scholarly journals Effect of the COVID-19 Pandemic Preparation and Response on Essential Health Services in Primary and Tertiary Healthcare Settings of Amhara Region, Ethiopia

2021 ◽  
Author(s):  
Wendemagegn Enbiale ◽  
Seid Getahun Abdela ◽  
Meaza Seyum ◽  
Dereje Bedanie Hundie ◽  
Kassawmar Angaw Bogale ◽  
...  
Keyword(s):  
Health Service Delivery ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
Healthcare Settings ◽  
Care Systems ◽  
Tertiary Healthcare ◽  
Adult Outpatient

Countries like Ethiopia have had to make difficult decisions to balance between the demands of the COVID-19 pandemic and maintaining the essential health service delivery. We assessed the effect of preventive COVID-19 measures on essential healthcare services in selected health facilities of Ethiopia. In a comparative cross-sectional study, we analyzed and compared data from seven health facilities over two periods: the pre-COVID-19 period before the first reported COVID-19 case in the country and during the COVID-19 period. Data were summarized using descriptive statistics and the independent t test. During the COVID-19 period the average number of monthly patient visits in the emergency department, pediatrics outpatient, and adult outpatient dropped by 27%, 30%, and 27%, respectively compared with the pre-COVID-19 period. Family planning; institutional delivery; childhood immunization; antenatal care-, hypertension- and diabetic patient follow-up, did not vary significantly between pre-COVID-19 and during COVID-19. Moreover, the monthly average number of tuberculosis (TB) and HIV patients who visited health facilities for drug refill and clinical evaluation did not vary significantly during the two periods. In conclusion, the study highlights that the effect of public restrictions to mitigate the COVID-19 pandemic on essential care systems should be considered.

scholarly journals Practices of injectable antibiotics preparation and administration among healthcare practitioners in multidisciplinary wards

2019 ◽  
Vol 10 (SPL1) ◽  
Author(s):  
Lih Ling Kwek ◽  
Shu Mei Lai ◽  
Fatin Sarahani Samedrik ◽  
Wei Yang Lee ◽  
Keerthy Venthen
Keyword(s):  
Cross Sectional Study ◽  
Staff Nurses ◽  
Contributing Factors ◽  
Cross Sectional ◽  
Personal Problems ◽  
Demographic Profiles ◽  
Healthcare Settings ◽  
Care Systems ◽  
Low Incidence ◽  
Collection Form

Injectable antibiotics with rapid deliveries to infection sites are preferable in healthcare settings. Low incidence of appropriate injectable antibiotics preparation and administration (IAPAA) among healthcare practitioners will cause antimicrobial resistance, thrombophlebitis, and mortality. This study aimed to identify rates of appropriate IAPAA, possible contributing factors, implement strategies, and evaluate their effectiveness.A cross-sectional study involving direct observation was conducted in Hospital Tanjung Karang (HTK) multidisciplinary wards from August 2018 to February 2019. 148 samples fulfilling criteria were randomly selected. Data collection form was used to record demographic profiles from bed-head-ticket (BHT) and observed IAPAA processes. Rates of appropriate IAPAA were determined and analyzed with SPSS Statistics. Descriptive statistics were employed. The rate of appropriate IAPAA upon verification was only 14.2%. All uncommon and slow intravenous (SIV) antibiotics demonstrated 0% appropriateness. Possible factors included unaware of rare procedures, inadequate references, knowledge, and monitoring. The rate was successfully improved to 49.3% after various implementations, including "SWeFT." Among all six IAPAA categories, reconstitution concentration and administration duration revealed the most improvements, from 33.8% to 93.8% and 18.9% to 52.7%. Staff nurses found antibiotics rarely initiated by visiting specialists less familiar. The least appropriate administration duration was mostly come from SIV antibiotics, whereby inadequate equipment and personal problems were the possible reasons. Inappropriate IAPAA practices are preventable with proper measures. Further innovations or inward patient care systems, containing electronic BHT and nursing injections preparation and administration alert systems, should be implemented to improve clinical outcomes and safety of patients.

scholarly journals Missed opportunities for vaccination among children aged 0–23 months visiting health facilities in a southwest State of Nigeria, December 2019

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0252798
Author(s):  
Akinola Ayoola Fatiregun ◽  
Laura Nic Lochlainn ◽  
Lassané Kaboré ◽  
Modupeola Dosumu ◽  
Elvis Isere ◽  
...  
Keyword(s):  
Health Service ◽  
Health Workers ◽  
Immunization Coverage ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Service Encounter ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
Missed Opportunities ◽  
Attitudes And Practices

