Preparedness for Mitigating Noncommunicable Diseases in Gaindakot Municipality, Nepal: Perspectives of Key informants

2021 ◽  
Vol 6 (1) ◽  
pp. 1320-1324
Author(s):  
Narayan Sapkota ◽  
Damaru Prasad Paneru
Keyword(s):  
Health System ◽  
Health Workforce ◽  
Prevention And Control ◽  
Local Level ◽  
Building Blocks ◽  
Health System Strengthening ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Screening Services ◽  
And Control

Introduction: Non-communicable Diseases (NCDs) are the major public health problem that leads to high morbidity and mortality in the world including Nepal. Government of Nepal has launched the Multi-sectoral NCD Action Plan in 2014 and established NCD and Injuries Poverty Commission in 2016 for the management and control of NCDs nevertheless the implementation status and its outcomes are not identified till date at the local level. Objectives: To explore the preparedness of the local government for the prevention and control of NCDs at Gaindakot, Nawalpur, Nepal. Methodology: A qualitative study was conducted in the Gaindakot municipality; Nawalpur to document the key informant's perspectives on health system's preparedness to prevent the potential impacts of NCDs. Face to face Indepth interview was performed using open-ended questions. Interview guidelines were prepared on the basis of building blocks of health system. Information was processed basis on thematic analysis. Result: The study revealed that health section has NCD preparedness structure but need to strengthening for the better delivery of health services. The study highlights that screening services and the medicine for major NCDs like hypertension and diabetes were available at local level. Limited budget was allocated and health workforce was not trained for NCDs prevention and control. There was no reporting mechanism for NCD related data from local level. Conclusion: Basic medicine and screening services were provided from the local level to the selected NCDs such as hypertension and diabetes. There was no provision of reporting NCD related information and health workforce were not trained to respond NCDs. Local level health system strengthening is an urgent need to address the increasing burden of NCDs.  

scholarly journals Experiences of COVID-19 patients admitted in a government infectious disease hospital in Nepal and its implications for health system strengthening: A qualitative study

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261524
Author(s):  
Anup Bastola ◽  
Rolina Dhital ◽  
Richa Shah ◽  
Madhusudan Subedi ◽  
Pawan Kumar Hamal ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Qualitative Study ◽  
Service Delivery ◽  
Health System ◽  
Health Workforce ◽  
Building Blocks ◽  
Access To Medicines ◽  
Health System Strengthening ◽  
Positive Experiences ◽  
Disease Hospital

Introduction The COVID-19 pandemic has affected the health systems in many ways. It has put unprecedented strain on health systems worldwide and exposed gaps in public health infrastructure. A health system comprises all institutions and resources working towards improving and maintaining health. Among the different aspects of health system strengthening, a patient’s experiences and expectations play a crucial role in determining how well the health facilities function. This study aims to explore health system strengthening’s implications based on experiences and feedback provided by COVID-19 patients admitted to a government tropical and infectious disease hospital in Nepal. Methods In this qualitative study, we collected the voluntary handwritten feedback by the admitted COVID-19 patients to document the feedback and experiences from a book, maintained by the hospital. We performed thematic content analysis using the World Health Organization’s six building blocks of health system as a theoretical framework which included service delivery, health workforce, information, leadership and governance, financing, and access to medicines. Results Most patients in this study had positive experiences on service delivery and health workforce. Some also highlighted the gaps in infrastructure, cleanliness, and hygiene. Many suggested positive experiences on other dimensions of the health system such as financing, governance and leadership, and access to medicines reflected upon by the patients’ thankfulness to the hospital and the government for the treatment they received. The responses also reflected the inter-connectedness between the different building blocks of health system. Conclusion This study approached a unique way to strengthen the health system by exploring patients’ feedback, which suggested an overall positive impression on most building blocks of health system. However, it also highlighted certain gaps in infrastructure, cleanliness, and hygiene. It reinforces the hospital management and government’s role to continue its efforts to strengthen the health system.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

Construction and improvement of the public health system in conditions of normalization of epidemic prevention and control (on the example of PRC)

2021 ◽  
Vol 96 (3) ◽  
pp. 53-59
Author(s):  
D. Yang ◽  
Keyword(s):  
Public Health ◽  
Health System ◽  
Prevention And Control ◽  
Chinese Communist Party ◽  
Public Health System ◽  
Health And Safety ◽  
The Public ◽  
Control Of Epidemics ◽  
And Control ◽  
Great Victory

New coronavirus pneumonia has had a significant impact on people's health and safety since the outbreak in the early 2020. The latest version of the new coronavirus pneumonia virus is still spreading around the world. China's public health system has passed a severe test: under the leadership of the Chinese Communist Party and the joint efforts of people of all ethnic groups, China won a great victory in the anti-epidemic campaign. Nevertheless, the public health system has also identified some challenges that need to be actively addressed in the area of medicine and health during the prevention and control of epidemics. This article deals with these issues.

scholarly journals ‘One Health’ Actors in Multifaceted Health Systems: An Operational Case for India

