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1
Tay, Ee Lin, and Chee Piau Wong. "A Cross-sectional Survey of Rehabilitation Service Provision for Children with Brain Injury in Selangor, Malaysia." Disability, CBR & Inclusive Development 1, no. 2 (October 2, 2018): 45–58. http://dx.doi.org/10.5463/dcid.v1i2.750.
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Purpose: Rehabilitation services in Malaysia are provided by both governmental and non-governmental agencies but there are challenges, such as the lack of integration between agencies, and accessibility barriers to services especially for the population of urban poor and people in the rural areas. With the help of a survey, this project aimed to gain a better understanding of rehabilitation services provided for children with brain injury within the state of Selangor and Federal Territories of Kuala Lumpur and Putrajaya.Method: A list of 205 organisations that provide rehabilitation services for children with neurological injuries was compiled. The researchers attempted to verify the services by visiting the facilities or via telephone or email communication if visits were not possible.Results: The researchers were able to verify 83% of the organisations identified. There are 40 hospitals and 17 service providers for acute and / or chronic physical rehabilitation services for persons with disabilities of all ages, including children.Conclusion: Findings showed the unequal distribution of rehabilitation service provision by districts. Service providers were concentrated in the urban areas. Setting up new healthcare facilities is one of the solutions but the costs for development, construction, and manpower could be high. An alternative solution is proposed, namely, the use of a home-based virtual rehabilitation programme.
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Ngangbam, Sapana, and Archana K. Roy. "Determinants of Health-seeking Behaviour in Northeast India." Journal of Health Management 21, no. 2 (May 22, 2019): 234–57. http://dx.doi.org/10.1177/0972063419835118.
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India’s northeast region comprises eight states, which, together, is home to 3.8 per cent of the country’s population. The quality of healthcare and manpower availability remains a cause for concern in the region, affecting the overall health-seeking behaviour of the people. This study attempts to understand the determinants of utilization of healthcare services in Northeast India. Healthcare and morbidity data for this study are based on a Northeast India sample from the National Sample Survey Organization’s (NSSO’s) health consumption data (2014). Probit, multinomial and mixed conditional logit models were employed in the study. In Northeast India, uneducated, higher-aged, Schedule Castes/Schedule Tribes (SCs/STs), Muslims, rural people and district people are served less by medical institutions and because of poor road connectivity they either remain untreated or seek care at underequipped primary healthcare services, while their counterparts utilize private facilities mostly for outpatient care and either public hospital or private facilities for inpatient care. There is also a tendency to substitute alternative healthcare when the cost of an inpatient healthcare service rises. To protect the interest of marginalized people and achieve the target of accessible, affordable and quality healthcare, the government needs to strengthen the primary healthcare in rural areas and improve the quality of healthcare in urban areas without increasing the cost of treatment.
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Islam, Md Ziaul, Farhana Zaman, Sharmin Farjana, and Sharmin Khanam. "Accessibility to Health Care Services of Upazila Health Complex: Experience of Rural People." Journal of Preventive and Social Medicine 38, no. 2 (June 28, 2020): 30–37. http://dx.doi.org/10.3329/jopsom.v38i2.47862.
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Background: Upazila health complex (UHC) is the first referral health facility at primary level of health care delivery system in the country. Rural people attend the UHCs to meet their health care needs and demands. But accessibility of the rural people to the UHCs is still not up to the mark.
Objective: This study was conducted to assess accessibility of rural people to health care services of UHC.
Methods: The study was a cross-sectional study, which was conducted at the Kaliakair UHC of Gazipur district in Bangladesh during the period from January to December 2016. The study included 300 rural adults, who were selected systemically. Data were collected by face-to-face interview with the help of a semi-structured questionnaire. Prior to data collection, informed written consent was taken from each participant.
Results: The study revealed that males (51.3%) and females (48.7%) were very close in proportion with mean age of 35.73(±11.74) years. More than three fourth (77.3%) were married and 31.3% had primary education while 28.7% were illiterate. One third was housewives; average family size was 5.43 (±2.54) and average monthly family income was Tk.13920 (±10290.75). Around half of the participants choose the UHC for effective treatment and due to close distance from their residence while one third for low cost treatment and free of cost treatment. Around half of them didn‟t find any display board at the UHC. More than three fourth (82.0%) regarded doctor‟s behavior as „Good‟ while behavior of supporting staff was regarded „Good‟ by 66.0% participants. About half of the participants went to the UHC by rickshaw and 32.0% on foot. Average waiting time was 23.99 (±15.07) minutes to get access to treatment. Off all, 62.0% got full course of prescribed drugs but majority (71.3%) didn‟t get access to advised laboratory facility. Most (82.7%) could not be admitted in the hospital due to insufficient bed (24.2%) and inadequate treatment facility (22.6%), manpower (62.8%) and drug supply. Overall accessibility to UHC was „good‟ (21.3%) followed by „average‟ (31.3%) and „poor‟ (47.3%). It was found that females (53.3%) had significantly (p<0.05) poor accessibility to the UHC services than their counterpart males (41.1%). On the contrary, young adults, elderly, illiterate and primary education groups had significantly (p<0.05) „poor‟ accessibility to UHC services. Higher education (42.9% Masters and 36.4% Graduates) group had significantly „good‟ accessibility. More than half (53.1%) of the service holders and majority (60.0%) of higher income (Tk.30001-50000) group had had „average‟ and „good‟ accessibility respectively, which is statistically significant (p<0.05). Barriers to accessibility included long waiting time (67.0%), inadequate drug supply (62.0%), limited laboratory facility (40.0%), inadequate manpower (37.9%) and poor cooperation of the staff (32.0%) and communication (18.4%).
Conclusion: To improve accessibility of the rural people to the health care services of the UHC, associated problems must be overcome by effective measures and program interventions.
JOPSOM 2019; 38(2): 30-37
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Egwu, I. N. "Community Health Intervention Program (Chip): Re-Educating Health Professionals for Primary Health Care." International Quarterly of Community Health Education 8, no. 1 (April 1987): 81–90. http://dx.doi.org/10.2190/5djn-v22j-farb-6wn4.
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Primary health care (PHC) in most developing countries remains largely inaccessible to a vast proportion of urban and rural populations. It is neither influenced by, nor integrated with, preventive care/community development. This may be attributed partly to lack of community participation by communities. Professional health care is isolated and impervious to the influence of health care users. In Nigeria all functional correlates are available in the existing health systems; yet, the impact is not felt. What is needed, and urgently, is an intervention to extend meaningful health care delivery into the urban poor and rural communities. The Nigerian Youth Service Corps (NYSC) scheme, through a rational and systematic mobilization and utilization of its health manpower, offers an excellent opportunity to demonstrate that PHC can work. A two-step intervention process is proposed: a reorientation during NYSC “orientation,” and a community-based practice module, during the NYSC “Primary Assignment” phase. Health professionals working as a “team,” and led by NYSC doctor(s), undertake their medical care responsibilities as well as community development projects as integrated aspects of PHC. It is envisaged that experiences accruing from such a deliberate intervention with a pilot project, will form a basis for operational adoption of the proposed CHIP as a national model.
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Karki, Bir Bahadur. "Strategic Planning in Co-operative Sector: A Study on Dairy." Journal of Nepalese Business Studies 2, no. 1 (April 2, 2007): 72–80. http://dx.doi.org/10.3126/jnbs.v2i1.57.
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Dairy co-operatives are found everywhere in both developed and developing countries. In developing countries, it is one of the income sources of their rural economy whereas in developed countries it takes as a sustainable business. These countries face different types of problems. Developing countries focus on increase in production volume of milk and milk product, and developed countries do on enhancement of milk product, brand, and merger of dairy co-operatives. Dairy cooperatives have been getting various opportunities as well as facing different challenges. They are going to formulate different types of strategic planning to cope with these challenges and to get success. Strategic plans of dairy cooperatives in developing countries are, generally to increase production volume of buffalo milk, bring about the internal improvement in cooperative societies, reduce cost of production, provide quality service to consumer through skill, trained and educated manpower, and e-commerce. Strategic plan of developed countries is quite different from that of developing countries. Their strategic plans are to merge different dairy cooperative societies / institutions into a dairy cooperative, and compete in the global market with quality of products.
Journal of Nepalese Business Studies Vol.2(1) 2005 pp.72-80
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Talukder, Md Humayun Kabir, BH Nazma Yasmeen, Rumana Nazneen, Md Zakir Hossain, and Ishrat Jahan Chowdhury. "Assessment of relevance and effectiveness of community health workforce (CHW) development system in Bangladesh." Northern International Medical College Journal 5, no. 2 (April 29, 2015): 332–35. http://dx.doi.org/10.3329/nimcj.v5i2.23129.
