scholarly journals Interventions in increasing availability of skilled healthcare providers in rural areas: A Case Study of Bihar (India)

2021 ◽  
Vol 24 ◽  
pp. 853-864
Author(s):  
Dilip Kumar
Keyword(s):  
Rural Health ◽  
Rural Areas ◽  
Service Providers ◽  
State Level ◽  
The State ◽  
Health Facilities ◽  
Working Environment ◽  
Health Staff ◽  
Personal Support ◽  
Rural Service

Population of rural areas face distinct health challenges due to economic conditions, cultural/behavioural factors, and health provider shortages that combine to impose striking disparities in health outcomes among them. The process of recruitment takes about four to six months for Recruitment of Medical officers and paramedics. The number of applicants is quite limited because of dearth of doctors and paramedics in the State. It was felt that the health staffs incentives will help to increase the turnover of health staffs to some extent in the rural and remote areas. Monitoring cell has been constituted at the state level. The trainings are being monitored at regular intervals of time. The motivational level of health staff at all levels seems to be low. Continuous communication and feedback by state level programme officers is needed on regular basis. Placement of the suitable trained personnel is needed at those health facilities where sufficient infrastructure is available. Since 2010-11, there has been a continuous focus on the capacity building of the existing manpower in  the  state.  Trainings  as  per  GOI  guidelines  on  Immunization,  IMNCI,  EmOC,  LSAS,  SBA  and Minilap/MVA etc. have been taken up with full strength. In addition, the State wide training on immunization for Medical Officers, IPC skills for breast feeding and basic training in neonatal resuscitation also has been taken up at various levels. More than four-fifth of the total staffs in the health facilities were agreed on all the educational interventions for retention of health staffs in rural areas. For the regulatory interventions such as enhanced scope of practice, different types of health workers; multi skilling of alternate service providers, compulsory rural service which may be mandatory for obtaining license to practice or can be a prerequisite for entry into specialization and subsidized education in return of assured services were agreed by four-fifth of the total staffs. For the interventions related to professional and personal support such as better living conditions (water, sanitation, electricity, telecommunications, schools, etc.), safe and supportive working environment, outreach activities to facilitate cooperation between health workforce from better served and underserved areas; use of tele-health, designing career development programmes linked with rural service: more senior posts in rural areas and professional networks for rural areas such as rural health professional associations, rural health journals, etc. about 88 percent of the HR categories of Staffs were agreed in the health facilities

scholarly journals LEGAL PRINCIPLES OF RURAL MEDICINE DEVELOPMENT IN THE CONTEXT OF MEDICAL REFORM IN UKRAINE

2020 ◽  
Vol 1 (383) ◽  
pp. 113-120
Author(s):  
V. M. Yermolenko ◽  
O. V. Hafurova ◽  
M. A. Deineha
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Rural Health ◽  
Rural Areas ◽  
Medical Equipment ◽  
The State ◽  
Health Facilities ◽  
Medical Services ◽  
Rural Medicine ◽  
Medical Reform

Legal support for the constitutional right of citizens to health care and medical care is an important condition for the realization of the principle of recognition the individual on the highest social value. The state guarantees everyone the right to protection of health, medical care and medical insurance; creates the conditions for effective and affordable medical care for all citizens. At the same time, the low level of provision of modern medical equipment, machinery and medicines makes it virtually impossible to provide timely and high-quality medical services in rural areas. The quality of primary health care in rural areas is in terrible condition and the people who live there, and this is more than 30 % of the total population of Ukraine, were very looking forward to changes in this area. After all, most of the old buildings and medical equipment are in poor condition. Medical institutions do not have a complete set of equipment, medical supplies and equipment necessary for primary care. The state of the legal regulation of providing medical care to the rural population of Ukraine objectively needs to be improved. Despite the adoption of numerous normative legal acts, the issues of providing health facilities located in rural areas with the necessary modern equipment and technology remained unresolved until recently. The goal of the article is to investigate the current problems of the legal support for providing medical care in the rural settlements. Particular attention is paid to the reform of the network of the rural health facilities and the problems of staffing. According to the results of the study it is established that from January 1, 2018, the implementation of the rural health reform began in Ukraine. This was due to the need to improve the availability of medical services for the population living in rural areas, to increase the efficiency and effectiveness of the use of funds allocated for the development of health care in the village, to bring the network of healthcare institutions in rural areas and their material and technical support into line with the needs of the population. Rural medicine reform is the lengthy process that requires not only careful adherence to legislation, but also a preliminary assessment of the real state of medicine in the remotest corners of Ukraine in order to prepare a platform for change. It is determined that the implementation of medical reform in cities is perceived better, and therefore much faster is happening, what not to say about the countryside. The prompt and timely solution of the problems of reforming rural medicine is possible with the assistance of the state authorities and local self-government, domestic businesses, foreign investors and financial donors, without which it is extremely difficult to cope with decentralization.

