scholarly journals Equity and the Cuban National Health System's response to COVID-19

2021 ◽  
Vol 45 ◽  
pp. 1
Author(s):  
Pedro Mas Bermejo ◽  
Lizet Sánchez Valdés ◽  
Lorenzo Somarriba López ◽  
Nelly Cristina Valdivia Onega ◽  
María Josefina Vidal Ledo ◽  
...  
Keyword(s):  
National Health ◽  
National Health System ◽  
Health Coverage ◽  
First Case ◽  
National Mortality ◽  
The Government ◽  
And Control ◽  
Universal Protocol ◽  
Principle Of Territoriality

Cuba’s National Health System has managed to guarantee an effective and equitable response to COVID-19. Universal and free health coverage, based on primary care, follows the principle of equity and the greatest resources are allocated to areas of the lowest socioeconomic stratum (where higher risk is concentrated), followed by those of medium and high strata, in that order. This allowed for similar mortality rates in the three strata, and Cuban national mortality rate was one of the lowest in the Region of the Americas. Before the first case was identified in Cuba, a Plan for Coronavirus Prevention and Control was elaborated with multisectoral participation, and when the first case was confirmed the Temporary National Working Group to Fight COVID-19 was created as an advisory body of the government. The actions to face the pandemic began with preventive measures in the community, continued in the isolation centers and ended again in the community with actions of surveillance and follow up of recovered patients. Following the principle of territoriality, molecular diagnosis laboratories were created in the provinces that did not have one. Free medical care and treatment; the preparation of a single national intersectoral government plan; the use of particular strategies for research, diagnosis and case tracing; and the implementation of a universal protocol for disease prevention and treatment of confirmed cases made it possible to control the disease with a health equity perspective.

scholarly journals Time trends in physical activity of adult users of the Brazilian National Health System: 2010-2014. Longitudinal study

2017 ◽  
Vol 135 (4) ◽  
pp. 369-375 ◽  
Author(s):  
Bruna Camilo Turi ◽  
Jamile Sanches Codogno ◽  
Rômulo Araújo Fernandes ◽  
Kyle Robinson Lynch ◽  
Eduardo Kokubun ◽  
...  
Keyword(s):  
Physical Activity ◽  
Longitudinal Study ◽  
Health System ◽  
National Health ◽  
Time Trends ◽  
Economic Status ◽  
National Health System ◽  
Sports Participation ◽  
Male Sex

ABSTRACT CONTEXT AND OBJECTIVE: In this longitudinal study, we aimed to describe time trends of physical activity (PA) in different domains from 2010 to 2014 among users of the Brazilian National Health System, taking into account the effects of sex, age and economic status (ES). DESIGN AND SETTING: Longitudinal study conducted in five primary care units in Bauru (SP), Brazil. METHODS: The sample was composed of 620 men and women who were interviewed in 2010, 2012 and 2014. The same group of researchers conducted the interviews, using the questionnaire developed by Baecke et al. Scores for occupational, exercise/sport, leisure-time/transportation and overall PA were considered in this longitudinal survey. Time trends of PA over the four years of follow-up were assessed according to sex, age and ES. RESULTS: We found that after four years of follow-up, the reduction in overall PA (-13.6%; 95% confidence interval, CI = -11.9 to -15.3) was statistically significant. Additionally, declines in the occupational domain and exercise/sports participation were affected by age, while the reduction in overall PA was affected by sex, age and ES. CONCLUSIONS: Overall PA decreased significantly from 2010 to 2014 among these outpatients of the Brazilian National Health System, and age and male sex were important determinants of PA in its different domains.

scholarly journals Early transmission dynamics of SARS-CoV-2 in Indonesia

2021 ◽  
Vol 1 (1) ◽  
pp. 1-6
Author(s):  
Mudatsir Mudatsir ◽  
Synat Keam ◽  
Wira Winardi ◽  
Amanda Yufika ◽  
Ali A. Rabaan ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Capital City ◽  
Transmission Dynamics ◽  
Disease Surveillance System ◽  
First Case ◽  
Directorate General ◽  
The Government ◽  
And Control ◽  
Importation Risk

