Telemedicine in neonatal care-Saving lives with technology!

2022 ◽  
Vol 71 (12) ◽  
pp. 2837-2837
Author(s):  
Shahamah Ahmed
Keyword(s):  
Rural Areas ◽  
Access To Health Care ◽  
Quality Care ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Neonatal Care ◽  
Health Care Facilities ◽  
World Health ◽  
Junior Doctors

Madam, neonatal mortality in Pakistan i.e. death of babies within first twenty eight days of life is 49 per 1000 live births. Moreover, Pakistan contributes to 7% of global neonatal deaths. (1) Cause of mortality may be infection, intra-partum complications, prematurity or congenital birth defects but there is one thing common in all; majority of them occur in rural population due to lack of access to health care facilities. (2) With recent advances, role of tele-medicine has proved to be a milestone in field of medicine especially in underdeveloped and rural areas. According to World Health Organization (WHO), Telemedicine is defined as affordable use of Information and Communication Technology (ICT) for provision of health facilities and care. (3) A study done in Karachi in early 2020 by Ashfaq A et al showed average knowledge of telemedicine among clinicians and junior doctors, but we are still hopeful that since after the global pandemic of COVID-19, not just this knowledge has improved but also perceptions regarding telemedicine should have changed (4).  In another study done in china by Makkar A. et al, they demonstrated the role of tele-medicine in not just tele-rounds of NICU but also successful e-examinations of Retinopathy of prematurity, tele-echocardiography, tele-NPR guidance to healthcare providers and family support. Moreover, home based care can be efficiently provided to preterm low birth weight babies including establishment of enteral feeding. (5) With a global shortage of physicians worldwide, lack of neonatologists is a major reason of neonatal referrals from rural areas and tele-medicine can give promising results in this regard. It can not only prevent unnecessary ambulation of tiny patients but also improve survival and quality care. Though under umbrella of private NGOs, tele-medicine is being started for satellite centers in few regions of country but obviously it doesn’t cover majority of population. It is high time to realize importance of Tele-medicine in periphery care setups. Though provision of equipment, installments of high quality ICT and infrastructure might seem a barrier in establishment of Tele-medicine but it can bring revolutionary improvement in neonatal care. It cannot just help reducing over burdening to tertiary care hospitals but also in avoiding hazards and cost of patient transfer.

Nursing Perspective

2018 ◽  
pp. 357-366
Author(s):  
Michelle M. Rhoads ◽  
Eileen Briening ◽  
Nancy Crego ◽  
Kimberly Paula-Santos ◽  
Lauren Huster
Keyword(s):  
Quality Care ◽  
Clinical Skill ◽  
Healthcare Providers ◽  
Child Life ◽  
Direct Care ◽  
Procedural Sedation ◽  
Healthcare Team ◽  
Multiprofessional Team ◽  
Effective Delivery

The nursing process can be used in the safe and effective delivery of pediatric sedation care. Nurses contribute to the direct care of sedated patients by developing competency and expanding knowledge and expertise within their specialty. While the provision of care to patients and families is of paramount importance, ensuring an environment conducive to delivery of safe, quality care by the healthcare team is another fundamental aspect of nursing. Management of sedation, analgesia, and anxiety in pediatric procedural sedation is an intrinsically multidisciplinary process that involves nursing, physicians, child life specialists, and other healthcare providers. In general, pediatric procedural sedation is a relatively new specialty with limited data on the role of the pediatric nurse in this multiprofessional team. It is an opportunity for nursing to collaborate with other healthcare professionals to establish guidelines and protocols to facilitate optimal patient care and efficiency as well as to share and expand their knowledge base and clinical skill set. Specialty certification and credentialing, team concept values, and the evolving role of the sedation nurse are all elements to consider within pediatric procedural sedation from the nursing perspective.

scholarly journals Patients’ and healthcare providers’ perspectives of diabetes management in Cambodia: a qualitative study

