integrated healthcare
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2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Irene G. Ampomah ◽  
Bunmi S. Malau-Aduli ◽  
Abdul-Aziz Seidu ◽  
Aduli E. O. Malau-Aduli ◽  
Theophilus I. Emeto

Abstract Background The Ghanaian government has implemented interventions that integrate traditional medicine (TM) into its national health system in response to the high prevalence of TM use. However, empirical evidence of the experiences of service users and the practice of integrated health in Ghana is scanty. Therefore, this study explored the experiences of people with TM integration into the formal health system in Ashanti region using an adapted TM integration framework. Methods A sequential explanatory mixed methods study design comprising survey administration and in-depth interviews for data collection was utilised to address the research objective. Framework analysis was used in analysing the qualitative data and for triangulation of results. Results Participants were aware of licensing and training of TM practitioners in a science-based university in Ghana. However, knowledge of the existence of TM units in selected hospitals in the region was minimal. Integration knowledge was largely influenced by sex, marital status, household size and residential status, where males and urban dwellers were more familiar with the process than females and rural dwellers. Low patronage of integrated health services in the region was attributable to weak cross referrals. However, service users who had engaged with the integrated system recounted a satisfactory outcome. Conclusion Service users’ unfamiliarity with the presence of integrated facilities in Ghana could be an impediment to the practice of integrated healthcare. Sensitisation of the public about the practice of an integrated system could refine the Ghanaian integrated system. Regular evaluation of patient satisfaction and outcome measures might also serve as an effective strategy for improving health services delivery since evaluation is becoming an important component of health service design and implementation. There is the need for future studies to focus on exploring the perceptions and experiences of health practitioners and hospital administrators regarding the practice of integrated health in Ghana.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
John L. Z. Nyirenda ◽  
Dirk Wagner ◽  
Bagrey Ngwira ◽  
Berit Lange

Abstract Introduction There are efforts in low and middle-income countries (LMICs) to integrate Tuberculosis (TB) and Diabetes mellitus (DM) healthcare services, as encouraged by WHO and other international health organizations. However, evidence on actual effect of different integration measures on bidirectional screening coverages and or treatment outcomes for both diseases in LMICs is scarce. Objectives and methods Retrospective chart review analysis was conducted to determine effects of integrated care on bidirectional screening and treatment outcomes for both TB patients and people with DM (PWD) recruited in eight Malawian hospitals. Data of ≥ 15 years old patients registered between 2016 to August 2019 were collected and analysed. Results 557 PWDs (mean age 54) and 987 TB patients (mean age 41) were recruited. 64/557 (11.5%) PWDs and 105/987 (10.6%) of TB patients were from an integrating hospital. 36/64 (56.3%) PWDs were screened for TB in integrated healthcare as compared to 5/493 (1.0%) in non-integrated care; Risk Difference (RD) 55.2%, (95%CI 43.0, 67.4), P < 0.001, while 10/105 (9.5%) TB patients were screened for DM in integrated healthcare as compared to 43/882 (4.9%) in non-integrated care; RD 4.6%, (95%CI − 1.1, 10.4), P = 0.065. Of the PWDs screened, 5/41 (12.2%) were diagnosed with TB, while 5/53 (9.4%) TB patients were diagnosed with DM. On TB treatment outcomes, 71/508 (14.8%) were lost to follow up in non-integrated care and none in integrated care were lost to follow-up; RD − 14.0%, (95%CI: − 17.0,-11.0), p < 0.001. Among PWDs, 40/493 (8.1%) in non-integrated care and 2/64 (3.1%) were lost to follow up in integrated care; RD − 5.0%, (95%CI:-10.0, − 0.0); P = 0.046. After ≥ 2 years of follow up, 62.5% PWDs in integrated and 41.8% PWDs in non-integrated care were retained in care, RD 20.7, (95%CI: 8.1, 33.4), P = 0.001. Conclusion We found higher bidirectional screening coverage and less loss to follow-up in one centre that made more efforts to implement integrated measures for TB and DM care than in 7 others that did not make these efforts. Decisions on local programs to integrate TB/DM care should be taken considering currently rather weak evidence and barriers faced in the local context as well as existing guidelines.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e053641
Author(s):  
Kristin Oliver ◽  
Anant Raut ◽  
Stanley Pierre ◽  
Leopolda Silvera ◽  
Alexander Boulos ◽  
...  

