The role of the public and private health sectors on factors associated with early essential newborn care practices among institutional deliveries in Ghana

Background Early essential newborn care is one of the important interventions developed by the World Health Organization to reduce morbidities and mortalities in neonates. This study investigated the role of the public and private sector health facilities on factors associated with early essential newborn care practices following institutional delivery in Ghana. Methods We used data from the 2017/2018 multiple indicator cluster survey for our analysis. A total of 2749 mothers aged 15–49 years were included in the study. Logistic regression analysis was used to assess the factors associated with early essential newborn care in both public and private health sectors. Results The prevalence of good early essential newborn care in the public sector health facilities was 26.4 % (95 % CI: 23.55, 29.30) whiles that of the private sector health facilities was 19.9 % (95 % CI: 13.55, 26.30). Mothers who had a Caesarean section in the public sector health facilities had 67 % lower odds of early essential newborn care compared to mothers who had a vaginal delivery [adjusted prevalence odds ratios (aPOR) = 0.33, 95 % CI: 0.20, 0.53]. Mothers without a health insurance in the public sector health facilities had 26 % lower odds of early essential newborn care compared to mothers with a health insurance (aPOR = 0.74, 95 % CI: 0.56, 0.97). However, these associations were not observed in the private sector health facilities. Conclusions The findings suggest that the prevalence of good early essential newborn care in the public sector health facilities was higher than that reported in the private sector health facilities. Child health programs on early essential newborn care needs to be prioritized in the private healthcare sector. The Government of Ghana may also need to increase the coverage of the national health insurance scheme for women in reproductive age.

Health Communication and Social Media

Social media networks have become platforms that the private and also public sector health corporations use for communucating with their patients and also finding solutions for their needs. To establish a healthy health communucation in between the patients and the health organisations and facilities and also to cover the needs of patients to reach true information is very important. Because of this, the performers using the social media must be examined. In this study, the authors examine and study the targets and the communucation strategies of medicine companies by using the social media and also thier medicine specifications to make a harmony in between these organisatipons and their products. In this study, the content analysis method is used to examine the Facebook page of Pfizer company in September and October 2020 posts. As a result of this Facebook page study of the company, the authors saw that 50% of the posts are acknowlagments, 31% about treatments of illnesses, and the rest (19%) are greetings.

Factors Contributing to Low Tuberculosis Detection Rates among Children Accessing Health Services in Selected Public Sector Health Facilities in Zimbabwe

Introduction: Zimbabwe is one of 8 African countries with high per capita incidence of TB, TB/HIV and multi-drug resistant TB. Zimbabwe experienced a proportionate decline in childhood TB contribution to all notifications from 9% in 2011 to 5% in 2017. Methodology: Analytical cross-sectional study was conducted in 20 public sector health facilities. Data were collected from healthcare workers (HCWs) using structured questionnaires, interview guide for health managers and data abstraction tool for childhood TB data in registers. Protocol received ethical approval and written informed consent was obtained from participants. Results: Eighty-one HCWs and 18 managers were interviewed; data for 21,791 children were abstracted. About 3.1% of children were screened for TB, and 63.2% of presumptive TB children had TB diagnostic tests. A majority (71.9%) of TB tests were conducted on the Gen Xpert MTB Rif platform. Thirty-one out of 335 children with TB tests were diagnosed with TB, and 93.5% were initiated on treatment. Seven facilities offered TB testing, 5 had TB guidelines and 5 had pediatric TB job aides. Five out of 7 microscopes and 4/7 GeneXpert machines were functional. About 64.1% of HCWs had childhood TB training, 51% had ever received mentorship on childhood TB management, 53.1% had ever collected childhood TB diagnosis specimen and 23.3% had ever initiated children on TB treatment. Discussion: Childhood TB screening and diagnosis was suboptimal, and this was a result of low healthcare worker capacity, shortage and breakdown of TB diagnostic machines and weak TB diagnostic sample transportation system.

An Assessment of Childhood Tuberculosis Detection in Public Sector Health Facilities in Zimbabwe

Introduction: Zimbabwe has consistently failed to meet the World Health Organization’s target of 10 to 15% of Tuberculosis (TB) notifications being children below 15 years, with the country experiencing a proportionate decline in childhood TB contribution to national notifications from 9% in 2011 to 5% in 2017. Methodology: We conducted a descriptive cross-sectional study in 20 public sector health facilities across 4 districts. We abstracted childhood TB screening, diagnosis and treatment data from facility registers for the year 2019. Study was approved by local ethics committee and a waiver of consent was obtained for accessing patient data. Results: Data for 21,791 children who accessed health services were abstracted, and 1,116 had documented TB management data. Overall, 3.1% of children were screened for TB; 0.8% for children below 5 years, 5.2% for ages 5-9, and 7.3% for ages 10-14 years. TB screening was significantly higher in referral (6.9%) than primary level (1.7%) facilities (p<0.05). About 63.2% of presumptive TB children had TB diagnostic tests; 51.2% for children below 5 years, 55.8% for ages 5-9 and 71.4% for ages 10-14 years. A majority (71.9%) of tests were conducted on GeneXpert MTB Rif platform and 17.9% were by microscopy. About 9.3% of tested children were diagnosed with TB, and 93.5% of these were initiated on treatment. Treatment outcomes for 65% of eligible children were evaluated. Conclusion: TB screening and diagnostic testing for children below 5 years was very low. There is need to screen all children presenting to primary level facilities.

