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Subba, Nawa Raj. "Delivery Practice among Rajbanshi Community of Nepal." Journal of Research Development Centre 1, no. 2 (2013): 39–44. https://doi.org/10.5281/zenodo.15106076.
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<strong>Abstract</strong>This is a cross-sectional study on Rajbanshi of Nepal with the objective of uncovering delivery practices among mothers. Methodology employed quantitative tools: semi-structured questionnaires and checklists covering 375 samples from different clusters of districts (Morang, Jhapa, and Sunsari districts) by systematic sampling method. In Findings, among the Rajbanshi population, 69.33% have done hospital delivery and 30.67% have done home delivery. Home delivery is practiced by the economic conditions of the very poor (18.87%), poor (8.8%), and rich (4%). Hospital delivery is practiced by economic conditions very poor (20.53%), poor (20.27%), and rich (28.53%). Similarly, home delivery is higher by occupation labour (24.27%), by education illiterate (10.67%), and by geography rural (34.28%). In conclusion, the status of hospital delivery in Rajbanshi overall was better than the district and national level of the country, but there was less hospital delivery and more home delivery found among very poor, illiterate, labour, and rural people than rich, literate, urban, and general population. Keywords: Home delivery, hospital delivery, Rajbansi, Nepal
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Lopez, Carrie, Abhinav Chandra, and Mary Sweigart. "Implementation of a survivorship clinic in a medically underserved comprehensive community cancer center." Journal of Clinical Oncology 36, no. 7_suppl (2018): 54. http://dx.doi.org/10.1200/jco.2018.36.7_suppl.54.
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54 Background: Historically, preparation of Survivorship Care Plans (SCPs) had been a cumbersome challenge that resulted in a limited number of plans delivered to eligible patients. In 2015, eleven breast SCPs were prepared and delivered by an RN. Upon review, it was determined the process of preparation and delivery of SCPs required refinement. Methods: Initially, we identified the barriers to our practice, which included limited knowledge, process, personnel, and software interfacing. We implemented a quality improvement project with the goal of delivery of SCPs to an increased number of cancer survivor patients. The project targeted staff education to identify eligible patient populations, create awareness of the Commission on Cancer accreditation requirements, and the knowledge necessary to create a SCP. We coordinated with the information technology department to attempt interfacing software programs, track the delivery of plans, and use provider notes to export data. We increased communication between departments to identify eligible patient populations. A nurse practitioner was assigned the responsibility for preparation and delivery of the document during a scheduled appointment, which focused on review and education in relation to the patient’s diagnosis, treatment plan, sequelae and recommended surveillance. Results: Through close coordination of interdisciplinary teams, we were able to implement strategies to develop a streamlined process to create and deliver SCPs. These interventions resulted in the Survivorship Clinic going from 11 breast cancer SCPs delivered in 2015 to 98 and counting, of all types of cancer, delivered in 2016. Patients requested follow up visits to the Survivorship clinic. Conclusions: We have successfully developed a Survivorship Clinic within a federally designated medically underserved community setting. Implementation of best practices resulted in nine-fold increase in delivery of SCPs. Most importantly, we have increased patient education and satisfaction. Our practices can be replicated by other programs and thereby curb the disparity of cancer survivorship care in rural areas.
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Fryefield, David C., Roberta Kafora, Lori Bradshaw-Hucko, et al. "Community oncology care delivery staffing model." Journal of Clinical Oncology 30, no. 34_suppl (2012): 87. http://dx.doi.org/10.1200/jco.2012.30.34_suppl.87.
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87 Background: In 2010, the US Oncology Network’s Clinical Advisory Council (CAC), a practice-based clinical leadership team, reviewed the care delivery process at 5 pilot community oncology clinics to determine how licensed and unlicensed clinical resources were used. The Lean Six Sigma methodology, which employs statistical analysis within a structured approach to problem-solving, was used to understand the required clinical activities of the practices within 3 primary areas. The objective of this pilot was to ensure patients receive timely, effective treatment from qualified personal in a cost-efficient model. Methods: A team led by a certified Master Black Belt studied tasks performed by licensed vs. non-licensed staff in the areas of physician services, treatment services and triage services at each practice. Based on the findings, tasks were realigned to maintain quality of care but to deliver care more efficiently. Results: Care Delivery processes comprised 95 tasks at baseline vs. 80 tasks in the redefined model. Within physician services, changes to workflow included rooming and clinic support (vitals, cleaning, and patient comfort) to be provided by Medical Assistants (MAs) instead of RN. RN duties were changed to MA supervision and tasks that require licensure. Changes to triage services included use of RNs to coordinate care and MAs for phone call screening, centralized triage (non-patient facing), and normal lab follow-up. Increased clarity of tasks and re-assignment of responsibilities reduced RN work load by 17% or 16.6 hours/day based on 120 patient visits. Each pilot site realized an annualized labor savings in excess of $100,000. This prospective, patient volume-based Care Delivery Staffing Model was adopted by the CAC as Network standard after completion of the pilot. Conclusions: Using Lean Six Sigma methods, the care delivery process was successfully re-designed such that clinical staff were re-aligned to better utilize each resource’s core competencies. Implementation of this care delivery model resulted in improved cost effectiveness while maintaining quality of care and also enabled prospective staff planning so that costs can be kept competitive in the future.
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Woodard, Katherine L. "Packaging Effective Community Service Delivery:." Administration in Social Work 18, no. 2 (1994): 17–43. http://dx.doi.org/10.1300/j147v18n02_02.
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Wolch, Jennifer R. "Community‐based human service delivery." Housing Policy Debate 7, no. 4 (1996): 649–71. http://dx.doi.org/10.1080/10511482.1996.9521237.
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MORRISSEY, JOSEPH P., MARK TAUSIG, and MICHAEL L. LINDSEY. "Community Mental Health Delivery Systems." American Behavioral Scientist 28, no. 5 (1985): 704–20. http://dx.doi.org/10.1177/000276485028005010.
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Bagale, Archana, and Shristi Lamichhane. "Factors Associated with the use of Institutional Delivery Services by Mothers in a Gorkha, Nepal Community." Nepal Journal of Science and Technology 22, no. 1 (2023): 15–21. http://dx.doi.org/10.3126/njst.v22i1.67157.
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Institutional delivery is a delivery that takes place at any medical facility staffed by skilled delivery assistance. A descriptive cross-sectional study design was adopted to find out the factors associated with institutional delivery service utilization among mothers. The study was done in wards 6 and 11 of Gorkha Municipality in Gorkha district. The sample size was 80. The data were analysed using SPSS 16. The majority of the respondents, i.e., 97.5%, were literate, and 60% of the respondents were homemakers. 38.5% of the respondent’s husband was involved in foreign employment. Obstetric factors for institutional delivery depict nearly three-fourths of the total respondents, i.e., 72.5% of mothers marry at the age of 15-20 years; nearly half, i.e., 48.8% of mothers deliver babies at the age of 21–25; and the majority of the respondents, i.e., 97.5%, visited for an ANC checkup more than four times. Only 18.8% had complications during pregnancy. The majority of the respondents, i.e., 97.5%, thought health institutions were the best place for delivery, of which 60.3% chose health institutions for quality services. The majority of the respondents, 93.8%, delivered babies at health institutions. Enabling factors for institutional delivery depict nearly two-thirds of the respondents, i.e., 62.5%, making their own decisions. The majority of the respondents, i.e., 85.7%, received delivery services by a nurse; nearly half of the respondents, i.e., 47.5%, travelled 30–60 minutes. More than half of the respondents (55.0%) went to health institutions by vehicle. Similarly, 57.1% of the respondents received health care within 15 minutes. The present study concluded that, in spite of the higher proportion of institutional delivery, no significant association was found among the selected socio-demographic variables, i.e., educational status, spouse educational status, ethnicity, religion level, and monthly income.