ObjectivesTo examine the factors associated with COVID-19 vaccine receipt among healthcare workers and the role of vaccine confidence in decisions to vaccinate, and to better understand concerns related to COVID-19 vaccination.DesignCross-sectional anonymous survey among front-line, support service and administrative healthcare workers.SettingTwo large integrated healthcare systems (one private and one public) in New York City during the initial roll-out of the COVID-19 vaccine.Participants1933 healthcare workers, including nurses, physicians, allied health professionals, environmental services staff, researchers and administrative staff.Primary outcome measuresThe primary outcome was COVID-19 vaccine receipt during the initial roll-out of the vaccine among healthcare workers.ResultsAmong 1933 healthcare workers who had been offered the vaccine, 81% had received the vaccine at the time of the survey. Receipt was lower among black (58%; OR: 0.14, 95% CI 0.1 to 0.2) compared with white (91%) healthcare workers, and higher among non-Hispanic (84%) compared with Hispanic (69%; OR: 2.37, 95% CI 1.8 to 3.1) healthcare workers. Among healthcare workers with concerns about COVID-19 vaccine safety, 65% received the vaccine. Among healthcare workers who agreed with the statement that the vaccine is important to protect family members, 86% were vaccinated. Of those who disagreed, 25% received the vaccine (p<0.001). In a multivariable analysis, concern about being experimented on (OR: 0.44, 95% CI 0.31 to 0.6), concern about COVID-19 vaccine safety (OR: 0.39, 95% CI 0.28 to 0.55), lack of influenza vaccine receipt (OR: 0.28, 95% CI 0.18 to 0.44), disagreeing that COVID-19 vaccination is important to protect others (OR: 0.37, 95% CI 0.27 to 0.52) and black race (OR: 0.38, 95% CI 0.24 to 0.59) were independently associated with COVID-19 vaccine non-receipt. Over 70% of all healthcare workers responded that they had been approached for vaccine advice multiple times by family, community members and patients.ConclusionsOur data demonstrated high overall receipt among healthcare workers. Even among healthcare workers with concerns about COVID-19 vaccine safety, side effects or being experimented on, over 50% received the vaccine. Attitudes around the importance of COVID-19 vaccination to protect others played a large role in healthcare workers’ decisions to vaccinate. We observed striking inequities in COVID-19 vaccine receipt, particularly affecting black and Hispanic workers. Further research is urgently needed to address issues related to vaccine equity and uptake in the context of systemic racism and barriers to care. This is particularly important given the influence healthcare workers have in vaccine decision-making conversations in their communities.


Author(s):  
Jahri Jahri

Toodler is an age group with rapid body growth. However, toddler is also nutritionally vulnerable group and easily suffer from nutritional disorders. Various studies related to nutrition state that, nutritional status can be caused by medical conditions, socioeconomic status of the family which includes mother's education, mother's work status, family income, household food outcome, and socio-cultural environment. Nevertheless, secondary data in working area of Tambelan Sampit’s Public Health Center, toddlers aged 0-59 months were 85% in good nutrition. This research aimed to explore, analyse, and describe the positive behaviour of housewives in form of parenting’ feeding habits, parenting’s cleaning habits and parenting’s health service with toddler’s good nutrition event from poor family in Tambelan Sampit Urban Village of Pontianak Timur District of Pontianak City. The type of this research was qualitative and the samples were 5 toddlers with good nutrition status from poor family. The samples were taken using purposive sampling, which the housewives were chosen selectively, and they must be the best housewives, would be selected as the research samples. The result showed that positive behaviour of parenting’s feeding habits for toddlers was less eating but it was done regularly, giving additional foods, and giving suplementary vitamines. Parenting’s cleaning habits involved washing hands before feeding the toddler, showering before the feeding, and taking care of the cleanliness of house and environment. While the positive behaviour of parenting’s health service was such as coming to the Integrated Healthcare Center regularly to weigh and to observe the toddler’s health every month, and if the toddler gets sick he or she must be brought to Public Health Center in order to get treatment. This research suggests to improve socialization about nutrition awareness family to increase mother’s knowledge in feeding especially for toddler. It also involves the importance sanitation and hygene, joins the Integrated Healthcare Center regularly, socializes positive behaviours of toddler’s mother from poor family which has been successfully maintained and stayed out of lack nutrition issue on toddlers by health staffs through various activities in Integrated Healthcare Center.


2021 ◽  
Vol 17 (S10) ◽  
Author(s):  
Michael H Rosenbloom ◽  
Leah R Hanson ◽  
Ana Diaz‐Ochoa ◽  
Aleta Svitak ◽  
Ann Brombach ◽  
...  

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 30-30
Author(s):  
Jeffrey Gregg ◽  
Rachel Rodriguez ◽  
Priyanka Mehta ◽  
Christine Gould

Abstract The Geriatric Scholars Program- Psychology Track (GSP-P) was implemented to address the dire shortage of mental health providers with geriatrics expertise within the VA, a large integrated healthcare system. One hundred and five psychologists participated in the GSP-P introductory geropsychology competencies course. Though they exhibited significant improvements in confidence, knowledge, and skills across geropsychology domains, increased depth (in addition to breadth) of training is needed. In 2019, GSP-P implemented an advanced workshop for graduates of the introductory course. Twenty-one psychologists participated in the workshop, which included 3.5 days of expert-led seminars followed by completion of an individualized learning plan over six months. Results from our evaluation indicated significant improvements in four of five geropsychology domains on the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool. Our findings demonstrate continued enhancement of geropsychology competencies through advanced coursework is feasible and improves depth of training, particularly when combined with individualized learning plans.


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