Background Despite efforts to improve childhood immunization coverage in Nigeria, coverage has remained below the national acceptable level. In December 2019, we conducted an assessment of Missed Opportunities for Vaccination (MOV) in Ondo State, in Southwest Nigeria. The objectives were to determine the magnitude of, explore the reasons for, as well as possible solutions for reducing MOV in the State. Methods This was a cross-sectional study using a mixed-methods approach. We purposively selected 66 health facilities in three local government authorities, with a non-probabilistic sampling of caregivers of children 0–23 months for exit interviews, and health workers for knowledge, attitudes, and practices (KAP) surveys. Data collection was complemented with focus group discussions and in-depth interviews with caregivers and health workers. The proportion of MOV among children with documented vaccination histories were determined and thematic analysis of the qualitative data was carried out. Results 984 caregivers with children aged 0–23 months were interviewed, of which 869 were eligible for inclusion in our analysis. The prevalence of MOV was 32.8%. MOV occurred among 90.8% of children during non-vaccination visits, and 7.3% during vaccination visits. Vaccine doses recommended later in the immunization series were given in a less timely manner. Among 41.0% of health workers, they reported their vaccination knowledge was insufficient. Additionally, 57.5% were concerned about and feared adverse events following immunization. Caregivers were found to have a low awareness about vaccination, and issues related to the organization of the health system were found to contribute towards MOV. Conclusions One in three children experienced a MOV during a health service encounter. Potential interventions to reduce MOV include training of health workers about immunization policies and practices, improving caregivers’ engagement and screening of vaccination documentation by health workers during every health service encounter.

scholarly journals Patient satisfaction in outpatient healthcare services at secondary level vs. tertiary level

2014 ◽  
Vol 142 (9-10) ◽  
pp. 579-585 ◽  
Author(s):  
Vesna Velikj-Stefanovska ◽  
Miodraga Stefanovska-Petkovska
Keyword(s):  
Patient Satisfaction ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Hospital Environment ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Significant Difference ◽  
Tertiary Healthcare ◽  
Patient Waiting Time

Introduction. Patients satisfaction is a very important part of any clinical practice both for evaluation and improvement of healthcare services. Objective. The aim of this study was to determine patient satisfaction with public outpatient healthcare services at secondary and tertiary level and to assess possible differences between the two levels. Methods. In a quantitative cross-sectional study, a convenient sample of 646 patients who experienced public outpatient healthcare services at the secondary and tertiary level during the last two months were interviewed. Patient satisfaction questionnaires, with statements regarding various aspects of satisfaction, were completed during face-to-face interviews (response rate 84.6%). The research instrument was tested for internal consistency using the Cronbach?s coefficient alpha estimate. Results. The patients were significantly more satisfied in tertiary than in secondary outpatient healthcare facilities in almost all aspects of assessment related to general settings, nurse/administrative staff performance and physician performance (p<0.001). The patients in the secondary healthcare services (SHCS) were more satisfied than in the tertiary healthcare services (THCS) but only regarding the information on location (83.9% vs.78.3%) and possibilities to enter and move inside the department (88.8% vs. 83.3%). Analysis of data for SHCS and THCS showed that there was no significant difference between the mean overall satisfaction scores with regard to patients? gender, age, marital status, educational level, employment and number of visits. Conclusion. There is a need to improve the current level of patient-provider relationship and communication, as well as that of hospital environment, while special efforts should be made to address the problem of patient waiting time and hospital bureaucracy.

Perceptions of Final Year Medical Students about Family Medicine as A Career Choice in Pakistan

2020 ◽  
Author(s):  
Dur-e- Nishat
Keyword(s):  
Medical Students ◽  
Family Medicine ◽  
Medical Profession ◽  
Healthcare Services ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Medical College ◽  
Chi Square Test

Background: Family medicine is a field in which complete and detailed set of healthcare services are provided to the patients and their families. In developed countries, freshly graduated students choose family medicine as a priority for their career. However, in Pakistan it is not the case. The present study is undertaken to determine the perceptions of final year medical students’ about Family Medicine as a viable career. Methods: A total number of 504 students participated in the study. This was a cross-sectional study. The study participants were in their final year of medical college. Data was collected using a preapproved questionnaire. Data was entered and analyzed via SPSS version 17 and Chi-Square test was used post-stratification. Results: Only 14.3% (n=72) medical students had heard about Family Medicine. Only 18% (n=92) would select family medicine as a profession. The most frequent rationale for choosing the field of Family Medicine was the variety of patients seen in general practice (55.4% n=51). Conclusion: There is a dire need to focus on increasing awareness about the field of family medicine among medical students. The students should be counseled on the advantages along with the disadvantages of choosing this field as a medical profession.

scholarly journals Health Status and Quality of Health Care Services of Congolese Refugees in Nakivale, Uganda

2016 ◽  
Vol 5 (3) ◽  
pp. 39
Author(s):  
Amegovu K. Andrew
Keyword(s):  
Health Status ◽  
Health Services ◽  
Resource Constraints ◽  
Service Providers ◽  
Geographic Origin ◽  
Health Service Delivery ◽  
Health Facilities ◽  
Cross Sectional ◽  
Adequate Food