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Schaffer, Rachel, Alyssa Ciancibello, David Bass, and Sara Powers. "Experiences From Healthcare and Community Organizations Delivering Evidence-Based Dementia Caregiving Programs." Innovation in Aging 5, Supplement_1 (2021): 7–8. http://dx.doi.org/10.1093/geroni/igab046.027.
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Abstract Best Practice Caregiving surveyed 324 healthcare and community organizations that replicated one or more of the 44 evidence-based programs about delivery organization characteristics, delivery staff, caregivers and persons with dementia served, funding sources, delivery challenges, perceived impact, and satisfaction. 211 (65.1%) organizations completed surveys about 30 different evidence-based programs. The most common types of organizations that delivered programs were healthcare organizations (23.8%) and Area Agencies on Aging (23.8%). Results showed on average organizations delivered programs for 49 months and served 68 families/year. The most common program delivery challenges were marketing (69.8%) and engaging participants (66.3%). Organizations generally agreed that programs had positive impacts on caregivers (59.5% strongly agree) but were less positive about benefits for persons with dementia (25.1% strongly agree). Discussion provides insights into successes and challenges organizations face when adopting evidence-based dementia caregiving programs in their communities.
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Page, Ruairi, Fiona Hynes, and James Reed. "Distance is not a barrier: the use of videoconferencing to develop a community of practice." Journal of Mental Health Training, Education and Practice 14, no. 1 (2019): 12–19. http://dx.doi.org/10.1108/jmhtep-10-2016-0052.
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Purpose The purpose of this paper is to describe the use of videoconferencing to deliver a post-graduate education programme in forensic mental services by video-conference across three sites in a large urban centre and develop a forensic community of practice. Design/methodology/approach This paper describes the setting up of the programme, equipment used, the challenges and evaluation of a teaching programme delivered using technology-enhanced education. Findings This forward thinking mechanism of delivery of education has propelled multi-disciplinary and multi-site discussion with the formation of a community of practice. Research limitations/implications Additional skills are demanded of clinicians including familiarisation with the equipment and an awareness of the restrictions in communication using videoconferencing. Practical implications The use of technology has facilitated delivery of a learning programme within our services. Practical benefits are readily evident with increased accessibility, cost and travel savings. Social implications The greatest benefit has been the development of a virtual community allowing peer support, an extended peer review and network development. Originality/value The paper describes use of technology to support delivery of a post-graduate forensic mental health training programme.
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Soucy, Nura L., Rowan M. Terrell, Rebecca A. Chedid, and Karen P. Phillips. "Best practices in prenatal health promotion: Perceptions, experiences, and recommendations of Ottawa, Canada, prenatal key informants." Women's Health 19 (January 2023): 174550572311582. http://dx.doi.org/10.1177/17455057231158223.
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Background: Prenatal health promotion includes the provision of evidence-based information and practical skills to optimize maternal–fetal outcomes. Increasingly, prenatal education is delivered by both healthcare professionals and allied childbirth educators, in community- or hospital-based group classes, targeted outreach programs, and online modules. Objectives: To better understand how prenatal health promotion relates to a diverse urban community, we assessed the perspectives of Ottawa, Canada prenatal key informants. Design: This is a qualitative research with key informant interviews. Methods: Semi-structured interviews were conducted with 11 prenatal key informants, responsible for the design, delivery, or promotion of publicly available prenatal health services. Interviews explored concepts and delivery of prenatal health promotion, strategies to address existing and emerging prenatal topics, identification of barriers to prenatal health services, and recommendations. Results: Key informants recommended a lifespan approach to prenatal health promotion, with an emphasis on healthy behaviors, emotional health, labor and delivery, and postpartum/early parenting. Recognizing community health disparities, key informants used community outreach, and intersectoral collaborations for Indigenous and other at-risk communities to mitigate barriers to prenatal service uptake. Conclusions: Ottawa key informants conceptualized prenatal health promotion as inclusive, comprehensive, and as an extension of preconception, school-based sexual education. Respondents recommended the design and delivery of prenatal interventions as culturally safe and trauma informed, using online modalities to complement in-person activities. The experience and intersectoral networks of community-based prenatal health promotion programs represent potential capacity to address emergent public health risks to pregnancy, particularly among at-risk populations. Plain Language Summary: A broad and diverse community of professionals deliver prenatal education to help people have healthy babies. We interviewed Ottawa, Canada experts in prenatal care/education to learn about the design and delivery of reproductive health promotion. We found that Ottawa experts emphasized healthy behaviors beginning before conception and through pregnancy. Community outreach was identified as a successful strategy to promote prenatal education to marginalized groups.
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Paolillo, William, Branka V. Olson, and Edward Straub. "People Centered Innovation: Enabling Lean Integrated Project Delivery and Disrupting the Construction Industry for a More Sustainable Future." Journal of Construction Engineering 2016 (May 11, 2016): 1–7. http://dx.doi.org/10.1155/2016/3704289.
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People-centered innovation is a paradigm shift in the construction industry. It is derived from the supposition that people not methods, schedules, or budgets deliver projects. Our data suggest that a multilevel, multidisciplinary project team through shared vision, values, and a common vernacular defines, designs, and delivers more successful projects than traditional methods. These projects meet the needs of shareholders, the community, stakeholders, and the planet. We employ the concepts of emotional intelligence and agency theory to explain an integrated project delivery (IPD) construction project using lean tactics that not only delivered, but also exceeded expectations resulting in a six-month schedule acceleration and $60M savings over the original estimated cost of the project calculated assuming traditional project delivery methods. The safety rating for this project was 50% better than the national average and the expected improvement in operating margin for the new building is 33% greater. This paper introduces the notion of people-centered innovation to an industry that has struggled to adapt and show positive results over recent decades. Our case study describes the significance of people-centered innovation in construction project delivery. We discuss the implications for the construction industry going forward.
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Craig, Tom K. J. "Community psychiatry–100 words." British Journal of Psychiatry 206, no. 2 (2015): 115. http://dx.doi.org/10.1192/bjp.bp.114.159673.
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We are social animals that exist in networks of family, friends and acquaintances. The size and quality of these networks and the environments within which they are embedded have profound influences on mental health. Community psychiatry is about shaping the content and delivery of mental healthcare to take account of this reality. It necessarily involves efforts to improve network support including, for example, family interventions, supported employment and peer support. Efforts to tackle stigma and to mitigate toxic environments are also essential. Closing asylums and developing systems to deliver care to people's homes is a job started, not job done.
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Hailu, Meaza, Fikru Tafese, Gebeyehu Tsega, et al. "Expanding Maternity Waiting Homes as an Approach to Improve Institutional Delivery in Southwest Ethiopia: A Community-Based Case-Control Study." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 58 (January 2021): 004695802110182. http://dx.doi.org/10.1177/00469580211018294.