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Background : Community Health Workforce (CHW) development has a rich history in South East Asian Region (SEAR). The first Community Health Unit was established in Sri Lanka in 1926 and then practiced over many of the regional countries like, Thailand, Mayanmar and India. Community Health Workers are in the fore front workforce to bring about change through community health programmes to national levels. In Bangladesh, there are also different categories of health workforce serving in the health care delivery system.Objectives : To assess relevance and effectiveness of community health workforce (CHW) development system in Bangladesh.Methods : This cross sectional study was conducted from 1st November 2010-30th April 2011 by purposive sampling technique. Study population were directors, administrators, principals, teachers of different institutes/ organizations and community health workers working in different corners of Bangladesh. Study places were different divisional towns of Bangladesh. Previously developed questionnaire & checklist were used for the collection of data from the institutes/ organizations by data collectors. These data were edited, processed and was analysed by using SPSS soft ware and a small portion by manually. No strong ethical issues were involved in this activity.Results : Study revealed that all the respondents (100%) are in favour of production of CHW in Bangladesh through formal academic institutional or pre service education (61.4%) .Most of the respondents (56.8%) viewed that there are scopes of utilisation of produced CHW in rural areas and most of the respondents (63.6%) also viewed that terminal/marginalized/underprivileged peoples of hard to reach areas at least can be served by CHW. Regarding the competency of produced CHW few of the respondents (43.2%) viewed positively. Most of the respondents (86.4%) viewed that both govt. & non govt. sectors should produce CHW with a very good coordination and co-operation. Study revealed the institutional capacities or situations about physical facilities, ongoing course, audiovisual aids, library, manpower and assessment procedure.Conclusion : Study revealed that there is strong & logical relevance present for the production of CHW in Bangladesh. So the existing Human Resource for Health (HRH) policy is to be revised & revisited as a time felt need to develop more competent CHW for Bangladesh to serve the marginalized, terminal, people of remote, rural & hard to reach areas.Northern International Medical College Journal Vol.5(2) 2014: 332-335
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Upadhyay, Ravi Prakash, Palanivel Chinnakali, Oluwakemi Odukoya, Kapil Yadav, Smita Sinha, S. A. Rizwan, Shailaja Daral, Vinoth G. Chellaiyan, and Vijay Silan. "High Neonatal Mortality Rates in Rural India: What Options to Explore?" ISRN Pediatrics 2012 (November 18, 2012): 1–10. http://dx.doi.org/10.5402/2012/968921.
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The neonatal mortality rate in India is amongst the highest in the world and skewed towards rural areas. Nonavailability of trained manpower along with poor healthcare infrastructure is one of the major hurdles in ensuring quality neonatal care. We reviewed case studies and relevant literature from low and middle income countries and documented alternative strategies that have proved to be favourable in improving neonatal health. The authors reiterate the fact that recruiting and retaining trained manpower in rural areas by all means is essential to improve the quality of neonatal care services. Besides this, other strategies such as training of local rural healthcare providers and traditional midwives, promoting home-based newborn care, and creating community awareness and mobilization also hold enough potential to influence the neonatal health positively and efforts should be made to implement them on a larger scale. More research is demanded for innovations such as “m-health” and public-private partnerships as they have been shown to offer potential in terms of improving the standards of care. The above proposed strategy is likely to reduce morbidity among neonatal survivors as well.
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Hamal, Pawan Kumar, Anuj Jung Rayamajhi, Nabin Pokhrel, Rupesh Kumar Yadav, Prajjwal Raj Bhattarai, and Navindra Raj Bista. "Can Ultrasound Guided Regional Anesthesia Improve Rural Anesthesia Services and Address Safety Issues in Low Income Country? Perspective from Nepal." Journal of Nepal Health Research Council 18, no. 1 (April 20, 2020): 144–46. http://dx.doi.org/10.33314/jnhrc.v18i1.2614.
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Provision of anesthesia services in a deprived area particularly in low income countries is a major challenge all over the globe. Along with issues of manpower, logistics, services, there lies agendas of safety and accuracy while delivering the services. With rise in ultrasound use in regional anesthesia, pain and perioperative care, it is prudent that some of these issues can be addressed with proper training, mentoring and monitoring. The global idea needs to be implemented locally to reach out to huge volume of patients who are inadequately treated for the various painful conditions. A group of regional enthusiasts from Nepal takes the vision and mission in Nepalese context to address the issues. Keywords: Low income country; rural anesthesia; safety; ultrasound guided regional anesthesia
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MacRorie, R. A. "Births, Deaths and Medical Emergencies in the District: A Rapid Participatory Appraisal in Nepal." Tropical Doctor 28, no. 3 (July 1998): 162–65. http://dx.doi.org/10.1177/004947559802800312.
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Two qualitative rapid appraisal techniques were used in a community-based study to investigate health beliefs, attitudes and practices in a rural district in Nepal. Pregnancy and childbirth remain non-medical activities managed at home. Deaths may be avoided by better access to hospital emergency services. Health awareness of some problems, e.g. oral rehydration in diarrhoeal disease, is high; but of others, e.g. association of haemoptysis with tuberculosis, is poor. These methods require few resources, are efficient in time and manpower required, and generate useful relevant information on a target population. They are recommended for district health development programmes elsewhere.
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McKelvey, Robert S., David L. Sang, and Hoang Cam Tu. "Is There a Role for Child Psychiatry in Vietnam?" Australian & New Zealand Journal of Psychiatry 31, no. 1 (February 1997): 114–19. http://dx.doi.org/10.3109/00048679709073807.
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Objectives:(i) To describe the need for child psychiatric services in Vietnam; (ii) to review child psychiatry's present role within the Vietnamese health care system; (iii) to identify cultural, economic and manpower obstacles to the development of child mental health services; and (iv) to recommend a course for the future development of child psychiatry in Vietnam. Method:The existing literature relevant to the Vietnamese health and mental health care systems, traditional practices and beliefs regarding health and mental health, and the current status of psychiatry and child psychiatry in Vietnam was reviewed. In addition, discussions regarding these topics, and the future of child psychiatry in Vietnam, were held with leading Vietnamese health and mental health professionals. Results:The current role of child psychiatry in Vietnam is limited by the health care system's focus on infectious diseases and malnutrition, and by cultural, economic and manpower factors. Treatment is reserved for the most severely afflicted, especially patients with epilepsy and mental retardation. Specialised care is available in only a few urban centres. In rural areas treatment is provided by allied health personnel, paraprofessionals and community organisations. Conclusions:While the present role of child psychiatry in Vietnam is limited, it can still make important contributions. These include:research defining the need for child and adolescent mental health services, identifying priority child psychiatric disorders and assessing the effectiveness of priority disease treatment; and training to enhance the skills of primary health care providers in the treatment of priority disorders.
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Haruna, Umar, Gordon Dandeebo, and Sylvester Z. Galaa. "Improving Access and Utilization of Maternal Healthcare Services through Focused Antenatal Care in Rural Ghana: A Qualitative Study." Advances in Public Health 2019 (July 1, 2019): 1–11. http://dx.doi.org/10.1155/2019/9181758.
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Improved access to and utilization of various maternal healthcare services have been seen as the panacea to poor maternal and child health outcomes characterizing many developing countries. Focused Antenatal Care (FANC) replaced the regular antenatal care model about a decade and a half ago. This study sought to document empirical outcomes of how the FANC approach translates access and utilization of maternal health services into positive maternal health outcomes. We utilized a descriptive qualitative design and analysis. We applied key informant interviewing to collect data from 206 respondents consisting of 140 women in their fertility age and 66 health workers across 14 communities in the study district. We found that FANC has been widely implemented across the district with most of the required services integrated into the existing healthcare delivery system. Overall, there has been successful implementation of FANC in the district, resulting in several benefits including the increased utilization of maternal healthcare services, acceptance of family planning, increased skilled delivery, and utilization of postnatal care (PNC) services. This notwithstanding, a number of issues need to be addressed to improve FANC services. These include provision of adequate infrastructure, essential supplies, communication and transportation systems, and manpower and adoption of positive sociocultural practices. No effort should be spared in providing these to sustain the successes and ensure sustainability of FANC.
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Glow, Steven D., Vincent J. Colucci, Douglas R. Allington, Curtis W. Noonan, and Earl C. Hall. "Managing Multiple-Casualty Incidents: A Rural Medical Preparedness Training Assessment." Prehospital and Disaster Medicine 28, no. 4 (April 18, 2013): 334–41. http://dx.doi.org/10.1017/s1049023x13000423.