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 387
Author(s):  
Sandul Yasobant ◽  
Walter Bruchhausen ◽  
Deepak Saxena ◽  
Timo Falkenberg
Keyword(s):  
Health System ◽  
Prevention And Control ◽  
One Health ◽  
District Level ◽  
Network Density ◽  
Second Phase ◽  
Local Health ◽  
Zoonotic Infections ◽  
And Control ◽  
The City

The surging trend of (re)emerging diseases urges for the early detection, prevention, and control of zoonotic infections through the One Health (OH) approach. The operationalization of the OH approach depends on the contextual setting, the presence of the actors across the domains of OH, and the extent of their involvement. In the absence of national operational guidelines for OH in India, this study aims to identify potential actors with an attempt to understand the current health system network strength (during an outbreak and non-outbreak situations) at the local health system of Ahmedabad, India. This case study adopted a sequential mixed methods design conducted in two phases. First, potential actors who have been involved directly or indirectly in zoonoses prevention and control were identified through in-depth interviews. A network study was conducted as part of the second phase through a structured network questionnaire. Interest and influence matrix, average degree, network density, and degree of centralization were calculated through Atlas.Ti (ATLAS.ti Scientific Software Development GmbH, Berlin, Germany), UCINET (Analytic Technologies, Lexington, KY, USA) software. The identified actors were categorized based on power, administrative level (either at the city or district level), and their level of action: administrative (policy planners, managers), providers (physicians, veterinarians), and community (health workers, community leaders). The matrix indicated that administrative actors from the district level were ‘context setters’ and the actors from the city level were either ‘players’ or ‘subjects’. The network density showed a strength of 0.328 during the last outbreak of H5N1, which decreased to 0.163 during the non-outbreak situation. Overall, there was low collaboration observed in this study, which ranged from communication (during non-outbreaks) to coordination (during outbreaks). The private and non-governmental actors were not integrated into collaborative activities. This study concludes that not only collaboration is needed for OH among the sectors pertaining to the human and the animal health system but also better structured (‘inter-level’) collaboration across the governance levels for effective implementation.

scholarly journals Clean and Safe Healthcare Environment: Knowledge, Attitude, and Practice of Infection Prevention and Control among Health Workforce at North Showa Zone Oromiya Region

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Kemal Jemal ◽  
Ketema Gashaw ◽  
Tadele Kinati ◽  
Worku Bedada ◽  
Belete Getahun
Keyword(s):  
Health Workforce ◽  
Prevention And Control ◽  
Positive Attitude ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Healthcare Facilities ◽  
Control Practice ◽  
Study Participants ◽  
And Control ◽  
Knowledge Attitude And Practice

Background. Infection prevention and control practice (IPCP) is essential for healthcare safety and quality service delivery. The Ethiopian government has already put in place programs and initiatives for clean and safe healthcare facilities. However, in the North Showa Zone of the Oromiya Region, the infection prevention and control practice level was not well understood. Therefore, this study aimed to assess the knowledge, attitude, and practice of infection prevention and control practice among the health workforce (HWF) in North Shoa healthcare facilities (NSHCFs) environment. Methods. Healthcare facility-based cross-sectional study design was employed. Structured and pretested self-administered questionnaires were distributed for 373 health workforce. Three hospitals and six health centers were randomly selected, and the study participants were selected by systematic sampling technique. Data were entered into Epi-data version 3.5.2 and then exported to SPSS version 23 for analysis. Multivariable logistic regression was performed to determine the associated factors with infection prevention practice, and a p value of less than 0.05 was considered statistically significant. Results. A total of 361 (96.8%) health workforce responded to self-administered questionnaires. About 55.70% of study participants had good knowledge, 59.3% of them had a positive attitude, and 46.8% had a good infection prevention practice. Age category of 20–29(AOR = 4.08, 95%, CI = (1.97, 8.49)), female participants (AOR = 3.87, 95%, CI = (1.91, 7.86)), single participants (AOR = 3.89, 95%, CI = (1.92, 7.87)), having greater than ten years of working experience (AOR = 3.10, 95% CI = (1.19, 8.10)), positive attitude (AOR = 10.07, 95% CI = (4.82, 21.05)), and availability of water at working area (AOR = 2.27, 95% CI = (1.18, 4.35)) were significantly associated with good infection prevention practice. Conclusion. In this study, a significant number of health workers had low knowledge, negative attitudes, and poor infection prevention practices. Female participants, higher work experience, a positive attitude, and water availability in the healthcare facilities were positively associated with infection prevention and control practice. Healthcare facilities should be continued capacitating the health workforce on infection prevention and control measures and equipping health facilities with infection prevention materials.

