scholarly journals Determinants of Accessibility of Hypertensive Drugs by Adult Patients Under Sustainable Development Goal Three in Nairobi City County, Kenya

2021 ◽  
Vol 5 (4) ◽  
pp. 108-119
Author(s):  
Dianah Kathambi Riungu ◽  
Patrick Mbataru
Keyword(s):  
Data Collection ◽  
Communicable Disease ◽  
Health Facilities ◽  
Public Hospitals ◽  
Adult Patients ◽  
Essential Medicines ◽  
Uncontrolled Hypertension ◽  
Hypertensive Patients ◽  
Essential Drugs ◽  
Medication Intake

Hypertension is noted to be the easiest non-communicable disease to diagnose treat and monitor if proper health systems are put in place to ensure hypertensive drugs are accessible to hypertensive patients who need them daily. It is estimated that prevalence rate of hypertension in Kenya range from 13 % to 50 % and only 1 in 5 of the diagnosed are on hypertensive medicines. Lack of medication intake leads to uncontrolled hypertension resulting to more serious health complications which result to premature deaths. Previous studies have provided little information on the determinants of hypertensive drugs accessibility to patients. An enquiry on the availability of hypertensive drugs in public hospitals is worthwhile because hypertension has become an important social problem. This study has investigated the determinants of accessibility of hypertensive drugs by adult patients who are supposed to have uninterrupted medication intake for a healthy living. The concept of essential drugs was adopted for this study. This concept of essential drugs contained essential medicines list (EML) and the eight elements of primary health care of 1978 with a goal to ensure equal access to medicines. Descriptive design has been adopted for the study. The targeted population of 6329 hypertensive patients in public health facilities within Nairobi County. Yamane formula was used to get the sample size, which will be a total of 394 patients. Systemic random sampling procedure was employed for the study. A questionnaire tool of data collection was used for data collection. The collected data was there after coded and analyzed using Statistical Package for Social Sciences (SPSS) both for descriptive statistics (frequencies and percentages) and inferential statistics (correlation analysis). Data is presented using pie charts tables and figures. The study revealed that accessibility of medication in Nairobi city county health facilities is contributed by lack of medication in the facilities.

Magnitude of Uncontrolled Hypertension and Associated Factors among Adult Hypertensive Patients in Public Hospitals of Central Zone, Tigray, Ethiopia: A Cross-sectional Study 2018

2019 ◽  
Author(s):  
Assefa Iyasu Negash ◽  
Desta Siyoum ◽  
Tsega Hailemariam ◽  
Berihu Hailu Kidanu ◽  
Gebreamlak Gebremdhin Gebremeskel ◽  
...  
Keyword(s):  
Antihypertensive Medication ◽  
Multivariable Analysis ◽  
Central Zone ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Uncontrolled Hypertension ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Co Morbidity

Abstract Background: - Uncontrolled hypertension is if SBP is ≥140 mm Hg and/or DBP ≥90 mm Hg for general hypertensive population or if SBP ≥130 mm Hg and/or DBP ≥80 mm Hg in patients with established diabetes mellitus or chronic kidney disease based on the average of two or more properly measured, seated, BP readings on each of two or more office visits. The aim of this study was to assess the magnitude of uncontrolled hypertension and associated factors among adult hypertensive patients in public hospitals of central zone, Tigray, Ethiopia, 2018. Methods:- A hospital based cross sectional study design was used. The study population was all sampled adult hypertensive patients who had follow up in public hospitals of central zone, Tigray and the data collection period was from March 01 to April 30, 2018. About 421 study participants were selected using systematic random sampling. Interviewer administered structured questionnaire, chart review checklist and measurements were used. The collected data was checked for its completeness manually and then entered and cleaned in to epi data version 3.1 and exported to Statistical packages for social science version 22 for analysis. Bivariate and multivariable analyses were done to identify factors of uncontrolled hypertension. Then those variables significant at p<0.25 with the outcome variable in bivariate analysis were selected for multivariable analysis and odds ratio with 95% confidence level was computed and p-value < 0.05 was described as a significant association in multivariable analysis. Result: - Among 421 respondents about 177(42%) had uncontrolled hypertension. Co-morbidity [AOR=0.36, (0.205, 0.631)], five to ten years duration of medication taken [AOR=0.398, (0.218, 0.725)], side effect of medication [AOR=0.542, (0.339, 0.866)] and medication adherence [AOR=4.092, (2.419, 6.924)] were significantly associated with uncontrolled hypertension. Conclusion: - In this study the magnitude of uncontrolled hypertension was high. Co-morbidity, antihypertensive medication taken for long duration, side effect of antihypertensive medication and non adherence to antihypertensive medication shows statistical association with uncontrolled hypertension.