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With the promising efforts in increasing institutional delivery yet, maternal and child mortality is high in Ethiopia. One of the strategies used to minimize this problem was the introduction of Maternity Waiting Homes (MWH). MWHs are residential facilities for pregnant women near a qualified medical facility. The introduction of MWHs has improved institutional delivery in many countries. In Ethiopia however, the contribution of MWHs was rarely studied. To fill this gap, we have conducted a community-based unmatched case-control study from March 1 to April 20, 2016, in Southwestern Ethiopia. Mothers who delivered at a health facility within 1 year were considered as cases while mothers delivered at home were controls. We used simple random sampling to identify study participants from the pool of cases and controls who were identified by census. Data were analyzed using SPSS Version 20. Binary logistic regression was used to identify significant predictors. A total of 140 cases and 273 controls were included in the study. Among the case, 86 (61.4%) used MWHs during their last delivery. Variables like educational status of the mothers [AOR = 2.96, 95% CI: 1.41, 6.23], educational status of the husband [AOR = 5.19, 95% CI: 1.52, 17.76], and having antenatal care follow up [AOR = 3.22, 95% CI: 1.59, 6.54]. This study remarks, accessing MWHs, creating better awareness in utilizing them, and practicing antenatal follow-up have a crucial role in improving institutional delivery. Therefore, strengthening the existing and establishing new MWHs to deliver quality services is a good strategy in reducing home delivery.
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Murphy, John W. "Service Delivery, Community Development, and Disability." Journal of Social Work in Disability & Rehabilitation 9, no. 2-3 (2010): 223–33. http://dx.doi.org/10.1080/1536710x.2010.493489.
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Verma, Arti, Shailendra Singh Chaudhary, Manisha Madhukar Nagergoje, Iqbal Aqeel Khan, Saroj Singh, and Sarvesh Awasthi. "Preferences and Practices regarding Delivery Place: A community-based cross-sectional study in Agra city, Uttar Pradesh." Indian Journal of Community Health 33, no. 3 (2021): 497–505. http://dx.doi.org/10.47203/ijch.2021.v33i03.016.
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Background: Understanding preferences and practices for delivery place among women would assist in better resource utilization for skilled attendants. Objectives: To study factors influencing women’s preference and practice regarding their place of delivery. Methods: A community based cross-sectional study was conducted in Agra from 1st October 2018 to 31st October 2020. Multi-stage random sampling was used. Data was collected using semi-structured interview schedule. Both bivariate and multivariate analysis was done. Result: Majority (72.67%) of women had preference for delivery at government hospital while 19.67% for private hospital and only 7.67% for home. In actual practice, 58.33% had delivered at government hospital and 32.33% delivered at private hospital while 9.33 % at home. On multiple-logistic regression analysis, parity found to have significant association with preference of delivery at government hospital. Preference for delivery in private hospital was found to be significant with OBC caste and in women whose husband has skilled/highly-skilled occupation. In actual practice, Government hospital as delivery place found to have significant association with parity and presence of ASHA. Private hospital as a delivery place found significant with literate mothers and parity. Conclusion: Majority had preferred and practiced institutional delivery, preferring government hospital over private hospital. In actual practice, delivery at private hospital as well as home delivery out-numbered the preferred proportion.
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Crespo-Gonzalez, Carmen, Sarah Dineen-Griffin, John Rae, and Rodney A. Hill. "A qualitative exploration of mental health services provided in community pharmacies." PLOS ONE 17, no. 5 (2022): e0268259. http://dx.doi.org/10.1371/journal.pone.0268259.
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The burden of mental health problems continues to grow worldwide. Community pharmacists’, as part of the primary care team, optimise care for people living with mental illness. This study aims to examine the factors that support or hinder the delivery of mental health services delivered in Australian community pharmacies and proposes ideas for improvement. A qualitative study was conducted comprising focus groups with community pharmacists and pharmacy staff across metropolitan, regional, and rural areas of New South Wales, Australia. Data were collected in eight focus groups between December 2020 and June 2021. Qualitative data were analysed using thematic analysis. Thirty-three community pharmacists and pharmacy staff participated in an initial round of focus groups. Eleven community pharmacists and pharmacy staff participated in a second round of focus groups. Twenty-four factors that enable or hinder the delivery of mental health services in community pharmacy were identified. Participant’s perception of a lack of recognition and integration of community pharmacy within primary care were identified as major barriers, in addition to consumers’ stigma and lack of awareness regarding service offering. Suggestions for improvement to mental health care delivery in community pharmacy included standardised practice through the use of protocols, remuneration and public awareness. A framework detailing the factors moderating pharmacists, pharmacy staff and consumers’ empowerment in mental health care delivery in community pharmacy is proposed. This study has highlighted that policy and funding support for mental health services is needed that complement and expand integrated models, promote access to services led by or are conducted in collaboration with pharmacists and recognise the professional contribution and competencies of community pharmacists in mental health care. The framework proposed may be a step to strengthening mental health support delivered in community pharmacies.
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Litwin, Howard, and Ernie Lightman. "The Development of Community Care Policy for the Elderly: A Comparative Perspective." International Journal of Health Services 26, no. 4 (1996): 691–708. http://dx.doi.org/10.2190/387a-f71l-qadx-9bp7.
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A comparison of the development of community care for the elderly in the province of Ontario, Canada, and in the State of Israel is presented in the light of the economic constraints currently challenging the expansion of welfare state services. The inquiry identified several common issues regarding the nature of the policy mandate for long-term care delivered in the home, the structure of the service delivery system, and matters concerning funding arrangements for community care. Issues that emerged in both settings include the relationship between health and social services in the delivery of care at the local level; the separation of purchaser and provider functions; the question of needs-driven versus service-driven social care provisions; accessibility concerns and the aspiration for one-stop entry to the delivery system; the growing involvement of the private sector in the delivery of domiciliary-based personal care services; and the relative paucity of current efforts to address the needs of family caregivers.
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Cowell, Sarah, and Charlotte Botes. "Experience with setting up community intravenous therapy clinics." British Journal of Community Nursing 25, no. 6 (2020): 300–302. http://dx.doi.org/10.12968/bjcn.2020.25.6.300.
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The NHS Long Term Plan aims for patients to receive more options, better support and integrated care at the right time and in the optimal care setting. Community nursing teams at the Wirral Community Health and Care NHS Foundation Trust have experienced several challenges in delivering intravenous antibiotics (IV) to patients within their own homes, especially for non-housebound patients, due to the complexity of and demand on the service. Traditionally, intravenous antimicrobials are administered in the acute hospital or in-patient settings. However, there is now a growing trend to deliver intravenous antibiotic therapy within the community. Community nurses have a wealth of knowledge and skills that can support the delivery of the NHS Long Term Plan by developing new models of care in integrated care systems while supporting the implementation and delivery of the governments five-year action plan on antimicrobial resistance. This article describes how the community nursing service at Wirral Community Health and Care NHS Foundation Trust set up community IV clinics.
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David, Odikeme E., Abraham Mercy Kinigi, Dr Solomon M. Uvoh, Lokobo J. Abraham, and Dr Onokpite Emmanuel. "Knowledge and Practice of Safe Delivery among Community Health Practitioners in Bayelsa Central Senatorial District, Nigeria." EAS Journal of Nursing and Midwifery 6, no. 03 (2024): 73–80. http://dx.doi.org/10.36349/easjnm.2024.v06i03.002.