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032578 ◽  
Author(s):  
Ei Ei Khaing Nang ◽  
Chhavarath Dary ◽  
Li Yang Hsu ◽  
Sokrath Sor ◽  
Vonthanak Saphonn ◽  
...  
Keyword(s):  
Diabetes Care ◽  
Rural Areas ◽  
Diabetes Management ◽  
Service Providers ◽  
Communicable Disease ◽  
Quality Care ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Healthcare Staff ◽  
Cross Sectional

ObjectiveThis study aimed to explore the challenges encountered by patients and healthcare providers and opportunities for improvement in managing diabetes mellitus (DM) in a low- and middle-income country (LMIC) facing a rise in DM prevalence.DesignQualitative cross-sectional study.SettingUrban, semiurban, and rural areas in Cambodia.ParticipantsThirty health service providers and fifty-nine adult DM patients.ResultsMost of the 59 DM patients reported having developed DM complications when they first sought treatment. The biggest challenges for the patients were geographical barriers, diet control, and shortage of medication supply. The healthcare staff expressed concerns about their limited knowledge and lack of confidence to treat diabetes, limited availability of diabetes care services, inadequate laboratory services, shortage of staff, poor patients’ compliance, and insufficient medication supplies. Both healthcare staff and patients urged an expansion of diabetes services in Cambodia and prioritisation of diabetes care in a manner similar to communicable disease control programmes of the recent past.ConclusionsCurrently, the Cambodian healthcare system has very limited capacity to provide quality care for chronic diseases. As a consequence, many patients are either left untreated or have interrupted care due to several barriers including financial, geographical, and lack of knowledge and skills. A more comprehensive and multipronged approach is urgently needed to improve DM care, which would require a collaborative effort from government, external funding agencies, private sector, and communities.

Healthcare infrastructure development in rural India: a critical analysis of its status and future challenges

2019 ◽  
Vol 25 (12) ◽  
pp. 1-9
Author(s):  
Nenavath Sreenu
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Access To Health Care ◽  
Health Care Facilities ◽  
Rural India ◽  
Infrastructure Development ◽  
Poor Access ◽  
Access To Health ◽  
Future Challenges

At present, the development of healthcare infrastructure in India is poor and needs fundamental reforms in order to deal with emerging challenges. This study surveys the growth of the healthcare infrastructure. The development of infrastructure and health care facilities, the position of the workforce, and the quality of service delivery are important challenges that are confronting healthcare centres in rural India. This article critically analyses the future challenges of Indian healthcare infrastructure development in rural areas, discussing the burden of disease, widespread financial deficiency, the vaccination policy and poor access to health care as some of the main issues. Life expectancy, literacy and per capita income are further considerations.

scholarly journals Evaluation of maternal mortality and their factors in GMCH, Aurangabad, India

2018 ◽  
Vol 7 (3) ◽  
pp. 879
Author(s):  
Ganesh Balasaheb Bharaswadkar ◽  
Murlidhar L. Kurtadikar
Keyword(s):  
Health Care ◽  
Maternal Mortality ◽  
Rural Areas ◽  
Community Education ◽  
Tertiary Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Maternal Deaths ◽  
Infective Hepatitis

Background: Analysing the factors related to maternal mortality is very important as they reflect the socioeconomic status and health care facility availabilities of the country. This study is aimed to analyse the epidemiological aspects and different causes of maternal death and evaluation of preventable factors and unavoidable factors if any causing maternal death.Methods: The retrospective study was carried out at GMCH, Aurangabad during the period from February 2002 to January 2004. All the data related to epidemiological factors and causes of maternal mortality was recorded and analyzed.Results: There were 33 maternal deaths during the study period. The mean maternal mortality rate was 211 per 1,00,000 total births. Maximum maternal deaths were reported at the age group of 26-30 years (36.1%), in primiparous women (46.8%) and from rural areas (78.38%). Most of the deaths (37.5%) were reported within first 24 hours of hospital admission at postpartum stage (87.5%). 84.37% of maternal deaths were due to direct causes. And toxemia of pregnancy (39.5%) was major direct cause. Anaemia and infective hepatitis constitutes for 9.3% each for the indirect causes maternal death.Conclusion: Most maternal deaths can be preventable by multidisciplinary approaches involving mass community education, improving sanitation, early referrals to tertiary care centres and by providing health care facilities in rural areas.

