Hepatitis C elimination in Pakistan is a distant dream unless government controls the health sector

2020 ◽  
pp. 1-8
Author(s):  
Arshad Altaf ◽  
Safdar Kamal Pasha
Keyword(s):  
Hepatitis C ◽  
Delivery System ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Health Sector ◽  
World Health Organisation ◽  
World Health ◽  
Short Report ◽  
Healthcare Delivery System ◽  
The Government

Abstract The World Health Organisation (WHO) has set an ambitious target to eliminate hepatitis C virus (HCV) by 2030. Pakistan is one of the focused countries because of the high prevalence of HCV. The prices of direct-acting antiviral drugs(DAA)have significantly reduced to between 11-25 dollars for a month’s treatment. To achieve the 2030 elimination target, Pakistan has to provide treatment to one million HCV-infected patients every year, beginning from 2018. This short report highlights a key barrier to achieve this target,i.e. the unsafe practices by regulated and unregulated healthcare delivery system comprising trained and untrained healthcare providers who can continue to churn out new patients with their unsafe healthcare practices and increase the possibility of re-infection in those who have been treated. Only the government has the power and authority to regulate and control the healthcare delivery system. Continuous...  

Developing a Charter of Spiritual Care for patients

2020 ◽  
Author(s):  
Akram Heidari ◽  
Abdolhasan Kazemi ◽  
Mohammad Abbasi ◽  
Seyed Hasan Adeli ◽  
Hoda Ahmari-Tehran ◽  
...  
Keyword(s):  
Literature Review ◽  
Delivery System ◽  
Expert Opinion ◽  
Systematic Literature Review ◽  
Spiritual Care ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
Spiritual Needs ◽  
Healthcare Delivery System

Abstract Background Spirituality is recognized as an important issue in healthcare, and every individual has spiritual needs. Despite increased knowledge about spiritual care and its necessity, there is no unique agreed upon framework for spiritual care among the practitioners. This study aimed to explore the concept from the viewpoint of both healthcare providers and patients within the Iranian social, cultural and overall context and present a charter for providing spiritual care. Methods The study consisted of a systematic literature review, two qualitative studies on the components of spiritual care from the perspective of healthcare providers and its dimensions as perceived by patients. The findings were then integrated to make up a charter draft that was accredited through expert opinion. Results The review of literatures led to the identification of 2 main themes and 10 themes. Perspectives of healthcare providers were categorized into 4 main themes and 10 themes and patients’ opinions were classified into 3 main themes and 11 themes. The themes and their subthemes were integrated to build the concepts and form the proposed charter with 30 statements. Conclusion The charter of spiritual care for patients is intended to present an agreed upon framework for spiritual care delivery and resolve some of the problems in this path. This can improve healthcare delivery system.

scholarly journals Private Sector in Indian Healthcare Delivery: Consumer Perspective and Government Policies to promote private Sector

2010 ◽  
Vol 1 (2) ◽  
pp. 79-87 ◽  
Author(s):  
Utkarsh Shah
Keyword(s):  
Private Sector ◽  
Medical Care ◽  
Delivery System ◽  
Healthcare Delivery ◽  
Private Investment ◽  
Specific Reference ◽  
Healthcare Delivery System ◽  
Quality Of Medical Care ◽  
The Government

This research paper attempts to collate literature from various sources, in an attempt to answer three pertinent questions related to healthcare in India. Firstly, what is it meant by ‘private sector’ in healthcare delivery system of India, secondly how has the private sector evolved over the decades and what has been the role of the government in propelling the growth. Finally, the paper tries to highlight some of the factors that have promoted the growth of private sector in India with specific reference to quality of medical care. The paper explicitly indicates that the deficiencies in the public health delivery system of India, was the key to growth of private infrastructure in healthcare. The shift of hospital industry for ‘welfare orientation’ to ‘business orientation’ was marked by the advent of corporate hospitals, supported by various policy level initiatives made by the government. Today, there are over 20 international healthcare brands in India with several corporate hospitals. However, a large section of the ‘private healthcare delivery segment’ is scattered and quality of medical care continues to remain a matter of concern. This paper tracks the various government initiatives to promote private investment in healthcare and attempts to explore the reasons for preference of the private sector. Surprisingly, in contrast to contemporary belief, quality of medical care doesn’t seem to be the leading cause for preference of the private sector. Except for a few select corporate and trust hospitals, quality of medical care in private sector seems to be poor and at times compromised.

scholarly journals THE NURSES AS HEALTHCARE WARRIORS IN COVID-19: PUBLIC HEALTH PERSPECTIVE

2020 ◽  
pp. 193-197
Author(s):  
Prof. Dr. Gitumoni Konwar ◽  
Ms. Urmijyoti Deori
Keyword(s):  
Public Health ◽  
Healthcare Delivery ◽  
Health Sector ◽  
Healthcare Services ◽  
Vital Role ◽  
World Health ◽  
Independent Practice ◽  
Healthcare Delivery System ◽  
Public Health Perspective ◽  
Health Organization