scholarly journals Assesssment of Health Facilities for Implementation of Package of Essential Non-communicable Disease in Nepal: Baseline Study in Kailali and Ilam District

2018 ◽  
Vol 16 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Binod Kumar Aryal ◽  
Mohammad Daud ◽  
Ambika Thapa ◽  
Anita Mahotra ◽  
Sudip Ale Magar ◽  
...  
Keyword(s):  
Health Workers ◽  
Communicable Disease ◽  
Action Plan ◽  
Descriptive Analysis ◽  
Health Facilities ◽  
Essential Medicines ◽  
World Health ◽  
Cross Sectional ◽  
Baseline Study ◽  
Non Communicable Disease

Background: Non-communicable Diseases are an alarming public health emergency in Nepal. Owing to the risk of NCD’s in Nepal, Government of Nepal has developed a Multisectoral Action Plan for Non-communicable Disease 2014-2020 and has adopted the World Health Organization Package of Essential Non-communicable Disease protocol. Prior for its implementation in Nepal, baseline study has been carried out to assess the status of health facilities in Nepal.Methods: A descriptive cross-sectional study was carried out in Kailali and Ilam district encompassing a total of 92 health facilities. A set of structured questionnaire and interview guideline was used to obtain the data. Collected data was transferred to Microsoft Excel, cleaned and analyzed in SPSS 16.0. Descriptive analysis was performed to express the frequencies and relative frequencies Results: Of the total health facilities, 49 and 43 health facilities of Ilam and Kailali were interviewed. The hospital of Ilam consisted all the procedure, equipment and medicine for the management of NCDs whilst, health posts lacked Oxygen services. Only 592 posts were fulfilled out of 704 sanctioned post in both the districts of which only 161 were trained in management of NCDs. Atotal of 231 patients were diagnosed with NCDs before the day of study in all the health facilities of both districts. Conclusions: Study reveals the gaps in capacity of health institution and system in terms of training, supply, equipments, and diagnostics. However, training of health workers, supply of essential medicines and improvising the service delivery would supplement the effective implementation of PEN in Nepal.

scholarly journals Structural Quality of Labour and Delivery Care in Government Hospitals of Ethiopia: A Descriptive Analysis

2021 ◽  
Author(s):  
Negalign B Bayou ◽  
Liz Grant ◽  
Simon C Riley ◽  
Elizabeth H Bradley
Keyword(s):  
Health Facilities ◽  
Public Hospitals ◽  
Sub Saharan Africa ◽  
Structural Quality ◽  
Delivery Care ◽  
Essential Drugs ◽  
Laboratory Services ◽  
Government Hospitals ◽  
Safe Blood