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Community health practitioners play a vital role in providing primary healthcare services, including antenatal/postnatal care and delivery. The research aim to identify safe normal delivery knowledge and practice among healthcare workers in primary healthcare clinics that plays significant role in the quality of care provided to pregnant women in their respective communities. Methods: A descriptive study design and a cluster sampling technique with the aid of questionnaires was used to select 210 community health practitioners from, Bayelsa Central Senatorial district. Results: From this study shows that 51.43% of respondents were within 25-34 years age bracket, 46.19% were married, 72.38% of respondents were CHEW’s, 53.81% were government employed and 92.38% were Christians while 1.90% and 5.71% were Islam and African traditional religion. An average knowledge of 94.76% community health practitioners on safe delivery was identified with a practice rate of 90.95% as well as 75.24% that has taken delivery successfully. Conclusion: Community health workers are known to be skilled birth attendants as well as positioned geographically and socially to deliver some aspects of MNH care. Hence we recommend that there should be an increased training and retraining of community health practitioners across Bayelsa state as this will help to protect life of women and their unborn /newborn babies.
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Lartey, Elizabeth, Victrine Tseung, Christine Faubert, et al. "Digital Impact: A Program Evaluation of the Digital Delivery of the Living with Stroke™ Program." International Journal of Integrated Care 25 (April 9, 2025): 366. https://doi.org/10.5334/ijic.icic24168.
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In response to the COVID-19 pandemic, organizations had to rapidly adapt stroke support services to provide digital delivery options. In the post-pandemic environment, there continues to be significant interest in maintaining digital delivery options. However, there is a gap in understanding the impact of digital programs and the potential barriers that digital program delivery may create. As community organizations seek to expand programming in a growing digital space, it is important to consider how to make programming as effective, accessible, and sustainable as possible. March of Dimes Canada (MODC) is a national non-profit organization that provides services to people with disabilities and their caregivers, including people who have experienced a stroke. In partnership with Heart and Stroke Foundation Canada, MODC delivered the digital Living with Stroke™ program between March 2022 and December 2023, reaching 400 participants. Living with Stroke™ is an education program for individuals who have experienced a stroke and their caregivers, that is co-facilitated by people with lived experience and MODC staff. The program underwent a two-year evaluation to measure program effectiveness and feasibility of digital delivery, as well as examine the impact of digital program delivery for people with disabilities and their caregivers. After 18 months of mixed methods data collection with participants with lived experience of stroke, the evaluation found that digital program delivery provides a safe environment for participants to learn and connect with others and improve health knowledge and confidence. The digital delivery decreased barriers for most participants allowing for timely, convenient, and efficient access to programming. Results highlighted the importance of peer support and the ability of digital programs to enable connections for people from different communities and circumstances, in a way that was not previously feasible. This presentation will highlight the impact of these outcomes and associated best practices for delivering digital programming to people with disabilities, underscoring how digital solutions can expand community organizations’ ability to deliver effective programming to their community.
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Yeoh, Yun Kit, Zigui Chen, Mamie Hui, et al. "Impact of inter- and intra-individual variation, sample storage and sampling fraction on human stool microbial community profiles." PeerJ 7 (January 11, 2019): e6172. http://dx.doi.org/10.7717/peerj.6172.
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Stools are commonly used as proxies for studying human gut microbial communities as sample collection is straightforward, cheap and non-invasive. In large-scale human population surveys, however, sample integrity becomes an issue as it is not logistically feasible for researchers to personally collect stools from every participant. Instead, participants are usually given guidelines on sample packaging and storage, and asked to deliver their stools to a centralised facility. Here, we tested a number of delivery conditions (temperature, duration and addition of preservative medium) and assessed their effects on stool microbial community composition using 16S rRNA gene amplicon sequencing. The largest source of variability in stool community composition was attributable to inter-individual differences regardless of delivery condition. Although the relative effect of delivery condition on community composition was small compared to inter-individual variability (1.6% vs. 60.5%, permutational multivariate analysis of variance [PERMANOVA]) and temporal variation within subjects over 10 weeks (5.2%), shifts in microbial taxa associated with delivery conditions were non-systematic and subject-specific. These findings indicated that it is not possible to model or accurately predict shifts in stool community composition associated with sampling logistics. Based on our findings, we recommend delivery of fresh, preservative-free stool samples to laboratories within 2 hr either at ambient or chilled temperatures to minimise perturbations to microbial community composition. In addition, subsamples from different fractions of the same stool displayed a small (3.3% vs. 72.6% inter-individual variation, PERMANOVA) but significant effect on community composition. Collection of larger sample volumes for homogenisation is recommended.
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Anshebo, Demeke, Bifitu Geda, Aregash Mecha, Alemu Liru, and Ritbano Ahmed. "Utilization of institutional delivery and associated factors among mothers in Hosanna Town, Hadiya Zone, Southern Ethiopia: A community-based cross-sectional study." PLOS ONE 15, no. 12 (2020): e0243350. http://dx.doi.org/10.1371/journal.pone.0243350.
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Background Institutional delivery is one of the key interventions that have been proven to reduce maternal and newborn morbidity and mortality. Ethiopia has initiated different efforts to enhance the acceptance of institutional delivery. In spite of this, the number of institutional deliverys is still very low in Ethiopia and varies from region to region. Therefore, this study aimed to assess the utilization of institutional delivery and of factors associated with it among mothers in Hossana Town, Southern Ethiopia. Methods This study was a community-based cross-sectional study of mothers who had given birth within 12 months before the study. Data were collected using a pretested questionnaire. During the study period, 403 mothers were selected using the systematic random sampling technique. Data entry was done using EpiData (version 3.1), and data were exported to SPSS (version 24) for analysis. Both bivariate and multivariable logistic regression analyses were used to identify the associated factors at 95% CI. Results This study revealed that 53.6% of mothers delivered their infants at health facilities. The factors associated with the institutional delivery were primigravidas (AOR = 3.9; 95% CI, 1.4–4.7), the availability of antenatal care (AOR = 3.4; 95%CI, 1.7–7.2), having planned pregnancies (AOR = 3.9; 95%CI, 1.7–9.3) and the involvement of both parents in decision making (AOR = 2.4; 95%CI, 1.4–2.5). However, when only the mother was involved in the decision making regarding the delivery, the figure decreased by 70% (AOR = 0.3; 95%CI, 0.1–0.8). Conclusions The findings of this study indicate that high numbers of births occur without skilled attendants or are non- institutional delivery. In terms of the factors that are associated with institutional delivery, the study suggests that strengthening sustained provision of education during antenatal care and at community levels are crucial.
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Harris, Spencer, and Barrie Houlihan. "Delivery networks and community sport in England." International Journal of Public Sector Management 27, no. 2 (2014): 113–27. http://dx.doi.org/10.1108/ijpsm-07-2013-0095.