The year 2020 is announced as “the year of the Nurses and midwives” by the World Health Organization to commemorate 200-year birth anniversary of Florence Nightingale. The declaration has given true sense by the outbreak of novel CORONA virus since the beginning of the year. The nurses are the frontline fighters against COVID-19 to save the humankind. They put their lives at risk and perform their duties and responsibilities round the clock towards the community, public health and hygiene. Nurses have been showing the act of heroism, be it during the wars, epidemics and at times of disasters such as Covid-19. Nurses are facing many challenges in carrying out their duties and one of the biggest challenges is shortage of nurses, due to which they are overloaded with work. Nurses play a crucial role in the healthcare delivery system and nursing services has a great impact on health outcome of patients and public. The nurses are the backbone of the healthcare services. The nurses play a vital role towards the improvement of public health and hygiene with their independent practice. There is incredible scope to utilize the qualified nurses in public health and hygiene in developing countries like India to improve the wellbeing and quality of life of community dwellers. The emphasis must be given in utilization of the professional nurses in the public health sector. KEY WORDS: Nurses, COVID-19, challenges, Independent role and public health perspective.

Issues Impacting Therapeutic Outcomes in Pediatric Patients: An Overview

2014 ◽  
Vol 10 (3) ◽  
pp. 184-193 ◽  
Author(s):  
Atin Kalra ◽  
Shishu Goindi
Keyword(s):  
Pediatric Patients ◽  
Healthcare Providers ◽  
World Health Organisation ◽  
Dosage Forms ◽  
World Health ◽  
Neglected Diseases ◽  
Therapeutic Outcomes ◽  
Immunodeficiency Virus ◽  
Academic Researchers ◽  
Child Friendly

The quest for achieving optimal therapeutic outcomes in pediatric patients has evaded the healthcare professionals for long and often lack of child specific dosage forms and the associated events that follow with it have been considered to be major contributor towards suboptimal outcomes. Consequently, there have been sustained efforts over the years to address this issue with the enactment of legislations like Best Pharmaceutical for Children Act (BPCA), Pediatric Research Equity Act (PREA) and Pediatric Regulation by European Union (EU) to incentivise the participation of pharmaceutical industry towards development of child friendly dosage forms. Initiatives taken in past by organisations like World Health Organisation (WHO) and Drugs for Neglected Diseases Initiative (DNDi) to spur the development of child friendly dosage forms has helped to address issues pertaining to management of Human Immunodeficiency Virus (HIV) and malaria in pediatric patients. Present efforts aimed at developing child friendly dosage forms include oro-dispersible platforms including thin films and mini-tablets. Despite these leaps and advancements in developing better dosage forms for children, lower therapeutic outcomes in pediatric patients continue to remain an unresolved issue because of detrimental effects of additional factors such as parents understanding of label instructions and complexities involved in executing pediatric clinical studies thus requiring a concerted effort from pharmaceutical companies, academic researchers, parents and healthcare providers to work for better treatment outcomes in children.

The healthcare delivery system: an overview

2017 ◽  
Author(s):  
Jan Abel Olsen
Keyword(s):  
Delivery System ◽  
Chronic Care ◽  
Tertiary Care ◽  
Healthcare Delivery ◽  
Healthcare Delivery System ◽  
Care Level ◽  
Primary Care Level ◽  
Internal Markets ◽  
System A ◽  
Policy Challenge

This chapter provides an overview of the healthcare delivery system. A figure illustrates how six different parts of the system relate to each other. The primary care level plays a key role in many countries by representing the gate, in which referrals to secondary care are being made. Tertiary care is principally of two types depending on patients’ prognosis: chronic care or rehabilitation. In addition to the three care levels, there are two parts with quite different roles: pharmacies provide pharmaceuticals, and sickness benefit schemes compensate the sick for their income losses. A recurrent policy challenge is to make each provider level take into account the resource implications of their isolated decisions outside of their own budgets. A brief discussion is included on the scope for ‘internal markets’.

How Research Will Adapt to HIPAA: A View from Within the Healthcare Delivery System

2002 ◽  
Vol 28 (4) ◽  
pp. 491-502
Author(s):  
Mary L. Durham
Keyword(s):  
Health Information ◽  
Healthcare Delivery ◽  
Healthcare Providers ◽  
The United States ◽  
Personal Health Information ◽  
Personal Health ◽  
Business Associations ◽  
Electronic Information ◽  
Healthcare Delivery System ◽  
Institutional Review

While the new Health Insurance Privacy and Accountability Act (HIPAA) research rules governing privacy, confidentiality and personal health information will challenge the research and medical communities, history teaches us that the difficulty of this challenge pales in comparison to the potential harms that such regulations are designed to avoid. Although revised following broad commentary from researchers and healthcare providers around the country, the HIPAA privacy requirements will dramatically change the way healthcare researchers do their jobs in the United States. Given our reluctance to change, we risk overlooking potentially valid reasons why access to personal health information is restricted and regulated. In an environment of electronic information, public concern, genetic information and decline of public trust, regulations are ever-changing. Six categories of HIPAA requirements stand out as transformative: disclosure accounting/tracking, business associations, institutional review board (IRB) changes, minimum necessary requirements, data de-identification, and criminal and civil penalties.

