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

2022 ◽  
Vol 05 (01) ◽  
Author(s):  
Oladeji Olusola ◽  
Elmi Farah Abdifatah ◽  
Robins Ann
Keyword(s):  
Health Services ◽  
Safety Net ◽  
Missed Opportunities ◽  
Somali Region

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

2021 ◽  
Author(s):  
Olusola Oladeji ◽  
Abdifatah Elmi Farah ◽  
Ann Robins
Keyword(s):  
Health Services ◽  
Large Scale ◽  
Social Protection ◽  
Main Tool ◽  
Safety Net ◽  
Cross Sectional ◽  
Somali Region ◽  
Health And Nutrition ◽  
Nutrition Service ◽  
Public Work

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.

Abstract 17207: Impact of Racial Differences in Treatment Intensification and Missed Visits on Disparities in BP Control

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Valy Fontil ◽  
Lucia Pacca ◽  
Brandon Bellows ◽  
Elaine Khoong ◽  
Charles McCulloch ◽  
...  
Keyword(s):  
Racial Differences ◽  
San Francisco ◽  
Structural Equation ◽  
Safety Net ◽  
Clinic Visit ◽  
Treatment Intensification ◽  
Missed Opportunities ◽  
Black Patients ◽  
Missed Visits ◽  
Equitable Treatment

Introduction: Hypertensive black patients have the lowest rates of blood pressure (BP) control. It is unknown to what extent variation in healthcare processes like treatment intensification (TI) and missed visits explain this disparity. Hypothesis: We hypothesized there would be no racial differences in TI but missed visits would be more frequent among black patients and mediate a sizable percentage of BP control disparities. Methods: We used a structural equation multivariate regression model to estimate the likelihood of BP control (BP<140/90 mm Hg) in black vs. white hypertensive patients, mediated by TI and missed visits. We included 6,556 patients who had diagnosis of hypertension and at least one clinic visit with uncontrolled BP (≥140/90 mm Hg) in 12 safety-net clinics in San Francisco from 2015-2017.We used the standard-based method (SBM), which is predictive of BP control, to calculate TI (dose increase or medication addition). We measured missed visits as the number of “no-shows” in the four weeks after an uncontrolled BP. BP control was defined based on the most recent BP as of Nov 15, 2017. The model adjusted for gender, age, first recorded BP between Jan 2015 and Nov 2017, visit frequency, and diagnosis of diabetes. Results: The mean (SD) age was 57.0 (11.2), 41% were female, and 44% were black. Compared to whites, blacks had more missed opportunities for TI (β=-0.02, p<0.001) and missed more visits (β=0.37, p<0.001). After accounting for these differences, black patients remained less likely than whites to achieve BP control (β=0.16, OR=0.85, 95% CI=0.76-0.95). The indirect effect of decreased TI and missed visits accounted for 22% and 13% of the total effect of black race on BP control, respectively (Figure). Conclusion: Racial inequities in treatment intensification may be responsible for over 20 percent of racial disparities in hypertension. Efforts to ensure more equitable treatment intensification may reduce black-white disparities in BP control.

scholarly journals 2286

2017 ◽  
Vol 1 (S1) ◽  
pp. 14-14
Author(s):  
William G. Adams ◽  
Michael Mendis ◽  
Shiby Thomas ◽  
David Center ◽  
Sara Curran
Keyword(s):  
Health Services Research ◽  
Health Services ◽  
Community Health ◽  
Comparative Effectiveness ◽  
Large Scale ◽  
Safety Net ◽  
Services Research ◽  
Patient Level Data ◽  
Patient Level ◽  
Level Data

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.

scholarly journals Health Budgeting at Woreda level and Effect on Access and Quality of Health Services in Somali Region of Ethiopia

2021 ◽  
Vol 9 (1) ◽  
pp. 118-126
Author(s):  
Oladeji Olusola
Keyword(s):  
Health Care ◽  
Health Services ◽  
Active Participation ◽  
Regional Level ◽  
Great Effort ◽  
Care Providers ◽  
Major Barrier ◽  
Somali Region ◽  
Budgeting Process

Ethiopia has made a great effort in recent years to improve maternal, newborn, child health outcomes, however, the uptake of services in Somali Region of the country is still very low. The study was a cross-sectional descriptive survey using qualitative methods, and the participants were key individuals involved in the management of health systems and knowledgeable about on health service delivery in the study sites. The study aimed to explore the budgeting process at the woreda (district) level and its effect on the utilization of equitable quality health services in the region. The woreda health officers determined what is included in the budget of the health facilities without active participation of stakeholders such as health care providers or the community members. Their knowledge and understanding of the planning and budgeting processes varied and little or no support available to them. This suboptimal budgeting process impacts negatively on the quality of health care services being provided, with shortages of essential drugs identified as a major barrier affecting utilization. The need for better budgeting process at the woreda level which could perhaps involve a range of regional level, woreda level and citizen level measures and active participation. This include the implementation of clearer guidelines from regional level, maybe the introduction of standard formulae that ensures that each health centre receives certain percent of overall health budget and specific percentage to be allocated for drugs and supplies and other essential services instead of each woreda official deciding on how much is to allocated arbitrarily.

