Tangrams: a simple visual tool for communicating the complexities of professionalism

Professionalism is vital for high quality healthcare and fundamental to health profession education. It is however complex, hard to define and can be challenging to teach, learn about and assess. We describe the development and use of an innovative visual tool, using a tangram analogy, to introduce and explore core professionalism concepts, which are often troublesome for both learners and educators. These include the hidden curriculum, capability, professional identity and the difference between unprofessionalism and high professional standards. Understanding these concepts can help individuals to see professionalism differently, encourage faculty to design professionalism programmes which focus on professional excellence, support assessors to feel more confident in identifying and addressing underperformance and facilitate learners to appreciate the complexity and uncertainty inherent in professionalism and to become more alert to the hidden curriculum and its potential impact. We have used the tangram model to educate for professionalism in multiple contexts with learners and educators. Participants regularly report that it leads to a deeper understanding and important new insights around professionalism and helps them identify ways of changing their practice. We believe this approach has relevance across the health professions and suggest ways it could be further developed to explore wider professionalism issues such as reflective practice, resilience and teamworking.

A model for sustainable, partnership-based telehealth services in rural India: An early process evaluation from Tuver village, Gujarat

Background Telehealth can improve access to high-quality healthcare for rural populations in India. However, rural communities often have other needs, such as sanitation or employment, to benefit fully from telehealth offerings, highlighting a need for systems-level solutions. A Business of Humanity approach argues that innovative solutions to wicked problems like these require strategic decision-making that attends to a) humaneness, e.g., equity and safety and b) humankind, or the needs and potential of large and growing markets comprised of marginalized and low-income individuals. The approach is expected to improve economic performance and long-term value creation for partners, thus supporting sustainability. Methods A demonstration project was conducted in Tuver, a rural and tribal village in Gujarat, India. The project included seven components: a partnership that emphasized power-sharing and complementary contributions; telehealth services; health promotion; digital services; power infrastructure; water and sanitation; and agribusiness. Core partners included the academic partner, local village leadership, a local development foundation, a telehealth provider, and a design-build contractor. This early process evaluation relies on administrative data, field notes, and project documentation and was analyzed using a case study approach. Results Findings highlight the importance of taking a systems perspective and engaging inter-sectoral partners through alignment of values and goals. Additionally, the creation of a synergistic, health-promoting ecosystem offers potential to support telehealth services in the long-term. At the same time, engaging rural, tribal communities in the use of technological advances posed a challenge, though local staff and intermediaries were effective in bridging disconnects. Conclusion Overall, this early process evaluation highlights the promise and challenges of using a Business of Humanity approach for coordinated, sustainable community-level action to improve the health and well-being of marginalized communities.

Why the World Should Not Follow the Failed United States Model of Fighting Domestic Hunger

Many industrialized nations have followed the lead of the United States (US) in reducing workers’ wages and cutting government safety nets, while giving their populaces the false impression that non-governmental organizations can meet the food and basic survival needs of their low-income residents. The history of the last 50 years and the global COVID-19 pandemic demonstrate why that is a mistake, leading to vastly increased household food insecurity, poverty, and hunger. This paper takes a close look at US data to help to better understand the significant impact US federal government policy measures had on limiting hunger throughout the pandemic and how we can learn from these outcomes to finally end hunger in America and other developed nations. The top three policy prescriptions vital in ending household food insecurity in the US and industrialized countries are as follows: (1) to create jobs; raise wages; make high quality healthcare and prescription medicine free; and ensure that high quality childcare, education, transportation, and broad-band access are affordable to all; (2) to enact a comprehensive “Assets Empowerment Agenda” to help low-income people move from owing to owning in order to develop middle-class wealth; and (3) when the above two steps are inadequate, ensure a robust government safety net for struggling residents that provides cash, food, and housing assistance.

Strengthening the Health System as a Strategy to Achieving a Universal Health Coverage in Underprivileged Communities in Africa: A Scoping Review

Universal health coverage (UHC) is defined as people having access to quality healthcare services (e.g., treatment, rehabilitation, and palliative care) they need, irrespective of their financial status. Access to quality healthcare services continues to be a challenge for many people in low- and middle-income countries (LMICs). The aim of this study was to conduct a scoping review to map out the health system strengthening strategies that can be used to attain universal health coverage in Africa. We conducted a scoping review and qualitatively synthesized existing evidence from studies carried out in Africa. We included studies that reported interventions to strengthen the health system, e.g., financial support, increasing work force, improving leadership capacity in health facilities, and developing and upgrading infrastructure of primary healthcare facilities. Outcome measures included health facility infrastructures, access to medicines, and sources of financial support. A total of 34 studies conducted met our inclusion criteria. Health financing and developing health infrastructure were the most reported interventions toward achieving UHC. Our results suggest that strengthening the health system, namely, through health financing, developing, and improving the health infrastructure, can play an important role in reaching UHC in the African context.

