Baseline assessment of therapeutic injection practices in Pakistan in 2020: a cross-sectional study

2021 ◽  
pp. 16-21
Author(s):  
Syed Sharaf Ali Shah ◽  
Safdar Pasha ◽  
Nikhat Iftikar ◽  
Altaf Ahmed Soomro ◽  
Nazia Farrukh ◽  
...  
Keyword(s):  
Public Sector ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Injection Equipment ◽  
Public And Private ◽  
Healthcare Facilities ◽  
The Public ◽  
Injection Safety

Objective: To assess the magnitude of the problem of injection safety in public and private health facilities in two districts of Sindh and Punjab provinces of Pakistan. Methods: A cross-sectional observational study was conducted between October and December 2020 among public and private health facilities of two districts of Pakistan: Gujarat in Punjab and Larkana in Sindh provinces. A convenient sample size of 60 healthcare facilities (30 from each district) was taken due to time and resource constraint. Six data collection tools were used which included structured observations and interviews with injection prescribers and providers based on WHO Revised Tool C, which were finalised after piloting. Results: Reuse of injection equipment was not observed in any of the 60 health facilities. In exit interviews of 120 patients, it was found that 27 (22.5%) patients reported receiving an injection, while 11 (9.2%) were prescribed intravenous (IV) drips. More injections and drips were prescribed in the private sector (n=15; 25.0%) in comparison with the public sector (n=12; 20.0%). Slightly higher proportion of IV drips were prescribed by the private providers when compared to public sector healthcare providers: 6 (10.0%) vs 5 (8.3%) respectively. Most of the prescribers (n=58; 96.7%) reported that patients who attended public and private health facilities demanded injectable medicines. Used syringes and drips were noted to be visible in open containers and buckets for final disposal in 20 (33.3%) assessed health facilities. Continuou...

scholarly journals A descriptive study of healthcare-providers’ experiences with the use and quality of oxytocin for the prevention of post-partum hemorrhage in Nigeria: A nation-wide survey

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0258096
Author(s):  
Chioma S. Ejekam ◽  
Florence M. Nyangara ◽  
Chimezie Anyakora ◽  
Jude Nwokike
Keyword(s):  
Public Sector ◽  
Postpartum Hemorrhage ◽  
Health Workers ◽  
Post Partum ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Middle Income ◽  
Healthcare Facilities

Background Oxytocin is recommended as an affordable and effective drug in the prevention of postpartum hemorrhage—one of the leading causes of maternal morbidity and mortality in low- and middle-income countries, however, there are concerns about its proper use and quality. This study builds on earlier work conducted in a South-Western state in Nigeria. Objective The study assessed the knowledge around oxytocin, usage, storage practices and perceived quality of oxytocin used by healthcare providers that directly administer oxytocin for the prevention of postpartum hemorrhage across Nigeria. Methods This was a descriptive cross-sectional study that surveyed a representative sample of 6,299 healthcare providers who offer obstetrics and gynecological services and recruited from 1,894 healthcare facilities in Public and Private sectors in 12 states across Nigeria. Data were collected using an electronic questionnaire, analyzed using SPSS, and presented in frequencies and percentages. Results Only forty-six percent of respondents (52.8% in private; 40.0% in public sector) had proper knowledge that oxytocin storage is in the refrigerator. Proper knowledge also varied by professional cadre, doctors (71.2%); nurses (46.6%); Community Health Workers (28.4%) and by years of experience, less than 10 years (51.4%); more than 10 years (40.8%). Only 34% of the respondents (41% in private and 27.5% in public sector) reported good practices that oxytocin is stored in the refrigerator in their facilities. Most healthcare providers used oxytocin for prevention of PPH (77.9%). Oxytocin was also used for augmentation (66.7%) and induction of labor (52.6%). Half of respondents used above the WHO-recommended oxytocin dose of 10IU for prevention of PPH. Twenty-three percent of respondents reported experiencing oxytocin failure in PPH prevention of whom, 54.3% changed to another uterotonic and 37.1% doubled the dose of oxytocin for their patients. Conclusion Our study findings should be used to establish clinical guidelines and trainings for healthcare providers to improve their knowledge and storage practices and use to safeguard the quality of these lifesaving medicines.