scholarly journals Duration of intervals in the care seeking pathway for lung cancer in Bangladesh: A journey from symptoms triggering consultation to receipt of treatment

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257301
Author(s):  
Adnan Ansar ◽  
Virginia Lewis ◽  
Christine Faye McDonald ◽  
Chaojie Liu ◽  
Muhammad Aziz Rahman
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Rural Areas ◽  
Care Pathway ◽  
Tertiary Care ◽  
Healthcare Providers ◽  
Care Seeking ◽  
Healthcare Seeking ◽  
Lung Cancer Patients ◽  
Initial Care

Timeliness in seeking care is critical for lung cancer patients’ survival and better prognosis. The care seeking trajectory of patients with lung cancer in Bangladesh has not been explored, despite the differences in health systems and structures compared to high income countries. This study investigated the symptoms triggering healthcare seeking, preferred healthcare providers (including informal healthcare providers such as pharmacy retailers, village doctors, and “traditional healers”), and the duration of intervals in the lung cancer care pathway of patients in Bangladesh. A cross-sectional study was conducted in three tertiary care hospitals in Bangladesh among diagnosed lung cancer patients through face-to-face interview and medical record review. Time intervals from onset of symptom and care seeking events were calculated and compared between those who sought initial care from different providers using Wilcoxon rank sum tests. Among 418 study participants, the majority (90%) of whom were males, with a mean age of 57 ±9.86 years, cough and chest pain were the most common (23%) combination of symptoms triggering healthcare seeking. About two-thirds of the total respondents (60%) went to informal healthcare providers as their first point of contact. Living in rural areas, lower levels of education and lower income were associated with seeking care from such providers. The median duration between onset of symptom to confirmation of diagnosis was 121 days, between confirmation of diagnosis and initiation of treatment was 22 days, and between onset of symptom and initiation of treatment was 151 days. Pre-diagnosis durations were longer for those who had sought initial care from an informal provider (p<0.05). Time to first contact with a health provider was shorter in this study compared to other developed and developing countries but utilizing informal healthcare providers caused delays in diagnosis and initiation of treatment. Encouraging people to seek care from a formal healthcare provider may reduce the overall duration of the care seeking pathway.

Determinants of Domestic Violence in Pakistan: A Qualitative and Econometric Analysis

Partner Abuse ◽  
2021 ◽  
pp. PA-D-20-00006
Author(s):  
Naeem Akram
Keyword(s):  
Domestic Violence ◽  
Rural Areas ◽  
Physical Violence ◽  
Household Head ◽  
Working Women ◽  
World Health ◽  
Socioeconomic Indicators ◽  
The Family ◽  
Health Organization

Domestic violence exists in every country, irrespective of the culture, ethnicity, age, income, and education of the women. World Health Organization (WHO) has estimated that approximately 35% of women worldwide had experienced sexual or physical violence. The present study has attempted to analyze the role of different socioeconomic indicators on the prevalence of domestic violence. In this regard, data of Pakistan Demographic and Health Survey (PDHS) 2017–2018 has been used and logit models have been estimated. It has been found that women married below the age of 18; living in rural areas; have more children; whose mothers experienced violence; feared their husbands; with little to or no autonomy in decision-making; had a bank account; married outside of the family; and had not inherited any land or property were significantly more vulnerable victims of domestic violence. It has been found that women’s education, education of her husband, and exposure to media by creating awareness may protect women from domestic violence. Furthermore, working women are more likely to face domestic violence, but women who have started working before marriage are significantly less vulnerable victims of domestic violence. However, the age of women herself, the age of husband, age of household head and wealth of household, living in the nucleus or joint family, receiving any support from Benazir Income Support Program (BISP) have no significant role in determining the domestic violence in Pakistan.

scholarly journals High Neonatal Mortality Rates in Rural India: What Options to Explore?