The objective of this study was to determine the transmission dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to evaluate the vigilance of the health system during the early phase of coronavirus disease 2019 (COVID-19) outbreak in Indonesia. The early epidemiology and transmission chains of COVID-19 were analyzed based on data from the Directorate General of Disease Prevention and Control of the Indonesian Ministry of Health. The results of this study shown although Indonesia is a country with a high relative importation risk of SARS-CoV-2, the first two cases of COVID-19 were identified on March 2, 2020. This relatively late date by regional standards raises the possibility of undetected cases beforehand. The first case was a foreigner citizen who visited the capital city of Jakarta and later was diagnosed COVID-19 after returning from Indonesia. One week later after the first case, 27 confirmed COVID-19 cases had been reported in Indonesia, and the majority of the cases were clustered together. Apart from the possibility of underdetection of COVID-19 cases in the country, the government has strengthened the disease surveillance system and established an outbreak preparedness system to diagnose and control COVID-19. 

scholarly journals The belated implementation of a long-awaited health system in Cyprus and the role of interest groups

2021 ◽  
Vol 9 (7) ◽  
Author(s):  
Denise Alexandrou ◽  
Marios Kantaris ◽  
Mamas Theodorou
Keyword(s):  
Health System ◽  
Interest Groups ◽  
National Health System ◽  
Insurance Companies ◽  
Health Coverage ◽  
The European Union ◽  
The Media ◽  
Path Dependent ◽  
The Government ◽  
Political Economic

It is really a paradox that 60 years were required to establish a modern health system in Cyprus, despite the expressed positive attitude οf all political parties and most governments. This article investigates the planning and implementation of the National Health System (NHS) and its delay determinants, by employing qualitative research of published sources, audio material and 33 interviews with elite key informants. A major anti-reform alliance, consisting of private doctors, private hospitals and health insurance companies was identified, further supported by doctors of the “old” public system, whose benefits were threatened. Delay contributions additionally arose from media and patient groups, whilst the pharmaceutical sector imposed insignificant influence. Τhe prevailing political, economic and social environment, along with aspects of the proposed reform, fueled this anti-reform movement. However, climate in favour of the NHS implementation gradually developed, attributed to the power balance shift supportingthe Minister of Health and the government, mobilization of important actors/stakeholders, including the Federation of Patients' Organizations of Cyprus and the Media, and significant decrease in the influence of reform-resistant groups. The new dynamics created a supportive environment leading to the NHS launch on June 1st, 2019; thus Cyprus has ceased to be the last state of the European Union (EU) without a universal health coverage system. The process of introducing this new system in Cyprus is a prime example of resource and power redistribution amongst different interest groups and of the catalysts required to exit the orbit of an extremely “path-dependent” system, potentially inspiring future reformers.

scholarly journals Overview of COVID-19 Response in Kaduna State, Nigeria, March-July 2020

2020 ◽  
Author(s):  
Gregory Umeh ◽  
Dauda Milgwe Madubu
Keyword(s):  
Action Plan ◽  
Northern Region ◽  
Infection Prevention And Control ◽  
Point Of Entry ◽  
First Case ◽  
National Guidance ◽  
The Face ◽  
The Government ◽  
And Control ◽  
Emergency Operating

The last six months have seen concerted efforts by government, development partners, communities, and individuals to contain the spread of the COVID-19 pandemic. COVID-19 has wreaked havoc in all the continents, from Asia, Europe, Africa, America to Australia. Nigeria recorded its first case of COVID-19 on 27 February 2020. Kaduna State, the former headquarters of the defunct northern region, with a total population of 10 million citizens, has recorded 1,457 confirmed cases and 21 deaths of COVID-19 as of 31 July 2020.In line with the national guidance, Kaduna State activated the COVID-19 Emergency Operating Centre (EOC) with the confirmation of a case to coordinate the response. The EOC developed an Incident Action Plan (IAP) with nine strategic pillars, including coordination, surveillance, and epidemiology, Infection Prevention and Control (IPC), case management, risk communication, logistics and supplies, laboratory, the point of entry, and research. COVID-19 is real, has maimed citizens, and claimed many lives. The economic, social, and human losses are enormous, and recession stares us in the face. We have no cure or vaccines to deal with the pandemic yet, so prevention and adherence to proven measures by citizens, corporate organizations, and the government to stem the incidence of the virus must be accepted as the new way of living. The challenges are daunting, but consultation, cooperation, and communication among citizens, corporate organizations, and government remain essential to finding the strength, resolve, and shared purpose to cultivate useful guidelines and measures to keep individuals, organizations and government running.

scholarly journals A Mathematical Model of COVID-19 Using Fractional Derivative: Outbreak in India with Dynamics of Transmission and Control

