Liberalising Health-seeking Behaviour of the Johanne Marange Apostolic Sect in Manicaland, Zimbabwe

Religious rights as enshrined in the Zimbabwean constitution are sacrosanct, however, when church doctrine bars followers from seeking modern medical care, they start infringing on health rights especially of the ‘lesser beings’ the women and children who are members of these religious sects. The ‘lesser beings’ are bearing the brunt of high maternal and neonatal mortality as they depend on unsafe traditional birth attendants and unconventional medicine. This study is ethnographic and presents lessons learnt from a programme aiming to improve maternal, newborn and child health outcomes among the Apostolic Church of Johanne Marange members in Manicaland province, Zimbabwe. The findings show that despite the stringent doctrine and barriers placed on apostolic members who want to access conventional medicine, the women and children are using clandestine approaches to circumvent the doctrine and barriers. This article argues that a barrage of unconventional and conventional approaches can lead to changes in health-seeking behaviour of the apostolic church and ultimately maternal and child health outcomes. The article argues that the intransigence of the apostolic can only be overcome by covert approaches to providing health services and save lives.

Socio-cultural Importance of Newborn Healthcare Practices of Parengi Porja Tribe Living in Hilly Forested Areas of Andhra Pradesh, India: An Anthropological Analysis

The study aims to understand the traditional healthcare management of the newborns of the Parengi Porja tribe. The Parengi Porja tribe is a Particularly Vulnerable Tribal Group (PVTG) that inhabits the Eastern Ghats, which is a continuous high hilly region of Visakhapatnam district, Andhra Pradesh, India. The members of this tribe strongly believe that the earliest weeks of a newborn’s life is the time for the greatest probability of death and disability. To avoid these misfortunes, they strictly follow the traditional healthcare regimen for newborns, which has significant socio-cultural importance. For this study, 105 neonates were purposively selected, and their mothers were interviewed for data collection. The research data were analysed by qualitative methods that included participant observation, in-depth interviews and focus group discussion. The collected data were repeatedly cross-checked with other elderly female members like grandmothers, and sutranimaizi (traditional birth attendant [TBA]) through interviews to strengthen the efficiency and authenticity of the data. The findings of the study show that this tribal population has its understanding of the management of neonatal health, which is socio-culturally ingrained, sanctioned and transmitted through generations.

Differences in Commuting Modes and Residential Locations as Factors of Turnover Intention of Healthcare Workers of Ambulatory Clinics

Organisations require novel perspectives for achieving a stable workforce. One of such perspectives is having healthy employees, through timely medical care in ambulatory clinics. But when healthcare providers exhibit turnover intentions, and ultimately turnover behaviour, the purpose for such facilities is defeated. The study sought to understand if healthcare workers’ commuting modes and the differences in their residential locations affect their turnover intentions. These variables, which are yet to be investigated in the turnover literature, were examined within the assumptions of discrete choice model. Therefore, 137 healthcare workers of 11 ambulatory clinics, randomly selected from operating clinics in Marina, Lagos Island, were surveyed using purposive sampling method. The results suggest that the differences in residential locations did not produce statistically significant differences in turnover intention. However, there were significant differences in turnover intentions of participants who drive their cars and those who commute with public transport ( F (1, 131) = 9.14, p < 0.01). Further result negates the constant travel time hypothesis and the discrete choice model. The recommendations are focused on coordinated transport schedules, decentralised congested economic activities and polycentric city planning policies. These will enhance dispersed commuting.

Lessons Learnt in Health Management: Paediatric Spinal Tumours: A 6-year Retrospective Review from Central India

Background: From the management perspective, rare medical conditions do not attract enough attention, though their management can often be resource intensive. Increased awareness among health professionals can lead to early diagnosis of cases and prevention of complications leading to improved outcomes. Paediatric spinal tumours are rare disease entities with an annual incidence of approximately 1 per 1 million children. The profile of spinal tumours in the paediatric population is significantly different than that in adults. In this study we retrospectively analyse a heterogenous variety of paediatric spinal tumours which were treated at our institution over the last 6 years, with the goal of contributing to existing knowledge of this relatively rare disease entity. Methods: This retrospective study includes paediatric patients (under 18 years of age) who underwent surgery for primary spinal tumours from 2014 to 2019. The medical records were reviewed retrospectively and the information regarding clinical presentation, tumour location, operative findings, and postoperative status and functional outcome were analysed. The modified McCormick grade was used to assess the neurological status. Patients with spinal metastasis or incomplete medical records were excluded from the study. Results: Of 74 patients with primary spinal tumours operated at our centre between 2014 to 2019, a total of 8 patients (5 males and 3 females) who met the inclusion criteria were identified for the present study. The mean age of the patients included was 12.1±5.3 and the median follow-up period was 24 months. An improvement in the neurological status, as assessed by the modified McCormick grade, was seen in 37.5% of the patients. Three of the patients received adjuvant radiotherapy, post-surgical resection. A unique feature of this series was the wide variety of cases encountered, as each case had a different histopathological diagnosis, despite being limited by its sample size. Conclusion: Primary paediatric spinal cord tumours are rare, and surgical resection remains the treatment of choice. Adjuvant therapy is warranted in cases of high-grade lesions or recurrences. Through this study, we realised that due to its relative rarity and low incidence, a lack of public awareness can often lead to disproportionately increased morbidity and mortality. Prospective multi-centric studies can provide tools to help develop future management strategies for improved survival rates and reduced complications.