Abstract Background Ethiopia has low skilled birth attendance rates coupled with low quality of care within health facilities contributing to one of the highest maternal mortality rates in Sub-Saharan Africa, at 412 deaths per 100,000 live births. There is lack of evidence on the readiness of health facilities to deliver quality labour and delivery (L&D) care. This paper describes the structural quality of routine L&D care in government hospitals of Ethiopia. Methods A facility-based cross-sectional study design, involving census of all government hospitals in Southern Nations Nationalities and People’s Region (SNNPR) (N = 20) was conducted in November 2016 through facility audit using a structured checklist. Data collectors verified the availability and functioning of the required items through observation and interview with the heads of labour and delivery case team. An overall mean score of structural quality was calculated considering domain scores such as general infrastructure, human resource and essential drugs, supplies, equipment and laboratory services. Summary statistics such as proportion, mean and standard deviation were computed to describe the degree of adherence of the hospitals to the standards related to structural quality of routine labour and delivery care. Results One third of hospitals had low readiness to provide quality routine L&D care, with only two approaching near fulfilment of all the standards. Hospitals had fulfilled 68.5% of the standards for the structural aspects of quality of L&D care. Of the facility audit criteria, the availability of essential equipment and supplies for infection prevention scored the highest (88.8%), followed by safety, comfort and woman friendliness of the environment (78.9%). Availability skilled health professionals and quality management practices scored 72.5% each, while availability of the required items of general infrastructure was 64.6%. The two critical domains with the lowest score were availability of essential drugs, supplies and equipment (52.2%); and laboratory services and safe blood supply (50%). Conclusion Substantial capacity gaps were observed in the hospitals challenging the provision of quality routine L&D care services, with only two thirds of required resources available. The largest gaps were in laboratory services and safe blood, and essential drugs, supplies and equipment. The results suggest the need to ensure that all public hospitals in SNNPR meet the required structure to enable the provision of quality routine L&D care with emphases on the identified gaps.

scholarly journals Uncontrolled Hypertension among Treated Hypertensive Patients

2018 ◽  
pp. 12-16 ◽  
Author(s):  
Al-Aghbari Khaled ◽  
Bamashmoos Mohammed ◽  
Askar Faiza
Keyword(s):  
Left Ventricular Hypertrophy ◽  
Renal Impairment ◽  
Ventricular Hypertrophy ◽  
Demographic Data ◽  
Laboratory Data ◽  
Left Ventricular ◽  
Adult Patients ◽  
Blood Cholesterol ◽  
Uncontrolled Hypertension ◽  
Hypertensive Patients

Objectives: To determine the prevalence of uncontrolled hypertension among Yemeni hypertensive patients on treatment. Methods: Cross sectional study was conducted among hypertensive adult patients presented to a private cardiac center in Sana’a from January to December 2016. All adult patients diagnosed to have hypertension for at least 3 months prior to the interview were included in this study. Each patient was clinically examined by training doctor on arrival to clinic and then every 3 months. The examination included; personal history, blood pressure, and through cardiovascular examination and recorded. Demographic data, special habits, body mass index, medication used and other laboratory data were registered. Collected data was coded and enter into Pc for statistical analysis. Results: The total number of patient with hypertension (HTN) presented into Cardiac Centre were 277. Of them 187 (67.5%) Were males and 90 (32.5%) were females, their age was ranged from 27 to 100 year with mean age of 57.5 ± 12.3. 61 patients (22.0%) had stage I hypertension (HTN) and stage II (HTN) was found in 182 Patients (65.7%). Of the total cases target BP controlled was achieved in 34 patients (12.3%). Several risk factors have been significantly associated with uncontrolled hypertension and these were; ischemic heart disease, elder age, left ventricular hypertrophy and renal impairment. There were no significant association between uncontrolled hypertension and other variables (Gender, Qat chewing, BMI, duration of hypertension and associated disease as diabetes mellitus, Cerebrovascular accident, medications & blood cholesterol level). Conclusion: Prevalence of uncontrolled hypertension was high in individuals with concomitant hypertension and comorbidity factors. IHD, renal impairment aging and left ventricular hypertrophy are the most important determinants of uncontrolled hypertension.

scholarly journals A Study on Service Availability and Readiness Assessment of Non-Communicable Diseases Using the WHO Tool for Gazipur District in Bangladesh