scholarly journals Behavior and major barriers faced by non-injectable drug users with HBV/HCV seeking treatment for hepatitis and drug addiction in Rio de Janeiro, Brazil

2011 ◽  
Vol 16 (12) ◽  
pp. 4777-4786 ◽  
Author(s):  
Monica Malta ◽  
Sabine Cavalcanti ◽  
Louis Gliksman ◽  
Edward Adlaf ◽  
Mariana de Andrea Vilas-Boas Hacker ◽  
...  
Keyword(s):  
Health Services ◽  
Rio De Janeiro ◽  
Drug Users ◽  
Addiction Treatment ◽  
Educational Background ◽  
Treatment Seeking ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Hepatitis Treatment

Drug users (DU) are a marginalized group and at risk for viral hepatitis, who seldom access health services. A cross-sectional survey was conducted with 111 DU with chronic HBV/HCV and 15 in-depth interviews with health professionals/policymakers in Rio de Janeiro, Brazil. Most interviewees were male, non-white, with a low educational background, unemployed and/or living on less than $245 a month (minimun wage). In the last 6 months, 61.8% of interviewees snorted cocaine, 64.7% at least once a week. Half of the interviewees had a stable partner and 38.3% of those with occasional partners never/almost never using condoms. Addiction treatment seeking was found to be associated with: being white (OR:5.5), high-school degree (OR:8.7), and employment (OR:5.7). Hepatitis treatment seeking was high (80.9%), and access to low-threshold, user-friendly health services was key for treatment seeking behaviors (OR:3.6). Missed opportunities for hepatitis treatment seem to be associated with structural (uneven political/financial support to hepatitis programs) and patient-related barriers (severe addiction and non-adherence). Those most in need were less likely to access treatment, calling for renewed strategies, in order to curb hepatitis among impoverished drug users and their sexual partners.

Mental health services for homeless mentally ill people

2012 ◽  
pp. 1500-1502
Author(s):  
Tom K. J. Craig
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Mentally Ill ◽  
Safety Net ◽  
Multidisciplinary Teams ◽  
Urban Mental Health ◽  
Homeless Mentally Ill

Specialist multidisciplinary teams for homeless mentally ill people provide an essential safety net for those who have fallen out of the wider mental health care system. They offer distinct advantages in terms of their capacity to work across traditional geographical and bureaucratic barriers, to take the longer-term view of the task of engagement, and to bring together the multiple strands of care across different provider agencies. Introduced as a temporary measure over a decade ago, they are still with us and likely to remain a permanent fixture of urban mental health care.

scholarly journals Fixing the Canadian Species at Risk Act: identifying major issues and recommendations for increasing accountability and efficiency

FACETS ◽  
2021 ◽  
Vol 6 ◽  
pp. 1474-1494
Author(s):  
Audrey Turcotte ◽  
Natalie Kermany ◽  
Sharla Foster ◽  
Caitlyn A. Proctor ◽  
Sydney M. Gilmour ◽  
...  
Keyword(s):  
At Risk ◽  
Safety Net ◽  
Species At Risk ◽  
Government Accountability ◽  
Missed Opportunities ◽  
Species Protection ◽  
Inclusive Approach ◽  
Legislative Amendments ◽  
Species At Risk Act ◽  
Risk Protection

Since the implementation of the Canadian Species at Risk Act (SARA) in 2003, deficiencies in SARA and its application have become clear. Legislative and policy inconsistencies among responsible federal agencies and the use of a subjective approach for prioritizing species protection lead to taxonomic biases in protection. Variations in legislation among provinces/territories and the reluctance of the federal government to take actions make SARA’s application often inefficient on nonfederally managed lands. Ambiguous key terms (e.g., critical habitat) and disregard for legislated deadlines in many steps impede the efficacy of SARA. Additionally, the failure to fully recognize Indigenous knowledge and to seek Indigenous cooperation in the species protection process leads to weaker government accountability, promotes inequity, and leads to missed opportunities for partnerships. New legislative amendments with well-defined and standardized steps, including an automatic listing process, a systematic prioritization program, and clearer demands (e.g., mandatory threshold to trigger safety net/emergency order) would improve the success of species at risk protection. Moreover, a more inclusive approach that brings Indigenous representatives and independent scientists together is necessary for improving SARA’s effectiveness. These changes have the potential to transform SARA into a more powerful act towards protecting Canada’s at-risk wildlife. (The graphical abstract follows.)

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