The second sputum sample complicates tuberculosis diagnosis for women: a qualitative study from Malawi

2017 ◽  
Vol 21 (12) ◽  
pp. 1258-1263
Author(s):  
M. Kumwenda ◽  
B-T. Nyang'wa ◽  
B. Chikuse ◽  
T. Biseck ◽  
S. Maosa ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Access ◽  
Sputum Sample ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
System Level ◽  
Diagnostic Process ◽  
Care System

SETTING: District hospital and peripheral health care facilities in Balaka District, Malawi.OBJECTIVE: To identify barriers encountered by women in submitting a second sputum sample.DESIGN: Focus-group discussions and semi-structured interviews.RESULTS: Women encounter barriers at several levels: personal, cultural, socio-economic and health care system. Personal, cultural and socio-economic barriers include the fear of a tuberculosis (TB) diagnosis, the perception and condition of the patient, the distance and cost of travel to a health care facility, the subordinate position of women in household decision-making and the social support that women receive. Barriers at the health care system level include high patient numbers, staff shortages, the duration of the TB diagnostic process as well as the uncaring attitude and poor communication of health care workers. These barriers may apply not only to the submission of the second sample, but to health care access in general.CONCLUSION: Women face multiple barriers in submitting a second sputum sample. These do not operate in isolation but instead compound each other. Although potential solutions to overcome these barriers are recognised, some have yet to be adopted. To improve TB case finding, innovative and community approaches should be adopted more rapidly.

scholarly journals NEED FOR DRUG PRICE CONTROL IN INDIA

2018 ◽  
Vol 1 (4) ◽  
pp. 12-18
Author(s):  
Sachin K. R. Parasiya ◽  
V. Balamuralidhara ◽  
Pramod Kumar T.M ◽  
A.J. Dave ◽  
R. Gujarati ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Essential Medicine ◽  
Care Facility ◽  
Price Control ◽  
Health Care Facilities ◽  
Pharmaceutical Pricing ◽  
Price Variation ◽  
Care Facilities ◽  
Care System

India is one of the developing countries. A substantial proportion of population of this country is largely exposed to the drug market whose purchasing power is extremely low. Around 42% population of this country lives under the National poverty line ($1.25 per day).  Vital issue concerning them is to access the health care facility at an affordable cost. Medicine is a part of health care cost and it costs to around 70% to 80% of total cost. Thus, cost of medicine is a governing factor of health care system especially when it comes to price control of health care facilities. To bring down the cost of health care facilities, government spends money for health care facilities. A comparative expenditure made by state government is depicted in this article. NPPA (National Pharmaceutical Pricing Authority) is the Indian pharmaceutical pricing regulating authority and it achieves its objectives by implementing the DPCO (Drug Pricing control order). In spite of existence of the DPCO, drastic price variation is observed between the products of same API (Active Pharmaceutical Ingredient) and several factors are responsible for the same. To overcome the stated problem and monopolistic trade practice by patent holder/brand manufacturer, TRIPS (Trade Related Intellectual Properties Rights) provides Compulsory Licenses which has its unique role to play in affordability of medicines. Essential medicine is a basic requirement of health care system to serve their customers and hence an effective and overt price control on drugs is the need of present. This study will thus try to justify the need to bring NLEM (National List of Essential Medicine) under DPCO.

scholarly journals Preparedness for Pediatric COVID-19 Using Systems Approach: Experience of a Health Care Facility from India

2021 ◽  
Author(s):  
Rathika D. Shenoy ◽  
Praveen Nayak ◽  
Ankeeta Menona Jacob ◽  
Swathi Sunil Rao ◽  
Shivakumar Hiremath
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Systems Approach ◽  
Care Delivery ◽  
Care Facility ◽  
Health Care Facility ◽  
Pediatric Care ◽  
Modifiable Factors ◽  
Service Areas ◽  
Care System