scholarly journals Methodology of Forming a Comprehensive Mechanism for Public Administration of Service Cooperation Development in Rural Areas of Ukraine

2019 ◽  
Vol 8 (4S) ◽  
pp. 152-156 ◽  
Keyword(s):  
Public Administration ◽  
Rural Areas ◽  
State Level ◽  
The State ◽  
Integrated System ◽  
Coherent System ◽  
Situational Analysis ◽  
Rural Settlements ◽  
Social Infrastructure ◽  
Cooperative Movement

with carrying out the decentralization reform public administration mechanisms play an important role in ensuring the comprehensive development of rural areas. Expanding the use of such mechanisms in the sphere of cooperation on the state level will facilitate development and support of small entrepreneurial forms, common use of material and technical basis, emerging new working places, building social infrastructure and engineering communications, providing qualitative services to citizens and preserving rural settlements. The objective of the article is to identify constituents of the comprehensive mechanism of public administration for development of service cooperation of rural areas in Ukraine and to integrate them into a coherent system which would facilitate realization of the state strategies and programmes to achieve the Sustainable Development Goals. The object of the research is a comprehensive mechanism of public administration for development of service cooperation. Research methodology is grounded upon the use of general scientific knowledge methods, in particular, logical and semantic, induction and deduction for formulating definitions, systemic and situational analysis for characterizing constituents of a comprehensive mechanism and identifying their interrelations. Based on the systemic approach it has been defined that comprehensive mechanism is an integrated system which combines interrelated and dependable functioning of legislative, institutional, organisational and economic, financial and credit, information and communication as well as staffing mechanisms in the sphere of developing cooperative movement in the rural localities. It is proved that every mechanism influences its particular direction and is formed at the international, national, regional and local levels based on cooperative values and generalized system of principles. Special attention is paid to the research of international and national legislation to generalize the system of principles of cooperation, intermunicipal cooperation, public authorities and public associations’ functioning, upon which the comprehensive mechanism for public administration of service cooperation development in rural areas of Ukraine is based.

scholarly journals Management of services in total quality management implemented and non-implemented health facilities

2021 ◽  
Vol 6 (4) ◽  
pp. 689-696
Author(s):  
Muhsina Begum ◽  
Ashees Kumar Saha ◽  
Sheuly Begum ◽  
Nasima Akhter ◽  
Pritikona Borua ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Management ◽  
Total Quality Management ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Facilities ◽  
Working Environment ◽  
Care Providers ◽  
Total Quality ◽  
Medical College

5S-CQI-TQM is a management technique that is aimed at bringing satisfaction of staff as well as the patients through improvement of working environment. A cross-sectional comparative study was carried out among 226 respondents who were selected purposively from the selected study place from 1st January to 31st December 2017. Among 226 respondents, 113 were taken from Dhaka Medical College and another 113 were taken from Mugdha Medical College. Among 113 respondents, 56 respondents were health care providers and 57 respondents were health care receivers. The purpose of this study to compare the management of services in Total Quality Management implemented (Dhaka Medical College and Hospital) and non-implemented (Mugdha Medical College and Hospital) health facilities. A Semi-structured interviewer administered questionnaire and an observational check list were developed to collect the data. Separate questionnaire was used for health care providers and health care receivers. The statistical analysis was conducted using SPSS (statistical package for social science) version 20 statistical software. Significant statistical differences were found between TQM implemented and TQM non-implemented hospital regarding workload (p=0.043), hospital authority always seriously consider staff’s suggestions for the improvement of quality of service (p<0.001), employees always respect to each other in the hospital (p<0.001) and 35 (62.5%) service providers expressed satisfactory opinion regarding management of the hospital. Asian J. Med. Biol. Res. December 2020, 6(4): 689-696

