scholarly journals HEALTH SECTOR DECENTRALIZATION AND ITS IMPLICATION TO HEALTH SERVICES IN INDONESIA

2019 ◽  
Vol 10 (1) ◽  
pp. 1-14
Author(s):  
Aderia Rintani ◽  
Adik Wibowo
Keyword(s):  
Health Status ◽  
Local Government ◽  
Health Services ◽  
Health Sector ◽  
Health Resources ◽  
Community Empowerment ◽  
Health Systems Management ◽  
Meta Analyses ◽  
Screening Result ◽  
Outcome Result

Background: After more than a decade, in what way decentralization has affected health service and population health status in Indonesia, is still partly known. This paper aims to review about to what extent the health sector decentralization has affected health services in Indonesia, especially in access and health systems management. Methods: We conducted systematic search studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).  We search for relevant studies using keywords ‘decentralization’ OR ‘decentralisation’ AND ‘(public health)’ AND ‘effect’ OR ‘impact’ AND ‘reform’ AND ‘(health inequalities)’ AND ‘Indonesia’ on electronic sources Proquest, Science Direct, and EBSCOHost.  The articles then filtered using pre determined criterias and duplication removal. Results:  Database search resulting on 628 articles in Proquest, 0 articles in Science Direct, and 13 articles in EBSCOHost. The screening result were 5 eligible articles. We found equality of access in health services were jeopardized by fragmented health services and worsen health disparities among districts that occured after decentralization.  This worsen gap between the most developed provinces of Java-Bali and those of other island groupings affected the community’s health status.  Low local government’s capacity in planning, managing  and utilizing health resources were the most reported evidence in decentralized health system. Conclusion: This study concludes that good capacity of local government, coordination and monitoring system between central and local government, partnership with private sectors and community empowerment are essential to achieve better health outcome result in decentralized Indonesia. Keywords: Decentralization, Health Services, Health Policy, Indonesia

scholarly journals A Study On Health Status Of Children Under Five Years Of Age In A Rural Village Of Eastern Part Of Nepal

2013 ◽  
Vol 2 (1) ◽  
pp. 49-54
Author(s):  
Dewa Adhikari
Keyword(s):  
Health Status ◽  
Health Services ◽  
Skin Diseases ◽  
Health Resources ◽  
Sampling Technique ◽  
Control Measures ◽  
Treatment Preference ◽  
Cross Sectional ◽  
Faith Healer ◽  
Under Five

Introduction: Every needy child should receive the best medical and surgical attention. In 1940, the White house Conference proposed adequate health services including medical and dental examination, immunization and early detection and treatment of diseases, vision and hearing tests, prevention and control of disease, health records and health services facilities. Objectives: To assess the health status of under five children. To know the treatment preference of the parents towards their sick children. To initiate control measures early, by allocating the health resources more efficiently and providing health awareness activities. Materials and Methods: Descriptive cross-sectional study was conducted. The entire 1-5 years age child (40children) residing in Dharan Municipality ward. No-17 at Phoklen Tapu was included. Simple random sampling technique (lottery method) was used to select the village and Census survey technique was followed to find out the 1-5 years children. The survey was conducted by investigator herself and self develop tools were used to health status of the child. Results: Most of the morbid conditions founded in the study were related to skin diseases (ring worm, boils/wound, cuts, eczema/ redness), ear infection, enlarged lymph node, Pneumonia, Diarrhoea/ vomiting, abdominal enlargement and malnutrition with different Grade. Conclusion: Majority of the parent were not having health education regarding child care. The treat their child with home remedies, by faith healer then after third time they seek sick child with health personnel. Journal of Nobel Medical College Vol. 2, No.1 Issue 3 Nov.-April 2013 Page 49-54 DOI: http://dx.doi.org/10.3126/jonmc.v2i1.7676

scholarly journals Equity in the Distribution of Health Resources: A Case Study in Southeast Iran