AbstractA pandemic leads to disruption and stretching of an existing health care system and its resources. Coronavirus disease 2019 (COVID-19) data show distinct and severe manifestations in children necessitating critical care. Children need prioritization as they are susceptible to COVID-19 as part of the family cluster, varied presentations, and mortality. The purpose of this report is to discuss the optimization of the health care system for pediatric care. The key initiatives were to identify our objectives, bring out changes to the organizational processes, and integrate the same into the existing system. A systems approach to health care delivery by optimizing infrastructure, human resources, materials, funding, leadership, and governance was undertaken. This resulted in creation of distinct COVID-19 and non-COVID-19 service areas, management protocols, and trained health care workers. Partnership was forged with the public health system. This preparedness and continued responses to the demands of the health care system helped us manage children ranging from neonates to adolescents efficiently. Though the health care system is mostly open, acting upon the modifiable factors gave better preparedness in a short time.

Balancing safety against obstruction to health care access: An examination of behavioral flags in the VA health care system.

2018 ◽  
Vol 5 (1) ◽  
pp. 35-41
Author(s):  
Linda E. Weinberger ◽  
Shoba Sreenivasan ◽  
Daniel E. Smee ◽  
James McGuire ◽  
Thomas Garrick
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Access ◽  
Care Access ◽  
Va Health Care System ◽  
Care System

The Great Awakening - Digitalization in Dental Healthcare during the pandemic COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 380-384
Author(s):  
Priyanka Paul Madhu ◽  
Yojana Patil ◽  
Aishwarya Rajesh Shinde ◽  
Sangeeta Kumar ◽  
Pratik Phansopkar
Keyword(s):  
Health Care ◽  
Task Force ◽  
Care Service ◽  
Health Care Service ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
World Health ◽  
Record System ◽  
The World

disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declared the agent as the (SARS-CoV-2) the severe acute respiratory syndrome and the World Health Organization had activated significant surveillance to prevent the spread of this infection across the world. Taking into the account about the rigorousness of COVID-19, and in the spark of the enormous dedication of several dental associations, it is essential to be enlightened with the recommendations to supervise dental patients and prevent any of education to the dental graduates due to institutional closure. One of the approaching expertise that combines technology, communications and health care facilities are to refine patient care, it’s at the cutting edge of the present technological switch in medicine and applied sciences. Dentistry has been improved by cloud technology which has refined and implemented various methods to upgrade electronic health record system, educational projects, social network and patient communication. Technology has immensely saved the world. Economically and has created an institutional task force to uplift the health care service during the COVID 19 pandemic crisis. Hence, the pandemic has struck an awakening of the practice of informatics in a health care facility which should be implemented and updated at the highest priority.

A Web-Based Interactive Map to Promote Health-Care Facility Flood Preparedness

2021 ◽  
pp. 1-4
Author(s):  
Elena Grossman ◽  
Michelle Hathaway ◽  
Amber Khan ◽  
Apostolis Sambanis ◽  
Samuel Dorevitch
Keyword(s):  
Health Care ◽  
Emergency Preparedness ◽  
Online Survey ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Term Care ◽  
Web Based ◽  
Care Facilities ◽  
Interactive Map

Abstract Objectives: Little is known about how flood risk of health-care facilities (HCFs) is evaluated by emergency preparedness professionals and HCFs administrators. This study assessed knowledge of emergency preparedness and HCF management professionals regarding locations of floodplains in relation to HCFs. A Web-based interactive map of floodplains and HCF was developed and users of the map were asked to evaluate it. Methods: An online survey was completed by administrators of HCFs and public health emergency preparedness professionals in Illinois, before and after an interactive online map of floodplains and HCFs was provided. Results: Forty Illinois HCFs located in floodplains were identified, including 12 long-term care facilities. Preparedness professionals have limited knowledge of whether local HCFs were in floodplains, and few reported availability of geographic information system (GIS) resources at baseline. Respondents intended to use the interactive map for planning and stakeholder communications. Conclusions: Given that HCFs are located in floodplains, this first assessment of using interactive maps of floodplains and HCFs may promote a shift to reliable data sources of floodplain locations in relation to HCFs. Similar approaches may be useful in other settings.

