scholarly journals The differential effect of the free maternity services policy in Kenya

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Henry O. Owuor ◽  
Stephen A. Asito ◽  
Samson O. Adoka
Keyword(s):  
Differential Effect ◽  
Health Information System ◽  
Interrupted Time Series ◽  
Relative Effect ◽  
District Health ◽  
Post Intervention ◽  
Healthcare Facilities ◽  
Maternity Services ◽  
Facility Type ◽  
The Government

Background: The Government of Kenya introduced the free maternity services (FMS) policy to enable mothers deliver at a health facility and thus improve maternal health indicators.Aim: The aim of this study was to determine if there was a differential effect of the policy by region (sub-county) and by facility type (hospitals vs. primary healthcare facilities [PHCFs]).Setting: The study was conducted in Nyamira County in western Kenya.Methods: This was an interrupted time series study where 42 data sets (24 pre- and 18 post-intervention) were collected for each observation. Monthly data were abstracted from the District Health Information System-2, verified, keyed into and analysed by using IBM-Statistical Package for the Social Sciences (SPSS-17).Results: The relative effect of the policy on facility deliveries in the county was an increase of 22.5%, significant up to the 12th month (p < 0.05). The effect of the policy on deliveries by region was highest in Nyamira North and Masaba North (p < 0.001 up to the 18th month). The effect was larger (46.5% vs. 18.3%) and lasted longer (18 months vs. 6 months) in the hospitals than in the PHCFs. The increase in hospital deliveries was most significant in Nyamira North (61%; p < 0.001). There was a medium-term effect on hospital deliveries in Borabu (up to 9 months) and an effect that started in the sixth month in Manga. The relative effect of the policy on facility deliveries in PHCFs was only significant in Nyamira North and Masaba North (p < 0.001).Conclusion: The effect of the FMS policy was varied by region (sub-county) and by facility type.

scholarly journals Emergence of cutaneous leishmaniasis in Nepal

2021 ◽  
Vol 49 (1) ◽  
Author(s):  
Kishor Pandey ◽  
Anup Bastola ◽  
Gong Haiyan ◽  
Uttam Raj Pyakurel ◽  
Basu Dev Pandey ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Health Information System ◽  
Control Program ◽  
The Body ◽  
District Health ◽  
Laboratory Findings ◽  
Facial Region ◽  
History Of ◽  
System 2 ◽  
The Government

Abstract Background Cutaneous leishmaniasis (CL) is endemic in 70 countries worldwide. Nepal is considered non-endemic for CL and hence the control program is targeted to visceral leishmaniasis (VL) only. Here, we report the emergence of CL cases in different parts of Nepal. Methods We analyzed the CL and VL cases reported to Epidemiology and Diseases Control Division (EDCD), Ministry of Health and Population, Nepal through District Health Information System 2 (DHIS-2) and Early Warning and Reporting System (EWRS) during the past 4 years (2016–2019). Any laboratory-confirmed case was included in the study. Demographic and clinical details of each patient were transcribed into Excel sheets, verified with the case report forms and analyzed. Results VL has been reported in Nepal since 1980, but CL was reported very recently. From 2016 to 2019, 42 CL cases were reported from 26 different hospitals to EDCD which had been diagnosed on the basis of clinical presentation, and laboratory findings (demonstration of amastigotes in Giemsa-stained smears and rK39 test results). Majority of the patients (31.0%, 13/42) visited to the hospital within 1–6 months of onset of lesions. Facial region (38.1%, 16/42) was the common place where lesions were found ompared to other exposed parts of the body. CL was successfully treated with miltefosine for 28 days. The majority of CL patients did not have history of travel outside the endemic areas and there was no report of sandfly from these areas. Conclusion These evidences highlight that the Government of Nepal need to pay more efforts on CL and include it in differential diagnosis by clinicians, and plan for an active surveillance when the country is targeting leishmaniasis elimination by the year 2025 with the decreasing number of VL cases.

scholarly journals “Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

2021 ◽  
pp. 1-6
Author(s):  
Nelofer Baig ◽  
◽  
Altaf H Nizamani ◽  
Keyword(s):  
Family Planning ◽  
Primary Healthcare ◽  
Health Information System ◽  
District Health ◽  
Family Planning Services ◽  
Healthcare Facilities ◽  
Average Percentage ◽  
Planning Methods ◽  
The Impact ◽  
Family Planning Methods