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AbstractObjectiveThe objectives of this study were to develop a novel training model for using mass-casualty incident (MCI) scenarios that trained hospital and prehospital staff together using Microsoft Visio, images from Google Earth and icons representing first responders, equipment resources, local hospital emergency department bed capacity, and trauma victims. The authors also tested participants’ knowledge in the areas of communications, incident command systems (ICS), and triage.MethodsParticipants attended Managing Multiple-Casualty Incidents (MCIs), a one-day training which offered pre- and post-tests, two one-hour functional exercises, and four distinct, one-hour didactic instructional periods. Two MCI functional exercises were conducted. The one-hour trainings focused on communications, National Incident Management Systems/Incident Command Systems (NIMS/ICS) and professional roles and responsibilities in NIMS and triage. The trainings were offered throughout communities in western Montana. First response resource inventories and general manpower statistics for fire, police, Emergency Medical Services (EMS), and emergency department hospital bed capacity were determined prior to MCI scenario construction. A test was given prior to and after the training activities.ResultsA total of 175 firefighters, EMS, law enforcement, hospital personnel or other first-responders completed the pre- and post-test. Firefighters produced higher baseline scores than all other disciplines during pre-test analysis. At the end of the training all disciplines demonstrated significantly higher scores on the post-test when compared with their respective baseline averages. Improvements in post-test scores were noted for participants from all disciplines and in all didactic areas: communications, NIMS/ICS, and triage.ConclusionsMass-casualty incidents offer significant challenges for prehospital and emergency room workers. Fire, Police and EMS personnel must secure the scene, establish communications, define individuals’ roles and responsibilities, allocate resources, triage patients, and assign transport priorities. After emergency department notification and in advance of arrival, emergency department personnel must assess available physical resources and availability and type of manpower, all while managing patients already under their care. Mass-casualty incident trainings should strengthen the key, individual elements essential to well-coordinated response such as communications, incident management system and triage. The practice scenarios should be matched to the specific resources of the community. The authors also believe that these trainings should be provided with all disciplines represented to eliminate training “silos,” to allow for discussion of overlapping jurisdictional or organizational responsibilities, and to facilitate team building.GlowSD, ColucciVJ, AllingtonDR, NoonanCW, HallEC. Managing multiple-casualty incidents: a rural medical preparedness training assessment. Prehosp Disaster Med. 2013;28(4):1-8.
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Mel Pande, Madhukar. "General Practice in urban and rural New Zealand: Results of the 2007 RNZCGP membership survey." Journal of Primary Health Care 1, no. 2 (2009): 108. http://dx.doi.org/10.1071/hc09108.
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INTRODUCTION: The provision of primary health care is an integral part of both a country’s health system, and of the overall social and economic development of its communities. An adequate general practice and primary health care workforce is a prerequisite to the provision of good primary health care. Countries with stronger primary health care services have better health and much lower health costs. This paper reports the results of the RNZCGP’s 2007 annual membership survey and discusses workforce development in urban and rural New Zealand (NZ). METHOD: In 2007, the RNZCGP sent a survey form to all its financial members as part of the annual subscriptions mail-out to gather data about College members’ current working patterns and help construct a longitudinal view of work preferences and hours worked per week. RESULTS: The response rate was 59% (1995 members/participants: 1098 males (55%) and 897 females). More female GPs (86%) worked in urban centres than male GPs (83%). NZ European GPs were over-represented (67%) in the South Island when compared to their representation within the total population. Numbers of international medical graduates (IMGs) had increased in urban centres since 2005. All regions experienced a decrease in self-employed GPs. Rural GPs spend more hours per week in general practice than urban GPs. CONCLUSION: The GP workforce is an integral part of the NZ primary health care workforce, and is currently facing many challenges. Stakeholders need to ensure that NZ remains an attractive primary health care environment in order to retain NZ-trained GPs and attract IMGs. KEYWORDS: Family physician, New Zealand, rural health services, manpower
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Rathore, Bhumika, Sireesha Sadasivan, and Vinay Bhardwaj. "Time Required by Dental Post Graduates and Graduates for Direct Patient Care in Peripheral Outreach Centre - A Comparative Work Sampling Analysis." Dental Journal of Advance Studies 04, no. 03 (December 2016): 152–55. http://dx.doi.org/10.1055/s-0038-1672062.
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AbstractBackground: The inequity of oral health services persist due to inadequate dentist to patient ratio in the peripheral areas. The possibility of management of more number of patients lies within an efficient work force, in order to render oral health services in a well-organised manner. Objectives: The research was taken up with the primary objective of determining the most time efficient manpower in a peripheral dental unit. Secondary objective was to determine the time spent in each treatment procedure in proportion to total time involved in direct patient care. Third objective, was to recommend an appropriate range of sample for further similar studies using observatory methodology in peripheral centres. Methodology: Work measurement was done for the postgraduate and the undergraduate students for the treatments performed by them in the unit. Participatory observations were made on randomly selected days, and timings were recorded using standardised stop watch. Descriptive analysis was performed for the data obtained using Statistical Package for Social Science (IBM Corp. Released 2010. IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp.). Results: Mean timing was found to be highest for all treatment procedures amongst graduates when compared to the postgraduates and maximum proportion of time was spent for extractions amongst all the treatments performed. Conclusion: Availability of speciality services will help the hospitals render more proficient services to the rural masses.
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French, Jeff, and Frances Cunning. "The East Cumbria Community Health Project." International Quarterly of Community Health Education 8, no. 3 (October 1987): 213–18. http://dx.doi.org/10.2190/41tj-0eu7-c7dp-atkp.
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The East Cumbria Health Project is in its second year and aims to encourage and support groups and individuals to explore, identify and action their own health education needs. The project is a unique joint venture between a local health authority, the United Kingdom's Open University and the Manpower Services Commission, who fund the project. The project employs one full-time co-ordinator and fourteen part-time community health facilitators. All facilitators were previously unemployed local residents. The project serves a mixed rural and urban community of approximately 180,000 in the North West of England between the Lake District and the Scottish Border. The project to date has demonstrated that non-professional health workers with appropriate training can work effectively to complement existing professional community health workers. The project has also demonstrated that workers drawn from the local population can be effective in stimulating local communities and groups of people to become more involved with health and health care issues. Finally, the project has demonstrated that community health workers drawn from the local population can act as useful links between the statutory and voluntary health services and local communities.
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Dahal, Ananta Raj. "Foreign Employment and its Socio-Economic Impacts on Rural People of Nepal: A Study Based on Mahalaxmi Municipality of Lalitpur." Patan Pragya 5, no. 1 (September 30, 2019): 53–62. http://dx.doi.org/10.3126/pragya.v5i1.30436.
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Foreign employment plays vital role in maintaining the Nepalese’s economy. This paper analyses the nature and socio-economic impacts of the foreign employment in Nepal with reference to Mahalaxmi Municipality of Lalitpur district. Main source of information of this study is primary data and some secondary data are also used for the supplementary usage of the study. Primary data were collected through the direct questionnaire method used the semi-structured for the sample area of people who were selected by judgemental sampling method. Descriptive statistics was used to analyse the data by the help of micro excel program. Major destination for foreign employment is Malaysia and Qatar. Employees who pursue the employment in those countries manage borrowing in interest. They collect the information about employment from brokers, manpower companies and agents. The people of the sample area have made more income from foreign employment than other occupation in local jobs and they spend for food and education. Remittance from the foreign employment has played very positive role to improve school education and better health services of the people of sample area.
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Mahmood, Naushin, and Syed Mubashir Ali. "The Disease Pattern and Utilisation of Health Care Services in Pakistan." Pakistan Development Review 41, no. 4II (December 1, 2002): 745–57. http://dx.doi.org/10.30541/v41i4iipp.745-757.
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Health is an important aspect of human life. In general terms, better health status of individuals reflects reduced illnesses, low level of morbidity, and less burden of disease in a given population. It is widely recognised that improved health not only lowers mortality, morbidity and level of fertility, but also contributes to increased productivity and regular school attendance of children as a result of fewer work days lost due to illness, which in turn have implications for economic and social well-being of the population at large. Hence investing in health is vital for promoting human resource development and economic growth in a country [World Bank (1993)]. A view of Pakistan’s health profile indicates that the sector has expanded considerably in terms of physical infrastructure and its manpower in both the public and private sector. This has contributed to some improvement in selected health status indicators over the years. However, the public health care delivery system has been inadequate in meeting the needs of the fast growing population and in filtering down its benefits to the gross-root level. As such, Pakistan still has one of the highest rates of infant and child mortality, total fertility and maternal mortality when compared with many other countries in the Asian region [UNDP (2000)]. Due to low priority given to social sector development in the past and low budgetary allocations made to the health sector, the evidence shows that mortality and morbidity indices have not reduced to the desired level and large gaps remain in the quality of care indicators, especially in rural areas [Federal Bureau of Statistics (2000)].