CONSUMO DE ALIMENTOS PROCESSADOS E ULTRAPROCESSADOS POR ESCOLARES DE ARROIO DO TIGRE, RS

2018 ◽  
Vol 7 (1) ◽  
pp. 157-164
Author(s):  
Rubiane Inara Wagner ◽  
Patrícia Molz ◽  
Camila Schreiner Pereira
Keyword(s):  
Public School ◽  
Nutritional Status ◽  
Private School ◽  
Food Habits ◽  
Cross Sectional Study ◽  
School Students ◽  
Cross Sectional ◽  
Public And Private ◽  
The Public ◽  
Cereal Bars

O objetivo deste estudo foi comparar a frequência do consumo de alimentos processados e ultraprocessados e verificar a associação entre estado nutricional por adolescentes do ensino público e privado do município de Arroio do Tigre, RS. Trata-se de um estudo transversal realizado com adolescentes, com idade entre 10 e 15 anos, de uma escola pública e uma privada de Arroio do Tigre, RS. O estado nutricional foi avaliado pelo índice de massa corporal. Aplicou-se um questionário de frequência alimentar contendo alimentos processados e ultraprocessados. A amostra foi composta por 64 adolescentes com idade média de 12,03±1,15 anos, sendo 53,1% da escola pública. A maioria dos adolescentes encontravam-se eutróficos (p=0,343), e quando comparado com o consumo de alimentos processados e ultraprocessados, a maioria dos escolares eutróficos relataram maior frequência no consumo de balas e chicletes (50,0%) e barra de cereais (51,0%), de 1 a 3 vezes por semana (p=0,004; p=0,029, respectivamente). Houve também uma maior frequência de consumo de alimentos processados e ultraprocessados como pizza (73,5%; p0,001), refrigerante (58,8%; p=0,036) e biscoito recheado (58,8%; p=0,008) entre 1 a 3 vezes por semana na escola pública em comparação a escola privada. O consumo de suco de pacote (p=0,013) foi relatado não ser consumido pela maioria dos alunos da escola particular em comparação a escola pública. Os dados encontrados evidenciam um consumo expressivo de alimentos processados e ultraprocessados pelos adolescentes de ambas as escolas, destacando alimentos com alto teor de açúcar e sódio.Palavras-chave: Hábitos alimentares. Adolescentes. Alimentos industrializados. ABSTRACT: The objective of this study was to compare the frequency of consumption of processed and ultraprocessed foods and to verify the association between nutritional status by adolescents from public and private schools in the municipality of Arroio do Tigre, RS. This was a cross-sectional study conducted with adolescents, aged 10 to 15 years, from a public school and a private school in Arroio do Tigre, RS. Nutritional status was assessed by body mass index. A food frequency questionnaire containing processed and ultraprocessed foods was applied. The sample consisted of 64 adolescents with a mean age of 12.03±1.15 years, 53.1% of the public school. Most of the adolescents were eutrophic (p=0.343), and when compared to the consumption of processed and ultraprocessed foods, most eutrophic schoolchildren reported a higher frequency of bullets and chewing gum (50.0%) and cereal bars (51.0%), 1 to 3 times per week (p=0.004, p=0.029, respectively). There was also a higher frequency of consumption of processed and ultraprocessed foods such as pizza (73.5%, p0.001), refrigerant (58.8%, p=0.036) and stuffed biscuit (58.8%, p=0.008) between 1 to 3 times a week in public school compared to private school. Consumption of packet juice (p=0.013) was reported not to be consumed by the majority of private school students compared to public school. Conclusion: The data found evidenced an expressive consumption of processed and ultraprocessed foods by the adolescents of both schools, highlighting foods with high sugar and sodium content.Keywords: Food Habits. Adolescents. Industrialized Foods.

scholarly journals Evaluation of rational prescribing and dispensing of medicines in Mali

2017 ◽  
Author(s):  
Yaya Coulibaly ◽  
Fanta Sangho ◽  
Aboubacar Alassane Oumar
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Treatment Guidelines ◽  
Generic Drugs ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Medical Practitioners ◽  
The Public ◽  
Quality Of Prescribing

Objective: The drug policy of Mali is based on the concept of essential generic drugs. The adoption of generic drugs in a program is often accompanied by irrational use of these drugs precisely because of the availability of these drugs. Thus, this study was initiated to assess the quality of prescribing and dispensing drugs in Mali. Methods: This is a descriptive cross-sectional study was conducted from 2004 to 2013, the survey was conducted in 20 primary health centers and 20 private pharmacies in three regions of the country. In each of these structures, 30 prescriptions filled at the time of the survey were collected. Results: The average number of drugs per prescription was 3.0 ± 1.3 and 2.4 ± 1.2, respectively, in the public and private sectors. Prescription of drugs under international name was 91.6% in the public sector and 37.2% in the private sector. The public sector prescribed 33.7% of injectable drug against 16.2% in the private sector (p <0.001). The average cost of a prescription was lower in the public sector (3415.3 FCFA or 5.21euros) than in the private sector (7111 FCFA or 10.85 euros).Conclusion: Generic drugs are commonly used in the public, but much less in the private sector. The treatment guidelines are already available, should be introduced interactively to medical practitioners, through visits and intensive supervision by more experienced managers in the hierarchy, it would be likely to improve the quality of prescribing practitioners.