scholarly journals How do caregivers of children with congenital heart diseases access and navigate the healthcare system in Ethiopia?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sugy Choi ◽  
Heesu Shin ◽  
Jongho Heo ◽  
Etsegenet Gedlu ◽  
Berhanu Nega ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Health Care System ◽  
Low Income ◽  
Congenital Heart ◽  
Heart Diseases ◽  
Heart Defects ◽  
Care Facility ◽  
Long Distance ◽  
Care System

Abstract Background Surgery can correct congenital heart defects, but disease management in low- and middle-income countries can be challenging and complex due to a lack of referral system, financial resources, human resources, and infrastructure for surgical and post-operative care. This study investigates the experiences of caregivers of children with CHD accessing the health care system and pediatric cardiac surgery. Methods A qualitative study was conducted at a teaching hospital in Ethiopia. We conducted semi-structured interviews with 13 caregivers of 10 patients with CHD who underwent cardiac surgery. We additionally conducted chart reviews for triangulation and verification. Interviews were conducted in Amharic and then translated into English. Data were analyzed according to the principles of interpretive thematic analysis, informed by the candidacy framework. Results The following four observations emerged from the interviews: (a) most patients were diagnosed with CHD at birth if they were born at a health care facility, but for those born at home, CHD was discovered much later (b) many patients experienced misdiagnoses before seeking care at a large hospital, (c) after diagnosis, patients were waiting for the surgery for more than a year, (d) caregivers felt anxious and optimistic once they were able to schedule the surgical date. During the care-seeking journey, caregivers encountered financial constraints, struggled in a fragmented delivery system, and experienced poor service quality. Conclusions Delayed access to care was largely due to the lack of early CHD recognition and financial hardships, related to the inefficient and disorganized health care system. Fee waivers were available to assist low-income children in gaining access to health services or medications, but application information was not readily available. Indirect costs like long-distance travel contributed to this challenge. Overall, improvements must be made for district-level screening and the health care workforce.

Pattern of ziprasidone exposures reported to Texas poison centers, 2001–2005

2008 ◽  
Vol 27 (4) ◽  
pp. 355-361 ◽  
Author(s):  
MB Forrester
Keyword(s):  
Health Care ◽  
Age Distribution ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Poison Control ◽  
Clinical Effects ◽  
Poison Control Centers ◽  
Poison Centers ◽  
The Mean

Information on potentially adverse exposures to the atypical antipsychotic drug ziprasidone is limited. This study described the pattern of exposures involving only ziprasidone (isolated exposures) reported to Texas poison control centers during 2001–2005. The mean dose was 666 mg. The patient age distribution was ≤5 years (11%), 6–19 years (30%), and ≥20 years (60%). The exposures were intentional in 53% of the cases. Seventy-five percent of the exposures were managed at health care facilities. The final medical outcome was classified as no effect for 39% of the cases and minor effects for 40% of the cases. Adverse clinical effects were listed for 53% of the patients; the most frequently reported being neurological (42%), cardiovascular (13%), and gastrointestinal (5%). The most frequently listed treatment was decontamination by charcoal (34%) or cathartic (28%). Potentially adverse ziprasidone exposures reported to poison control centers are likely to involve management at a health care facility and involve some sort of adverse clinical effect. With proper treatment, the outcomes of such exposures are generally favorable.

scholarly journals Engaging African American Veterans with Health Care Access Challenges in a Community Partnered Care Coordination Initiative: A Qualitative Needs Assessment

2018 ◽  
Vol 28 (Supp) ◽  
pp. 475-484
Author(s):  
Adriana Izquierdo ◽  
Michael Ong ◽  
Felica Jones ◽  
Loretta Jones ◽  
David Ganz ◽  
...  
Keyword(s):  
Health Care ◽  
African American ◽  
Los Angeles ◽  
Health Care System ◽  
Health Care Access ◽  
Veterans Health ◽  
Health Administration ◽  
Health Care Environment ◽  
Care Access ◽  
Care System