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Ravi Prakash Upadhyay ◽  
Palanivel Chinnakali ◽  
Oluwakemi Odukoya ◽  
Kapil Yadav ◽  
Smita Sinha ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Rural Areas ◽  
Relevant Literature ◽  
Healthcare Providers ◽  
Newborn Care ◽  
Neonatal Care ◽  
Standards Of Care ◽  
Neonatal Health ◽  
Middle Income ◽  
Trained Manpower

The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as “m-health” and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.

scholarly journals Maternal mortality in a tertiary care centre in North India: a retrospective study

2017 ◽  
Vol 6 (12) ◽  
pp. 5559
Author(s):  
Prachi Sarin Sethi ◽  
Sujata Sharma ◽  
Indu Chawla
Keyword(s):  
Maternal Mortality ◽  
Maternal Death ◽  
Rural Areas ◽  
Tertiary Care ◽  
Care Facility ◽  
North India ◽  
World Health ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Maternal Deaths

Background: The World Health Organization (WHO) estimates that, of 536,000 maternal deaths occurring globally each year, 136,000 take places in India. Maternal death has serious implications to the family, the society and the nation. It deprives the surviving infant of mother's care. This study was done to assess maternal mortality in a tertiary care centre in north India where large numbers of patients are referred from the peripheral centers and the rural parts. This study was done to assess the causes of maternal mortality and suggest remedial measures to reduce the same. Objective of present study was to assess the causes of maternal death over a period of one year at G.M.C Amritsar, India.Methods: A retrospective hospital based study of 22 maternal deaths over a period of 1 year from June 2012 to June 2013. The information regarding demographic profile and reproductive parameters were collected and results were analyzed.Results: Over the study period, there were 22 deaths and 7272 live births (Majority were referral from other districts all over Punjab). Most common direct cause of maternal mortality was haemorrhage and anemia was the most common indirect cause. Most maternal deaths were seen in patients from rural areas, unbooked, illiterate patients and patients from low socioeconomic status.Conclusions: Proper health education should be given to the women; early registration of antenatal cases should be done which allows for rapid diagnosis and treatment of high risk cases. Also constructing a well equipped health care facility with trained staff and prompt transport facilities for early referral can bring down the maternal mortality rate in our country.

scholarly journals Prevalence of hypertension in a rural community of coastal Karnataka: a cross sectional study

2017 ◽  
Vol 4 (8) ◽  
pp. 2774
Author(s):  
Trapti Saxena ◽  
Rajeev K. H.
Keyword(s):  
Blood Pressure ◽  
Rural Community ◽  
Rural Areas ◽  
Rural Population ◽  
Access To Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Health Concern ◽  
Sectional Study ◽  
Cross Sectional

Background: Hypertension is major risk factor for CVDs and its complications account for 9.4 million deaths worldwide every year. Hypertension itself is responsible for about 45% and 51% deaths due to heart disease and stroke respectively. Hypertension is a major public health concern in India both in urban and rural areas and it is increasing at an alarming rate in rural population. Because of inadequate access to health care facilities at rural areas, the early screening and treatment of hypertension is not done regularly, so we conducted this study. The objective of the study was to determine the prevalence of hypertension in a rural community of coastal Karnataka.Methods: A community based cross sectional study was conducted at rural field practice area of Srinivas Institute of Medical Sciences. Sample size was 300 and convenient sampling method used. Data was collected visiting homes and blood pressure measured with mercury sphygmomanometer by. Descriptive statistics were used to analyse the data.Results: Among 300 participants, 45% and 55% were males and females respectively and mean age of the participants was 50.6±15.4 years. The overall prevalence of hypertension among them was 18% and the proportion of hypertension was more among males, people aged >45 years and illiterates.Conclusions: Our study shows that, hypertension has seeped into rural population also which was a concern of the urban population earlier. New cases of hypertension diagnosed were also more which indirectly indicates, most people are not aware of their blood pressure and importance of regular monitoring of blood pressure. So, doing regular screening and creation of awareness at rural areas will help in reducing the morbidity and mortality due to hypertension and its complications. 

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