scholarly journals Using the Kirkpatrick Model to evaluate the Maternity and Neonatal Emergencies (MANE) programme: Background and study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032873
Author(s):  
Meabh Cullinane ◽  
Helen L McLachlan ◽  
Michelle S Newton ◽  
Stefanie A Zugna ◽  
Della A Forster
Keyword(s):  
Health Service ◽  
Health Services ◽  
Rural Health ◽  
Service Providers ◽  
Significant Proportion ◽  
Newborn Care ◽  
The State ◽  
Maternity Service ◽  
Consumer Experience ◽  
Service Staff

IntroductionOver 310 000 women gave birth in Australia in 2016, with approximately 80 000 births in the state of Victoria. While most of these births occur in metropolitan Melbourne and other large regional centres, a significant proportion of Victorian women birth in local rural health services. The Victorian state government recently mandated the provision of a maternal and neonatal emergency training programme, called Maternal and Newborn Emergencies (MANE), to rural and regional maternity service providers across the state. MANE aims to educate maternity and newborn care clinicians about recognising and responding to clinical deterioration in an effort to improve clinical outcomes. This paper describes the protocol for an evaluation of the MANE programme.Methods and analysisThis study will evaluate the effectiveness of MANE in relation to: clinician confidence, skills and knowledge; changes in teamwork and collaboration; and consumer experience and satisfaction, and will explore and describe any governance changes within the organisations after MANE implementation. The Kirkpatrick Evaluation Model will provide a framework for the evaluation. The participants of MANE, 27 rural and regional Victorian health services ranging in size from approximately 20 to 1000 births per year, will be invited to participate. Baseline data will be collected from maternity service staff and consumers at each health service before MANE delivery, and at four time-points post-MANE delivery. There will be four components to data collection: a survey of maternity services staff; follow-up interviews with Maternity Managers at health services 4 months after MANE delivery; consumer feedback from all health services collected through the Victorian Healthcare Experience Survey; case studies with five regional or rural health service providers.Ethics and disseminationThis evaluation has been approved by the La Trobe University Science, Health and Engineering College Human Ethics Sub-Committee. Findings will be presented to project stakeholders in a deidentified report, and disseminated through peer-reviewed publications and conference presentations.

scholarly journals How to attract and retain health workers in rural areas of a fragile state: Findings from a labour market survey in Guinea

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0245569
Author(s):  
Sophie Witter ◽  
Christopher H. Herbst ◽  
Marc Smitz ◽  
Mamadou Dioulde Balde ◽  
Ibrahim Magazi ◽  
...  
Keyword(s):  
Working Conditions ◽  
Rural Areas ◽  
Health Workers ◽  
Human Resources For Health ◽  
Health Staff ◽  
Policy Dialogue ◽  
Cross Sectional ◽  
Remote Areas ◽  
Nationally Representative ◽  
Rural Service

Most countries face challenges attracting and retaining health staff in remote areas but this is especially acute in fragile and shock-prone contexts, like Guinea, where imbalances in staffing are high and financial and governance arrangements to address rural shortfalls are weak. The objective of this study was to understand how health staff could be better motivated to work and remain in rural, under-served areas in Guinea. In order to inform the policy dialogue on strengthening human resources for health, we conducted three nationally representative cross-sectional surveys, adapted from tools used in other fragile contexts. This article focuses on the health worker survey. We found that the locational job preferences of health workers in Guinea are particularly influenced by opportunities for training, working conditions, and housing. Most staff are satisfied with their work and with supervision, however, financial aspects and working conditions are considered least satisfactory, and worrying findings include the high proportion of staff favouring emigration, their high tolerance of informal user payments, as well as their limited exposure to rural areas during training. Based on our findings, we highlight measures which could improve rural recruitment and retention in Guinea and similar settings. These include offering upgrading and specialization in return for rural service; providing greater exposure to rural areas during training; increasing recruitment from rural areas; experimenting with fixed term contracts in rural areas; and improving working conditions in rural posts. The development of incentive packages should be accompanied by action to tackle wider issues, such as reforms to training and staff management.

scholarly journals Forecasting hospitalizations due to COVID-19 in South Dakota, USA.