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Jeon, Jeongbae, Solhee Kim, Gu Hyun Kang, and Kyo Suh. "Analysis of Emergency Medical Vulnerability and Survival Rates Following Real-Time Traffic Information." Applied Sciences 10, no. 18 (September 17, 2020): 6492. http://dx.doi.org/10.3390/app10186492.
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Providing rapid access to emergency medical services (EMS) within the “golden time” for survival is important to improve the survival rate of emergency patients. This study analyzes the accessibility of EMS based on driving speed changes following real-time road traffic conditions by time to estimate vulnerable areas for EMS and survival rates of emergency patients. The key results of the network analysis based on real-time road speed and this evaluation of vulnerable areas by village level across South Korea reveal the different characteristics of urban and rural areas to access emergency medical facilities. In urban areas, road traffic congestion during rush hour delays the patients’ access time to EMS. In contrast, in rural areas, the long geographical distance to an emergency medical facility is a hurdle for receiving care from an EMS during the “golden time” because emergency medical facilities are mostly located in urban areas. The existing standard to assess vulnerable areas of EMS accessibility is based on the speed limit of roads, but the time may be underestimated because the speed limit alone does not reflect the real road conditions. The study results show that an effective way to increase the survival rate is receiving immediate first aid treatment, which means that the government should continuously train the public to perform cardiopulmonary resuscitation (CPR) as well as install automated external defibrillators (AEDs) in populated places, and train the public to use them. Reducing assess time to emergency medical centers in urban areas and providing additional manpower to help with first aid in rural areas are reasonable ways to improve the survival rate of emergency patients.
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Paul, Debarshi, Gourangie Gogoi, and Rupali Baruah. "Assessment of the availability of infrastructure, manpower, materials and knowledge of health care providers regarding child health care services in the sub centers of a block of Dibrugarh district, Assam." International Journal Of Community Medicine And Public Health 6, no. 5 (April 27, 2019): 2264. http://dx.doi.org/10.18203/2394-6040.ijcmph20191855.
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Background: The SCs are under constant criticism for their inability to deliver quality services. Every year some 12 million children of developing countries die before they reach their fifth birthday. Around 90% of mortality rate can be prevented by the improvement of health care quality.Methods: Cross-sectional study conducted among health care providers of sub-centers in a randomly selected block of Dibrugarh district of Assam.Results: All SCs had two health worker (female)/ANMs and a multipurpose health worker male (MPW Male). Only 20% SCs adhered to scheduled opening but 100% adhered to scheduled closing time of the health facilities. 100% of SCs were housed in government building. 70% of the SCs had motorable roads. All the SCs had a regular and good supply of BCG, OPV, measles, TT, pentavalent (90% SCs) vaccines.Conclusions: SCs play a crucial role to decrease the morbidity and mortality of under five children in the rural areas. Full-fledged SCs with sufficient manpower, good infrastructure and good knowledge of delivery of child health care among health care providers would definitely improve the level of child health care provided to the community.
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Chan, K. Ming, G. Bryan Young, and Sharon Warren. "National Human Resources Survey of Clinical Neurophysiologists in Canada." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 36, no. 03 (May 2009): 321–25. http://dx.doi.org/10.1017/s0317167100007058.
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Background:Although electromyography (EMG), electroencephalography (EEG) and evoked potential (EP) studies are common investigation tools for patients with neurologic illnesses, no formal data on the manpower supply in Canada exists. Because of the importance of these on training requirements and future planning, the purpose of this study was to establish a comprehensive profile of the human resources situation in clinical neurophysiological services across Canada.Methods:A questionnaire was sent to all clinical neurophysiologists in Canada. To capture the maximal number of respondents, a total of three rounds of mail out were done. In addition, to obtain accurate demographic data on supporting technologists, a separate survey was also carried out by the Association of Electrophysiological Technologists of Canada.Results:Of the 450 clinical neurophysiologists identified and surveyed, the provincial response rate was 59±14% (mean±SD). Of these, the vast majority practiced in urban centres. There was substantial regional disparity in different provinces. While the wait time for most EEG and EP laboratories was less than six weeks, the wait time for EMG was substantially longer. With the age of the largest number of practitioners in their sixth decade, projected retirement over the next 15 years was 58%. The demographic distribution of the supporting technologists showed a similar trend.Conclusions:In addition to considerable regional disparity and urban/rural divide, a large percentage of clinical neurophysiologists and supporting technologists planned to retire within the coming decade. To ensure secure and high standard services to Canadians, solutions to fill this void are urgently needed.
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Ayanlola, Atanda Luqman, and Ugwulebo Jeremiah Emeka. "Graduate Joblessness: Conviction for Entrepreneurship Studies in Library and Information Science Programme of Nigerian Tertiary Institutions." International Journal of Sociology 2, no. 1 (January 29, 2021): 52–63. http://dx.doi.org/10.47604/ijs.1210.
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Purpose: The purpose of the study was to understand what the Nigerian graduates are passing through, most especially graduate of library and information science programme of Nigerian tertiary institutions.
Findings: The statistics of unemployed graduates in Nigeria as at 2011 showed that a disheartening figure of 42.7 million with over 1,8 million graduates churned out of our higher institutions yearly. It was further revealed that the unemployment rate in Nigeria stood at 38 percent in 2013 with further increase expected in succeeding years. The slow rate of economic growth and undeveloped private sector, faulty manpower planning, high expectations of the fresh graduate attitude towards some types of jobs, recruitments, the quest for higher education, inadequate educational curricular, immobility of labour, the long period of initial unemployment among graduates of higher institution, use of capital intensive technology, wide rural-urban migration
Conclusion: It is evident that entrepreneurship education is important for Library and Information Science students in higher institution of learning. The training of Library and Information Science students must reflect the 21st century development in the field which is influenced by the emergence of Information Technology, hence, Library and Information Science students must have computer proficiency, familiarity with metadata, database management and application, web development and design, knowledge of electronic resources and services
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Mwangi, J. H., A. G. Gachau, and E. W. Kabiru. "The levels of utilization of visual inspection screening of cervical cancer in Kitui, Kenya." East and Central Africa Medical Journal 3, no. 1 (July 31, 2018): 30–34. http://dx.doi.org/10.33886/ecamj.v3i1.34.
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Background: Cervical cancer is a disease of public health importance with a high global morbidity and mortality. More than 266,000 women die every year,with 87% of them coming from low and middle-income countries. These are the areas where programmes for screening and treatment are either deficient or underutilized. The morbidity and the mortality rates remain high in Kenya despite the screening and treatment services that the Ministry of Health has rolled out all over the country. Low levels of utilization of the established screening systems leads to increased morbidity and mortality. The problem is more prevalent in the rural Kenya where socioeconomic status of the majority in the population is low. Kitui County is such a rural region in Kenya.
Objective: To determine the factors influencing the levels of utilization of the Visual Inspection method (VIA/VILI) for cervical cancer screening services in Kitui County, Kenya.
Methodology: This was a descriptive study involving 370 women of reproductive age attending public MCH/FP clinics in Kitui County Kenya. Systematic random sampling method was used to select the participants. Exit interview was the main data collection technique. Key informants were also interviewed and facilities’ preparedness to provide adequate screening services was assessed using a facility survey checklist.
Results: A total of 370 women were interviewed, 69.2% of whom were aged below 29 years, 68% were married, 75% had three or fewer children, 19% did not have the basic level of formal education and 61% were earning less than 50 US$per month. The level of awareness on cervical cancer and its prevention was 53.8%, with significant difference in relation to VIA/VILI utilization (OR 3.0675 p=0.000). Significance difference was also observed in cervical cancer testing and level of education (X 2 =21.728, df=3, P= 0.000), the main source of income, (X 2 = 15.030, df=2, P=0.01), average monthly income, (X 2 =27.942, df=4, P=0.0001) and the main decision maker in the family, (X 2 =6.908, df=2, p=0.032). Public health facilities were not adequately equipped and well staffed to provide the VIA/VILI screening services.
Conclusion: Low levels (53.8%) of awareness about cervical cancer and its prevention among eligible clients in Kitui Central Sub-county Kenya, which was below the national target of over 70%, low coverage of health facilities and shortage of manpower lead to low levels of VIA/VILI screening. Therefore, there is a need to strengthen the existing services and interventions strategies, and enhance cancer awareness campaigns in order to reduce the incidence of the disease.