Physical and emotional wellness, as well as access to healthcare, are foundations for successful resettlement. Without feeling healthy, it is difficult to work, to go school, or take care of a family. Many factors can affect refugee health, including geographic origin and refugee camp conditions. Refugees may face a wide variety of acute or chronic health issues (Office of Refugee Resettlement, ORR Annual Report to Congress 2014; http://www.acf.hhs.gov). Resettlement of refugees in Uganda is usually supported by concerted efforts of UNHCR, Governments through the Office of the Prime Minister, OPM with support from host communities, local and international Non-Governmental Organizations. Due to resource constraints and local factors, immigrants are often subjected to poor living conditions which coupled with inadequacy inessential medical supplies might significantly affects quality of care and health service delivery and hence, rendering refugees to poor health status. This study was conducted from 2013-2014 to assess the determinants of health status of Congolese refugees living in Nakivale refugee settlement, in Isingiro district- South Western Uganda. A cross-sectional study design was used involving mixed techniques of both qualitative and quantitative KAP survey. The study focussed on Congolese refugee population in Nakivale Refugee settlement. 2401 key informants’ interviews and 8 focus group discussions respectively were conducted targeting service providers and beneficiaries/Congolese refugees in this case. The data was analysed using SPSS ver.20, 2011. Although majority (97%) of respondents sought medical services from established health facilities, findings confirm a high level of ill health prevalence among Congolese refugees in Nakivale camp, however, the difference in health services and perceived health status in camp versus the one in DRcongo is insignificant ( p=0.000) with respondents perceiving their health status as worse than when they were their own Country before the resettlement. Identified key challenges affecting access &amp; uptake of available health services includes: language barrier; inadequate drugs; and the long distances to access health facilities. The health status of refugees could be improved by addressing the challenges related to language, drug supplies in addition to humanising conditions of shelter, providing appropriate waste disposal facilities while proving adequate food rations and clean &amp; safe drinking water.

scholarly journals Socioeconomic determinants of unmet need for outpatient healthcare services in Iran: a national cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sajad Vahedi ◽  
Amin Torabipour ◽  
Amirhossein Takian ◽  
Saeed Mohammadpur ◽  
Alireza Olyaeemanesh ◽  
...  
Keyword(s):  
Health System ◽  
Age Groups ◽  
Unmet Need ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Outpatient Services ◽  
Self Medication ◽  
Cross Sectional ◽  
Organizational Policies ◽  
Utilization Of Healthcare

Abstract Background Unmet need is a critical indicator of access to healthcare services. Despite concrete evidence about unmet need in Iran’s health system, no recent evidence of this negative outcome is available. This study aimed to measure the subjective unmet need (SUN), the factors associated with it and various reasons behind it in Iran. Methods We used the data of 13,005 respondents over the age of 15 from the Iranian Utilization of Healthcare Services Survey in 2016. SUN was defined as citizens whose needs were not sought through formal healthcare services, while they did not show a history of self-medication. The reasons for SUN were categorized into availability, accessibility, responsibility and acceptability of the health system. The multivariable logistic regression was used to determine significant predictors of SUN and associated major reasons. Results About 17% of the respondents (N = 2217) had unmet need for outpatient services. Nearly 40% of the respondents chose only accessibility, 4% selected only availability, 78% chose only responsibility, and 13% selected only acceptability as the main reasons for their unmet need. Higher outpatient needs was the only factor that significantly increased SUN, responsibility-related SUN and acceptability-related SUN. Low education was associated with higher SUN and responsibility-related SUN, while it could also reduce acceptability-related SUN. While SUN and responsibility-related SUN were prevalent among lower economic quintiles, having a complementary insurance was associated with decreased SUN and responsibility-related SUN. The people with basic insurance had lower chances to face with responsibility-related SUN, while employed individuals were at risk to experience SUN. Although the middle-aged group had higher odds to experience SUN, the responsibility-related SUN were prevalent among elderly, while higher age groups had significant chance to be exposed to acceptability-related SUN. Conclusion It seems that Iran is still suffering from unmet need for outpatient services, most of which emerges from its health system performance. The majority of the unmet health needs could be addressed through improving financial as well as organizational policies. Special attention is needed to address the unmet need among individuals with poor health status.

scholarly journals The Effects of the Civility, Respect, and Engagement in the Workplace (CREW) Program on Social Climate and Work Engagement in a Psychiatric Ward in Japan: A Pilot Study