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

scholarly journals “Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

2021 ◽  
pp. 1-6
Author(s):  
Nelofer Baig ◽  
Keyword(s):  
Family Planning ◽  
Primary Healthcare ◽  
Health Information System ◽  
District Health ◽  
Family Planning Services ◽  
Healthcare Facilities ◽  
Average Percentage ◽  
Planning Methods ◽  
The Impact ◽  
Family Planning Methods

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

scholarly journals Impact of the 2016 Policy Change on the Delivery of MedsCheck Services in Ontario: An Interrupted Time-Series Analysis

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 115
Author(s):  
Shakeri ◽  
Dolovich ◽  
MacCallum ◽  
Gamble ◽  
Zhou ◽  
...  
Keyword(s):  
Time Series ◽  
Policy Change ◽  
Community Pharmacists ◽  
Professional Community ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Post Intervention ◽  
Term Care ◽  
The Government ◽  
The Impact

MedsCheck (MC) is an annual medication review service delivered by community pharmacists and funded by the government of Ontario since 2007 for residents taking three or more medications for chronic conditions. In 2010, MC was expanded to include patients with diabetes (MCD), home-bound patients (MCH), and residents of long-term care homes (MCLTC). The Ontario government introduced an abrupt policy change effective 1 October 2016 that added several components to all MC services, especially those completed in the community. We used an interrupted time series design to examine the impact of the policy change (24 months pre- and post-intervention) on the monthly number of MedsCheck services delivered. Immediate declines in all services were identified, especially in the community (47%–64% drop MC, 71%–83% drop MCD, 55% drop MCH, and 9%–14% drop MCLTC). Gradual increases were seen over 24 months post-policy change, yet remained 21%–76% lower than predicted for MedsCheck services delivered in the community, especially for MCD. In contrast, MCLTC services were similar or exceeded predicted values by September 2018 (from 5.1% decrease to 3.5% increase). A more effective implementation of health policy changes is needed to ensure the feasibility and sustainability of professional community pharmacy services.

scholarly journals 1225. How Frequently Should Sink Drains Be Disinfected?

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S440-S440
Author(s):  
Jorge A Ramos-Castaneda ◽  
Matthew L Faron ◽  
Joshua Hyke ◽  
Blake W Buchan ◽  
Rahul Nanchal ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Horizontal Transmission ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Control Group ◽  
Care Hospital ◽  
Bacterial Reduction ◽  
Post Intervention ◽  
Bacterial Colony ◽  
Healthcare Facilities

Abstract Background New evidence shows the relevance of sink drains in the horizontal transmission of multidrug-resistant organisms. We recently demonstrated that a peroxide-based disinfectant (product B) was better than bleach at disinfecting sink drains; however, we did not determine the duration of this effect. In this study, we evaluate the duration of bacterial reduction in sink drains treated with product B and compared it to an enhanced hydrogen peroxide agent (product A). Methods Testing was performed in a 26-bed medical intensive care unit at a 566-bed tertiary care hospital in Milwaukee, WI. Two disinfectants were compared: product A (hydrogen peroxide, octanoic acid, and peroxyacetic acid; Virasept, Ecolab) and product B (hydrogen peroxide-based disinfectant; Peroxide Multi Surface Cleaner and Disinfectant, Ecolab). Sinks were randomly assigned to product A, product B, and control (no disinfection). On day 0, baseline cultures were obtained and disinfectant agents were applied. On post-intervention days 1, 3, 5, and, 7, samples from each drain were collected using E-swabs (Copan, Italy). Quantitation of Gram-negative burden was determined by serial dilution in saline plated to MacConkey agar and dilutions that contained 20–200 colonies were used for bacterial colony-forming units (CFU). Multivariate multiple linear regression and analysis of variance were used to compare mean Ln(1+CFU) between groups using R v3.5.0. Environmental sampling, cultures, and statistical analyses were performed blinded to the disinfected used. Results All three groups had similar CFU counts at baseline (P > 0.05). On day 1, a statistically significant reduction in bacterial CFUs was observed in the group treated with product A compared with sinks treated with product B (P = 0.04) or the control group (P < 0.01). The same differences were observed on day 3 post-intervention. There were no significant reductions on days 5 and 7. Conclusion Product A was the most effective product at disinfecting sink drains but its effect disappeared at 5 days post-disinfection. These results suggest that treating sink drains every 5 days with a hydrogen peroxide mixture would be ideal for healthcare facilities dealing with sink drain contamination. Disclosures All authors: No reported disclosures.