Millennium development goals (MDGs-2000-2015) to sustainable development goals (SDGs-2030): a chronological landscape of public sector health care segment of Pakistan

Objective: To study health related Millennium Development Goals in context of Pakistan’s progress in improving health system of Pakistan. Methods: Chronological landscape of health conditions with temporal limit of 2000 to 2015 and progress was measured in five, ten and fifteen years of MDGs in view of Public Sector Health Care Segment (PSHCS). Statistical package IBM-SPSS-21 was used for analyzing the data. ANOVA was conducted at level of significance (p<0.05). Results: Different parameters of PSHCS in context of MDGs were analyzed to evaluate the improvement in public health conditions. No difference in infrastructure was observed during the MDGs (2000-2015) era; Hospitals (p=0.262), Basic Health-Units (p=0.910), Mother & child health centers (p=0.345), Rural Health Centers (p=0.226) Tuberculosis centers (p=0.660), Total-Beds (p=0.220) and Population per bed (p=0.772). However, significant difference was observed in no. of dispensaries (p=0.001). We also observed significant difference in workforce; Registered doctors (p=0.024) dentists (p=0.001) nurses (p=0.047) midwives (p=0.032) and lady-health-workers (p=0.007). No significant difference was observed in the expenditures; health-expenditure (p=0.515), development-expenditure (p=0.678), current-expenditure (p=0.481), percentage-change (p=0.998) expenditure as per GDP (p=0.908). Family planning sector was also without any significant change; Population growth (p=0.108), crude birth rate (p=0.705), crude death rate p=0.460) and life expectancy (p=0.319). It was observed that sick population preferred private facilities compared to the PSHCS facilities. Conclusion: We did not observe any significant difference in most of the health care segments during 2000-2015 and MDGs remained underachieved. Therefore, a way forward is proposed for improvement in PSHCS to persevere SDGs.

Turnover Intention among Public Sector Health Workforce: Is Job Satisfaction the Issue?

Introduction: The paper explores turnover intention and job satisfaction among healthcare employees of Ministry of Health (MOH) Malaysia. Methods: A nationwide study was carried out in order to identify dimensions of job satisfaction and turnover intention among public healthcare employees. Data was collected by means of self-administered questionnaire and distributed based on quota sampling. Results: The study shows that public healthcare workforce is generally satisfied with their work (mean 3.45). In addition, medical specialists and assistant medical officers were found to be significantly more satisfied than other job designations. However, intention to resign was high among medical specialists, pharmacists and dentists. A high proportion of medical specialists also had received job offers from the private sector. Conclusion: The findings showed that employee turnover may not necessarily be due to job dissatisfaction, but rather due to demand from the private sector. Findings from the study would assist policy-makers with respect to talent management in public healthcare service.

Experiences of a new cadre of midwives in Bangladesh: findings from a mixed method study

Background Bangladesh did not have dedicated professional midwives in public sector health facilities until recently, when the country started a nation-wide programme to educate and deploy diploma midwives. The objective of the findings presented in this paper, which is part of a larger study, was to better understand the experience of the midwives of their education programme and first posting as a qualified midwife and to assess their midwifery knowledge and skills. Methods We applied a mixed method approach, which included interviewing 329 midwives and conducting 6 focus group discussions with 43 midwives and midwifery students. Sampling weights were used to generate representative statistics for the entire cohort of the midwives deployed in the public sector health facilities. Results Most of the midwives were satisfied with different dimensions of their education programme, with the exception of the level of exposure they had to the rural communities during their programme. Out of 329 midwives, 50% received tuition fee waivers, while 46% received funding for educational materials and 40% received free accommodation. The satisfaction with the various aspects of the current posting was high and nearly all midwives reported that a desire to work in the public sector in the long run. However, a significant proportion of the midwives expressed concerns with equipment, accommodation, transport and prospect of transfers. The scores on the knowledge test and self-reported skill levels were varied but reasonably high. Conclusion While the midwives are highly motivated, satisfied with many aspects of their current jobs and have adequate knowledge and skills, there are some bottlenecks and concerns that, if unaddressed, may derail the success of this programme. To capture the career progress of these midwives, additional research, including a follow-up study with the same cohort of midwives, would be beneficial to this programme.

Protecting essential health services in low-income and middle-income countries and humanitarian settings while responding to the COVID-19 pandemic

In health outcomes terms, the poorest countries stand to lose the most from these disruptions. In this paper, we make the case for a rational approach to public sector health spending and decision making during and in the early recovery phase of the COVID-19 pandemic. Based on ethics and equity principles, it is crucial to ensure that patients not infected by COVID-19 continue to get access to healthcare and that the services they need continue to be resourced. We present a list of 120 essential non-COVID-19 health interventions that were adapted from the model health benefit packages developed by the Disease Control Priorities project.