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Hajizadeh, Shayesteh, Fahimeh Ramezani Tehrani, Masoumeh Simbar, and Farshad Farzadfar. "Effects of Recruiting Midwives into a Family Physician Program on the Indices of Maternal Health Program in the Rural Areas of Kurdistan." Global Journal of Health Science 8, no. 11 (March 1, 2016): 92. http://dx.doi.org/10.5539/gjhs.v8n11p92.
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<p>A family physician program has been implemented in rural areas of the country since the early 2005.Therefore, due to the increase in the density of midwives in this project, it is expected that more services would be provided to pregnant women. This cross-sectional study used the difference-in-differences model and Matchit statistical model to compare the indices of maternal health program before and after the implementation of a family physician program. It compared health centres that had increase in their density of midwives in the course of the study with those that did not. The study sample consisted of 668 mothers of 2-month-old children in 2013. Data were collected using a questionnaire that was administered in structured interviews. In this study, in 2013, 38.8% of the women received preconception care, 66.5% received prenatal care and 41.6% received postpartum care, as defined by the standards. Based on the results of statistical models of difference-in-differences analyses and Matchit, there was no significant change in indices of maternal health program between 2005 and 2013. The results of this study showed that an increase in the density of midwives in a family physician program did not have an impact on the indices of maternal health program; it indicated that the increase in the density of midwives alone was not efficient. In other words, the quality of primary health care is strongly dependent on the use of trained health workers. In addition, manpower planning and management can have an important role in improvement of prenatal care.</p>
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Dwivedi, Yogesh K., Ganesh P. Sahu, Nripendra P. Rana, Monika Singh, and Rajesh K. Chandwani. "Common Services Centres (CSCs) as an approach to bridge the digital divide." Transforming Government: People, Process and Policy 10, no. 4 (October 17, 2016): 511–25. http://dx.doi.org/10.1108/tg-01-2016-0006.
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Purpose Despite the increasing technological capabilities and its affordability, a significantly large proportion of developing nations’ population are still lacking resources to own basic information and communication technologies such as computer and internet. This suggests that majority of the citizens from developing countries (e.g. India) are also not able to access and use emerging electronic government applications and services. This is leading to a further and bigger digital divide gap that already exists between rural and urban as well as economically less and more able population. To reduce the widening digital divide, India has innovated Common Services Centres (CSCs) as means to deliver public services electronically to citizens at the village level. This viewpoint paper aims to discuss some of the challenges and obstacles of such CSCs and to offer some recommendations for their effective implementations and sustainable operations. Design/methodology/approach This is a viewpoint paper that is based on authors’ awareness of the context as well as knowledge and issues relevant to the research topic. A number of appropriate and current citations have been utilised to illustrate the current state on the topic as well as to support authors’ arguments presented in this paper. Findings The paper identified a number of key issues relevant for effective implementation and sustainable operation of CSCs. The authors present their views and recommendations related to the following key issues: connectivity problems, lack of or delayed rollout of government to citizen (G2C) services, demotivated village-level entrepreneurs due to lack of G2C services, low computer literacy, lack of awareness about services and facilities, lack of adequate training and support, poor provisioning of an effective infrastructure, lack of support from the concerned government officials, inaccessible locations, burden of high investment, corruption at the government level, lack of skilled manpower to run the CSCs, lack of power supply, language barrier, lack of space, problem with maintenance and management of connectivity network and problem caused by the Naxalite and anarchist activity. Originality/value The discussion and recommendations presented in this paper would be valuable to various agencies (both from public and private sectors) as well as policymakers for effective implementation and long-term sustainability of CSCs. The approach discussed in this paper offers an effective way to diffuse e-government applications and services in other developing countries (particularly resource-constrained nations from African, Asian and Latin American regions).
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RN, EGWUENU, and G. I. NSHI RN. "NIGERIAN NURSES AND MIDWIVES UNEMPLOYMENT SURVEY." International Journal of Research -GRANTHAALAYAH 8, no. 6 (June 30, 2020): 92–101. http://dx.doi.org/10.29121/granthaalayah.v8.i6.2020.340.
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Background: The quacking controversy that trailed the Nursing & Midwifery Council of Nigeria’s (N&MCN) release of a “License Community Nurse (LCN)” circular (Ref No. N&MCN/SG/RO/CIR/24/VOL.4/152 dated March 3, 2020) which conveyed the intention of the council to lower the existing standard of nursing education for the LCN programme that will take secondary school leavers at least a credit in English and Biology to be admitted into and two years to complete, and inter alia blamed the crude situation and abysmal performance of the Nigerian Primary Healthcare (PHC) system in the community settings on mass migration of Nurses & Midwives to urban areas and to other countries prompted UGONSA to initiate this survey to empirically determine whether there are indeed a shortage of Nurses & Midwives to fill the manpower need of the Nigerian PHC system in the community settings or not, or whether the shortage is as a result of the deliberate age-long policy of attrition and displacement of Nurses & Midwives from the PHC system in the community settings and their replacement with Community Health Extension Workers (CHEWs) [who do not have nursing education, training, skills or the ethical leaning to be responsible and accountable for nursing & midwifery services] by the National Primary Healthcare Development Agency (NPHCDA).
Objective: The main aim of the study was to determine if there is a shortage of nurses that could fill the nursing needs of the PHC system in the community settings. The study also sought to compile the list of unemployed and underemployed Nurses & Midwives and to find out if unemployed Nurses & Midwives are willing to work in the community settings if the opportunity to serve the PHC system in the community setting is offered to them by the NPHCDA. The study further sought to determine the ratio of unemployed Nurses & Midwives in relation to the possible number of graduates that can be licensed by the N&MCN in a session.
Methods: Using Google forms an online compilation was carried out from March 7 to April 08, 2020, in a descriptive survey of unemployed Nurses & Midwives that could be reached online within the timeline. Names, Phone numbers, State of Residence, Year of Graduation, Qualification(s), and how long they have remained unemployed after graduation were compiled. In addition, two questions were asked about the objective of the study. Analysis of data was done via Google forms statistical tools.
Results: A total of 3317 unemployed Nurses & Midwives responded to the survey. Among these unemployed Nurses & Midwives – 38% holds RN only, 19% holds both RN & RM, 15.4% holds RM only, while 27.6% holds BNSc plus another qualification. For the year they have remained unemployed after graduation 57.1% have spent 0–2 years, 29.9% have been unemployed for 3–5 years, 7% have been unemployed for 6 – 8 years and 6.1% have been unemployed for more than 8 years. To the question, “Do you think there is a shortage of Nurses and Midwives in Nigeria?” – 47.5% said yes, 43.5% said no whereas 9% were undecided (said maybe). Furthermore, the result showed that while 95% of the unemployed Nurses & Midwives are willing to work in the rural community settings, 1% was not willing to work in the rural community settings and 4% were undecided (.i.e. said maybe) on whether they will work in the rural community settings or not. The result also revealed that the 3317 unemployed Nurses & Midwives captured in the survey represents graduates of 66 Nursing & Midwifery schools per session out of a total of 162 schools that are currently accredited by the N&MCN. This represents 41% of the possible number of graduates that can be turned out of the accredited Nursing & Midwifery Schools (excluding Post-basic schools) in a session.
Conclusion: Despite the reported migration of Nurses to urban areas and other countries, at least 41% of Nigerian Nurses & Midwives produced in a session remain unemployed and 95% of them are willing to work in the rural community settings if given the opportunity. These unemployed Nurses & Midwives can bridge the Nursing & Midwifery manpower needs in the Primary Healthcare System should the NPHCDA engage their services with a commensurate or higher payment to what their employed counterparts receive in Federal Government-owned establishments and hospitals. There is no current shortage of Nurses that necessitates the lowering of the existing standard of nursing education. Nurses & Midwives are not responsible for the design, implementation, and delivery of healthcare services at the PHC level and therefore are not culpable for the deplorable condition and abysmal performance of the Nigerian PHC System.
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Goleva, O. P., Zulfiya B. Tasova, O. N. Prudnikova, O. V. Leonov, and N. V. Shirinskaya. "About problem of timeliness of detection of cervix malignant neoplasms in population of Omsk region." Health Care of the Russian Federation 60, no. 6 (May 24, 2019): 298–302. http://dx.doi.org/10.18821/0044-197x-2016-60-6-298-302.