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Mohammad Khammarnia ◽  
Hesam Ghiasvand ◽  
Fateme Javadi ◽  
Fatemeh Safdari Adimi
Keyword(s):  
Health Status ◽  
Gini Index ◽  
Health Workers ◽  
Healthcare Providers ◽  
Health Sector ◽  
Health Resources ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional

Background: Equity in the distribution of equipment and resources in the health sector constitutes one of the main dimensions of justice, improving health status and increasing people's satisfaction. Objectives: The current study aimed at determining how health resources and equipment are distributed in the poorest region of Iran. Methods: The current retrospective, cross-sectional study was performed in Sistan and Baluchistan Province, as the poorest region of Iran, in 2020. Data were collected using a standard checklist from all five health centers affiliated to Zahedan University of Medical Sciences (ZAUMS). Excel and STATA software was used for data analysis; the Gini index was also calculated. Results: The Gini index for the distribution of midwives and rural health workers was equitable (0.216 and 0.287, respectively). The distribution of urban healthcare providers, nutrition and psychology counselors, and active beds in ZAUMS were 0.675, 0.545, 0.454, and 0.526, respectively. The distribution of general practitioners, based on the Gini index (0.492), was not fair. Also, the distribution of specialists and nurses was unfair (Gini index: 0.494 and 589, respectively). Conclusions: The distribution of most resources in the poorest region of Iran was not fair. Unfair distribution and disparities can affect population health status in the future. Then, it is suggested that health policymakers and managers pay more attention to deprived regions.

scholarly journals Health Empowerment: Health Service Strategies to Poor Community Around Conserved Forest

2019 ◽  
Vol 4 (8) ◽  
pp. 45-53
Author(s):  
Muria Herlina
Keyword(s):  
High School Students ◽  
Health Services ◽  
Health Sector ◽  
Community Empowerment ◽  
Access To Health Services ◽  
School Students ◽  
Health Empowerment ◽  
Access To Health ◽  
School Senior ◽  
Service Strategies

This research was done in Central Bengkulu District, in suburbs of Semidang Bukit Kabu within conserved forest area. Poverty and isolation were the causes of low access to health services. This weakness requires a strategy through health empowerment. This research purpose was to explore the benefits of community empowerment activities in health as healthy house renovation, doctors visiting to village and free medical treatment and integrated service for elderly by Community Economic Zone (CEZ)-CSR PT. Pertamina. It uses qualitative method to produce descriptive data on public health phenomena related to forests society. There were 11 informants selected by purposive sampling. The data was collected by observation, in-depth interviews and FGD. The research found that informants were elementary school-senior high school students, aged 21-57 years, and came from the Rejang and Serawai tribes, work as coffee plantation farmers, oil palm plantation cultivators and coal vehicle drivers. Their income was IDR 150,000 up to IDR 275,000 per week. The family member were 4-6 person, most of them had semi-permanent and permanent houses, legacy from parent or rent. Diseases often found were hypertension, rheumatic, malaria/typhoid, diabetes, dyspepsia, respiratory diseases, dermatitis, and common cold. The research found that most of them supported the health empowerment program, with various phenomena and meanings from informants. The poor in conserved forest areas need health services through community empowerment in health sector.

scholarly journals IMPLEMENTASI PROGRAM DAN ALTERNATIF STRATEGI MENURUNKAN ANGKA KEMATIAN BAYI BERBASIS SOSIAL BUDAYA

2019 ◽  
Vol 10 (1) ◽  
pp. 33-50
Author(s):  
Yulfira Media
Keyword(s):  
Health Promotion ◽  
Content Analysis ◽  
Infant Mortality ◽  
Health Services ◽  
Swot Analysis ◽  
Health Resources ◽  
Community Empowerment ◽  
Social Culture ◽  
Alternative Strategies ◽  
West Sumatra

