Implementation of the Healthy Indonesia Card Program at the Sayang Rakyat Regional General Hospital, Makassar City

Quality health services are a hope for every Indonesian people, because this is closely related to one aspect of fulfilling basic life needs for humans, therefore it requires commitment from these health service providers, especially hospitals in supporting the implementation of government programs through the Healthy Indonesia Card. The purpose of this study is to determine and analyze the implementation of services based on the Healthy Indonesia Card program at the Sayang Rakyat Regional General Hospital in Makassar City using qualitative research methods. The results showed that the implementation of the Healthy Indonesia Card program at the Sayang Rakyat Regional General Hospital in Makassar in general was in accordance with the South Sulawesi Provincial Regulation regarding health providers and regarding cooperation in providing free health services, and presidential regulation (Perpres) Number 64 of 2020 concerning National health insurance. This is reflected in the implementation of services provided by the Sayang Rakyat Hospital to patients using the Healthy Indonesia Card (KIS) (PBI) which do not differentiate from general patients or other insurance users, provided that the patient has met the terms and conditions as a KIS patient (PBI). All medical expenses for KIS patients (PBI) who undergo outpatient or inpatient treatment are entirely borne by the government.

Using Data Integration to Improve Health and Welfare Insights

The Australian Institute of Health and Welfare (AIHW) is a leader in the provision of high-quality health and welfare information. Its work program has built a strong evidence base for better decisions that deliver improved health and welfare outcomes. The evolution of the AIHW’s data integration program has exemplified innovation in identifying and addressing key information gaps, as well as responsiveness to opportunities to develop and capture the data required to inform national priorities. The AIHW conducts data integration in partnership with data custodians and specialists in integration and analysis. A linkage project requiring the integration of Australian government data must be undertaken by an accredited integrating authority. The AIHW has met stringent criteria covering project governance, capability, and data management to gain this accreditation. In this capacity, the AIHW is trusted to integrate Australian government data for high-risk research projects. To date, the AIHW’s integration projects have generated improved research outcomes that have identified vulnerable population groups, improved the understanding of health risk factors, and contributed to the development of targeted interventions. These projects have fostered new insights into dementia, disability, health service use, patient experiences of healthcare, and suicide. Upcoming projects aim to further the understanding of interrelationships between determinants of wellbeing.

Assessment of the quality of sexual and reproductive health services delivered to adolescents at Ujala clinics: A qualitative study in Rajasthan, India

The Adolescent Friendly Health Clinic (AFHCs), a key component of the Government of India’s National Adolescent Health Programme a.k.a. Rashtriya Kishor Swasthya Karyakram (RKSK), aims to increase the accessibility and utilization of sexual-reproductive health services by adolescents and youth. However, low quality of care provided at AFHCs by counsellors calls for attention. We, thus, explore both the clients’ and providers’ perspectives using the World Health Organization’s (WHO) global standards for quality health-care services for adolescents to assess the quality of the sexual reproductive health service delivery at AFHCs in Rajasthan, India. We conducted a qualitative study, comprising observation of the service delivery using mystery clients (MCs) (n = 12) and in-depth interviews with the counsellors (n = 4) in four AFHCs. Interviews were transcribed in local language and were translated in English. The transcripts were coded thematically. Our study, using five of the eight WHO global standards for quality health-care services for adolescents highlighted several gaps in the quality-of-service delivery at AFHCs. We unearth various intricacies related to the quality of the services provided at the AFHCs by referring to the relevant input, process, and the output criteria of WHO global standards I, III, IV, V and VI. Our study calls for efforts to improve- (i) the counsellors’ competencies to increase adolescents’ health literacy on sensitive topics, (ii) the facilities at the clinic to ensure privacy, comfort and confidentiality of the adolescents seeking services, (iii) the referrals to improve appropriate package of services, and (iv) an overall environment to ensure an equity and non-discrimination for all the adolescents. Our findings unearth the barriers that both the service providers and the adolescents face at the AFHCs and underscore the need for regular monitoring and evaluation of the AFHCs to strengthen the facility-based intervention of the RKSK programme.

