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

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.

scholarly journals Preoperative multidisciplinary program for bariatric surgery: a proposal for the Brazilian Public Health System

2017 ◽  
Vol 54 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Elinton Adami CHAIM ◽  
José Carlos PAREJA ◽  
Martinho Antonio GESTIC ◽  
Murillo Pimentel UTRINI ◽  
Everton CAZZO
Keyword(s):  
Public Health ◽  
Bariatric Surgery ◽  
Health System ◽  
Public Health System ◽  
Wound Dehiscence ◽  
Pulmonary Complications ◽  
Multidisciplinary Program ◽  
The Impact ◽  
Access To Surgery

ABSTRACT BACKGROUND Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program. RESULTS There were 176 individuals who underwent the multidisciplinary program and 226 who did not. Individuals who underwent the program had significantly lower occurrence of the following variables: hospital stay; wound dehiscence; wound infection; pulmonary complications; anastomotic leaks; pulmonary thromboembolism; sepsis; incisional hernias; eventrations; reoperations; and mortality. Both loss of follow-up and weight loss failure were also significantly lower in the program group. CONCLUSION The adoption of a comprehensive preoperative multidisciplinary approach led to significant improvements in the postoperative outcomes and also in the compliance to the postoperative follow-up. It represents a reproducible and potentially beneficial approach within the context of the Brazilian public health system.

scholarly journals If We Build It, Will They Come? Estimating the Need for Community-Based Palliative Care in a Public Health System (S708)

2018 ◽  
Vol 55 (2) ◽  
pp. 660
Author(s):  
Anne Kinderman ◽  
Heather Harris ◽  
Kathleen Kerr ◽  
Michael Rabow ◽  
Brian Cassel
Keyword(s):  
Public Health ◽  
Palliative Care ◽  
Health System ◽  
Public Health System ◽  
Community Based

Health strike is unlikely to shape Kenya national vote

2017 ◽  
Keyword(s):  
Public Health ◽  
Public Sector ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Content Type ◽  
The Public ◽  
General Elections ◽  
Slow Progress ◽  
National Settlement

Significance Public sector doctors have been on strike since early December citing multiple grievances including pay, conditions at facilities and lack of investment in the public health system. The bitter dispute is the latest in a series of public-sector strikes and comes amid campaigning for August’s general elections. Impacts Agreeing to the strikers' full demands would add pressure for higher salaries in private facilities and the public sector. A national settlement could slow progress towards full devolution of health responsibilities to the counties. Elite segments of society do not rely on the public health system and may be less sympathetic to health workers’ grievances.

scholarly journals The importance of strengthening public health systems based on primary health care in designing a successful vaccination strategy: an example of qualitative research in three regions of Senegal.

2019 ◽  
Author(s):  
Jacopo Bianchi ◽  
Chiara Milani ◽  
Angela Bechini ◽  
Sara Boccalini ◽  
Maria José Caldes Pinilla ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Conventional Medicine ◽  
Specific Information ◽  
The Public ◽  
Primary Health

Abstract Background Because of its low cost and its capability in reducing child mortality and morbidity, vaccination is considered a successful preventive deed in Low and Middle-Income Countries. In Senegal, vaccines are provided free of charge by the public health system, but the provision of the service is not evenly distributed between and within the Regions. Our study aimed at identifying barriers and enabling factors towards vaccination in three Regions of Senegal. Methods We performed 41 face-to-face semi-structured interviews with health services’ workers and three focus groups with local women in nine different structures in three different Regions of Senegal. We combined health workers’ (HW) and mothers’ points of view with direct observation in order to fulfill our purpose. Results We identified three groups of barriers – structural, personal and psychological – and many subthemes for each of them. Structural and personal barriers such as inadequacy of health structures, shortage of HW, lack of money, distance between villages and health facilities and lack of public transport, hamper mothers from utilising the vaccination service, even when they want to. The lack of effective communication between health personnel and mothers, the lack of collaboration between traditional and conventional medicine and the lack of trust in the public health system as a whole, are major problems to the vaccination uptake too. Conclusions The interlink of several elements in conditioning vaccination coverage suggests the need of implementing global and national strategies to overcome them. The key factor is the presence of a solid health system, publicly funded, based on primary health care. On the other hand, context-specific determinants cannot be detected based on global and non-specific information. The role of community health workers (CHWs) is crucial in overcoming wrong beliefs, lack of knowledge and distrust. They must be regarded as a bridge between HW and population. CHWs should be formally included in the organization of the social-health system, adequately formed and enhanced.

scholarly journals Pemberian Edukasi Tentang Hipertensi Dengan Media WhatsApp Blast Di Puskesmas Dadok Tunggul Hitam Kota Padang

2021 ◽  
Vol 3 (1) ◽  
pp. 113
Author(s):  
Annisa Novita Sary
Keyword(s):  
Public Health ◽  
Health Education ◽  
Health Center ◽  
Health Workers ◽  
Communicable Disease ◽  
Public Health Center ◽  
The Public ◽  
Post Test ◽  
Level Of Knowledge ◽  
Non Communicable Disease