Abstract Background: One of the problems and strategic issues of regional development in West Sumatra Province is the high infant mortality rate (IMR). Objective: an overview of the implementation of programs and constraints related to maternal and child health services and the formulation of alternative strategies for reducing socio-cultural based IMR. Methods: The study was conducted in 10 districts/cities in West Sumatra Province with qualitative methods. Research informants: mothers with infant mortality cases; pregnant women/child; traditional birth attendant; public figure; stake holders. Research themes; program implementation; performance coverage and constraints; alternative strategies to reduce IMR based on social culture. Data analysis with content analysis and SWOT analysis. Results: Barriers to the implementation of programs/activities to reduce IMR are: low access to health services; socio-cultural problems in the utilization of health services. Alternative efforts to reduce IMR based on socio-culture through health promotion strategies and community empowerment as well as strengthening the capacity of health resources that have the competency and based on local socio-culture. Conclusion: Socio-cultural barriers in West Sumatra are still limited knowledge, the existence of habits and community beliefs related to maternal/child health. The results of the SWOT analysis as an alternative strategy are health promotion and community empowerment and strengthening the capacity of health resources that have the competence and are based on local socio-culture. Key words: strategy, social culture, infant mortality Abstrak Latar Belakang: Salah satu masalah dan isu srategis pembangunan daerah Provinsi Sumatera Barat adalah masih tingginya Angka Kematian Bayi (AKB). Tujuan: gambaran pelaksanaan program dan hambatan terkait pelayanan kesehatan ibu dan anak serta perumusan alternatif strategi upaya penurunan AKB berbasis sosial budaya. Metode: Penelitian dilaksanakan pada 10 Kabupaten/Kota di Provinsi Sumatera Barat dengan metode kualitatif (Focus Group Discussion, wawancara mendalam dan observasi). Informan penelitian: ibu dengan kasus kematian bayi; ibu hamil/balita; dukun beranak; tokoh masyarakat; dan pemegang program. Tema penelitian; pelaksanaan program/kegiatan; output kinerja program dan hambatannya; alternatif strategi dalam upaya menurunkan AKB berbasis sosial budaya. Analisis data dengan content analysis dan analisis SWOT. Hasil: Hambatan pelaksanaan program/kegiatan penurunan AKB adalah: belum optimalnya akses layanan kesehatan; masalah sosial budaya dalam pemanfaatan pelayanan kesehatan ibu dan anak. Alternatif upaya penurunan AKB berbasis sosial budaya melalui strategi promosi kesehatan dan pemberdayaan masyarakat serta penguatan kapasitas sumber daya kesehatan yang mempunyai kompetensi dan berbasis sosial budaya lokal. Kesimpulan: Hambatan sosial budaya di Sumatera Barat adalah masih terbatasnya pengetahuan, adanya kebiasaan serta kepercayaan masyarakat terkait dengan kesehatan ibu/bayi. Hasil analisis SWOT sebagai strategi alternatif adalah promosi kesehatan dan pemberdayaan masyarakat dan penguatan kapasitas sumber daya kesehatan yang mempunyai kompetensi serta berbasis sosial budaya lokal.   Kata kunci: strategi, sosial budaya, kematian bayi

scholarly journals A STUDY ON INTER-STATE DISPARITIES IN PUBLIC HEALTH EXPENDITURE AND ITS EFFECTIVENESS ON HEALTH STATUS IN INDIA

2018 ◽  
Vol 6 (2) ◽  
pp. 54-64
Author(s):  
L. Ganesan ◽  
R. Senthamizh Veena
Keyword(s):  
Public Health ◽  
Health Status ◽  
Health Services ◽  
Universal Health Coverage ◽  
Health Expenditure ◽  
Health Sector ◽  
Health Coverage ◽  
The People ◽  
Universal Health ◽  
Inter State