scholarly journals PREVENTIVE MEDICINE DEPARTMENT;

2012 ◽  
Vol 19 (02) ◽  
pp. 162-167
Author(s):  
MUHAMMAD AYAZ BHATTI ◽  
MAHMOOD UR RAHMAN
Keyword(s):  
Family Planning ◽  
Public Sector ◽  
Sampling Technique ◽  
Poor Performance ◽  
Cross Sectional Study ◽  
Annual Reports ◽  
Current Status ◽  
Growth Monitoring ◽  
Cross Sectional ◽  
The Public

Objectives: To measure the current status of preventive activities in civil and military hospitals. To compare the quantum ofpreventive and curative activities in the hospitals. To make recommendations for promotion of preventive activities to reduce the curative burdenfrom the hospitals. Study Design: This was a cross-sectional study. Sampling Technique: Universal sampling. All the major military and publicsector hospitals having bed strength more than 400 in Rawalpindi were included in the study. All the preventive and curative work was taken intoaccount. Methodology: A structured questionnaire was developed and data regarding the quantum of work was collected from all the fourmajor Military and civil hospitals having bed strength more than 400 beds through registers and annual reports of the hospital and was analyzedin the form of frequencies, tabulation, cross tabulation, percentages and was displayed in tables and graphs using SPSS (10.5), Microsoft Exceland calculus. Results: Only seven percent work is preventive and ninety three percent is curative. In the preventive activity MH is marginallyhigher than the rest of the hospitals. In all the hospitals among the preventive activities 31% are antenatal visits, 20 % tetanus toxoid injection,19% BCG, Growth monitoring 13%, Measles injection 11% and family planning 6% in all the hospitals. Ante natal activities in the army sectorhospitals are more prominent 39-44% and also in the public sector 17-26%. Next to the antenatal are tetanus toxoids to pregnant ladies whichrange from 16-35% in military and 16-20 % in the public sector hospitals. Growth monitoring is more efficiently carried out in the RawalpindiGeneral Hospital i.e. 17% while in others 7-12%. Family Planning services are delivered very poorly only 9% in RGH and 6% in DHQ, zero % inCMH and 5% in MH. Measles vaccination is carried out efficiently in DHQ 27%, 11% in RGH and 8% in MH and again poorly 3% in CMH. BCG is27% in DHQ, 20% in MH, 17% in RGH and 10% in CMH. Conclusions: The study show that hospitals are showing very poor performance inpreventive aspect and this is the reason that countries like Pakistan are facing economic burden on the national exchequer and this burden willkeep on increasing if no appropriate action is taken.

scholarly journals Healthcare providers’ level of involvement in provision of smoking cessation interventions in public health facilities in Kenya

2015 ◽  
Author(s):  
Judy W. Gichuki ◽  
Rose Opiyo ◽  
Possy Mugyenyi ◽  
Kellen Namusisi
Keyword(s):  
Public Health ◽  
Smoking Cessation ◽  
Smoking Status ◽  
Healthcare Providers ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Level Of Involvement ◽  
Public Health Facilities

Healthcare providers can play a major role in tobacco control by providing smoking cessation interventions to smoking patients. The objective of this study was to establish healthcare providers’ practices regarding smoking cessation interventions in selected health facilities in Kiambu County, Kenya. This was a descriptive cross-sectional study carried out among healthcare providers working in public health facilities in Kiambu County, Kenya. Self-administered questionnaires were distributed to 400 healthcare providers selected using a two-stage stratified sampling technique. Only 35% of the healthcare providers surveyed reported that they always asked patients about their smoking status. Less than half (44%) reported that they always advised smoking patients to quit. Respondents who had received training on smoking cessation interventions were 3.7 times more likely to have higher practice scores than those without training (OR=3.66; 95%CI: 1.63-8.26; P=0.003). Majority of the healthcare providers do not routinely provide smoking cessation interventions to their patients. Measures are needed to increase health worker’s involvement in provision of smoking cessation care in Kenya.