ABSTRAK Hipertensi merupakan penyakit tidak menular yang menjadi salah satu penyebab utama kematian di dunia. Berdasarkan data Puskesmas Dadok Tunggul Hitam terdapat kasus dengan diagnosa hipertensi sebanyak 5.587 jiwa (2018) meningkat menjadi 6.367 jiwa (2019). Salah satu intervensi yang dapat dilakukan yaitu pemberian edukasi tentang hipertensi. Kegiatan dilaksanakan di Puskesmas Dadok Tunggul Hitam pada bulan September 2020. Kegiatan diawali dengan pemberian pre test untuk melihat tingkat pengetahuan masyarakat tentang penyakit hipertensi, kemudian pemberian edukasi kesehatan tentang penyakit hipertensi. Pelaksanaan penyuluhan kesehatan dilaksanakan dengan memberikan edukasi terkait hipertensi kepada masyarakat melalui media Whatsapp Blast, dan diakhiri dengan post test untuk mengukur peningkatan pengetahuannya. Hasil dari kegiatan pengabdian masyarakat terhadap pasien yang terdiagnosis penyakit hipertensi dari 15 orang pasien terdapat 5 orang (33%) memiliki tingkat pengetahuan yang baik tentang hipertensi sebelum diberikan penyuluhan. Setelah diberikan penyuluhan secara daring melalui media Whatsapp Blast  dari 15 orang pasien terdapat 12 orang (80%) memiliki pengetahuan yang baik tentang hipertensi dan upaya pencegahannya. Dapat disimpulkan adanya pengingkatan pengetahuan tentang upaya pencegahan hipertensi setelah diberikan edukasi dengan media Whatsapp Blast. Disarankan agar pemberian edukasi dengan media Whatsapp Blast dapat dilakukan bagi petugas kesehatan dalam memberikan promosi kesehatan kepada masyarakat tentang pencegahan penyakit hipertensi.Kata Kunci: Hipertensi; media whatsapp blast; edukasi  ABSTRACT                                                                                          Hypertension is a non-communicable disease which is one of the main causes of death in the world. Based on data from the Public Health Center Dadok Tunggul Hitam, there were cases of hypertension from 5,587 people (2018), increase to 6,367 people (2019). The intervention from this case by providing education about hypertension. The activity was carried out at the Public Health Center Dadok Tunggul Hitam in September 2020. The activity started by giving a pre test about hypertension, then providing health education about hypertension. The health education is delivered through the Whatsapp Blast media, and ends with a post test. The results of the activities for patients diagnosed with hypertension, from 15 patients there were 5 patients (33%) who had a good level of knowledge before given education. After given education through Whatsapp Blast media, there were 12 patients (80%) who had good knowledge about hypertension and its prevention efforts. It can be concluded that there is an increase in knowledge about hypertension and prevention after given education through Whatsapp Blast media. It is suggested that education using Whatsapp Blast media can be carried out for health workers in providing health promotion to the public regarding the prevention of hypertension.Keywords: Hypertension; whatsapp blast media; education 

Abstract MP64: Estimated Impact Of Public Health System Reforms To Increase Hypertension Treatment Coverage In India

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Matti Marklund ◽  
Rajeev Cherukupalli ◽  
Priya Pathak ◽  
Dinesh Neupane ◽  
Ashish Krishna ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Health Workers ◽  
Scale Up ◽  
System Reform ◽  
Task Sharing ◽  
Treatment Coverage ◽  
The Public ◽  
The Status

Background: Approaches to scale up hypertension (HTN) treatment are needed in India, where only ~10% of individuals with HTN have controlled blood pressure. Objective: Estimate the current HTN treatment capacity of the public health system in India and model the effects of selected health system reform options. Methods: Using constrained optimization models, we estimated the HTN treatment capacity and salary costs of HTN-treating staff within the public health system; and simulated the potential effects of 1) increased workforce, 2) greater task sharing, and/or 3) reduced visit frequency (quarterly) vs the common practice of monthly visits for prescription refills. Results: An estimated 8% of all adults with HTN could be treated in the status quo (current number of health workers, no further task sharing, and monthly visits) (Figure). Treating 70% of adults with HTN with monthly visits without greater task sharing could require an additional 1.6 million staff, with ~200 billion ₹ (≈US$2.7 billion)) in additional annual salaries. Greater task sharing was estimated to allow the current workforce to treat ~25% of individuals with HTN with monthly visits. Quarterly visits (i.e., longer prescription periods) together with greater task sharing could allow the current workforce to treat ~70% of patients with HTN in India. Conclusion: Expanding HTN treatment coverage through workforce expansion alone will require substantial human and financial resources. The combination of greater task sharing and quarterly visits could increase the coverage of HTN treatment to ~70% of adults with HTN in India, without any expansion of the current workforce of the public health system.

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