Public health services play an important role in the health status of the people and Health Expenditure by the Government occupies crucial part in influencing the health outcome in the country. The healthcare finances are influenced by the respective State's budgetary allocation which leads to inter-state disparity in health services and health status in India. This has implications on providing Universal Health Coverage, which aims at ensuring equitable health services to people at all levels in the country (National Health Portal, GoI). The researcher has selected 15 major states based on the level of population (which accounts for about 90 percent of the total population in India) to analyse the inter-state disparities in health sector. Alongside, this study focuses on the performance of public health sector of the selected states through a comparative analysis of various parameters depicting health expenditure, availability of health services, their utilization and health outcomes. With vast variation in the availability, affordability and utilisation of health services across different states, it is found that the economic conditions, health finance, infrastructure and effectiveness of health services at the state level have direct bearing on the health status of the people in the respective states. Therefore, it is essential to take necessary corrective measures that target the disparity, to achieve better and equitable health services for all, leading to Universal Health Coverage which is the real inclusiveness.

scholarly journals Child Health Status of Nepal: Social Exclusion Perspective

2009 ◽  
Vol 29 (2) ◽  
pp. 79-84 ◽  
Author(s):  
Gagan Gurung
Keyword(s):  
Health Status ◽  
Child Health ◽  
Health Services ◽  
Social Exclusion ◽  
Social Groups ◽  
Health Sector ◽  
Childhood Mortality ◽  
Child Health Services ◽  
Wealth Status ◽  
Child Health Status

Introduction: Nepal has achieved a spectacular success in child health over the last decades but the achievement is not uniform across different social groups. Therefore, there is urgent need to identify the groups who are excluded from access of child health services which would give us population at risk to prioritize and utilize the scarce resources available in health sector more effectively and efficiently. Methods: The study was descriptive type and was based on review of secondary data of different studies done in past. The study used World Bank framework of dimension of exclusion to analyze social exclusion in child health in Nepal. The health differentials in child health across different social groups were analyzed using simple descriptive analysis like percentage and ratios. The trends of the child health disparities over the ten years were done comparing the data of NFHS1996 and NDHS 2006. Results: The study showed there were disparities in child health status by ethnicity, location, wealth status. In most of the cases, the trends of disparities are increasing for mortality indicators and malnutrition status. Interestingly, the gaps in accessibility indicators of child health services are becoming narrowed down. Conclusion: This study showed the discrepancies in child health status in different social groups. The inequality in childhood mortality and malnutrition are increasing over the period for different groups where as it is decreasing for accessibility indicators of childhood health services. Key words: Child health status, inequality, social exclusion, social groups.   doi: 10.3126/jnps.v29i2.2044 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.79-84

A Socio-ecological Framework for Understanding Workplace Violence in China’s Health Sector: A Qualitative Analysis of Health Workers' Responses to an Open-ended Survey Question

2020 ◽  
pp. 088626052098038
Author(s):  
Dan Wu ◽  
Yun Wang ◽  
Sheng Zhi Yang ◽  
Nan Wang ◽  
Kai Sing Sun ◽  
...  
Keyword(s):  
Law Enforcement ◽  
Health Services ◽  
Workplace Violence ◽  
Health Workers ◽  
Health Sector ◽  
Health Resources ◽  
Organizational Level ◽  
Ecological Framework ◽  
Law Enforcement Agencies ◽  
Survey Question

Workplace violence (WPV) in the health sector is a global public health issue. The magnitude of WPV is a particular concern in China’s health system. To examine the potential causes of WPV, we analyzed 3,045 qualitative responses to an open-ended question in a survey with health workers in the Zhejiang province, China. We adapted a four-level socio-ecological framework (societal/systemic, community/organizational, interpersonal, and individual) to thematically analyze the data. Ten sub-themes emerged. Within the societal/systemic level, we identified three sub-themes: (a) lack of legislation against WPV, (b) suboptimal accessibility and affordability of health services due to maldistributed health resources, commercialized health services, and inadequate health insurance, and (c) unregulated mass media reports. Within the community/organizational level, three sub-themes emerged: (a) lack of supportive health facility leadership, (b) inaction by government authorities, and (c) inefficient law enforcement agencies. Within the interpersonal level, two sub-themes were identified: (a) poor provider–patient communication and (b) distrust between health workers and patients. Finally, we identified the personal characteristics of health workers (e.g., competence and professionalism) and patients (e.g., sociodemographic background and expectations/satisfaction) as two individual-level sub-themes. We recognized interactions among different levels. The weak state of Chinese legislation in this area and lack of high-level political will and guidance (societal/systemic) has left health facilities and law enforcement agencies (community/organizational) unclear about how to address WPV. The maldistribution of quality health resources (societal/systemic) has led to overcrowded outpatient clinics at higher-level care facilities (community/organizational). In light of the insufficient government funding and profit-oriented health services (societal/systemic), health workers were motivated to seek profits by providing unnecessary services, which compromised their professionalism (individual). Provider–patient relationships deteriorated (interpersonal), and patients sometimes held unrealistically high expectations associated with high medical expenses (individual). We propose multisectoral prevention strategies to address WPV in the health sector at all levels using a socio-ecological framework.