scholarly journals On ignoring instead of chasing after coagulation factor VII during warfarin management; an interrupted time series study

Blood ◽  
2021 ◽  
Author(s):  
Alma R. Oskarsdottir ◽  
Brynja R. Gudmundsdottir ◽  
Hulda M. Jensdottir ◽  
Bjorn Flygenring ◽  
Ragnar Palsson ◽  
...  
Keyword(s):  
Time Series ◽  
Coagulation Factor ◽  
Maintenance Phase ◽  
Interrupted Time Series ◽  
Factor Vii ◽  
Segmented Regression ◽  
Post Intervention ◽  
Coagulation Factor Vii ◽  
Monitoring Test ◽  
Time In Range

During warfarin management, prothrombin time (PT) based PT-INR variability is partly due to clinically inconsequential fluctuations of factor (F) VII. The new Fiix-PT and Fiix-normalized ratio (Fiix-NR), unlike PT-INR, is only affected by reduced FII and FX. Starting July 1st 2016 we replaced PT-INR monitoring of warfarin with Fiix-NR in our patients. Using interrupted time series methods, we retrospectively assessed if this affected thromboembolism (TE) and major bleeding (MB) incidence during 12 months prior to and 18 months after the replacement, months 13-18 being predefined as transitional months. The dynamic cohort comprised all our service´s 2,667 maintenance phase warfarin patients managed at any time during the 30 months. Using two-segmented regression, a breakpoint in total TE monthly incidence became evident six months after laboratory monitoring test replacement, followed by 56% reduction in TE incidence (from 2.82% to 1.23% per patient year, P=0.019 by ANOVA). Three-segmented regression found no significant TE incidence trend (slope +0.03) prior to test replacement but during months 13-18 and 19-30 the TE incidence gradually decreased (slope -0.12; R2=0.20;P=0.007). Based on segmented regressions, MB incidence (2.79% ppy) did not differ pre- or post-intervention. Incidence comparison during the 12 month Fiix- and PT-periods confirmed a statistically significant 55-62% reduction in TE. Fiix-monitoring reduced testing, dose adjustments and normalized ratio variability, and prolonged testing intervals and time in range. We conclude that ignoring FVII during Fiix-NR monitoring in real world practice stabilizes the anticoagulant effect of warfarin and associates with major reduction in thromboembolism without increasing bleeding.

scholarly journals Membangun Komunikasi dalam Sinergi Pelayanan Kesehatan di Kabupaten Bandung

2020 ◽  
Vol 14 (1) ◽  
pp. 17-28
Author(s):  
Ditha Prasanti ◽  
Ikhsan Fuady ◽  
Sri Seti Indriani
Keyword(s):  
Public Health ◽  
Health Service ◽  
Health Services ◽  
Active Role ◽  
Communication Process ◽  
Public Health Services ◽  
District Health ◽  
The Government ◽  
The One ◽  
The Village