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The study was carried out to evaluate timeliness of detection of cervix malignant neoplasms against the background of supply of necessary manpower in the region. The indices of active detection of cervix neoplasm and its stages, degree of neglect of tumor process and lethality during the first year of diagnosed disease are considered. The enumerated indices are correlated with quality of medical services шт part of availability and characteristics of training of available personnel. The comparison of data of the Omsk region with average national data was implemented. The corresponding indices of Omsk and municipal districts of oblast in 2004-2014 were also compared. The percentage of active detection ofcervix cancer decreased to the end ofanalyzed period. However, in municipal districts of oblast it continues to be quite high. The detection of disease at early stages (I-II) in the region is on the whole significantly lower as compared with average national indices. The indices of degree of neglect of tumor process in Omsk, in spite of better conditions of diagnostic of this pathology, are significantly lower as compared with corresponding indices in municipal districts. During analyzed period, annual lethality in the Omsk region decreased up to 1.6 times (decreasing rate - 35.6%). The process proceeded especially actively in rural districts of the oblast (decreasing rate - 70.5%). The lethality at first year of diagnosed disease was absent in 25 municipal districts of region. The staffing of oncologists in "The clinical oncologic dispensary" makes up to 100% and 36.8% out of them have highest category. In the central district hospitals, the staffing of specialists made up to 81.3%. Factually in all institutions this position is combined by specialists of another profile i.e. therapists, obstetrician-gynecologists, surgeons, etc.
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Rogers, Michelle, Janice Masud-Paul, and Rania El Desoki. "Understanding the use of health information technology for maternal and child health practitioner training in low and middle income countries." Proceedings of the Human Factors and Ergonomics Society Annual Meeting 63, no. 1 (November 2019): 743–46. http://dx.doi.org/10.1177/1071181319631521.
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Objectives: To assess the evidence of information communication technology (ICT) use in the training of maternal and child health (MCH) workers, discuss methodological issues present in the identified studies, and identify future work areas. Introduction: The explosive growth of cellphone usage in low and middle-income countries (LMIC) has made mobile technology an increasingly attractive form of information communication technology (ICT) to be used to meet healthcare needs that go unmet, rising due to the paucity of trained clinical workers (O’Donovan, Bersin, & O’Donovan, 2015). The portability and relative low cost of cellphones have made them ubiquitous and efficient to use. For example, subscriptions in Africa have risen from 12.4 per hundred inhabitants in 2005 to per hundred inhabitants in 2015 (ITU, 2017). ICT is an umbrella term that encompasses the hardware, software and networks that provide its users with data and information resources. As far as healthcare is concerned, these resources include access to varied tools and services such as electronic health records, point-of-care databases, decision support systems, clinical guidelines or training modules for continuing education (Machingura et al., 2014). This technology has made healthcare more efficient in affluent countries where funding and infrastructure to build, support and maintain ICT is readily available. However, ICT development is critical to LMIC’s which have the greatest barriers to effective and efficient healthcare systems and fewer resources to overcome challenges. The aims of this paper are to (1) summarize the literature on ICT use in the training of MCH workers, (2) discuss methodological issues present in the identified studies, and (3) identify future work areas. Our specific research questions are: Which ICT tools have been used in developing countries for training the MCH workforce? How successful are the tools for instructing health care workers? A major impediment to health care improvements in underdeveloped countries is the low ratio of health professionals to patients. A developed workforce is critical for sustaining healthcare infrastructure. Because there is an insufficient number of professional practitioners, many MCH health needs are met by community workers with limited or no formal training (Chipps et al., 2015). Since the level of services range from general check-ups to life-saving interventions, training must address a variety of educational requirements. (Agarwal et al., 2015). In addition to primary professional education, health workers require training for re-licensure and continuous professional development (CPD). Training, particularly in remote areas, requires travel, time away from work as well as funding for food and lodging (Chipps et al., 2015). This exacerbates uneven healthcare coverage with the majority of MCH health care workers concentrated in urban centers, leaving rural residents with inadequate services (Middleberg et al., 2013; Modi et al., 2015). ICT reduces costs by enabling personnel to remain in their communities while providing digital access to educational content, mentors, guidelines and decision support systems (Saronga et al., 2015). It is commonly recognized that underdeveloped countries have occasional brown-outs in their urban centers and the power grid may not reach rural or remote areas. Even if seed money is acquired for start-up costs, funding for technology maintenance and technical manpower beyond the pilot stage can be tentative (Achampong, 2012). Secondly, while cell phone use across LMICs has exploded in recent years, its use for advancing training has not grown in comparison. A limited number of reports have been published, reporting the use of ICT for communication (Andreatta et al., 2011), tracking health worker behavior (Awoonor-Williams et al., 2013), attitudes towards using ICT (Sukums et al., 2014; Zakane et al., 2014), and the impact of the design of ICT (Valez et. al., 2014). This paucity of studies understanding the impact of ICT on measurable training outcomes leaves a troubling gap in the literature if progress is to be made in addressing the training needs. Finally, government entities, educators and administrators may be reluctant to adopt ICT into health training for practical, fiscal and political reasons. Because health personnel may not have exposure to technology in their daily lives, staff may require basic computer training on operating systems, file management, word processing and databases in conjunction with ICT projects (Sukums, 2014). In addition to a lack of knowledge about computers in general, use of ICT also comes with associated monetary costs. Both of these issues are also exacerbated by resulting government policy changes. We endeavored to fill this gap by completing a literature review to bring the disparate work together, but to our surprise, it did not really exist. This paper reports on (1) what studies have been conducted on the use of ICT in training; (2) what common methods are used and how they are evaluated and (3) what outcomes have been reported. Methods: Medline (OVID), CINAHL and Web of Science were searched for relevant articles published between January 1, 2007 and February 28, 2017. Studies were included if they included training and education in low and middle-income countries using ICT for maternal child health workers. Results: 111 unique articles from electronic searches with seven additional articles discovered through hand-searching reference lists were identified. After review, 15 articles aligned with the necessities to analyze the current environment of the ICT tools. The study designs in the reviewed articles were usually pre- and post-evaluations (n=7). There were also a small number of single cross-sectional studies (n=3) measuring the use of the tool. Two studies also evaluated the use of electronic clinical decision support systems (CDSS) applications or algorithms. The remainder of the studies (n=3) used ICT to provide resources for meeting information needs, as well as repositories of protocols and best practice documents. The outcomes reported ranged from access to medical resources (n=3), accuracy in clinical documentation (n=2), need for remedial computer training (n=2) and an increase in clinical knowledge and proper use of protocols (n=4) Discussion and conclusion: The current evidence-base does not show a clear indication that there were particular initiatives using ICT for the training of health workers. While the majority of projects identified were shown to improve outcomes, there were limited results reported. This lack of documented evidence hinders decisions about the content and methods that should be used to support training. We are missing an opportunity for advancement. The World Health Organization identified community health worker training as a lever to move the improvement of health care in low and middle-income countries (LMICs). An understanding of barriers and facilitators to using ICTs to meet this need, provides key directions for policy makers and non-governmental organizations as they apply limited resources to these issues.
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Moses Azerimi Azewara, Okyere Korankye, Emmanuel Amankwah, and Matthew Takyi. "The Realities of Teacher Distribution in Primary and Junior High Schools in Ghana: Experiences of Rural Areas in Sekyere Central District." Social Education Research, July 24, 2021, 230–40. http://dx.doi.org/10.37256/ser.222021939.
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The study critically looked at teacher distribution in Ghana's Primary and Junior High Schools in Sekyere
Central District; in the Ashanti Region of Ghana. Data were gathered from Education Monitoring Information Systems (EMIS) from the District Education Office, Nsuta for the analysis. Evidence from the rural communities in teacher deployment for the 2021 academic year for 10 rural Primary Schools and 5 Junior High Schools depicted a gloomy picture because there was uneven teacher deployment to these areas where their services are needed. There was a huge teacher deficit in the rural communities so the question of quality and equitable education will not be achieved if policymakers fail to provide incentive packages to the rural teachers. The paper recommends that rural teachers' conditions of service should be different from those of their colleagues in the urban areas. When this is done, teacher manpower utilization and retention of teachers in rural communities would be improved.
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Tokwe, Hose. "Advocacy for School Library Development." IASL Annual Conference Proceedings, February 22, 2021, 409–20. http://dx.doi.org/10.29173/iasl7525.
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The paper focuses on describing the importance and value for development of Rural School Libraries in Africa in order to overcome the increasing gap between the information rich and the information poor that currently threatens educational achievement in remote and inaccessible rural schools. It further discusses that main challenges faced when establishing and developing a rural school library to ensure that the socially excluded rural children have access to reading material. The question is - What are the materials and human resources needed to overcome these challenges. In conclusion, the paper offers recommendations that urge the government to establish School Library Service and to enact legislation to address the needs of rural schools in terms of infrastructure, equipment, material resources, appropriate manpower and the introduction of ICTs in rural schools to foster vital knowledge necessary to address local needs.
