colebunders ◽  
Wilma A. Stolk ◽  
Joseph Nelson Siewe Fodjo ◽  
Charles D. Mackenzie ◽  
Adrian Hopkins

Abstract To achieve the elimination of onchocerciasis transmission in all African countries will entail enormous challenges, as has been highlighted by the active discussion around onchocerciasis intervention strategies and evaluation procedures in this journal. Serological thresholds for onchocerciasis elimination, adapted for the African setting, need to be established. The Onchocerciasis Technical Advisory Subgroup of the World Health Organization is currently developing improved guidelines to allow country elimination committees to make evidence-based decisions. Importantly, onchocerciasis-related morbidity should not be forgotten when debating elimination prospects. A morbidity management and disease prevention (MMDP) strategy similar to that for lymphatic filariasis will need to be developed. This will require collaboration between the onchocerciasis elimination program, the community and other partners including primary health and mental health programs. In order to reach the goal of onchocerciasis elimination in most African countries by 2025, we should prioritize community participation and advocate for tailored interventions which are scientifically proven to be effective, but currently considered to be too expensive.


2019 ◽  
Vol 4 (2) ◽  
pp. 238146831989628 ◽  
Author(s):  
Elisa Sicuri ◽  
Fadima Yaya Bocoum ◽  
Justice Nonvignon ◽  
Sergi Alonso ◽  
Bakar Fakih ◽  
...  

Background. The World Health Organization has recommended pilot implementation of a candidate vaccine against malaria (RTS,S/AS01) in selected sub-Saharan African countries. This exploratory study aimed to estimate the costs of implementing RTS,S in Burkina Faso, Ghana, Kenya, Mozambique, and Tanzania. Methods. Key informants of the expanded program on immunization at all levels in each country were interviewed on the resources required for implementing RTS,S for routine vaccination. Unit prices were derived from the same sources or from international price lists. Incremental costs in 2015 US dollars were aggregated per fully vaccinated child (FVC). It was assumed the four vaccine doses were either all delivered at health facilities or the fourth dose was delivered in an outreach setting. Results. The costs per FVC ranged from US$25 (Burkina Faso) to US$37 (Kenya) assuming a vaccine price of US$5 per dose. Across countries, recurrent costs represented the largest share dominated by vaccines (including wastage) and supply costs. Non-recurrent costs varied substantially across countries, mainly because of differences in needs for hiring personnel, in wages, in cold-room space, and equipment. Recent vaccine introductions in the countries may have had an impact on resource availability for a new vaccine implementation. Delivering the fourth dose in outreach settings raised the costs, mostly fuel, per FVC by less than US$1 regardless of the country. Conclusions. This study provides relevant information for donors and decision makers about the cost of implementing RTS,S. Variations within and across countries are important and the unknown future price per dose and wastage rate for this candidate vaccine adds substantially to the uncertainty about the actual costs of implementation.


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