2020 ◽  
Author(s):  
Jeff S Wesner ◽  
Dan Van Peursem ◽  
Jose Flores ◽  
Yuhlong Lio ◽  
Chelsea Wesner
Keyword(s):  
New York ◽  
South Dakota ◽  
Rural Areas ◽  
Prior Information ◽  
State Level ◽  
The United States ◽  
The State ◽  
Policy Implications ◽  
Weibull Function ◽  
Minimal Data

Anticipating the number of hospital beds needed for patients with COVID-19 remains a challenge. Early efforts to predict hospital bed needs focused on deriving predictions from SIR models, largely at the level of countries, provinces, or states. In the United States, these models rely on data reported by state health agencies. However, predictive disease and hospitalization dynamics at the state level are complicated by geographic variation in disease parameters. In addition it is difficult to make forecasts early in a pandemic due to minimal data. However, Bayesian approaches that allow models to be specified with informed prior information from areas that have already completed a disease curve can serve as prior estimates for areas that are beginning their curve. Here, a Bayesian non-linear regression (Weibull function) was used to forecast cumulative and active COVID-19 hospitalizations for South Dakota, USA. As expected, early forecasts were dominated by prior information, which was derived from New York City. Importantly, hospitalization trends also differed within South Dakota due to early peaks in an urban area, followed by later peaks in other rural areas of the state. Combining these trends led to altered forecasts with relevant policy implications.

scholarly journals SARS-CoV-2 Seroprevalence in Tamil Nadu in October-November 2020

2021 ◽  
Author(s):  
Anup Malani ◽  
Sabareesh Ramachandran ◽  
Vaidehi Tandel ◽  
Rajeswari Parasa ◽  
Sofia Imad ◽  
...  
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Tamil Nadu ◽  
State Level ◽  
The State ◽  
Fatality Rate ◽  
Serological Study ◽  
Substantial Variation ◽  
Elderly Age ◽  
Working Age

AbstractA population-representative serological study was conducted in all districts of the state of Tamil Nadu (population 72 million), India, in October-November 2020. State-level seroprevalence was 31.6%. However, this masks substantial variation across the state. Seroprevalence ranged from just 11.1% in The Nilgris to 51.0% in Perambalur district. Seroprevalence in urban areas (36.9%) was higher than in rural areas (26.9%). Females (30.8%) had similar seroprevalence to males (30.3%). However, working age populations (age 40-49: 31.6%) have significantly higher seroprevalence than the youth (age 18-29: 30.7%) or elderly (age 70+: 25.8%). Estimated seroprevalence implies that at least 22.6 million persons were infected by the end of November, roughly 36 times the number of confirmed cases. Estimated seroprevalence implies an infection fatality rate of 0.052%.

scholarly journals Analysing the expenditure on childbearing: a community-based cross-sectional study in rural areas of Punjab (India)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Niharika Mahajan ◽  
Baljit Kaur
Keyword(s):  
Public Health ◽  
Rural Areas ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Health Staff ◽  
Sectional Study ◽  
Catastrophic Expenditure ◽  
Cross Sectional ◽  
Maternity Services ◽  
Government Hospitals

Abstract Background A vast array of literature has established that high maternity expenditure precludes women from accessing health services. Further, this maternity expenditure takes catastrophic form, forcing individuals or households to significantly lower their standard of living now or at some time in future. The present study analyses expenditure on childbearing in rural areas of one of the richest and top performer states on health parameters in India, namely Punjab along with examining the determinants of catastrophic expenditure. It also attempts to examine the implementation of Janani Shishu Suraksha Karyakaram (JSSK) which entitles pregnant women to free maternity services in public health facilities. Methods A cross-sectional study was conducted in rural areas of Punjab involving 420 recently delivered women, who were questioned about their socio-economic attributes and expenditure incurred in the process of childbearing using face to face, semi-structured interviews. Employing logistic regression, an attempt has been made to understand the determinants of catastrophic maternity expenditure, i.e., expenditure exceeding 10% of annual household income. Results Of the 420 respondents surveyed, 96.7% reported bearing expenditure on childbearing, irrespective of the type of health facility used and 25% respondents spent catastrophically. On an average, respondents have spent US$62.87 on antenatal care, US$112.86 on delivery and US$6.55 on postnatal care. The results of multivariable analysis reveal that respondents belonging to general category (non reserve category), lower wealth quintiles and using private health facilities have higher odds of incurring catastrophic expenditure. At the same time, poor quality of care at government hospitals and inability of public health staff to provide timely treatment are the driving forces for utilizing private health facilities. Even in the presence of free maternity scheme at government hospitals, respondents on an average spent US$55.22 on availing maternity services. Conclusion The study shows that risk of bearing catastrophic expenditure and being pushed down to abject poverty is higher for respondents who are already at the bottom of wealth quintiles. The policy imperative has to swing towards upgrading the creaky health infrastructure and addressing the issues of poor accountability and corruption at government hospitals, along with thwarting unregulated expansion of private health sector.