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Ngomane, Luyanda, and Nthatisi Khatleli. "DESIGN OF A CAPABILITY MATURITY FRAMEWORK (CMF) FOR RESILIENT INFRASTRUCTURE MANAGEMENT (RIM) IN RURAL MUNICIPALITIES IN SOUTH AFRICA." Proceedings of International Structural Engineering and Construction 8, no. 1 (July 2021). http://dx.doi.org/10.14455/isec.2021.8(1).con-26.
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Cities worldwide are often faced with manpower capacity deficits to develop and manage infrastructure. There remain discrepancies between global SDG aspirations and national realities in most Sub-Saharan African (SSA) countries in achieving universal access to services by 2030. Service provision in South African municipalities has been beset by deficient engineering skills (ES) and infrastructure management (IM) capabilities as a result. IM capabilities are crucial enablers for continuous service provision. Yet, on the contrary, in South Africa, nearly 58% of all engineering professionals are found in metropolitan municipalities, with some 9% placed in urban municipalities. Furthermore, 67% of all the professionals, technicians, and engineers in the municipal system countrywide are employed in only 27 of the 257 municipalities. There is a notable lack of resilient IM in South African rural (category B4) municipalities. Likewise, current Capability Maturity Models (CMM) are rendered inappropriate for rural municipalities. Thus, this on-going research contends for prominent structural shifts in improving IM capabilities in rural municipalities, arguing that previous engineering capacity building programmes omitted the resilience component in their design parameters. The on-going study aims to design a capability maturity framework for resilient IM in rural municipalities following sequential multi-data collection procedures, pilot interviews with experts, then a survey questionnaire. Descriptive statistics will be used to analyze the survey data and thematic analysis for analyzing the qualitative data. In terms of contribution to academia, it is hoped that the on-going study would assist category B4 municipalities to close the resilience gap in infrastructure management.
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A, Chandra, Rao N, and Srivastava D. "Telemedicine Underutilized in Post COVID Lockdown Period." Austin Journal of Nephrology and Hypertension 8, no. 1 (March 16, 2021). http://dx.doi.org/10.26420/austinjnephrolhypertens.2021.1089.
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COVID-19 (Coronavirus disease) pandemic has put tremendous pressure on healthcare providers to seek for ways to provide a sustainable model of healthcare to the distantly located patients. The desired model needs to be easily accessible, affordable and effective enough to address the needs of the patients. Telehealth is one such way which can help a medical expert reach to the remotely located population. State government has taken multiple initiatives to start telehealth services in its tertiary care hospitals. Ours being a tertiary care hospital, telemedicine services were started in May 2020 and have continued till date. The response to this new service was good in the initial months when lockdown due to COVID-19 was in place and was expected to improve as its awareness spreads across the region. However, post lockdown the trend has not been very encouraging. In nephrology, from catering to 20-25 patients per session it went down to 4-5 patients per session. This called for an active search of possible elements operating behind this development and take remedial measures. A detailed discussion with the service providers was held. The physicians were quick to respond to the need of the system and were able to converse and write prescriptions to be uploaded in the pdf format. One resident and one consultant were present in each session. The frequency of the nephrology consultation sessions stood at once per week with provision of an increment as per response from the patients. Confidentiality related issues were well taken care by the trained manpower recruited by the hospital authorities. Internet connectivity issue rarely surfaced from the hospital side as the provided band width was usually 20-30 mbps. Though there were some poor bandwidth and connectivity issues at patients’ end, mostly from the rural areas. Limited internet access is a significant hurdle in preventing telemedicine usage by the rural population. [1,2]. A small survey among 106 patients visiting Nephrology OPD (Outpatient Department) revealed that only 15% of them were aware about the telemedicine services being offered by the hospital. This highlighted the need to relook into the effectiveness of the means of communication used to spread the information about this new service. The news was circulated primarily via newspapers and website of the hospital. The frequency of its publication was high in the initial months but declined later. In order to achieve a wider coverage, use of SMS (Short Message Service), e-mails and telephonic conversation giving details of tele-outpatient services may be of great help. Radio and television broadcast may further enhance awareness. Even after restoration of the regular physical OPD services, it may be useful to continue educating patients about this relatively new virtual service which is particularly useful in later follow-ups. Careful monitoring of the telemedicine programme with a watch on its smooth functioning and effectiveness in terms of patient numbers and their satisfaction scores can help improve the services. Goal oriented telemedicine programs are need of the hour. Our hospital didn’t have a running telemedicine department. The whole team worked in close collaboration with the personnel responsible for running the hospital information system. Setting a separate department or section to deal with telemedicine services can go a long way in its effective operation. Such departments can aid in laying down policies and plans to improve the utilization of the services. With the kind of impetus from the government in terms of manpower, hardware, software and electricity, an extra effort in spreading the awareness can provide the vital thrust the program needs. A change in mindset of the physicians about prescriptions sans physical examination will also be of help. A multidirectional and constant effort is required by physicians, administrators and policy holders to make the vision of providing telehealth to all, a success.
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"Assessing Competency of Community Healthcare Workers." VOLUME-8 ISSUE-10, AUGUST 2019, REGULAR ISSUE 8, no. 10 (August 10, 2019): 377–80. http://dx.doi.org/10.35940/ijitee.j9033.0881019.
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Background: Community healthcare workers (CHW) play an important role in preventive healthcare system in India. CHW link the community to the health system of the country. As the population in India covers majorly in village, community healthcare workers are the face of the healthcare. These CHW competencies are yet to be ascertained. Objectives: To determine standardized framework for competency of the Community healthcare workers in India. Methods: By using structured questionnaire with 5 point Likert scale is implemented to evaluate the competency of CHW. Respondents are 35 participants including Accredited Social Health Activist (ASHA), Medical social worker and diabetes educator in and around Chennai. Findings: Suggested that community health workers are highly competent. More clarity in role of community healthcare workers is required. Government should initiate program to nurture the service quality of primary centers, equipment, manpower facility in health centers, etc Training regarding the maternity care and communication skills are core competency required for a CHW to perform his/her role properly. Conclusions: The results of the study show that CHW of India is also competent. Community healthcare workers are contributing more in maternal care and preventive care. They put more effort in health education and sanitation in rural areas.
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Singh, Sudheer, Shailesh Kumar Mishra, Shivani Kalhan, Puja Sharma, Rahul N. Satarkar, and Pawan Singh. "Utilization, Manpower and Information Management of the Blood Transfusion Services in a Large New Rural Based Tertiary Care Centre." Annals of International medical and Dental Research 4, no. 3 (May 2018). http://dx.doi.org/10.21276/aimdr.2018.4.3.pt9.
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Neti, Desi Fitria, Lukman Waris, and Anni Yulianti. "Penganggaran dan Penerimaan Dana Kapitasi Program JKN di Daerah Terpencil Kabupaten Kepulauan Mentawai." Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan, October 9, 2018, 92–101. http://dx.doi.org/10.22435/jpppk.v1i2.503.
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Abstrak
Program Jaminan Kesehatan Nasional (JKN) dilaksanakan atas hak setiap warga negara memperoleh layanan kesehatan, baik yang bertempat tinggal di perkotaan maupun di perdesaan termasuk di daerah terpencil perbatasan kepulauan. Pelaksana program JKN dilaksanakan oleh unit pelayanan kesehatan mulai dari pelayanan kesehatan di puskesmas sampai dengan pelayanan kesehatan rujukan di rumah sakit dengan pembayaran yang dilakukan oleh Badan Pelaksana Jaminan Sosial Kesehatan (BPJS) kepada unit pelaksana pelayanan kesehatan dengan mekanisme transfer berdasarkan sistem dana kapitasi. Penelitian ini bertujuan untuk mendeskripsikan dan menganalisis pelaksanaan penganggaran dan penerimaan dana kapitasi tenaga kesehatan program jaminan kesehatan nasional di daerah terpencil Puskesmas Mapaddegat Kabupaten Kepulauan Mentawai dengan mengunakan metode kualitatif. Pengumpulan informasi melalui observasi wawancara mendalam terhadap informan dan informan kunci dan Dokumentasi. Penelitian dilaksanakan bulan januari s/d juni 2017. Hasil penelitian menggambarkan bahwa pelaksanaan penganggaran dan penerima dana kapitasi tenaga kesehatan pada tahun 2014-2015 belum berjalan sesuai ketentuan pembayaran, tahun 2016 masih ditemukan permasalahan pembayaran norma kapitasi oleh BPJS Kesehatan sudah normatif namun belum sesuai dengan jumlah peserta yang terdaftar. Tahun 2017 penerimaan dana kapitasi sudah berjalan lebih baik dibuktikan dengan telah teradministrasi dan terdokumentasi semua bentuk pemanfaatan dan realisasi belanja pencairan dana kapitasi untuk seluruh petugas di puskesmas dan jaringannya.