Taking action on prevention and control of noncommunicable diseases in Bhutan by strengthening gross national happiness

2018 ◽  
Vol 4 (2) ◽  
pp. 46-50
Author(s):  
Gyambo Sithey ◽  
Anne Marie Thow ◽  
Jayendra Sharma ◽  
Karma Lhazin ◽  
Mu Li
Keyword(s):  
Risk Factors ◽  
Prevention And Control ◽  
Action Plan ◽  
Health Sector ◽  
Public Health Problem ◽  
Noncommunicable Diseases ◽  
Major Public Health Problem ◽  
Gross National Happiness ◽  
National Happiness ◽  
And Control

Noncommunicable diseases (NCDs) are major public health problem in Bhutan, accounting for 68% of total deaths. The growing epidemic of NCDs threatens the achievement of Gross National Happiness (GNH). NCDs are the results of complex interaction of social and economic risk factors and change in diet and lifestyle. Effective action to prevent and control these diseases requires a whole-of-government approach.In this paper we review new evidence to support political priority for NCDs in Bhutan. One third of the Bhutanese are overweight (33%) and hypertensive (35.7), and 6.4% are diabetic. The prevalence of modifiable risk factors is also very high. We also present the analysis of strategic policy opportunities for health sector to integrate the ‘Multisectoral national action plan for the prevention and control of NCDs, 2015-2020’ into policies across all relevant sectors. Our analysis has identified three specific opportunities for the health sector to engage strategically to strengthen action on NCDs and GNH, concurrently: 1) raising priority actions on NCDs within the existing GNH multisectoral committee, to achieve both health and happiness objectives; 2) identifying shared agenda between NCDs and GNH to achieve both health and happiness objectives; and 3) identifying shared GNH determinants between NCDs and GNH to enhance action on NCDs. Addressing NCDs aligns with the optimization of Gross National Happiness. It is imperative that the Government of Bhutan recognize that action on NCDs is an integral element for achieving GNH.

scholarly journals Advancing a Science for Sustaining Health: Establishing a Model Health District in Madagascar

2017 ◽  
Author(s):  
Matthew H. Bonds ◽  
Andres Garchitorena ◽  
Laura Cordier ◽  
Ann C. Miller ◽  
Margaret McCarty ◽  
...  
Keyword(s):  
Primary Care ◽  
Health System ◽  
Low Income ◽  
Building Blocks ◽  
International Standards ◽  
Health District ◽  
Health System Strengthening ◽  
Systems Research ◽  
Data Platform ◽  
Government District

AbstractObjectiveWe demonstrate a replicable model health district for Madagascar. The governments of many low-income countries have adopted health policies that follow international standards, and yet there are four hundred million people without basic access to primary care. Closing this global health delivery gap is typically framed as an issue of scale-up, accomplished primarily through integrating international donor funds with broad-based health system strengthening (HSS) efforts. However, there is no established process by which healthcare systems measure improvements at the point of service and how those, in turn, impact population health. There is no gold standard, equivalent to randomized trials of individual-level interventions, for health systems research. Here, we present a framework for a model district in Madagascar where national policies are implemented along with additional health system interventions to allow for bottom-up adaptation.SettingThe intervention takes place in a government district in Madagascar, which includes 1 district hospital, 20 primary care health centers, and a network of community health workers.InterventionThe program simultaneously strengthens the WHO’s six building blocks of HSS at all levels of the health system within a government district and pioneers a data platform that includes 1) strengthening the district’s health management information systems; 2) monitoring and evaluation dashboards; and 3) a longitudinal cohort demographic and health study of over 1,500 households, with a true baseline in intervention and comparison groups.ConclusionThe integrated intervention and data platform allows for the evaluation of system output indicators as well as population-level impact indicators, such as mortality rates. It thus supports field-based implementation and policy research to fill the know-do gap, while providing the foundation for a new science of sustaining health.Data Sharing StatementData can be made available upon request by [email protected].

scholarly journals Field Epidemiology Training Program Response to COVID-19 During a Conflict: Experience From Yemen

2021 ◽  
Vol 9 ◽  
Author(s):  
Abdulwahed Abduljabar Al Serouri ◽  
Yasser Ahmed Ghaleb ◽  
Labiba Anam Al Aghbari ◽  
Mohammad Abdullah Al Amad ◽  
Abdulhakem Sharaf Alkohlani ◽  
...  
Keyword(s):  
Public Health ◽  
Training Program ◽  
Health Workforce ◽  
Prevention And Control ◽  
Public Health Workforce ◽  
Infection Prevention And Control ◽  
Field Epidemiology ◽  
Effective Manner ◽  
And Control ◽  
Field Epidemiology Training Program

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and investigated in a timely and effective manner. During the COVID-19 pandemic, the Yemen FETP's response has been instrumental through participating in country-level coordination, planning, monitoring, and developing guidelines/standard operating procedures and strengthening surveillance capacities, outbreak investigations, contact tracing, case management, infection prevention, and control, risk communication, and research. As the third wave is circulating with a steeper upward curve than the previous ones with possible new variants, the country will not be able to deal with a surge of cases as secondary care is extremely crippled. Since COVID-19 prevention and control are the only option available to reduce its grave impact on morbidity and mortality, health partners should support the Yemen FETP to strengthen the health system's response to future epidemics. One important lesson learned from the COVID-19 pandemic, especially in the Yemen context and applicable to developing and war-torn countries, is that access to outside experts becomes limited, therefore, it is crucial to invest in building national expertise to provide timely, cost-effective, and sustainable services that are culturally appropriate. It is also essential to build such expertise at the governorate and district levels, as they are normally the first respondents, and to provide them with the necessary tools for immediate response in order to overcome the disastrous delays.

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