scholarly journals Formation of strategic management of hemp cultivation in a developing country: A case of Ukraine

2021 ◽  
Vol 19 (2) ◽  
pp. 1-13
Author(s):  
Liubov Mykhailova ◽  
Andrii Mykhailov ◽  
Liudmyla Korenivska ◽  
Lyudmyla Khromushyna ◽  
Marharyta Chuprina
Keyword(s):  
Strategic Management ◽  
Development Strategy ◽  
Rural Areas ◽  
Cannabis Sativa ◽  
Rapid Development ◽  
State Level ◽  
The State ◽  
Strategic Decisions ◽  
Processing Plants ◽  
Key Issues

After a long period of decline and persecution, there is a revival and rapid development of the cannabis industry around the world: the use of this unique crop is expanding rapidly, and finally, it was transferred from a narcotic to an agricultural one (except for Ukraine). Nowadays, the Ukrainian hemp industry has practically gone unnoticed by the state, scientists, practitioners and society. At the same time, it has development prospects and can play a significant role for rural areas and the national economy. The paperis aimed at exploring the possibilities of growing hemp (Cannabis sativa L.) and justifying the need for strategic management of the development of the cannabis industry in Ukraine. Based on the analysis of hemp production, it is established that during the years of Ukraine’s independence, the area of hemp crops has decreased almost 8 times; the number of producers is limited; hemp processing plants do not function; the yield of technical hemp seeds has a slight tendency to increase andapproximates 6-7 kg/ha. The prospects for cannabis cultivation require building strategic management of the cannabis industry to address key issues and mitigate threats. The key elements of the production development strategy are identified as improving institutional and financial support at the state level. The main guidelines of strategic management of hemp cultivation are: simplification of regulation for producers; intensification of agribusiness entities; increasing production volumes; and improving the competitive environment in the hemp market. It is proved that the strategic development of the hemp industry requires developing hemp processing enterprises; disseminating knowledge among the population about the usefulness and benefits of this multi-purpose culture. To substantiate the effectiveness of strategic decisions, the algorithm was proposed for assessing the effectiveness of growing different types of hemp products by different technologies, which is carried out using economic and mathematical modeling.

Videoconferencing in the Queensland health service

2001 ◽  
Vol 7 (5) ◽  
pp. 266-271 ◽  
Author(s):  
Craig Kennedy ◽  
Ilse Blignault ◽  
Danielle Hornsby ◽  
Peter Yellowlees
Keyword(s):  
Mental Health ◽  
Health Service ◽  
Health Professionals ◽  
Average Duration ◽  
Clinical Care ◽  
The State ◽  
Health Facilities ◽  
Health Staff ◽  
Mental Health Staff ◽  
Queensland Health

Videoconferencing was introduced in the Queensland health service in 1995. By the end of 1999, there were more than 150 videoconferencing units in health facilities around the state. Six audits of videoconferencing usage were conducted using similar methodology at six-month intervals from November 1997 to May 2000. Between November 1997 and November 1999, the number of calls more than doubled, from 566 to 1378. Hours of usage almost trebled, from 671 to 1724. The average duration of calls remained similar, at about 1 h 12 min. The proportion of calls involving more than two sites (multipoint videoconferences) increased from 44% to 65%. The majority of the activity was for education (including training). Videoconferencing was also used for administration and clinical care. Mental health staff were the heaviest users, but use by health professionals from other specialty areas increased during the study period. The Queensland health service has realized a number of important benefits from telehealth.

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