PELATIHAN DETEKSI DINI GANGGUAN JIWA PADA KADER KESEHATAN DI DESA BUGANGAN KABUPATEN PEKALONGAN

2021 ◽  
Vol 2 (1) ◽  
pp. 35
Author(s):  
Hana Nafiah ◽  
Aisyah Dzil Kamalah
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Early Detection ◽  
Health Services ◽  
Community Service ◽  
Mental Health Problems ◽  
Health Sector ◽  
Health Resources ◽  
Primary Care Level ◽  
Service Activity

Mental disorders still become an important issue in the health sector. Problems related to mental health in the community include knowledge, stigma and mental health services. Health resources in Indonesia still has various limitation, and integrating primary services so an effort that can be solve is to integrate primary services. One of the efforts that can be made at the primary care level is the formation of mental health cadres. Health cadres need to be given training in an effort to improve cadres' abilities to manage health services, especially to providing health education directly to the surrounding community. Community service activities carried out were training on early detection of mental disorders for 25 health cadres in Bugangan Village. Cadre knowledge about mental disorders increased 28% and cadres were able to know how to do early detection of mental disorders. The output of this community service activity is the formation of mental health cadres capable of early detection of mental disorders in the community. The next community service activity is expected to be able to screening the results of early detection of the community in as a form of preventive measures for risk groups.Key words: early detection; mental health cadres; mental health problems  

Health Cadres Commitmentin Child Health Care in Moslem Society of Banyumas District

2016 ◽  
Vol 1 ◽  
pp. 60-65
Author(s):  
Umi Solikhah ◽  
Hari Kusnanto ◽  
Fitri Haryanti
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Services ◽  
Group Discussion ◽  
Community Empowerment ◽  
Child Health Services ◽  
Child Health Care ◽  
Minimum Requirements ◽  
Social Esteem ◽  
The Government

Community empowerment with regard to maternal and child health services at the community level carried out by cadre.Cadre is health volunteers, selected by the community.404 number of active cadres in primary health care of South Purwokerto entirely female, although it may be a cadre of men. Active cadre toddler actively providing services every month for child before 5 years age. Interest to know the various reasons committed cadres in performing their duties. The method used is qualitative study,to describe a variety of reasons commitment to perform cadre duties in child health care. Retrieving data using interview techniques through the focus group discussion. Data from 30 cadres.Results of interviews taken until the data saturation, as a reason believed by cadres in the commitment to carry out tasks of serving the Muslim community. Characteristic respondent are mean of age 38 years (the youngest age of 25 years and the oldest 55 years old), a 100% Islamic religion, level of education majority of senior high school(at least primary school). Educational level health cadres in Banyumas has met the minimum requirements by the WHO.Results of the analysis showed thatcommitment includes a cadre of dedicated, caring community, a desire to learn, social esteem, individual satisfaction, togetherness, organization, and spirituality. The spirit of cadre to the community need the attention of the government for development and prosperity in accordance with their duties.Spiritual reasons become one of the motivations in providing health services to the community, albeit to a spirit of dedication and a great desire to learn. Cadres continue to provide services, even to families with different spiritual.

Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Healthcare Provision ◽  
The Public ◽  
Public Health Sector ◽  
The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

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