Cases of Dispute and Pending Claims in Hospitals in the Era of National Health Insurance

Background: Indonesia began to implement a National Health Insurance System based on the National Social Security System in 2014 with the support of government regulations which states that Indonesia requires every citizen to have access to comprehensive and quality health services so that can continue their life through the National Health Insurance. Pending and dispute claims are problems that often occur in the era of national health insurance that can affect hospital budget allocation and planning policies, increasing the high cost burden for hospitals which will affect the quality of health services provided. The purpose of this study was to determine pending cases and dispute claims in hospitals in the Era of National Health Insurance.Methods: The study used a descriptive method with a qualitative approach. The data collection technique used is the observation method, namely directly to the e-claim file at several hospitals. 15 e-claim files taken in total from April – July 2021.Results: Obtained 13 cases of pending claims and 2 cases of dispute claims. Cases pending claims are caused by not complying with the code with evidence or resources, not in accordance with medical clinical practice guidelines and the rules of the health insurance provider.Conclusions: In coding, it is necessary to match the theory on the ICD-10, update the ICD-10. It is necessary to understand the rules and provisions made by the insurer and the related guidelines and rules. Please be aware of every latest code update.

Advancing child health and educational equity during the COVID-19 pandemic through science and advocacy

The COVID-19 pandemic has underscored the changing role of scientists, clinicians, ethicists, and educators in advocacy as they rapidly translate their findings to inform practice and policy. Critical efforts have been directed towards understanding child well-being, especially with pandemic-related educational disruptions. While school closures were part of early widespread public health measures to curb the spread of COVID-19, they have not been without consequences for all children, and especially for children from disadvantaged backgrounds. In a recent Isr J Health Policy Res perspective, Paltiel and colleagues demonstrate the integral role of academic activism to promote child well-being during the pandemic by highlighting work of the multidisciplinary academic group on children and coronavirus (MACC). In this commentary, we explore parallels to MACC’s work in an international context by describing the efforts of a multidisciplinary team at Johns Hopkins University in Baltimore, Maryland, United States, to aggregate data, conduct analyses, and offer training tools intended to minimize health and educational inequities for children throughout the COVID-19 pandemic. As both MACC and our work collectively demonstrates, multidisciplinary partnerships and public-facing data-driven initiatives are crucial to advocating for children's equitable access to quality health and education. This will likely not be the last pandemic that children experience in their lifetime. As such, efforts should be made to apply the lessons learned during the current pandemic to strengthen multidisciplinary academic-public partnerships which will continue to play a critical role in the future.

Systematic review of performance-enhancing health worker supervision approaches in low- and middle-income countries

Background The strength of a health system—and ultimately the health of a population—depends to a large degree on health worker performance. However, insufficient support to build, manage and optimize human resources for health (HRH) in low- and middle-income countries (LMICs) results in inadequate health workforce performance, perpetuating health inequities and low-quality health services. Methods The USAID-funded Human Resources for Health in 2030 Program (HRH2030) conducted a systematic review of studies documenting supervision enhancements and approaches that improved health worker performance to highlight components associated with these interventions’ effectiveness. Structured by a conceptual framework to classify the inputs, processes, and results, the review assessed 57 supervision studies since 2010 in approximately 29 LMICs. Results Of the successful supervision approaches described in the 57 studies reviewed, 44 were externally funded pilots, which is a limitation. Thirty focused on community health worker (CHW) programs. Health worker supervision was informed by health system data for 38 approaches (67%) and 22 approaches used continuous quality improvement (QI) (39%). Many successful approaches integrated digital supervision technologies (e.g., SmartPhones, mHealth applications) to support existing data systems and complement other health system activities. Few studies were adapted, scaled, or sustained, limiting reports of cost-effectiveness or impact. Conclusion Building on results from the review, to increase health worker supervision effectiveness we recommend to: integrate evidence-based, QI tools and processes; integrate digital supervision data into supervision processes; increase use of health system information and performance data when planning supervision visits to prioritize lowest-performing areas; scale and replicate successful models across service delivery areas and geographies; expand and institutionalize supervision to reach, prepare, protect, and support frontline health workers, especially during health emergencies; transition and sustain supervision efforts with domestic human and financial resources, including communities, for holistic workforce support. In conclusion, effective health worker supervision is informed by health system data, uses continuous quality improvement (QI), and employs digital technologies integrated into other health system activities and existing data systems to enable a whole system approach. Effective supervision enhancements and innovations should be better integrated, scaled, and sustained within existing systems to improve access to quality health care.