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Purpose – The paper aims to utilise Adam and Kriesi's network approach to policy analysis to examine the range of exogenous factors that affect interactions in the community sport policy process from a local authority perspective. Design/methodology/approach – The research is based upon two case studies. Each case study involved semi-structured interviews with three local authority middle/senior managers, three senior County Sport Partnership (CSP) representatives, and eight regional/county national governing bodies of sport (NGB) representatives. Findings – While the two cases exhibit distinctive socio-economic and structural profiles they provide valuable evidence regarding the operation of the network of partners involved in community sport and also illustrate the utility of Adam and Kriesi's analytical framework. In relation to Adam and Kriesi's power/interaction model both cases illustrate the fragmentation of power at the community level although interaction in one case exhibits a pattern best characterised as “competition” whereas interaction in the other is more closely associated with “horizontal cooperation”. Research limitations/implications – The paper highlights the need for improved theorisation of partnership arrangements in community sport, in particular: examining the relationship between issues such as resources, organisational capacity, and traditional involvement in sport development and attitudes toward the community sport policy process; linked to this, mapping the causal relationships in partnerships, i.e. what factors lead to what actions or behaviours; and investigating the utility of various strategies in developing a more cohesive and effective sub-regional policy system. Originality/value – Local authority perspectives of community sport policy is an under-researched topic. It is timely to study these perspectives due to the refreshed community sport policy for 2013-2017, the traditional status of local government as the major funder of community sport, and the public sector budget reductions and reported implications for non-statutory services, such as community sport
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Bearinger, Linda H., and Elizabeth R. McAnarney. "Integrated community health delivery program for youth." Journal of Adolescent Health Care 9, no. 6 (1988): S36—S40. http://dx.doi.org/10.1016/0197-0070(88)90007-1.
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Ampofo, Gifty Dufie, and Harry Tagbor. "Community delivery of malaria chemoprevention in pregnancy." Lancet Global Health 11, no. 4 (2023): e487-e488. http://dx.doi.org/10.1016/s2214-109x(23)00126-2.
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Faulkner, Kathryn. "Successes and failures in videoconferencing: A community health education programme." Journal of Telemedicine and Telecare 7, no. 2_suppl (2001): 65–67. http://dx.doi.org/10.1258/1357633011937182.
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Women's Health Queensland Wide began delivery of community education programmes for rural women via videoconferencing in the year 2000. A series of three, 90 min videoconference sessions from Brisbane were delivered to 13 sites in northern Queensland. The sessions related to health issues for women at midlife. The sessions were delivered by health experts in Brisbane, who provided a short presentation on their topic; the majority of the videoconference was dedicated to questions from the participants. Each site was supported by a technical coordinator, who ensured that the equipment functioned properly, and a local health worker, who facilitated women's participation in the videoconference as well as providing a local services perspective. Women's Health Queensland Wide was responsible for overall planning and promotion of the sessions. Feedback from these programmes demonstrated women's and health-care professionals’ acceptance of videoconferencing as a mechanism for receiving health information. Sustainability of these programmes depends upon the following issues: cost, delivery model, and the availability of appropriate technology and women-friendly sites.
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Wilfong, Lalan S., Neal Dave, Wendy Hemmen, Erica Feinberg, and Gury K. Doshi. "Impact of the end of public health emergency oral dispensing flexibilities for at-risk patients in a community oncology practice." JCO Oncology Practice 19, no. 11_suppl (2023): 209. http://dx.doi.org/10.1200/op.2023.19.11_suppl.209.
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209 Background: Many studies have shown the benefit of medically integrated pharmacies for cancer specialty oral drugs in improving patient adherence and reducing waste compared to external pharmacies. Anti-kickback regulations have limited practice’s ability to deliver prescriptions to patient’s homes from physician offices. During the Covid Public Health Emergency (PHE), flexibility for prescription delivery by a physician owned pharmacy was allowed leading many practices to deliver oral cancer therapies to patients who could not otherwise come to clinics to fill their medications. With the end of the PHE, CMS reversed this flexibility. We sought to determine the impact on patients with this change in CMS regulations. Methods: Utilizing the pharmacy database of prescriptions delivered to a patient’s home for a large statewide community oncology practice in Texas during the PHE, we identified patients with Medicare part D who would no longer be able to utilize their physician’s pharmacy for home delivery of their specialty medications. We determined the distance of those patient’s primary address to the nearest clinic and further matched them to the address deprivation index (ADI) a well-validated approach that rank orders zip codes in deciles from lowest to highest need. Results: We found 970 patients receiving home delivered prescriptions with traditional Medicare Part D. 687 or 71% of patients lived within 20 miles of the nearest clinic. 213 or 22% lived between 20 and 50 miles with 70 or 7% more than 50 miles from the nearest clinic. 60 addresses could not be matched to the ADI database. Focusing on those available addresses in the top half of the ADI at highest need, we found that 40% of patients living within 20 miles of the clinic are at significant risk of disparity vs 67% of those 20-50 miles and 61 % of those living more than 50 miles from the clinic. Conclusions: The removal of the PHE flexibility for home delivery of prescriptions from physician offices will significantly increase the burden on patients in Texas, forcing many to drive long distances to obtain drugs and disproportionately affecting those at greatest risk of disparity. We encourage revising policies to allow medically integrated pharmacies to allow home delivery of cancer specialty drugs to meet CMS stated goals of improving health equity.
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Alatinga, Kennedy A., Jennifer Affah, and Gilbert Abotisem Abiiro. "Why do women attend antenatal care but give birth at home? a qualitative study in a rural Ghanaian District." PLOS ONE 16, no. 12 (2021): e0261316. http://dx.doi.org/10.1371/journal.pone.0261316.
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Background The Sustainable Development Goal Three has prioritised reducing maternal, under-5 and neonatal mortalities as core global health policy objectives. The place, where expectant mothers choose to deliver their babies has a direct effect on maternal health outcomes. In sub-Saharan Africa, existing literature has shown that some women attend antenatal care during pregnancy but choose to deliver their babies at home. Using the Andersen and Newman Behavioural Model, this study explored the institutional and socio-cultural factors motivating women to deliver at home after attending antenatal care. Methods A qualitative, exploratory, cross-sectional design was deployed. Data were collected from a purposive sample of 23 women, who attended antenatal care during pregnancy but delivered their babies at home, 10 health workers and 17 other community-level stakeholders. The data were collected through semi-structured interviews, which were audio-recorded, transcribed and thematically analysed. Results In line with the Andersen and Newman Model, the study discovered that traditional and religious belief systems about marital fidelity and the role of the gods in childbirth, myths about consequences of facility-based delivery, illiteracy, and weak women’s autonomy in healthcare decision-making, predisposed women to home delivery. Home delivery was also enabled by inadequate midwives at health facilities, the unfriendly attitude of health workers, hidden charges for facility-based delivery, and long distances to healthcare facilities. The fear of caesarean section, also created the need for women who attended antenatal care to deliver at home. Conclusion The study has established that socio-cultural and institutional level factors influenced women’s decisions to deliver at home. We recommend a general improvement in the service delivery capacity of health facilities, and the implementation of collaborative educational and women empowerment programmes by stakeholders, to strengthen women’s autonomy and reshape existing traditional and religious beliefs facilitating home delivery.
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Restu Purwaningtyas, Endang Silaningsih, Wahyuni Diandra Maharani, Andi Hardiansyah, and Resti Amelia. "Penerapan Importance Performance Analysis (IPA) untuk Meningkatkan Kualitas Pelayanan pada Restoran Solaria." MENAWAN : Jurnal Riset dan Publikasi Ilmu Ekonomi 3, no. 3 (2025): 137–57. https://doi.org/10.61132/menawan.v3i3.1470.