2020 ◽  
Author(s):  
Amjad S. Shaikh ◽  
Iqbal N. Shaikh ◽  
Kottakkaran Sooppy Nisar
Keyword(s):  
Mathematical Model ◽  
Fixed Point Theory ◽  
Control Strategies ◽  
Real Data ◽  
Control Measures ◽  
Approximation Technique ◽  
Transform Method ◽  
First Case ◽  
The Government ◽  
And Control

Since the first case of 2019 novel coronavirus disease (COVID-19) detected on Jan 30, 2020, in India, the number of cases rapidly increased to 3819 cases including 106 deaths as of 5 April 2020. Taking this into account, in the present work, we are studying a Bats-Hosts-Reservoir-People transmission fractional-order COVID-19 model for simulating the potential transmission with the thought of individual social response and control measures by the government. The real data available about infectious cases from $14^{th}$ March to $26^{th}$ March 2020 is analysed and accordingly various parameters of the model are estimated or fitted. The Picard successive approximation technique and Banach's fixed point theory have been used for verification of the existence and stability criteria of the model. Numerical computations are done utilizing the iterative Laplace transform method. In the end, we illustrate the obtained results graphically. The purpose of this study is to estimate the effectiveness of preventive measures, predicting future outbreaks and potential control strategies using the mathematical model.

scholarly journals Challenges to effective governance in a low income healthcare system: a qualitative study of stakeholder perceptions in Malawi

2020 ◽  
Author(s):  
Sarah C Masefield ◽  
Alan Msosa ◽  
Jean Grugel
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Health System ◽  
National Health ◽  
Low Income ◽  
Service Providers ◽  
Health Sector ◽  
National Health System ◽  
Low Income Countries ◽  
Health Coverage

Abstract BackgroundAll countries face challenging decisions about healthcare coverage. Malawi has committed to achieving Universal Health Coverage (UHC) by 2030, the timeframe set out by the Sustainable Development Goals (SDGs). As in other low income countries, scarce resources stand in the way of more equitable health access and quality in Malawi. Its health sector is highly dependent on donor contributions, and recent poor governance of government-funded healthcare saw donors withdraw funding, limiting services and resources. The 2017 National Health Plan II and accompanying Health Strategic Plan II identify the importance of improved governance and strategies to achieve more effective cooperation with stakeholders. This study explores health sector stakeholders’ perceptions of the challenges to improving governance in Malawi’s national health system within the post-2017 context of government attempts to articulate a way forward.MethodsA qualitative study design was used. Interviews were conducted with 22 representatives of major international and faith-based non-government organisations, civil society organisations, local government and government-funded organisations, and governance bodies operating in Malawi. Open questions were asked about experiences and perceptions of the functioning of the health system and healthcare decision-making. Content relating to healthcare governance was identified in the transcripts and field notes and analysed using inductive content analysis.ResultsStakeholders view governance challenges as a significant barrier to achieving a more effective and equitable health system. Three categories were identified: accountability (enforceability; answerability; stakeholder-led initiatives); health resource management (healthcare financing; drug supply); influence in decision-making (unequal power; stakeholder engagement).ConclusionsHealth sector stakeholders see serious political, structural, and financial challenges to improving governance in the national health system in Malawi which will impact the government’s goal of achieving UHC by 2030. Stakeholders identify the need for improved oversight, implementation, service delivery and social accountability of government-funded service providers to communities. Eighteen months after the introduction of the policy documents, they see little evidence of improved governance and have little or no confidence in the government’s ability to deliver UHC. The difficulties stakeholders perceive in relation to building equitable and effective healthcare governance in Malawi have relevance for other resource-limited countries which have also committed to the goal of UHC.

scholarly journals Compare the epidemiological and clinical features of imported and local COVID-19 cases in Hainan, China

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Biao Wu ◽  
Zi-Ying Lei ◽  
Kun-Liang Wu ◽  
Jian-Rong He ◽  
Hui-Juan Cao ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Effective Management ◽  
Igg Antibodies ◽  
Viral Shedding ◽  
First Case ◽  
Epidemic Period ◽  
Imported Cases ◽  
Concurrent Infections ◽  
And Control

