Impact of the COVID-19 pandemic on the utilisation of health services at public hospitals in Yemen: a retrospective comparative study

BackgroundThe COVID-19 pandemic has led to a global crisis, creating an unprecedented situation, which has taken the world by storm, overshadowing on all life’ aspects and having a significant impact on the health systems of most countries. In this study, the delivery of health services is investigated both before and during the outbreak of the COVID-19 pandemic at public hospitals in Yemen to assess the impact of COVID-19 on the utilisation of health services.MethodData collected from 127 hospitals in Yemen were reviewed using the DHIS2 system. The data represented 3 months before the outbreak of COVID-19 between January and March 2020 and during the outbreak of COVID-19 outbreak between April and June 2020. The results were then compared with the same period in 2019. The utilisation pattern of healthcare services during the period of investigation was compiled and analysed by applying a generalised estimating equation (GEE) to examine the effects of the COVID-19 outbreak in Yemen. The data collected from the targeted hospitals included information related to consultations, surgeries, deliveries, C-sections and penta-3rd dose immunisation.ResultsThe trendline of health services used during the pandemic showed a gradual decline beginning from April 2020 for consultations, surgeries and penta-3rd dose utilisation. The GEE model revealed a significant effect (p<0.05) during the outbreak compared with preoutbreak in the consultation services (B=−1,343.9; 95% CI −1,767.2 to −920.6; χ2=38.718), surgeries (B=−54.98; 95% CI −79.13 to −30.83, χ2=19.911) and penta-3rd dose (B=−24.47; 95% CI −30.56 to −18.38 and χ2=62.010). As for deliveries and C-sections, the results were shown to be statistically non-significant.ConclusionThe impact of COVID-19 on continuity of health services delivery in Yemen has been distinct and profound, where the study revealed that the number of the consultations, surgeries and number of vaccinated children have been declined during the COVID-19 pandemic, likely due to the partially lockdown measures taken and fear of being infected. However, the deliveries and C-section services remained nearly in the same level and did not affect by the COVID-19 pandemic.

COVID-19, Anxiety, and Hopelessness: Quality of Life Among Healthcare Workers in Turkey

The aim of the study is to investigate the effects of intense anxiety and hopelessness experienced by healthcare workers during the pandemic on their quality of life. This cross-sectional, online questionnaire-based study was conducted between August 31, 2020 and October 31, 2020, with 729 healthcare workers in Turkey. The study showed that hopelessness, the weekly working time, fatigue, and the workload of healthcare workers negatively affected their quality of life, those who found the pandemic measures inadequate had a lower quality of life and higher hopelessness levels, and those who needed knowledge on various issues to improve their skills had lower quality of life and higher levels of anxiety and hopelessness. Increasing the measures to make healthcare workers feel competent and ready during the COVID-19 pandemic and meet their information needs to improve their skills will reduce their anxiety and hopelessness and improve their quality of life. Identifying the factors affecting anxiety, hopelessness, and quality of life will help achieve sustainable success in the delivery of health services and promote employee health and safety.

Shame, Stigma, HIV

The affective climate often associated with HIV prevention and care practices is often dominated by negative emotions such as shame, fear and suspicion which arise because of HIV’s historical stigma. This article explores the experiential consequences of this affective climate and the continued stigma associated with HIV, through a focus on the experience of shame anxiety which can be under- stood as the chronic anticipation of shame or shameful exposure. Exploring first- person narratives of gay men living with HIV, the article gives an account of how shame anxiety is central to understanding how stigma causes harm, especially in experiences of chronic illnesses such as HIV. Using a philosophical framework, through phenomenology, it will be demonstrated how shame anxiety manifests in bodily lived experience through the structure of the “horizon”. The article will finish with reflections on how shame anxiety can act as a barrier to the effective delivery of health services for those with stigmatised chronic illnesses and, fur- thermore, why the experience of shame anxiety might be useful to consider when delivering health services.

Disparities in Usage of Telemedicine in Era of CoVid-19: A Scoping Review Protocol

Review question / Objective: This study aims to distinguish disparities in usage and telemedicine access in the era of CoVid-19 from diverse perspectives. Condition being studied: Telemedicine is the distribution and delivery of health services through remote telecommunications. Since the beginning of the CoVid-19 Pandemic, the application of telemedicine services has been grown; and by increasing the usage of telemedicine, the access gaps of telemedicine are multiplied. The disparities of telemedicine access and use are being reviewed and discussed in this review. Information sources: Pubmed, Embase (via Ovid), Psychinfo (via Ovid), WHO Global Index Medicus, Global Health (via Ovid), Cochrane CENTRAL Register of Controlled Trials, Web of Science, SCOPUS, and CINAHL(EBSCO).