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Community service initiatives often struggle to meet the needs of beneficiaries. This study explores the application of Importance Performance Analysis (IPA) to improve the effectiveness of community service programs, using Solaria Restaurant’s customer service efforts as a case study. The research investigates the gap between beneficiaries’ expectations and their perceptions of delivered services. Data is collected through surveys administered to a sample of Solaria Restaurant patrons who have benefitted from the restaurant’s community service programs. By analyzing the importance and performance ratings provided by participants, the study identifies areas for improvement within Solaria’s service delivery. This research demonstrates the value of IPA as a tool for enhancing community service programs. By aligning service delivery with beneficiary expectations, organizations can maximize the impact of their efforts and create more meaningful community engagement.
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Arzika, Ahmed M., Ramatou Maliki, Abdou Amza, et al. "Comparison of door-to-door and fixed-point delivery of azithromycin distribution for child survival in Niger: A cluster-randomized trial." PLOS Global Public Health 3, no. 11 (2023): e0002559. http://dx.doi.org/10.1371/journal.pgph.0002559.
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Recent evidence indicates mass azithromycin distribution reduces under-5 mortality. This intervention is being considered for child survival programs in high mortality sub-Saharan African settings. The delivery approach used in prior studies required a full-time census and distribution team, which is not feasible for most programs. To determine the optimal programmatic approach to delivery, this study aimed to compare treatment coverage, costs, and acceptability of different delivery approaches with existing community health workers (CHWs). This cluster-randomized trial included rural and peri-urban communities in Dosso, Niger (clinicaltrials.gov, NCT04774991). A random sample of 80 eligible communities was randomized 1:1 to biannual door-to-door or fixed-point delivery of oral azithromycin to children 1–59 months old over 1 year. Data analysts alone were masked given the nature of the intervention. The primary outcome was community-level treatment coverage defined as the number of children treated recorded by CHWs divided by the number of eligible children determined using a post-distribution census. Costs were monitored through routine administrative data collection and micro-costing. The census included survey questions on intervention acceptability among caregivers, community leaders, and CHWs. After randomization, 1 community was excluded due to inaccuracies in available administrative data, resulting in 39 communities receiving door-to-door delivery. At the second distribution, community-level mean treatment coverage was 105% (SD 44%) in the door-to-door arm and 92% (SD 20%) in the fixed-point arm (Mean difference 13%, 95% CI -2% to 28%, P-value = 0.08). The total cost per dose delivered was $1.91 in the door-to-door arm and $2.51 in the fixed-point arm. Indicators of acceptability were similar across stakeholder groups in both arms, with most respondents in each group indicating a preference for door-to-door. Overall, door-to-door delivery is the preferred approach to azithromycin distribution in this setting and might reach more children at a lower cost per dose delivered than fixed-point. Trial Registration: clinicaltrials.gov NCT04774991.
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Brewster, Sarah, Richard Holt, Jane Portlock, and Hermione Price. "The role of community pharmacists and their position in the delivery of diabetes care: an update for medical professionals." Postgraduate Medical Journal 96, no. 1138 (2020): 473–79. http://dx.doi.org/10.1136/postgradmedj-2020-137511.
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Pharmacists are the third largest group of healthcare professionals worldwide, but are underused in the delivery of diabetes care. The aim of this narrative was to describe how integration of community pharmacy services into existing healthcare models may improve diabetes care. Relevant literature exploring pharmacy-led interventions for diabetes were identified from a search of Medline, Embase and Cinahl online databases. This review highlights that community pharmacists are accessible, experts in medicine management, trusted by the public and able to achieve financial savings. They are poorly integrated into existing healthcare models, and commissioning arrangements can be poorly perceived by the public and those working in primary care. Community pharmacy interventions in type 2 diabetes have similar, if not greater effects compared to those delivered by other healthcare professionals. It was concluded that community pharmacy interventions in diabetes are feasible, acceptable and deliver improved health outcomes. Future work should build public recognition of pharmacists and improve communication between them and other healthcare professionals.
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Huston, Sally A., David R. Ha, Lindsey A. Hohmann, Tessa J. Hastings, Kimberly B. Garza, and Salisa C. Westrick. "Qualitative Investigation of Community Pharmacy Immunization Enhancement Program Implementation." Journal of Pharmacy Technology 35, no. 5 (2019): 208–18. http://dx.doi.org/10.1177/8755122519852584.
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Background: Despite widely available nonseasonal immunization services in community pharmacies, actual pharmacist-administered vaccines are not yet optimal. A flexible choice multicomponent intervention, the “We Immunize” program, was implemented in Alabama and California community pharmacies, with the goal to enhance pneumococcal and zoster immunization delivery. Limited research has been done to qualitatively understand factors influencing immunization service expansion. Objective: Explore pharmacist perceptions of the We Immunize program in terms of its acceptability, impact, and real-world feasibility, and pharmacist-perceived facilitators and barriers influencing success in immunization delivery enhancement. Methods: This practice-focused qualitative research used semistructured telephone interviews with 14 pharmacists at the completion of the 6-month intervention. Results: Major program implementation facilitators were technician inclusion, workflow changes, training and feedback, goal setting, and enhanced personal selling and marketing activities. Multiple pharmacies increased the number of delivered pneumococcal and zoster immunizations, and increased revenue. Many pharmacists felt professional image, knowledge, skills, roles, and personal satisfaction were enhanced, as were technician knowledge, skills, and roles. Program flexibility, along with multiple perceived benefits, increases the potential for success. Conclusions: The We Immunize program appears to have been viewed positively by participating pharmacists and was seen as having a beneficial impact on immunization delivery in the community pharmacies in which it was implemented.
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Solomon, Hiwote, Elizabeth G. Henry, Julie Herlihy, et al. "Intended versus actual delivery location and factors associated with change in delivery location among pregnant women in Southern Province, Zambia: a prespecified secondary observational analysis of the ZamCAT." BMJ Open 12, no. 3 (2022): e055288. http://dx.doi.org/10.1136/bmjopen-2021-055288.
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ObjectivesThis prespecified, secondary analysis of the Zambia Chlorhexidine Application Trial (ZamCAT) aimed to determine the proportion of women who did not deliver where they intended, to understand the underlying reasons for the discordance between planned and actual delivery locations; and to assess sociodemographic characteristics associated with concordance of intention and practice.DesignPrespecified, secondary analysis from randomised controlled trial.SettingRecruitment occurred in 90 primary health facilities (HFs) with follow-up in the community in Southern Province, Zambia.ParticipantsBetween 15 February 2011 and 30 January 2013, 39 679 pregnant women enrolled in ZamCAT.Secondary outcome measuresThe location where mothers gave birth (home vs HF) was compared with their planned delivery location.ResultsWhen interviewed antepartum, 92% of respondents intended to deliver at an HF, 6.1% at home and 1.2% had no plan. However, of those who intended to deliver at an HF, 61% did; of those who intended to deliver at home, only 4% did; and of those who intended to deliver at home, 2% delivered instead at an HF. Among women who delivered at home, women who were aged 25–34 and ≥35 years were more likely to deliver where they intended than women aged 20–24 years (adjusted OR (aOR)=1.31, 95% CI=1.11 to 1.50 and aOR=1.32, 95% CI=1.12 to 1.57, respectively). Women who delivered at HFs had greater odds of delivering where they intended if they received any primary schooling (aOR=1.34, 95% CI=1.09 to 1.72) or more than a primary school education (aOR=1.54, 95% CI=1.17 to 2.02), were literate (aOR=1.33, 95% CI=1.119 to 1.58), and were not in the lowest quintile of the wealth index.ConclusionDiscrepancies between intended and actual delivery locations highlight the need to go beyond the development of birth plans and exposure to birth planning messaging. More research is required to address barriers to achieving intentions of a facility-based childbirth.Trial registration numberClinicalTrials.gov Registry (NCT01241318).