2016 ◽  
Vol 7 (2) ◽  
pp. 1-13 ◽  
Author(s):  
Mohammad Rashemdul Islam ◽  
Shamima Parvin Laskar ◽  
Darryl Macer
Keyword(s):  
Respiratory Disease ◽  
Chronic Respiratory Disease ◽  
Communicable Diseases ◽  
Health Facilities ◽  
Essential Medicines ◽  
Service Availability ◽  
Diabetes Diagnosis ◽  
Cross Sectional ◽  
Non Communicable Diseases ◽  
Service Readiness

Non-communicable diseases (NCDs) disproportionately affect low and middle-income countries where nearly three quarters of NCD deaths occur. Bangladesh is also in NCD burden. This cross-sectional study was done on 50 health facilities centres at Gazipur district in Bangladesh from July 2015 to December 2015 to introduce SARA for better monitoring and evaluation of non-communicable diseases health service delivery. The General Service readiness index score was 61.52% refers to the fact that about 62% of all the facilities were ready to provide general services like basic amenities, basic equipment, standard precautions for infection prevention, and diagnostic capacity and essential medicines to the patients. But in case of non-communicable diseases, among all the health facilities 40% had chronic respiratory disease and cardiovascular diseases diagnosis/ management and only 32% had availability of diabetes diagnosis/management. Overall readiness score was 52% in chronic respiratory disease, 73% in cardiovascular disease and 70% in diabetes. Therefore, service availability and readiness of the health facilities to provide NCD related health services were not up to the mark for facing future targets.  A full-scale census survey of all the facilities of the study area would give a better understanding of the availability and service readiness.

scholarly journals Pengaplikasian Metode Activity Based Costing Pada Perhitungan Unit Cost di Pelayanan Kesehatan Gigi dan Mulut

2020 ◽  
Vol 8 (2) ◽  
pp. 101-110
Author(s):  
Rika Irma Yanti ◽  
Febrian Febrian ◽  
Desy Purnama Sari
Keyword(s):  
Data Collection ◽  
Dental Health ◽  
Unit Cost ◽  
Health Facilities ◽  
Financial Accounting ◽  
Cost Calculation ◽  
Activity Based Costing ◽  
Accounting Data ◽  
Dental Clinics ◽  
Cost Calculations

Dental clinic is one type of privateowned service enterprise providing dental and oral health services. In the current global era, dental clinics must be able to compete with other dental health facilities. Dental clinics are required to manage effectively clinical management, especially in financial accounting. Unit cost calculation using Activity Based Costing (ABC) method is a modern calculation. It has been implemented in several health facilities. The basic concept of ABC is a product derived from activities that will consume costs. The purpose of this paper is to provide an overview of the application of unit cost calculations with ABC in dental clinics. So it can formulated four steps of unit cost calculation with ABC as follows: preparation of data collection, data collection, ABC calculation of the first stage, ABC calculation of the second stage. The results of the calculation of unit cost with ABC are clinical financial accounting data which are used as a consideration in making desicion of the clinical strategy.

scholarly journals EVALUATION OF THE EFFECT OF CORONAVIRUS PANDEMIC ON SUPPLY CHAIN OF HIV TEST KITS ONDO STATE, SOUTHWEST NIGERIA

2021 ◽  
Vol 6 (9) ◽  
pp. 34-78
Author(s):  
Michael Olabode Tomori ◽  
Funmilayo Adenike Fadiji
Keyword(s):  
Supply Chain ◽  
Data Analysis ◽  
Communicable Disease ◽  
Primary Objective ◽  
Health Facilities ◽  
Least Square ◽  
National Guidelines ◽  
Cross Sectional ◽  
Hiv Test ◽  
Ondo State