Nationalisation of Health Workforce in Saudi Arabia’s Public and Private Sectors: A Review of Issues and Challenges

Presently, Saudi Arabia depends largely on expatriate health workforce for delivery of health services. This article provides an overview of Saudization policy introduced by the Kingdom of Saudi Arabia and analyses its underlying impact on health workforce in public and private sectors. It also examines key strategic initiatives undertaken by the government for health workforce development and challenges of replacing expatriates in the country as envisaged in the Vision 2030. There are concerns about low participation of females in nursing, mainly due to a poor image attached to the profession, and further exacerbated by religious and cultural factors. There is a strong need to adopt a health workforce development policy that integrates local culture, values and social ties. Government needs to follow a multipronged approach to change the mindset of citizens to take up health care jobs, particularly nursing and pharmacist professions.

Improvement of the Pre-Analytical Phase of Nasopharyngeal Samples During the COVID 19 Pandemic: Experience of the Institute Pasteur De Côte d’Ivoire in 2020

The clinical laboratory is playing an increasingly important role in the patient-centered approach to the delivery of health services. Early detection of the importation of COVID-19 is a crucial challenge for all countries at risk of importation from areas of active transmission. This article aims to share the experience of the IPCI in the optimum management of the pre-analytical phase related to diagnostic tests for COVID 19. From the start of the pandemic the state and the IPCI made several organizational decisions to respond effectively to all trends of the COVID 19 epidemic in our country. Outsourcing of pre-analysis with creation of several sections: preparation of tube kits, aliquoting of samples from patients suspected of COVID19, reception, sorting and decontamination. Exemplary use of administrative and laboratory support staff. Our findings should help establish urgent priorities for intensified preparedness and response support in specific African countries with moderate or high risk of COVID-19 importation and whose capacity to manage the health emergency is low relatively low.

Effective health service planning and delivery: A qualitative case study exploring health service users perspectives

IntroductionHealthcare service is an essential determinant to population health. This qualitative case study aims to explore health service users’ perspective of effective health services delivery and the current challenges affecting the management and delivery of health services at a primary healthcare facility in Madang Province, Papua New Guinea (PNG).MethodsQualitative data were collected using semi-structured interviews with key informants (KI) representing academics, undergraduate students, administration staff, patients and healthcare workers. The interviews covered three main areas: users’ views of effective health services, current challenges affecting effective planning and management of primary healthcare services, and interventions to improve health services planning and delivery.ResultsThe services users associated effective health services delivery with increased availability, accessibility, acceptability, and quality healthcare. Many factors exist to influence the effective planning and delivery of health services. The results show that health systems and personal factors have a major influence on the planning and health services delivery.ConclusionThe findings from this study call for an evaluation of the current healthcare system, particularly at the primary healthcare level, as the primary point of contact to the formal healthcare system, and the need for developing a contextual model of healthcare that meet the needs of the service users. We concluded that if health services users’ perspectives are considered in health policy, the local community may experience significant improvement in health status.

Effective health service planning and delivery: A qualitative case study exploring health service users perspectives

Introduction: Healthcare service is an essential determinant to population health. This qualitative case study aims to explore health service users’ perspective of effective health services delivery and the current challenges affecting the management and delivery of health services at a primary healthcare facility in Madang Province, Papua New Guinea (PNG). Methods: Qualitative data were collected using semi-structured interviews with key informants (KI) representing academics, undergraduate students, administration staff, patients and healthcare workers. The interviews covered three main areas: users’ views of effective health services, current challenges affecting effective planning and management of primary healthcare services, and interventions to improve health services planning and delivery. Results: The services users associated effective health services delivery with increased availability, accessibility, acceptability, and quality healthcare. Many factors exist to influence the effective planning and delivery of health services. The results show that health systems and personal factors have a major influence on the planning and health services delivery. Conclusion: The findings from this study call for an evaluation of the current healthcare system, particularly at the primary healthcare level, as the primary point of contact to the formal healthcare system, and the need for developing a contextual model of healthcare that meet the needs of the service users. We concluded that if health services users’ perspectives are considered in health policy, the local community may experience significant improvement in health status.