The "one data" policy driven by the government through the Ministry of Health is believed to be able to innovate and give a new face to health services. Of course, the improvement of health services starts from the smallest and lowest layers, namely Polindes. Starting from this policy and the finding of relatively low public health service problems, the authors see a health service in Polindes, which contributes positively to improving the quality of public health services. The health service is the author's view of the communication perspective through the study of Communication in the Synergy of Public Health Services Polindes (Village Maternity Post) in Tarumajaya Village, Kertasari District, Bandung Regency. The method used in this research is a case study. The results of the study revealed that public health services in Polindes are inseparable from the communication process that exists in the village. The verbal communication process includes positive synergy between the communicator and the communicant. In this case, the communicators are village midwives, village officials, namely the village head and his staff, the sub-district health center, and the active role of the village cadres involved. In contrast, the communicant that was targeted was the community in the village of Tarumajaya. This positive synergy results in a marked increase in public services, namely by providing new facilities in the village, RTK (Birth Waiting Home).   Kebijakan “one data” yang dimotori oleh pemerintah melalui Kementerian kesehatan diyakini mampu membuat inovasi dan memberikan wajah baru terhadap layanan kesehatan. Tentunya, perbaikan layanan kesehatan tersebut dimulai dari lapisan terkecil dan terbawah yakni Polindes. Berawal dari kebijakan tersebut dan masih ditemukannya masalah pelayanan kesehatan publik yang relatif rendah, penulis melihat sebuah layanan kesehatan di Polindes, yang memberikan kontribusi positif dalam peningkatan kualitas layanan kesehatan masyarakat. Pelayanan kesahatan tersebut penulis lihat dari perpektif komunikasi melaui penelitian Komunikasi dalam Sinergi Pelayanan Kesehatan Publik Polindes (Pos Bersalin Desa) di Desa Tarumajaya, Kecamatan Kertasari, Kabupaten Bandung ini dilakukan. Metode yang digunakan dalam penelitian ini adalah studi kasus. Hasil penelitian mengungkapkan bahwa pelayanan kesehatan publik di Polindes, tidak terlepas dari adanya proses komunikasi yang terjalin di desa tersebut. Proses komunikasi verbal tersebut meliputi sinergitas positif antara pihak komunikator dan komunikan. Dalam hal ini, komunikator tersebut adalah Bidan Desa, Aparat Desa yakni Kepala Desa beserta staffnya, Puskesmas tingkat kecamatan, serta peran aktif dari para kader desa yang terlibat. Sedangkan komunikan yang menjadi target adalah masyarakat di desa Tarumajaya. Sinergitas positif tersebut menghasilkan peningkatan pelayanan publik yang nyata, yaitu dengan adanya penyediaan fasilitas baru di desa, RTK (Rumah Tunggu Kelahiran).

scholarly journals Kebijakan Pengendalian HIV/AIDS di Denpasar

2013 ◽  
Vol 8 (1) ◽  
pp. 45
Author(s):  
Tri Rini Puji Lestari
Keyword(s):  
Local Governments ◽  
People Living With Hiv ◽  
District Health ◽  
Aids Epidemic ◽  
The Government ◽  
Living With Hiv ◽  
And Control ◽  
The City ◽  
Government Perspective ◽  
Hiv Aids

Secara nasional, Indonesia telah mengantisipasi epidemi HIV/AIDS, tetapi jumlah kasus HIV/AIDS di Provinsi Bali dari tahun ke tahun memperlihatkan peningkatan yang semakin mengkhawatirkan. Penelitian ini bertujuan untuk mengetahui perkembangan jumlah kasus dan kebijakan penanggulangan HIV/AIDS di Denpasar. Penelitian ini menggunakan metode kualitatif yang dilakukan di Denpasar pada tanggal 11-17 September 2011. Sampel penelitian ini menggunakan informan terpilih yaitu kepala bappeda, pejabat Dinas Kesehatan Kabupaten Denpasar, direktur rumah sakit, puskesmas, ketua komisi penanggulangan AIDS di kabupaten/kota dan pemerhati HIV/AIDS termasuk ODHA. Penelitian menemukan jumlah kasus HIV/AIDS di Kota Denpasar yang tertinggi dan penularan terbesarnya melalui hubungan seks. Namun, dukungan pemerintah daerah dalam upaya pencegahan dan penanggulangan HIV/AIDS terlihat belum maksimal. Padahal kebijakan penanggulangan HIV/AIDS sangat ditentukan oleh cara pandang pemerintah terhadap penyakit HIV/AIDS. Untuk itu, perlu peningkatan pemahaman tentang HIV/AIDS serta pencegahan dan penanganan semua pihak terkait sehingga penanggulangan HIV/AIDS dapat lebih efektif, efisien, dan tepat sasaran.Nationally, Indonesia anticipated HIV/AIDS epidemic, but the number of cases of HIV/AIDS in Bali province from year to year showed an increase in the increasingly alarming. This study aimed to determine the number of cases and the development of policies on HIV / AIDS in Denpasar. This research was conducted using qualitative methods in Denpasar on 11-17 September 2011. The study sample was selected using the informant is head of planning, Denpasar District health officers, the director of the hospital, health center, chairman of the commission on AIDS in the district/city and observer of HIV / AIDS, including people living with HIV. The study found the number of cases of HIV / AIDS in the city of Denpasar is the highest and greatest transmission through sexual intercourse. However, the support of local governments in efforts to prevent and control HIV/AIDS looks not maximized. In fact the policy of HIV/AIDS is largely determined by the government perspective on HIV / AIDS. To that end, should be an increased understanding of HIV/AIDS as well as prevention and treatment of all parties concerned. So that HIV/ AIDS can be more effective, efficient, and targeted.