Kata kunci: Tenaga kesehatan, penganggaran, penerimaan dana kapitasi dan program JKN.
Abstract
The National Health Insurance Program (JKN) is implemented on the right of every citizen to receive health services in both urban and rural areas, including in remote border areas of the island. Implementing the JKN program is implemented by health care unit starting from health service at puskesmas to referral health service in hospital with payment made by BPJS to health service implementation unit with transfer mechanism based on capitation fund system. This study aims to describe and analyze the implementation of budgeting and receiving capitation funds health workers national health insurance program in remote areas Mapaddegat Puskesmas Mentawai Islands by using qualitative methods. Information gathering through in-depth interview observation of key informants and informants and Documentation. The study was conducted from January to June 2017. The results of this study illustrate that the implementation of budgeting and recipients of capitation funds of health personnel in 2014-2015 has not run according to payment terms, in 2016 still found the problem of payment of capitation norms by BPJS Health has been normative but not in accordance with number of registered participants according to the provisions. In 2017, the capitation of the capitation funds has been better implemented as proven by the administration and documentation of all forms of utilization and realization of capitation fund disbursement expenditure for all officers at the puskesmas and its network.
Keywords: Health Manpower, policy, budgeting, admission of capitation funds and Health Insurance Program.
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Jha, A. K., and D. Gurung. "Reaching the Unreached- A Model for Sustainable Community Development Through Information and Communication Technology." Journal of Nepal Medical Association 51, no. 184 (December 31, 2011). http://dx.doi.org/10.31729/jnma.36.
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Telemedicine, which is defi ned as ‘the practice of healthcare using interactive audio, visual and data communications and includes healthcare delivery, diagnosis, consultation and treatment as well as education and transfer of medical data’, has been gaining popularity in the health services sector. Dermatology as a specialty is particularly suitable for telemedicine and more so in geographic regions with scarcity of qualifi ed manpower, where it has greatly facilitated the outreach of specialist care delivery. However, the cost of telemedicine technology is a signifi cant hurdle which makes the sustainability of such services challenging. Maximum utilization of such technology by active participation of well motivated benefi ciary communities and bringing innovative strategies for its use will be crucial in sustaining such services in rural communities.
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Motwani, Neelam Vinod, Abhishek Joshi, Sonali G. Choudhari, and Abhay M. Gaidhane. "Assessment of Services at Tertiary Care Hospital Located in Central India, using ‘Kayakalp Initiative Tool’." Journal of Pharmaceutical Research International, July 15, 2021, 138–44. http://dx.doi.org/10.9734/jpri/2021/v33i37a31989.
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Background: Kayakalp is an innovative initiatory started by the Health and Family Welfare Ministry through Swachh Bharat Abhiyan campaign on 15th May 2015. These instructions concentrate on advancement of desirable schemes for housekeeping facilities, pest control procedure, water sanitation, appointment & tutoring of manpower, advancement and accomplishment of appropriate cleansing procedure in terms of protocols / Standard Operating Procedures (SOPs), powerful management and inspection by the employees and inherent Machinery in the treaties linked with an organizational framework which places a bonus on excellent cleaning services and sanitary facilities. This study aims to describe the experiences and knowledge based on assessment of Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha District using this tool.
Objectives: To assess and document hospital upkeep, Sanitation, Hygiene Practices, Hygiene Promotion and to study Handling of Biomedical Waste, Infection Control and Hospital Support Services.
Methodology: This cross sectional hospital based study that will be conducted at Acharya Vinoba Bhave Rural Hospital, Sawangi (Meghe), Wardha District.
Apart from observation of various practices and Processes, the participants to be interviewed will be Nursing staff in-charge in different wards along with Biomedical engineers, Administrative officers and beneficiary patients. For Quantitative data collection, a kayakalp checklist will be used. Data will be collected through observation, staff interview, record keeping, and patient interview forms as per Kayakalp Initiative Tool.
Results: This study would help to understand current hospital sanitation procedures, hospital hygiene, infection prevention, general maintenance, waste management, and support services, etc. and will help to improve services based on findings of the study so as to improve satisfaction of population catered by hospital and provide an ideal working environment for all stakeholders.
Conclusion: This work will assist in improving hospital/facility management and will aid in improvement of sanitation and hygiene practices, it will also improve overall satisfaction of all stakeholders after due implementation of changes suggested at the end of study.
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Wundavalli, L., and N. Topno. "India’s national health insurance scheme: Analysis using the Growth Diagnostics Framework." European Journal of Public Health 30, Supplement_5 (September 1, 2020). http://dx.doi.org/10.1093/eurpub/ckaa165.393.
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Abstract The world's largest health assurance scheme, Ayushman Bharat-Pradhan Mantri Jan Suraksha Yojana (AB-PMJAY) was launched in India in 2018 to achieve universal health coverage aspired in the National Health Policy 2017. Our objective was to critically analyse AB-PMJAY through the lens of Growth Diagnostics Framework developed by Hausmann, Rodnik et al using secondary data. The framework analysed the scheme on five aspects: physical investment, knowledge/application/productivity, productive livelihood, skill set and cooperative federalism in terms of demand and supply side problems. The analysis was conducted for six months. The results highlighted issues relating to supply side such as availability of beds, equipment, manpower, information systems, deficient rural public health facilities, health insurance governance, scaling technological capabilities, improving procurement of drugs, equipment, technical training of staff in IT; highly skewered ratio of public and private sector hospital beds and manpower. Demand side issues include high demand of services, requirement of research and development related to premium rates, maturity of the scheme, pay outs, increased demand of specialists/technicians/health administrators in government sector and willingness of federal states to enroll in the scheme. Our recommendations highlight the importance of gaining the trust and confidence of citizens in public sector, reducing asymmetric information, mandating a formulary policy in hospitals, measures to prevent private hospitals from indulging in cream skimming and dumping patients, increasing package amounts for chronic conditions like dialysis, more health technology assessments, strengthening referral levels of care, focusing on outcome based standards for facilities, creating demand for preventive and promotive care using innovative ICT tools and coordination with different systems of medicine, addressing social determinants of health through inter-sectoral convergence. Key messages Growth Diagnostics Framework is a novel way to study a national health insurance scheme. India's national health insurance scheme is dynamic and aspirational that requires multi sectoral co-ordination.
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Mumtaz, Nazia, and Ghulam Saqulain. "Hospital and health administrator level barriers and priorities for National Neonatal Hearing Screening in Pakistan: A thematic analysis." Pakistan Journal of Medical Sciences 36, no. 5 (June 17, 2020). http://dx.doi.org/10.12669/pjms.36.5.1965.
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Objectives: To investigate the Barriers and Priorities accorded by hospital and health administrators to neo-natal hearing screening.
Methods: This qualitative exploratory descriptive study employing purposive sampling technique was conducted in Islamabad, over a period of 18 months from 1st August 2015 to 31st January 2017. Sample included the stakeholders i.e., Heads of public sector hospitals of Islamabad including Pakistan Institute of Medical Sciences, Capital Hospital, and Federal Government Services Hospital, Islamabad. Study included in depth interviews using a self-structured interview guide and audio recording. Recorded data was transcribed followed by thematic analyses which was manually drawn and verified.
Results: The Outcomes from thematic analysis were drawn as Planning, Essential requirements for NNHS, High risk screening, education, Existence of skilled maternal & newborn health workers. Hearing screening equipment//facility instrumentation, Logistic support, Health ministry support and Financial cover are also significant outcomes. Lack of awareness in the public and professionals regarding the importance of early identification of HI, poor health infrastructure, burden on tertiary care and lack of referral top the list of barriers to initiation of NNHS program at hospital administrative level.
Conclusion: The Barriers to NNHS identified at Hospital and Health care administrator level include lack of awareness, poor health infrastructure, burden on tertiary care and lack of referrals. Inherent barriers to NNHS cover the spectrum of lack of liaison/ linkages between obstetrics and other departments, deliveries at homes especially in rural areas, poor follow-up, scarcity of technical and adequately trained manpower. Intangible barriers to NNHS comprise lack of health care information system, attitudinal barriers, inadequate fiscal resources, and lack of integrated approach at intra departmental levels.
doi: https://doi.org/10.12669/pjms.36.5.1965
How to cite this:Mumtaz N, Saqulain G. Hospital and health administrator level barriers and priorities for National Neonatal Hearing Screening in Pakistan: A thematic analysis. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.1965
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