COVID-19 pandemic has required swift revamping of health systems and public health measures at a scale never observed. The pandemic emergence has a direct effect on the health system, negatively affecting its capacity as depletion of resources are now channelled to curb the emergency of the communicable disease, especially among individuals living with HIV disease which drew our attention to how individuals suffering from HIV and people who needed to know their HIV status has not been able to visit the health facilities due to the effect of coronavirus pandemic on the supply of the test kits used in the health facilities. This study evaluated the effect of the coronavirus pandemic on the supply chain of HIV test kits in Ondo State, Nigeria. The primary objective was to determine the effect of the coronavirus pandemic on the supply of HIV test kits in Ondo State. The research was a sequential cross-sectional design using a quantitative method of analysis with a total sample size of 100 respondents with all samples drawn from 30 supported health facilities in the state. In addition, literature review was also used to know the effect of the coronavirus on reach of 95% of UNAIDS 2030 target. The study used both descriptive and inferential methods of data analysis where the descriptive statistics comprise of frequency distribution, percentage distribution, weighted mean score, and standard deviation while the inferential method of data analysis used ordinal least square (simple linear regression) to determine the effect of coronavirus pandemic on the supply chain test kits. Findings from the result concluded that pandemic and the methods of supply chain management indicated a significant effect. In addition, from the review the major impacts of COVID-19 were innovation, increased technology, research and development, depletion of supply chain personnel. Therefore, there is a need to develop national guidelines on supply chain strategy for emergencies in Nigeria as well as adhere strictly to some recommendations made in the study.

scholarly journals KNOWLEDGE OF NURSES ON SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS IN PUBLIC FACILITIES

2020 ◽  
Vol 5 (5) ◽  
pp. 1
Author(s):  
Maina Eva Mumbi ◽  
Mwangi John Hiuhu ◽  
Njuguna Felix Tharao ◽  
Maingi Nancy Nyambura
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Sexually Transmitted Infections ◽  
Health Facilities ◽  
Unique Contribution ◽  
Data Collection Tool ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Public Health Facilities ◽  
Syndromic Approach

Purpose: The main purpose of this study is to assess the knowledge of nurses on syndromic management of STIs in public health facilities within Kirinyaga west Sub County. Methodology: The study utilized descriptive cross-sectional study design, with a target population of 70 nurses working in 16 Kirinyaga west public health facilities. The dependent variable was applying syndromic approach management of sexually transmitted infections, independent variables as knowledge and practices. The study utilized purposive sampling technique to determine the sample size of 49 nurses. The study employed the use of a questionnaire as a data collection tool and check list. A pretest of the data collection tool was conducted at Karatina sub county hospital MCH/FP Findings The study findings showed that 90% of the respondents had general knowledge of what syndromic approach is though 38% were not able to identify the common STIs syndromes and 39% couldn’t correctly identify the STIs that present a genital ulcer. 45% depended on laboratory investigations to diagnose and manage STIs, while 74% had not undergone any training or CME in the last 2 years on syndromic management of STIs and 96%reported that the health facilities they were stationed did not have readily available WHO/NASCOP 2015 guidelines. The respondents did not apply the syndromic approach in managing STIs and that, knowledge and practice on syndromic management of STIs among nurses in Kirinyaga west Sub County is low at 41%. Unique contribution to theory, practice and policy: There is need for more awareness through capacity building among health workers managing sexually transmitted infections in the communities and therefore the study recommends county Governments to organize for trainings and CMEs on STIs/syndromic approach and identify an STIs management focal person in public health facilities.

scholarly journals Paediatric/young versus adult patients with long QT syndrome or catecholaminergic polymorphic ventricular tachycardia

2021 ◽  
Author(s):  
Sharen Lee ◽  
Jiandong Zhou ◽  
Kamalan Jeevaratnam ◽  
Wing Tak Wong ◽  
Ian Chi Kei Wong ◽  
...  
Keyword(s):  
Ventricular Tachycardia ◽  
Long Qt Syndrome ◽  
Primary Outcome ◽  
Public Hospitals ◽  
Adult Patients ◽  
Polymorphic Ventricular Tachycardia ◽  
Qtc Interval ◽  
Long Qt ◽  
Old Patients ◽  
Qt Syndrome