Abstract Background Effective management of imported cases is an important part of epidemic prevention and control. Hainan Province, China reported 168 coronavirus disease 2019 (COVID-19), including 112 imported cases on February 19, 2020, but successfully contained the epidemic within 1 month. We described the epidemiological and clinical characteristics of COVID-19 in Hainan and compared these features between imported and local cases to provide information for other international epidemic areas. Methods We included 91 patients (56 imported and 35 local cases) from two designated hospitals for COVID-19 in Haikou, China, from January 20 to February 19, 2020. Data on the demographic, epidemiological, clinical and laboratory characteristics were extracted from medical records. Patients were followed until April 21, 2020, and the levels of antibodies at the follow-ups were also analysed by the Wilcoxon matched-pairs signed ranks test. Results Of the 91 patients, 78 (85.7%) patients were diagnosed within the first three weeks after the first case was identified (Day 1: Jan 22, 2020), while the number of local cases started to increase during the third week. No new cases occurred after Day 29. Fever and cough were two main clinical manifestations. In total, 15 (16.5%) patients were severe, 14 (15.4%) had complicated infections, nine (9.9%) were admitted to the intensive care unit, and three died. The median duration of viral shedding in feces was longer than that in nasopharyngeal swabs (19 days vs 16 days, P = 0.007). Compared with local cases, imported cases were older and had a higher incidence of fever and concurrent infections. There was no difference in outcomes between the two groups. IgG was positive in 92.8% patients (77/83) in the follow-up at week 2 after discharge, while 88.4% patients (38/43) had a reduction in IgG levels in the follow-up at week 4 after discharge, and the median level was lower than that in the follow-up at week 2 (10.95 S/Cut Off (S/CO) vs 15.02 S/CO, P <  0.001). Conclusion Imported cases were more severe than local cases but had similar prognoses. The level of IgG antibodies declined from week 6 to week 8 after onset. The short epidemic period in Hainan suggests that the epidemic could be quickly brought under control if proper timely measures were taken.

Perioperative Antibiotic Prophylaxis in Spanish Hospitals: Results of a Questionnaire Survey

1999 ◽  
Vol 20 (6) ◽  
pp. 436-439 ◽  
Author(s):  
Carles Codina ◽  
Antoni Trilla ◽  
Nuria Riera ◽  
Montserrat Tuset ◽  
Xavier Carne ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Questionnaire Survey ◽  
National Health System ◽  
Surgical Site Infections ◽  
Surveillance Systems ◽  
Perioperative Antibiotic Prophylaxis ◽  
Spanish Hospital ◽  
Surveillance Programs ◽  
And Control

AbstractA questionnaire survey was sent to a random sample of the Spanish network of National Health System public acute-care hospitals. Of responding institutions (representing 25% of Spanish hospital beds), nearly 75% had active surveillance programs for the prevention and control of surgical-site infections (SSIs), but only 20% performed postdischarge surveillance. Overall, perioperative antibiotic prophylaxis (PAP) was used in 84% of all surgical procedures. For 77% of procedures, there were written guidelines for the choice and use of PAR Cefazolin was the most commonly used antibiotic (38%). Duration of PAP was shorter than 24 hours in 75% of procedures, and only a single dose was given in 52% of procedures. PAP was commonly used in breast (52%) and inguinal hernia repair (69%) procedures, as well as in laparoscopic abdominal surgery (86%). In summary, the use of PAP in Spanish hospitals is adequate, but improvements can be made in the frequency of prolonged PAP and in the use of broad-spectrum antibiotics. Surveillance systems for SSI, including postdischarge follow-up, also should be improved.

scholarly journals Multifocal meningioangiomatosis in a 3-year-old patient

2012 ◽  
Vol 10 (6) ◽  
pp. 486-489 ◽  
Author(s):  
Osama Jamil ◽  
Shakti Ramkissoon ◽  
Rebecca Folkerth ◽  
Edward Smith
Keyword(s):  
Pediatric Population ◽  
Unique Case ◽  
First Case ◽  
And Control ◽  
The Brain

Meningioangiomatosis consists of benign hamartomatous lesions of the brain and the leptomeninges, which typically present with seizure. Management is predicated on resection and control of seizures with medication. Lesions are typically solitary. Multifocal meningioangiomatosis is extremely rare, with only 2 cases reported in adults and none in children. The authors report the first case, to their knowledge, of multifocal meningioangiomatosis in a child. This unique case highlights therapeutic challenges associated with these lesions and demonstrates that multifocality is possible in the pediatric population. This finding has implications for diagnosis and follow-up for children afflicted with these tumors.

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