The Impact of Transformational Leadership on Job Satisfaction and Organisational Commitment Among Hospital Staff: A Systematic Review

Background: Improving quality of relationship among hospital staff and leaders is a necessity to increase levels of job satisfaction and organisational commitment. Transformational leadership style has become an ideal practical solution that can resolve these dilemmas and enhance the quality of healthcare services and patients’ safety. This study aims to examine the impact of transformational leadership on job satisfaction and organisational commitment among hospital staff. Methods: The research strategy for this systematic review involves four electronic databases. Empirical peer-reviewed studies that uses quantitative design and that examines the relationship among transformational leadership, job satisfaction and organisational commitment among hospital staff, are included. Studies are evaluated by using a quality assessment tool, and the data extraction table and analysis are completed on the entire included studies. Results: A total of 367 titles and abstracts are screened, yielding 26 studies that are included in this review. The collected variables are analysed to determine the effect of transformational leadership style on job satisfaction and organisational commitment. A total of 19 studies examining the relationship between transformational leadership and job satisfaction ( n = 15) are found to have a positive relationship, while 13 studies examining the relationship between transformational leadership and organisational commitment ( n = 11) are found to have a positive relationship. Conclusion: The results of the review provide evidence that transformational leadership has a great effect on hospital staff and the hospital environment. The transformational leadership style should be universally used in hospitals to increase medical staff job satisfaction and organisational commitment, which may lead to increased productivity, quality of healthcare services and patients’ safety.

Out-of-pocket Health Spending and Its Impact on Household Well-being in Maharashtra

Health is one of the major determinants of the overall well-being of a society. The World Health Organization has emphasised the right to health for all, and the universal health coverage is a paradigm of this emphasis with an agenda of nobody to be left behind in the provision of health services without any financial burden by 2030.This article tries to analyse the extent of catastrophic expenditure being incurred by the people despite being sheltered under a financial protection (Health Insurance) in the state of Maharashtra. The impact caused by out-of-pocket (OOP) health expenditure on the economic status of the people in the state is assessed using the National Sample Survey Office’s 71st round conducted by the Ministry of Health and Family Welfare, Government of India. It was found that over 4.18% of the population endured the burden caused by OOP expenditure by falling below the poverty line post health payments. A higher proportion of rural population is observed to have experienced a fall in the economic status from above poverty line (APL) to below poverty line (BPL) due to high OOP expenditure than that of the urban population in Maharashtra.

Service Quality Components and Inpatients Satisfaction at District Hospitals in Haryana: An Empirical Analysis

Success of any health facility can be directly correlated with the perceived satisfaction of outpatients and inpatients availing treatment at these facilities. Therefore, patient satisfaction is a commonly used measure to assess the quality of services at various health facilities. The present article attempts to analyse the impact of service quality on inpatient satisfaction across all the district hospitals (DHs) of Haryana. Among other things, the article extracted eight factors, namely treatment services (TSs), food services (FSs), laboratory services (LSs), wards services (WSs), admission services (ASs), infrastructural services (ISs), medicine services (MSs) and nursing services (NSs) through exploratory factor analysis. Further, TSs were found to be the most important to predict the satisfaction of inpatients of DHs of Haryana followed by FSs, LSs, ISs, WSs, NSs, ASs and MSs. The article suggests the areas that require interventions to bring about overall course-correction and improve the overall quality of health services in the State and also contributes towards the existing literature on understanding service quality dynamics and measuring patients’ satisfaction for health care.

Consanguineous Marriages in India: Prevalence and Determinants

Consanguineous marriage is the legal union of male and female of a common ancestor related by blood. The most common prevailing form of consanguineous marriages is between first cousins. Middle East Asian countries and southern states in India show high prevalence. A comparative analysis between the two rounds of National Family Health Survey 1 and 4 have shown a declining trend for the practice of consanguineous marriages. The highest percentage of consanguineous marriages is seen among the first cousins from both father’s and mother’s side, most commonly practice in the southern states of Andhra Pradesh, Telangana, Tamil Nadu, and Karnataka except Kerala. Importantly, the practice of consanguineous marriage is higher among the Muslims of North India and Hindus of Southern India, among the Other Backward Classes and the less educated population of the middle and richer wealth index. A significant relationship can be noticed among consanguineous marriages and socio-economic variables.

Intolerable Burden of Malaria among Primitive Tribal Community in Odisha: Examining the Fundamental Cause

This study seeks to examine the living conditions, working conditions, and health seeking behaviour for malaria among Kondho community after one is infected with malaria. The residential surroundings of those diagnosed with malaria positive cases were extremely conducive for mosquito breeding. For instance, the majority of households threw garbage near their house, went for open defecation, the cowshed was beside their houses, and above all the houses were mostly situated in the jungle or near thick forest. Sub-centre followed by the community health centres was the first point of contact in most cases but medical care was sought only after routine life was affected. While malaria treatment plans are changing towards administering more powerful drugs as a result of chloroquine resistance but not as much has been done in the ground to prevent malaria at the first place. Therefore, together with continuing curative care for malaria—more emphasis is needed on its prevention. Community, civil society and the government need to work in tandem to improve the living and working conditions of backward communities particularly those living in malaria endemic zone so as to be able to take effective preventive measures for malaria.