AbstractIntroductionLong QT syndrome (LQTS) and catecholaminergic ventricular tachycardia (CPVT) are less prevalent cardiac ion channelopathies than Brugada syndrome in Asia. The present study compared paediatric/young and adult patients with these conditions.MethodsThis was a territory-wide retrospective cohort study of consecutive patients diagnosed with LQTS and CPVT attending public hospitals in Hong Kong. The primary outcome was spontaneous ventricular tachycardia/ventricular fibrillation (VT/VF).ResultsA total of 142 LQTS (mean onset age= 27±23 years old) and 16 CPVT (mean presentation age=11±4 years old) patients were included. For LQTS, arrhythmias other than VT/VF (HR=4.67, 95% confidence interval=[1.53-14.3], p=0.007), initial VT/VF (HR=3.25 [1.29-8.16], p=0.012) and Schwartz score (HR=1.90 [1.11-3.26], p=0.020) were predictive of the primary outcome for the overall cohort, whilst arrhythmias other than VT/VF (HR=5.41 [1.36-21.4], p=0.016) and Schwartz score (HR=4.67 [1.48-14.7], p=0.009) were predictive for the adult subgroup (>25 years old; n=58). All CPVT patients presented before the age of 25 but no significant predictors of VT/VF were identified. A random survival forest model identified initial VT/VF, Schwartz score, initial QTc interval, family history of LQTS, initially asymptomatic, and arrhythmias other than VT/VF as the most important variables for risk prediction in LQTS, and initial VT/VF/sudden cardiac death, palpitations, QTc, initially symptomatic and heart rate in CPVT.ConclusionClinical and ECG presentation vary between the pediatric/young and adult LQTS population. All CPVT patients presented before the age of 25. Machine learning models achieved more accurate VT/VF prediction.

scholarly journals Magnitude and determinants of self-referrals among women seeking skilled birth attendance services: a cross-sectional hospital-based study in Marsabit County, Kenya

2021 ◽  
Vol 8 (5) ◽  
pp. 2124
Author(s):  
Joseph O. Adoyo ◽  
Eliphas G. Makunyi ◽  
George O. Otieno ◽  
Alison Yoos
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Skilled Birth Attendance ◽  
Health Facilities ◽  
Public Hospitals ◽  
Systematic Sampling ◽  
P Value ◽  
Cross Sectional ◽  
Factors Associated ◽  
Birth Attendance ◽  
Referral Hospitals

Background: Self-referral to higher-level hospitals by women seeking skilled birth attendance services reflects in part their non-adherence to established referral pathways. This choice results in an inappropriate utilization of resources within health system. The Kenya Health Sector Referral Strategy aims at optimising the utilization and access of facilities. The aim of this study was to determine the prevalence and factors associated with self-referral among women seeking skilled birth attendance services in Marsabit County between 1st and 31st Oct 2019.Methods: A cross-sectional study was adopted at the maternity department in the selected public hospitals in Marsabit County, by use of interviewer-administered questionnaires to collect information from 161 women, through systematic sampling between 1st and 31st Oct 2019. Chi-square and multiple logistic regression analysis were used to test for factors associated with self-referral at 95% confidence interval.Results: Of the 161 women interviewed, 47.2% (n=76) were self-referrals. The odds of self-referral to the higher level health facilities were more likely among women: - aged 25-29 (AOR 5.174, CI 1.015-26.365, p-value 0.048); those referred for other ANC services (AOR 4.057, CI 1.405-11.720, p-value 0.010); and those, - who visited the referral facility before for delivery (AOR 5.395, CI 1.411 – 20.628, p-value 0.014). However, self-referral were less likely among women who perceived privacy and confidentiality of services at the referral hospitals (AOR 0.370, CI 0.138-0.990, p-value 0.048).Conclusions: Almost half of women seeking skilled birth attendance were self-referrals, relates to a possible implication on an unprecedented increased workload at referral hospitals and underutilization of primary health facilities.

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