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Aheto, Justice Moses K., Tracy Gates, Isaac Tetteh, and Rahmatu Babah. "A multilevel analysis of the predictors of health facility delivery in Ghana: Evidence from the 2014 Demographic and Health Survey." PLOS Global Public Health 4, no. 3 (2024): e0001254. http://dx.doi.org/10.1371/journal.pgph.0001254.
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Health facility delivery has the potential to improve birth and general health outcomes for both newborns and mothers. Regrettably, not all mothers, especially in low-and-middle income countries like Ghana deliver at health facilities, and mostly under unhygienic conditions. Using data from the 2014 Ghana Demographic and Health Survey, we fitted both weighted single-level and random intercept multilevel binary logistic regression models to analyse predictors of a health facility delivery among mothers aged 15–49 years and to quantify unobserved household and community differences in the likelihood of health facility delivery. We analysed data on 4202 mothers residing in 3936 households and 427 communities. Of the 4202 mothers who delivered, 3031 (75.3%—weighted and 72.1%—unweighted) delivered at the health facility. Substantial unobserved household only (Median Odds Ratio (MOR) = 5.1) and household conditional on community (MOR = 4.7) level differences in the likelihood of health facility delivery were found. Mothers aged 25–34 (aOR = 1.4, 95%CI: 1.0–2.1) and 35–44 (aOR = 2.9, 95%CI: 1.7–4.8), mothers with at least a secondary education (aOR = 2.7, 95%CI: 1.7–4.1), with health insurance coverage (aOR = 1.6, 95%CI: 1.2–2.2) and from richer/richest households (aOR = 8.3, 95%CI: 3.6–19.1) and with piped water (aOR = 1.5, 95%CI: 1.1–2.1) had increased odds of health facility delivery. Mothers residing in rural areas (aOR = 0.3, 95%CI: 0.2–0.5) and with no religion (aOR = 0.5, 95%CI: 0.3–1.0) and traditional religion (aOR = 0.2, 95%CI: 0.1–0.6), who reported not wanting to go to health facilities alone as a big problem (aOR = 0.5, 95%CI: 0.3–0.8) and having a parity of 2 (aOR = 0.4, 95%CI: 0.3–0.7), 3 (aOR = 0.3, 95%CI: 0.2–0.6) and ≥4 (aOR = 0.3, 95%CI: 0.1–0.5) had reduced odds of health facility delivery. Our predictive model showed outstanding predictive power of 96%. The study highlights the need for improved healthcare seeking behaviours, maternal education and household wealth, and bridge the urban-rural gaps to improve maternal and newborn health outcomes.
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While, Alison. "Integrated care delivery." British Journal of Community Nursing 23, no. 9 (2018): 414. http://dx.doi.org/10.12968/bjcn.2018.23.9.414.
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While, Alison. "Improving service delivery." British Journal of Community Nursing 24, no. 3 (2019): 146. http://dx.doi.org/10.12968/bjcn.2019.24.3.146.
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Luty, Suzanne E., and Sebastiano Scalia. "Can interpersonal psychotherapy be delivered by a community agency?" Australasian Psychiatry 26, no. 2 (2018): 200–205. http://dx.doi.org/10.1177/1039856217751784.
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Objectives: There are limited options for depressed patients to have access to evidence-based psychotherapies in the community. This pilot study explored the feasibility of delivering interpersonal psychotherapy (IPT) to clients in a community support agency. Method: A total of 18 clients with depression completed at least eight sessions of IPT (range 8–13) and 17 completed a range of pre- and post-treatment measures. Results: Clients had a high level of depression and were functioning poorly. All found the delivery of IPT in the community useful and would recommend therapy to others. There was a significant reduction in self-report and clinician-rated depression, and improvement in social functioning. Conclusions: This study supports the notion that therapy can be delivered by appropriately trained non-mental-health clinicians in the community with good effect and adds to the range of options for delivery of psychiatric care.
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Khan, Zainu, and Theo Haupt. "Community participation — a necessary element of community development projects." Acta Structilia 13, no. 2 (2006): 39–61. https://doi.org/10.38140/as.v13i2.1520.
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his article presents a number of important findings of a research project evaluat-ing the importance of community participation in infrastructure delivery in the Western Cape. There is an emerging trend in South Africa that recognises that development is much more than the expansion of income and wealth and that economic growth is not enough. The focus is increasingly on human develop-ment. Participation in the development process must allow the members of the communities to use their own views and convictions to address specific condi-tions and problems prevailing in their community. In addition, participation must be acknowledged as a voluntary process that influences the direction and exe-cution of community development projects in contrast to communities merely being consulted or receiving project benefits. The emerging participatory para-digm suggests two perspectives. The first consists of substantively involving local people in the selection, design, planning and implementation of programmes and projects that will affect them. The second is to make more continuous and comprehensive feedback an integral part of development activities. This paper reviews community participation and its importance in the delivery of develop-ment projects.
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Lloyd, M. G., and B. M. Illsley. "A Community Leadership Initiative for Scotland?" Politics 21, no. 2 (2001): 124–29. http://dx.doi.org/10.1111/1467-9256.00143.
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The Scottish Executive intends to introduce a statutory power of community initiative and of community planning in the forthcoming Local Government Bill. Community planning is developing as an important aspect of local governance in Scotland. It is viewed as a way for councils at the local level to work together with the community, voluntary and private sectors to develop and deliver an agreed joint vision for their communities. This article examines the nature of the community planning concept in Scotland and considers the lessons arising from experience to date. It addresses the tensions in community planning arising from its dual function of bringing some order to the fragmented institutional arrangements for service delivery and providing a strategic, integrated framework for the management of change.
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Legg, David E., Rodney L. Davis, and Jerry P. Buk. "AgTiIPS: A Customized Voice-mail System for Delivering Lawn, Garden, and Horticulture Information to the Public." HortTechnology 3, no. 2 (1993): 245–48. http://dx.doi.org/10.21273/horttech.3.2.245.
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A computerized information delivery system (AgTiIPS) was developed to deliver lawn, garden, and horticultural information to the public. AgTiIPS was based on voice-mail technology, which allows the public to access about 100 messages through a tone-producing telephone. AgTiIPS has been functioning in a Wyoming community of 47,000 since July 1990, and has delivered more than 700 messages in 1.5 years. Economic analyses for setting up voice-mail systems were conducted and the role of voice-mail in delivering lawn, garden, and horticultural information was discussed.
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Elizabeth, Misbah Zulfa. "REPRODUKSI GENDER MELALUI TRANSMISI TEKS AGAMA." Jurnal THEOLOGIA 23, no. 1 (2017): 251–72. http://dx.doi.org/10.21580/teo.2012.23.1.1766.