Drivers for Teleconsultation Acceptance in Brazil: Patients’ Perspective during the COVID-19 Pandemic

ABSTRACT Context: teleconsultation can be a strategic technological tool for patients to access quality healthcare while dealing with resource challenges within health industry. It can be particularly relevant during and after the COVID-19 pandemic, when the social distancing world had to scramble for new technological solutions to offer quality healthcare services with reduced personal contact. Objective: our research proposes an integrative technology acceptance model to evaluate the drivers of teleconsultation adoption by patients, aligning constructs from the technology acceptance model with other drivers, such as technology readiness, trust, and self-efficacy. Methods: analyses included descriptive statistics and structural equations modeling based on survey’s data from a sample of 415 consumers. Results: results indicate significant relationships between the assessed constructs, with particular relevance on the effects of perceived usefulness, anteceded by trust and technology readiness, on attitude and intention to use teleconsultation. Conclusion: our findings provide helpful insights for health organizations and regulators associated with the diffusion of teleconsultation. The study findings also indicate that the challenging COVID-19 pandemic context may be affecting patients’ intention to adopt teleconsultation.

An Explanatory Study of User Satisfaction

In achieving one of Brunei Vision 2035, which is to be among the top 10 in the world for quality of life, Ministry of Health (MOH) Brunei Darussalam has responded by implementing Brunei Healthcare Information and Management System (Bru-HIMS) that is equivalent to international best practices. Bru-HIMS has been implemented for about eight years since it first launched on 11 September 2012 where the outcome to user experience is unknown. Hence, this chapter investigates user satisfaction on Bru-HIMS specifically at RIPAS hospital and studies improvement towards providing quality healthcare in Brunei. DeLone and McLean Information System framework is applied to evaluate Bru-HIMS user satisfaction based on the six variables: information quality, system quality, service quality, intention to use and usage, perceived net benefits, and user satisfaction. Questionnaire survey was conducted to obtain primary data from Bru-HIMS. The findings demonstrate positive relationships between the six variables, which indicates Bru-HIMS has positively influenced Bru-HIMS users.

Social Enterpreneurs: Emerging Trend in Health Sector of Pakistan

The term Social Entrepreneurs is relatively new in the country like Pakistan. These groups try to overcome the existing social problems and derive sustainable social change in the economy through their innovative ideas and plans. The purpose of this study is to compare and explore the emerging trends of social entrepreneurs with the government in the health sector of Pakistan. This study tries to cover the research gap in the area of social entrepreneurship and highlight the growing role of social entrepreneurs in providing healthcare services to the people of Pakistan. For empirical evidence, three different healthcare institutions are selected. They include: Indus Hospital, Sindh Institute of Urology Transplantation and Shaukat Khanum Memorial Hospital. The services provided by these Healthcare Institutions are compared over the period of time. Trend analyses are carried out to study the role of these institutions by using various healthcare indicators and quantify the contribution of these organizations towards health improvement facilities in Pakistan. Some financial variables are also used to investigate resource mobilization in the sector. The result of the analysis revealed that these institutions are providing quality healthcare services to the people of Pakistan that are increasing with the passage of time.

Strengthening eHealth Systems to Support Universal Health Coverage in sub-Saharan Africa

The aim of universal health coverage (UHC) is to ensure that all individuals in a country have access to quality healthcare services and do not suffer financial hardship in using these services. However, progress toward attaining UHC has been slow, particularly in sub-Saharan Africa. The use of information and communication technologies for healthcare, known as eHealth, can facilitate access to quality healthcare at minimal cost. eHealth systems also provide the information needed to monitor progress toward UHC. However, in most countries, eHealth systems are sometimes non-functional and do not serve programmatic purposes. Therefore, it is crucial to implement strategies to strengthen eHealth systems to support UHC. This perspective piece proposes a conceptual framework for strengthening eHealth systems to attain UHC goals and to help guide UHC and eHealth strategy development.