scholarly journals Application of Lean Six Sigma to Improve Service in Healthcare Facilities Management: A Case Study

2017 ◽  
Vol 1 (1) ◽  
pp. 9-18 ◽  
Author(s):  
Will T. Shirey ◽  
Kenneth Timothy Sullivan ◽  
Brian Lines ◽  
Jake Smithwick
Keyword(s):  
Quality Improvement ◽  
Six Sigma ◽  
Healthcare Organization ◽  
Research Literature ◽  
Lean Six Sigma ◽  
Facilities Management ◽  
Post Intervention ◽  
Healthcare Facilities ◽  
Computerized Maintenance Management System

ABSTRACT The purpose of this paper is to present a case study on the application of the Lean Six Sigma (LSS) quality improvement methodology to facilities management (FM) services at a healthcare organization. Research literature was reviewed concerning whether or not LSS has been applied in healthcare-based FM, but no such studies have been published. This paper aims to address the lack of an applicable methodology for LSS intervention within the context of healthcare-based FM. The Define, Measure, Analyze, Improve, and Control (DMAIC) framework was followed to test the hypothesis that LSS can improve the service provided by an FM department responsible for the maintenance and repair of furniture and finishes at a large healthcare organization in the southwest United States of America. Quality improvement curricula and resources offered by the case study organization equipped the FM department to apply LSS over the course of a five-month period. Qualitative data were gathered from pre- and post-intervention surveys while quantitative data were gathered with the Organization's computerized maintenance management system (CMMS) software. Overall, LSS application proved to be useful for the intended purpose. The authors proposes that application of LSS by other FM departments to improve their services could also be successful, which is noteworthy and deserving of continued research.

scholarly journals Microbial load of healthcare wastes in Aba Metropolis, Abia State

2021 ◽  
Vol 3 (1) ◽  
pp. 17-23
Author(s):  
Elendu, C. Onwuchekwa ◽  
Anaele, C. C. ◽  
Emeonye, O. P. ◽  
Felix C. J. ◽  
Ikechukwu-Okoroezi, J. ◽  
...  
Keyword(s):  
Viable Count ◽  
Microbial Load ◽  
Microbial Count ◽  
Unique Contribution ◽  
Healthcare Facilities ◽  
Healthcare Waste ◽  
Microbiological Techniques ◽  
Hospital Wastes ◽  
Laboratory Waste ◽  
The Government

Introduction: Healthcare waste is the total waste both solid and liquid from healthcare establishment and laboratories. A hospital produces waste by giving their services to the patients. Purpose: This study examined the microbial load of waste from selected healthcare facilities in Aba metropolis, Abia State. Methodology: Tenfold serial dilution was used for processing of all the samples. After the dilutions, exactly 0.5ml of each the sample was planted on the media using the spread plate method and evaluated using the standard microbiological techniques. Results: The viable count (TVC) ranged from 1.0×103cfu/g to 0.3×108cfu/g, coliform count (TCC) ranged from 0.4×102 cfu/g to 4.2×104 cfu/g, staphylococcal count (TSC) ranged from 1.0×101 cfu/g to 1.4×102 and fungal counts ranged from 2.0×102 cfu/g to 0.8×103cfu/g in the microbial count of various waste samples within the Aba metropolis, Abia State. The laboratory waste had the highest microbial counts, followed by the Out-patient department waste and the least was the pharmaceutical waste. The microorganisms isolated from the hospital wastes were Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Aspergillus niger, A. Fumigatus, Candida albicans and among others. Unique contribution to theory, practice and policy: This research has revealed that healthcare waste contained pathogens with high microbial load densities, suggesting that the hospital wastes may pose a major health and environmental threat, if not properly managed. The study recommends that, the government should ensure that there is a policy on hospital waste management in line with recommended international best practices, which should be monitored and enforced. 

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