scholarly journals Seroprevalence of antibodies to SARS-CoV-2 in healthcare workers: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043584 ◽  
Author(s):  
Joseph E Ebinger ◽  
Gregory J Botwin ◽  
Christine M Albert ◽  
Mona Alotaibi ◽  
Moshe Arditi ◽  
...  
Keyword(s):  
African American ◽  
Los Angeles ◽  
Delivery System ◽  
Healthcare Workers ◽  
Los Angeles County ◽  
Healthcare Delivery ◽  
Healthcare Delivery System ◽  
Hispanic Ethnicity ◽  
Factors Associated ◽  
African American Race

ObjectiveWe sought to determine the extent of SARS-CoV-2 seroprevalence and the factors associated with seroprevalence across a diverse cohort of healthcare workers.DesignObservational cohort study of healthcare workers, including SARS-CoV-2 serology testing and participant questionnaires.SettingsA multisite healthcare delivery system located in Los Angeles County.ParticipantsA diverse and unselected population of adults (n=6062) employed in a multisite healthcare delivery system located in Los Angeles County, including individuals with direct patient contact and others with non-patient-oriented work functions.Main outcomesUsing Bayesian and multivariate analyses, we estimated seroprevalence and factors associated with seropositivity and antibody levels, including pre-existing demographic and clinical characteristics; potential COVID-19 illness-related exposures; and symptoms consistent with COVID-19 infection.ResultsWe observed a seroprevalence rate of 4.1%, with anosmia as the most prominently associated self-reported symptom (OR 11.04, p<0.001) in addition to fever (OR 2.02, p=0.002) and myalgias (OR 1.65, p=0.035). After adjusting for potential confounders, seroprevalence was also associated with Hispanic ethnicity (OR 1.98, p=0.001) and African-American race (OR 2.02, p=0.027) as well as contact with a COVID-19-diagnosed individual in the household (OR 5.73, p<0.001) or clinical work setting (OR 1.76, p=0.002). Importantly, African-American race and Hispanic ethnicity were associated with antibody positivity even after adjusting for personal COVID-19 diagnosis status, suggesting the contribution of unmeasured structural or societal factors.Conclusion and relevanceThe demographic factors associated with SARS-CoV-2 seroprevalence among our healthcare workers underscore the importance of exposure sources beyond the workplace. The size and diversity of our study population, combined with robust survey and modelling techniques, provide a vibrant picture of the demographic factors, exposures and symptoms that can identify individuals with susceptibility as well as potential to mount an immune response to COVID-19.

Research on Understanding the vulnerabilities of Children with Disabilities Living in Alternative Care

2021 ◽  
pp. 234930032110228
Author(s):  
Shamim Ferdous ◽  
Mohammad Deloar Hossain
Keyword(s):  
Social Services ◽  
Quantitative Methods ◽  
Children With Disabilities ◽  
World Health Organisation ◽  
World Health ◽  
Persons With Disabilities ◽  
Secondary Sources ◽  
Qualitative And Quantitative Methods ◽  
Residential Institutions ◽  
The Government

Children with disabilities (CWDs) are one of the most marginalised and excluded groups in the society. Facing daily discrimination in the form of negative attitudes, lack of adequate policies and legislation, they are effectively barred from realising their rights to healthcare, education and even survival. It has been estimated that exposure towards all forms of violence against CWDs is four-time greater than that of children without disabilities. Bangladesh has an estimated 7–10 million CWDs (out of a total of 72 million children, World Health Organisation Report). Most of the time, these children are treated as a burden to their families or the community and thus become subject to violence. There are very few specialised institutions with residential facility to take care of them. So, they are institutionalised in general residential institutions at a significantly higher rate than other children. But both the special and general residential institutions have lack of skilled human resources and knowledge of the special situation and needs of CWDs. Peer groups of the CWDs are also less sensitised, which result in further stigma and discrimination of CWDs. A 2010 study was done by the Ministry of Women and children Affairs. The findings from interviews with adolescents’ aged 13–16 in 12 locations of Dhaka City revealed their extreme vulnerability. In 2010, a study by Bangladesh Protibondhi Foundation that conducted a survey supported by the Save the Children Sweden–Denmark found that 51.4% of CWDs are either at risk of sexual abuse (12.5%) or have been sexually abused (38.9%).The government of Bangladesh has taken a number of legislative and policy steps that indicate commitment to advancing the rights of persons with disabilities. In terms of international instruments, Department of Social Services under Ministry of Social Welfare operates various types of institutions for the children and also CWDs. The study will adopt qualitative and quantitative methods to collect information from both primary and secondary sources and also assess the situation of government non-government organisations/religious institutions where CWDs have residential facilities in order to understand which factors contribute to increased vulnerability of these children.

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