Working towards integrated client-oriented care and services: A qualitative study of the perceptions of Finnish health and social care professionals

Introduction Client orientation is an essential principle that underlines the delivery of high-quality health and social care. Despite this, little is known about how the health and social care professionals perceive this principle. The aim of this qualitative study was to describe the integrated perceptions of health and social care professionals of client orientation and the requirements for competencies and care and service systems. Methods The 29 participants were Finnish health and social care professionals and the data were collected with asynchronous online discussions in a closed Internet-based group from November 2017 to January 2018 and analysed with inductive content analysis. Results Client orientation was a core value in health and social care and services due to the humane approach required and the client's rights and responsibilities. It also required the professionals to have specific competencies and collaborate. The system elements that supported client orientation were an integrating and responsive service system, service availability and accessibility, guidance, leadership, resources and the effective use of technology. Discussion Professionals need additional training and structural support from their organizations if they were to deliver efficient, flexible, high-quality client-oriented health and social care and services.

Caring for the Caregivers Through Healthy Human Resource Practices

India has a colossal shortage of human resources for health. The management of human resources in a healthcare institution is vital to enable the delivery of efficient and effective medical services and to achieve patient satisfaction. Everyone proclaims that the human asset is the most important asset. On the other side, health is declared to be one of the most important wealth. Hospitals and pharmaceutical companies constitute two arms of the “health management/ maintenance” effort of humanity. Human resource professionals face many hurdles in their attempt to deliver high-quality health care to citizens. Some of these constraints include budgets, lack of congruence between different stakeholders' values, absenteeism rates, high rates of turnover, and low morale of health personnel.

The public-private partnership (PPP) initiative in healthcare system: as the pathways to achieve the SDGs in Nepal

Globally, financing healthcare is one of the biggest challenges and it becomes a life or death issue in poor countries. Nepal is strongly committed to universal health coverage and Sustainable Development Goals. Existing public health services are inadequate to cater to the growing demands of quality health care and Public Private Partnership (PPP) evolved as newer arrangement for robust healthcare system, improved healthcare quality and enhance cost-effectiveness. Nepal has successfully utilized the PPP model in multiple sectors, however there is limited experience in healthcare. Strengthening PPP models in healthcare could be the pathway for Nepal toward SDG’s and UHC achievement.

A Review of Chronological Evolution of Air Quality Indexing Systems (1966 To 2021)

Air quality index (AQI) also known as air pollution index (API) is the way of describing ambient air quality to assess the health risk associated with pollution. With the advent of time, there have been several air quality indexing systems starting from the first air Quality Index developed in 1966 by Marvin H. Green and various modifications have been made ever since to improve the accuracy of measurement. Such systems can assess the air quality by several factors like the concentration of different pollutants or by various empirically established formulas based on past experiences. In this review article, an effort has been made to chronologically evaluate the AQI system developed across the world from 1966 to 2021. Every indexing system has its own unique method for air quality determination and each method has its own merits and demerits. This pape rcovers various parameters, empirical relationships, standards, merits, and demerits, which in hind sight will help to develop an amalgamation of various indexing systems that can be used as a standard method for monitoring the quality of air. This paper also covers the AQI systems that prevail in India. A fuzzy logic system is very helpful in handling the uncertainty in air quality assessment. So, fuzzy-based air quality indexing systems developed from 2010 to 2017 have also been reviewed. The review of articles established that the results obtained through fuzzybased AQI aremore reliable than the other methods. Out of all the above describing methods, fuzzy synthetic evaluation-based AQI system and fuzzy air quality health index (FAQHI) are more powerful tools to describe the air quality. But till 2017, thereis no development of AQI systems based on fuzzy logic, considering PM2.5 as one of the pollutants. So, there is a need to develop the fuzzy-based AQI system considering PM2.5 as a pollutant with other air pollutants.