scholarly journals Pathways and associated costs of care in patients with confirmed and presumptive tuberculosis in Tanzania: A cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025079 ◽  
Author(s):  
Grace Mhalu ◽  
Jerry Hella ◽  
Francis Mhimbira ◽  
Khadija Said ◽  
Thomas Mosabi ◽  
...  
Keyword(s):  
Healthcare Providers ◽  
Indirect Costs ◽  
Healthcare Utilisation ◽  
Cross Sectional Study ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Costs Of Care ◽  
Poverty Status

ObjectiveTo assess pathways and associated costs of seeking care from the onset of symptoms to diagnosis in patients with confirmed and presumptive tuberculosis (TB).DesignCross-sectional study.SettingDistrict hospital in Dar es Salaam, Tanzania.ParticipantsBacteriologically confirmed TB and presumptive TB patients.Primary and secondary outcome measuresWe calculated distance in metres and visualised pathways to healthcare up to five visits for the current episode of sickness. Costs were described by medians and IQRs, with comparisons by gender and poverty status.ResultsOf 100 confirmed and 100 presumptive TB patients, 44% of confirmed patients sought care first at pharmacies after the onset of symptoms, and 42% of presumptive patients did so at hospitals. The median visits made by confirmed patients was 2 (range 1–5) and 2 (range 1–3) by presumptive patients. Patients spent a median of 31% of their monthly household income on health expenditures for all visits. The median total direct costs were higher in confirmed compared with presumptive patients (USD 27.4 [IQR 18.7–48.4] vs USD 19.8 [IQR 13.8–34.0], p=0.02), as were the indirect costs (USD 66.9 [IQR 35.5–150.0] vs USD 46.8 [IQR 20.1–115.3], p<0.001). The indirect costs were higher in men compared with women (USD 64.6 [IQR 31.8–159.1] vs USD 55.6 [IQR 25.1–141.1], p<0.001). The median total distance from patients’ household to healthcare facilities for patients with confirmed and presumptive TB was 2338 m (IQR 1373–4122) and 2009 m (IQR 986–2976) respectively.ConclusionsPatients with confirmed TB have complex pathways and higher costs of care compared with patients with presumptive TB, but the costs of the latter are also substantial. Improving access to healthcare and ensuring integration of different healthcare providers including private, public health practitioners and patients themselves could help in reducing the complex pathways during healthcare seeking and optimal healthcare utilisation.

scholarly journals Trends in treatment of anterior cruciate ligament injuries of the knee in the public and private healthcare systems of Brazil

2013 ◽  
Vol 131 (4) ◽  
pp. 257-263 ◽  
Author(s):  
Diego Costa Astur ◽  
Rodrigo Ferreira Batista ◽  
Gustavo Goncalves Arliani ◽  
Moises Cohen
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Cross Sectional Study ◽  
Medical Decision ◽  
Cross Sectional ◽  
Public And Private ◽  
The Public ◽  
Private Healthcare ◽  
Anterior Cruciate

CONTEXT AND OBJECTIVE Orthopedic surgery implies high costs for both public and private healthcare. The aim of this study was to better understand the differences between the public and private sectors regarding treatment of a damaged anterior cruciate ligament, which is a common knee injury. DESIGN AND SETTING Descriptive cross-sectional study conducted during the Brazilian Orthopedics Congress in Brasília. METHODS We applied questionnaires during the 2010 Brazilian Orthopedics Congress, with participation by 241 knee surgeons from 24 Brazilian states. This was followed by statistical analysis on the data that were obtained. RESULTS The orthopedic surgeons who were evaluated used different approaches and treatment options in different Brazilian states, comparing between the public and private systems. CONCLUSION Both in the public and in the private systems in Brazil, because of non-medical issues surrounding the treatment, the best medical decision is not always made. This may be harmful both to patients and to physicians.

scholarly journals Violence against the Brazilian elderlies: an analysis of hospitalizations

2018 ◽  
Vol 71 (suppl 2) ◽  
pp. 777-785 ◽  
Author(s):  
Vivian Carla de Castro ◽  
Leidyani Karina Rissardo ◽  
Lígia Carreira
Keyword(s):  
Public Sector ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Demographic Variables ◽  
Chi Square ◽  
Cross Sectional ◽  
The Public ◽  
Unified Health System ◽  
Quantitative Descriptive ◽  
Old Men