2021 ◽  
Vol 11 (2) ◽  
pp. 320-330
Author(s):  
Utako Sawada ◽  
Akihito Shimazu ◽  
Norito Kawakami ◽  
Yuki Miyamoto ◽  
Lisa Speigel ◽  
...  
Keyword(s):  
Work Engagement ◽  
Cross Sectional Study ◽  
Social Climate ◽  
Psychiatric Ward ◽  
Medical Doctors ◽  
Cross Sectional ◽  
Factors Affecting ◽  
Staff Members ◽  
Utrecht Work Engagement Scale ◽  
Healthcare Settings

Background: Good social climate and high work engagement are important factors affecting outcomes in healthcare settings. This study observed the effects of a program called Civility, Respect, and Engagement in the Workplace (CREW) on social climate and staff work engagement in a psychiatric ward of a Japanese hospital. Methods: The program comprised 18 sessions installed over six months, with each session lasting 30-min. Participation in the program was recommended to all staff members at the ward, including nurses, medical doctors, and others, but it was not mandatory. A serial cross-sectional study collected data at four time-points. Nurses (n = 17 to 22), medical doctors (n = 9 to 13), and others (n = 6 to 10) participated in each survey. The analysis of variance was used to evaluate the changes in the following dependent variables, the Essen climate evaluation schema (EssenCES), the CREW civility scale, and the Utrecht work engagement scale (UWES) over time. Result: We found no significant effects. The effect size (Cohen’s d) for EssenCES was 0.35 from baseline to post-installation for all staff members. Effect sizes for EssenCES for medical doctors and UWES for nurses were 0.79 and 0.56, respectively, from baseline to post-program. Conclusions: Differences in social climate and work engagement among Japanese healthcare workers between the baseline and post-installation of the CREW program were non-significant.

Prevalence and distribution of causes of infertility according to women’s age – a cross-sectional study in a tertiary healthcare hospital setup

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Keerthana Dhandapani ◽  
Bhagyalakshmi Kodavanji ◽  
Vinodini Nithyananda Madom Anantharaya ◽  
Nayanatara Arun Kumar
Keyword(s):  
Tertiary Care ◽  
Developed Countries ◽  
Cross Sectional Study ◽  
Female Infertility ◽  
Secondary Infertility ◽  
Cross Sectional ◽  
Female Population ◽  
Infertile Women ◽  
Tertiary Healthcare ◽  
The Individual

Abstract Objectives Infertility has disastrous consequences, particularly for women. Causes of infertility in developed countries have been investigated but there is a significant lack of data among Indian female population. The aim of the present study was to analyze the causes and the proportion of the individual factors contributing to infertility, considering the age factor. Methods The data of 204 infertile women (18–45 years) were collected from the files in tertiary care hospitals. Causes and age of infertile women were grouped. The prevalence of each cause was evaluated. Data analysis was done using SPSS (Statistical Package for Social Sciences) version 17.0. Results Polycystic ovarian syndrome (PCOS) was the most common (14.71%) cause of female infertility. Ovulatory dysfunctions (25.55%) were the foremost cause in primary infertility, whereas in secondary infertility, uterine factors (26.86%) were most common. The incidence of primary and secondary infertility was more evident in patients who were more than 30 years of age. Conclusions Causes of infertility vary according to the age. The causes of female infertility were unexplained infertility, ovulatory disorders and uterine factors most commonly affecting women at ≤30 years.

scholarly journals Results of a Patient Reported Experience Measure (PREM) to measure the rare disease patients and caregivers experience: a Spanish cross-sectional study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Mercedes Guilabert ◽  
Alba Martínez-García ◽  
Marina Sala-González ◽  
Olga Solas ◽  
José Joaquín Mira
Keyword(s):  
Rare Disease ◽  
Rare Diseases ◽  
Healthcare Services ◽  
Paediatric Population ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Optimal Care ◽  
Cross Sectional ◽  
Patient Reported ◽  
Mean Time

Abstract Objective To measure the experience of the person having a rare disease in order to identify objectives for optimal care in the health care received by these patients. Methods. A cross-sectional study was conducted in Spain involving patients associated with the Spanish Rare Diseases Federation [Federación Española de Enfermedades Raras] (FEDER). A modified version of the PREM IEXPAC [Instrumento para evaluar la Experiencia del Paciente Crónico] instrument was used (IEXPAC-rare-diseases). Scores ranged between 0 (worst experience) and 10 (best experience). Results A total of 261 caregivers (in the case of paediatric population) and patients with rare diseases (response rate 54.4%) replied. 232 (88.9%) were adult patients and 29 (11.1%) caregivers of minor patients. Most males, 227 (87%), with an average age of 38 (SD 13.6) years. The mean time since confirmation of diagnosis was 7.8 (SD 8.0) years. The score in this PREM was 3.5 points out to 10 (95%CI 3.2–3.8, SD 2.0). Caregivers of paediatric patients scored higher, except for coordination of social and healthcare services. Conclusions There are wide and important areas for improvement in the care of patients with rare diseases. This study involves a first assesment of the experience of patients with rare diseases in Spain.

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