Background: Little has been written about engaging potentially eligible members of a health care system who are not accessing the care to which they are entitled. Know­ing more about the experiences of African American Veterans who regularly experi­ence health care access challenges may be an important step toward equitable, coordi­nated Veterans Health Administration (VHA) care. This article explores the experiences of African American Veterans who are at risk of experiencing poor care coordination.Design: We partnered with a community organization to recruit and engage Veterans in three exploratory engagement workshops between October 2015 and February 2016.Participants and Setting: Veterans living in South Los Angeles, CaliforniaMain Outcome Measures: Veterans were asked to describe their experiences with community care and the VHA, a division of the US Department of Veterans Affairs (VA). Field notes taken during the workshops were analyzed by community and academic partners using grounded theory methodol­ogy to identify emergent themes.Results: 12 Veterans and 3 family members of Veterans participated in one or more en­gagement workshops. Their trust in the VA was generally low. Positive themes included: Veterans have knowledge to share and want to help other Veterans; and connecting to VA services can result in positive experi­ences. Negative themes included: functional barriers to accessing VA health care services; insensitive VA health care environment; lack of trust in the VA health care system; and Veteran status as disadvantageous for accessing non-VA community services.Conclusions: Veterans living in underserved areas who have had difficulty accessing VA care have unique perspectives on VA services. Partnering with trusted local com­munity organizations to engage Veterans in their home communities is a promising strategy to inform efforts to improve care access and coordination for vulnerable Vet­erans.Ethn Dis. 2018;28(Suppl 2):475-484; doi:10.18865/ed.28.S2.475.

scholarly journals The impact of introducing ambulance and delivery fees in a rural hospital in Tanzania.

2020 ◽  
Author(s):  
Corinna Vossius ◽  
Estomih Md ◽  
Robert Moshiro ◽  
Paschal M ◽  
Jan Terje Kvaløy ◽  
...  
Keyword(s):  
Health Care ◽  
Access To Health Care ◽  
Low Birthweight ◽  
Care Facility ◽  
Health Care Facility ◽  
Skilled Birth Attendance ◽  
Health Care Facilities ◽  
Birth Attendance ◽  
Vaginal Deliveries ◽  
The Impact

Abstract Background: Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees . Methods: Retrospective analysis of data from a prospective observational study. Data was compared between the period before introduction of fees from February 2010 through June 2013 and the period after from January 2014 through January 2017. Logistic regression modelling was used to construct risk-adjusted variable-life adjusted display (VLAD) and cumulative sum (CUSUM) plots to monitor changes. Results: A total of 28,601 births were observed. The monthly number of births was reduced by 17.3% during the post-introduction period. Spontaneous vaginal deliveries were registered less frequently, while labour complication and caesarean sections were more frequent. There was a reduction of newborns with birth weight less than 2500 grams. The observed changes were stable over time. For most variables, a significant change could be detected after a few weeks. Conclusion: After the introduction of ambulance and delivery fees an increase in labour complications and caesarean sections of about 80 per 1000 births and a decrease in non-cephalic presentations and newborns with low birthweight of about 17 per 1000 births each was observed. This might indicate that women delay the decision to seek skilled birth attendance or do not seek help at all, possibly due to financial reasons. Lower rates of births in a safe health care facility like HLH is of great concern, as access to skilled birth attendance is a key requirement in order to further reduce perinatal mortality. Therefore, free delivery care should be a high priority.

scholarly journals Factors influencing health-care access of female commercial sex workers in India: an in-depth review

2017 ◽  
Vol 4 (4) ◽  
pp. 886 ◽  
Author(s):  
Rudrajit Paul ◽  
Meera Suresh ◽  
Jayati Mondal
Keyword(s):  
Health Care ◽  
Health Care Access ◽  
Sex Workers ◽  
Healthcare Access ◽  
Care Facility ◽  
Health Care Facility ◽  
Commercial Sex ◽  
Commercial Sex Workers ◽  
Factors Affecting ◽  
Care Access

Commercial sex workers (CSW) are a vulnerable section of the society with diverse health problems. However, different surveys have consistently shown limited healthcare access by this group. There are a lot of factors, related both to the health care facility and the potential users, which influence this access. In this review, we have analysed some of the factors affecting healthcare access of female CSWs in India. The analysis has been done according to a standard conceptual framework. Certain remedial measures have also been proposed at the end. 

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