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The sustainability and cultural change, including gender, was associated with the delivery of value between generations. The existence of well-established interpretation of the text, which does not allow a new interpretation of the text, which is delivered to religious community make gender values remained relatively unchanged, even continuously reproduced. In this case, the transmitter of religious value, the preachers, seen in the Muslim community as the respectable and credible persons. Therefore, the doctrine they convey tend to be trusted and obeyed, without any possibility of other interpretations. The delivery model of one-direction model of messages delivery with lack of dialogue and participation of the audiences, no chance to new interpretations are another causes that led the concept of gender relatively unchanged
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Nshiowo, Kingsley Chikaodili, and C. A. Owopetu. "Mothers’ Experiences of Delivery Services by Traditional Birth Attendants at Egbe Community, Yagba West Lga Kogi State, Nigeria." International Journal of Nursing, Midwife and Health Related Cases 8, no. 2 (2022): 35–52. http://dx.doi.org/10.37745/ijnmh.15/vol80n2pp3552.
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A lot of women gave birth in their homes historically, and are often attended by a family member or assisted by a woman residing in the communities who are known as Traditional Birth Attendants (TBAs).The mothers’ experiences before labor, after delivery and care of the new born was a mixed one. This study was aimed to explore mothers’ that have delivered with TBAs in the past at Egbe Community, Yagba West Local Government Area, Kogi State, Nigeria. The study employed a qualitative research design with in-depth interview supported with two Focus Group Discussions as method of data collection, to explore the experiences of mothers’ during with TBAs. Sixteen participants were used for FGD, eight in each group and thirteen participants for one-on-one in-depth interview using a snowball sampling technique. Both the FGD and IDI sessions were audio taped and transcribed verbatim. The research was analysed using a manual method of qualitative data. The findings revealed that majority of the participants used the services of traditional birth attendants because of the affordable cost. Majority were delivered at their homes and they had good experience. Relatives were allowed to stay with them during labor. They were not given food during labor and their babies were taken good care of. However, few of them would like to deliver at a regular hospital in next delivery due to some complications they experienced. In conclusion, many of the women patronized TBAs because of the cost and services provided were just basic. Therefore, it’s recommended that the cost of delivery at the hospitals should be subsidised and the TBAs should be trained and supervised on a regular basis by the Primary health care centres at the Local Government Areas nearest to them.
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Hill, Zelee, Yared Amare, Pauline Scheelbeek, and Joanna Schellenberg. "‘People have started to deliver in the facility these days’: a qualitative exploration of factors affecting facility delivery in Ethiopia." BMJ Open 9, no. 6 (2019): e025516. http://dx.doi.org/10.1136/bmjopen-2018-025516.
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ObjectivesTo understand the recent rise in facility deliveries in Ethiopia.DesignA qualitative study.SettingFour rural communities in two regions of Ethiopia.Participants12 narrative, 12 in-depth interviews and four focus group discussions with recently delivered women; and four focus group discussions with each of grandmothers, fathers and community health workers.ResultsWe found that several interwoven factors led to the increase in facility deliveries, and that respondents reported that the importance of these factors varied over time. The initial catalysts were a saturation of messages around facility delivery, improved accessibility of facilities, the prohibition of traditional birth attendants, and elders having less influence on deciding the place of delivery. Once women started to deliver in facilities, the drivers of the behaviour changed as women had positive experiences. As more women began delivering in facilities, families shared positive experiences of the facilities, leading to others deciding to deliver in a facility.ConclusionOur findings highlight the need to employ strategies that act at multiple levels, and that both push and pull families to health facilities.
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Salem, Leila, Emily Reichert, Julianne Siegfriedt, Taylor Hall, and Stephanie W. Hartwell. "Boston Offender Needs Delivery Project." International Journal of Offender Therapy and Comparative Criminology 62, no. 11 (2017): 3485–98. http://dx.doi.org/10.1177/0306624x17741807.
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To bridge a gap in access to community services for releasing state inmates, the Boston Offender Needs Delivery (BOND) project was developed as a longitudinal study (2014-2016) of adult inmates with a history of substance use and co-occurring mental health disorders returning to the community following detention in one of Massachusetts’ State correctional facilities. Pre-release inmates who were wrapping up their sentence (i.e., no community supervision) and presented with mental illness and/or substance use disorder were recruited. Participants were provided substance abuse treatment immediately post-release, as well as a variety of recovery supports for a follow-up period of 6 months. This first manuscript is intended to describe the rationale behind the BOND project, as well as the methods and procedure used to collect the data.
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DiGiulio, Daniel B., Benjamin J. Callahan, Paul J. McMurdie, et al. "Temporal and spatial variation of the human microbiota during pregnancy." Proceedings of the National Academy of Sciences 112, no. 35 (2015): 11060–65. http://dx.doi.org/10.1073/pnas.1502875112.
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Despite the critical role of the human microbiota in health, our understanding of microbiota compositional dynamics during and after pregnancy is incomplete. We conducted a case-control study of 49 pregnant women, 15 of whom delivered preterm. From 40 of these women, we analyzed bacterial taxonomic composition of 3,767 specimens collected prospectively and weekly during gestation and monthly after delivery from the vagina, distal gut, saliva, and tooth/gum. Linear mixed-effects modeling, medoid-based clustering, and Markov chain modeling were used to analyze community temporal trends, community structure, and vaginal community state transitions. Microbiota community taxonomic composition and diversity remained remarkably stable at all four body sites during pregnancy (P > 0.05 for trends over time). Prevalence of a Lactobacillus-poor vaginal community state type (CST 4) was inversely correlated with gestational age at delivery (P = 0.0039). Risk for preterm birth was more pronounced for subjects with CST 4 accompanied by elevated Gardnerella or Ureaplasma abundances. This finding was validated with a set of 246 vaginal specimens from nine women (four of whom delivered preterm). Most women experienced a postdelivery disturbance in the vaginal community characterized by a decrease in Lactobacillus species and an increase in diverse anaerobes such as Peptoniphilus, Prevotella, and Anaerococcus species. This disturbance was unrelated to gestational age at delivery and persisted for up to 1 y. These findings have important implications for predicting premature labor, a major global health problem, and for understanding the potential impact of a persistent, altered postpartum microbiota on maternal health, including outcomes of pregnancies following short interpregnancy intervals.
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Raheb, Jenna. "Health Care Delivery, Patient Resources, and Community Reintegration." Physical Medicine and Rehabilitation Clinics of North America 32, no. 3 (2021): 581–89. http://dx.doi.org/10.1016/j.pmr.2021.02.009.
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Eastman, Peggy. "ACCC Conference Showcases Innovative Community Cancer Care Delivery." Oncology Times 42, no. 20 (2020): 17–18. http://dx.doi.org/10.1097/01.cot.0000721332.87527.fd.
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Kirwin, Patricia M., and Lenard W. Kaye. "Parallel Service Delivery in Community Long-Term Care." Journal of Social Service Research 17, no. 1-2 (1993): 19–40. http://dx.doi.org/10.1300/j079v17n01_02.
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Delmez, James A., and David W. Windus. "Hemodialysis prescription and delivery in a metropolitan community." Kidney International 41, no. 4 (1992): 1023–28. http://dx.doi.org/10.1038/ki.1992.155.
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Levitan, Nathan. "Developing a Network of Community-Based Delivery Sites." Oncology Issues 15, no. 3 (2000): 14–19. http://dx.doi.org/10.1080/10463356.2000.11905128.
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