ABSTRACT Objective: to identify the prevalence of physical aggression and neglect and abandonment in the hospitalizations of Brazilian elderly people for violence and assault from 2008 to 2013 and the association of these causes with socio-demographic variables related to hospitalization. Method: quantitative, descriptive, cross-sectional study with elderlies hospitalized for assault. Inclusion criteria: to be 60 years old or over, to have been hospitalized in the Unified Health System (SUS) for assault or neglect and abandonment, between 2008 and 2013. The data were collected in February 2016, in Datasus database and descriptive and inferentially, using the Chi-square distribution, in the Epi Info 3.5.4 program. Results: the prevalence of hospitalizations due to assaults and violence prevailed among 60 and 69 years old men in the public sector. For abandonment and neglect, there was a higher prevalence in women, over 80 years old, in the public sector. Conclusion: nurses must be able to identify and prevent violence against the elderly.

scholarly journals Patient and provider attitudes to emergency department-based HIV counselling and testing in South Africa

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Bhakti Hansoti ◽  
Sarah E. Hill ◽  
Madeleine Whalen ◽  
David Stead ◽  
Andy Parrish ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Hiv Knowledge ◽  
Provider Attitudes ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Hiv Counselling And Testing ◽  
Privacy And Confidentiality

Background: The national South African HIV Counselling and Testing (HCT) guidelines mandate that voluntary counselling and testing (VCT) should be offered in all healthcare facilities. Emergency departments (EDs) are at the forefront of many healthcare facilities, yet VCT is not routinely implemented in this setting.Methods: We conducted a cross-sectional study that surveyed patients and healthcare providers at a tertiary care ED in the spring and summer of 2016 to ascertain their attitudes to VCT in the ED. We also used two previously validated survey instruments to gather data on patients’ HIV knowledge and providers’ stigma against patients living with HIV, as we anticipated that these may have an impact on providers’ and patients’ attitudes to the provision of HIV testing within the ED, and may offer insights for future intervention development.Results: A total of 104 patients and 26 providers were enrolled in the study. Overall, patients responded more favourably to ED-based HIV testing (92.3%) compared to providers (only 40% responded favourably). When asked about potential barriers to receiving or providing HIV testing, 16.4% of patients and 24% of providers felt that the subject of HIV was too sensitive and 58.7% of patients and 80% of providers indicated that privacy and confidentiality issues would pose major barriers to implementing ED-based HIV testing.Conclusion: This study shows that while ED-based HIV testing is overall highly acceptable to patients, providers seem less willing to provide this service. The survey data also suggest that future development of ED-based testing strategies should take into consideration privacy and confidentiality concerns that may arise within a busy emergency care setting. Furthermore, every effort should be made to tackle HIV stigma among providers to improve overall attitudes towards HIV-positive individuals that present for care in the ED.

scholarly journals Choice of birth place among antenatal clinic attendees in rural mission hospitals in Ebonyi State, South-East Nigeria

2019 ◽  
Author(s):  
Leonard O. Ajah ◽  
Fidelis A. Onu ◽  
Oliver C. Ogbuinya ◽  
Monique I. Ajah ◽  
Benjamin C. Ozumba ◽  
...  
Keyword(s):  
Public Health ◽  
Healthcare Providers ◽  
Significant Proportion ◽  
Antenatal Clinic ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Public Hospitals ◽  
Cross Sectional ◽  
Maternity Services ◽  
Birth Place

AbstractBackgroundLow utilization of health facilities for delivery by pregnant women poses a public health challenge in Nigeria.AimTo determine the factors that influence the choice of birth place among antenatal clinic attendees.MethodologyThis was a cross-sectional study of the eligible antenatal clinic attendees at Mater Misericordiae Hospital, Afikpo and Saint Vincent Hospital, Ndubia in Ebonyi State from February 1, 2016 to June 30, 2016. Analysis was done using EPI Info 7.21 software (CDC Atlanta Georgia).ResultsA total of 397(99.3%) completely filled questionnaires were collated and analysed. Approximately 71% of the health facilities closest to the respondents had maternity services. It took at least 1 hour for 80.9% of the respondents to access health facilities with maternity services. Most (60.2%) of the respondents had antenatal care attendance and majority of them did so at public hospitals. Approximately 43.8% of the respondents were delivered by the skilled birth attendants. The common determinants of birth place were nearness of the health facilities, familiarity of healthcare providers, improved services, sudden labour onset and cost. Also 61.7% of the respondents chose to deliver in public health facilities due to favourable reasons but this could be hampered by the rudeness of some healthcare providers at such facilities. A significant proportion of private health facilities had unskilled manpower and shortage of drugs.ConclusionA greater proportion of women will prefer to deliver in health facilities. However there are barriers to utilization of these facilities hence the need for reversal of this ugly trend.

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