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Public ,private Health Facilities

Marc F O'Reilly, Khalid M Mohamed, Eoin C Sheehan
INTRODUCTION: Disorders of the musculoskeletal system are the main cause of disability and lost working days worldwide, and osteoarthritis affects almost half a million people in Ireland. Appropriate access and resourcing of general practice and orthopaedics is a necessary measure for the provision of a safe and efficient health service. One area that remains particularly challenging in Ireland is that of outpatient waiting lists, and the purpose of this study was to assess the attitudes and experiences of general practitioners in the Irish midlands with regard to orthopaedic services and to evaluate these in the context of national strategies and international best practice...
October 18, 2018: Irish Journal of Medical Science
Yacob Pinchevsky, Frederick Raal, Neil Butkow, Tobias Chirwa, Larry Distiller, Alan Rothberg
Purpose: With the realities of resource constraints existing in South Africa's public sector and the evidence of disparities in health care between populations, the study sought to compare the quality of diabetes care and health-related quality of life (HRQoL) in patients with type 2 diabetes mellitus (T2DM) receiving care within two specialized settings: one in the public and the other in the private sector. Particular emphasis was placed on complication rates at the two sites. Patients and methods: Quantitative and qualitative data were collected between June and October 2016 from existing patients' records at each setting...
2018: International Journal of General Medicine
Ties Boerma, Carine Ronsmans, Dessalegn Y Melesse, Aluisio J D Barros, Fernando C Barros, Liang Juan, Ann-Beth Moller, Lale Say, Ahmad Reza Hosseinpoor, Mu Yi, Dácio de Lyra Rabello Neto, Marleen Temmerman
In this Series paper, we describe the frequency of, trends in, determinants of, and inequalities in caesarean section (CS) use, globally, regionally, and in selected countries. On the basis of data from 169 countries that include 98·4% of the world's births, we estimate that 29·7 million (21·1%, 95% uncertainty interval 19·9-22·4) births occurred through CS in 2015, which was almost double the number of births by this method in 2000 (16·0 million [12·1%, 10·9-13·3] births). CS use in 2015 was up to ten times more frequent in the Latin America and Caribbean region, where it was used in 44·3% (41·3-47·4) of births, than in the west and central Africa region, where it was used in 4·1% (3·6-4·6) of births...
October 13, 2018: Lancet
Redempta Mbatia, Jessica Cohen, Martin Zuakulu, Appolinary Bukuku, Shikha Chandarana, Eliudi Eliakimu, Sisty Moshi, Elysia Larson
Background: Poor health system experiences negatively affect the lives of poor people throughout the world. In East Africa, there is a growing body of evidence of poor quality care that in some cases is so poor that it is disrespectful or abusive. This study will assess whether community feedback through report cards (with and without non-financial rewards) can improve patient experience, which includes aspects of patient dignity, autonomy, confidentiality, communication, timely attention, quality of basic amenities, and social support...
2018: Frontiers in Public Health
Anastasia Yenban Bongajum, Divine Mbiydzenyuy Dufe, Paul Théodore Biyaga Tjek, Daniel Ter Goon, Céline Nguefeu Nkenfou, Julius Mbekem Nwobegahay, Robinson Mbu
BACKGROUND: Evidence from previous research has shown that antiretroviral (ARV) drug initiation to seropositive pregnant women could significantly contribute to eliminating new paediatric infections even when started during labour and delivery. This study therefore seeks to assess missed opportunities for ARV initiation during this critical period of pregnancy to improve outcomes of the prevention of mother-to-child transmission (PMTCT) programmes in Cameroon. METHODS: A retrospective study was conducted on the 2014 PMTCT data for labour and delivery among pregnant women of unknown HIV status within health facilities in six regions of Cameroon (428 eligible facilities)...
October 14, 2018: African Journal of AIDS Research: AJAR
Taufique Joarder, Lal B Rawal, Syed Masud Ahmed, Aftab Uddin, Timothy G Evans
BACKGROUND: Retaining doctors in rural areas is a challenge in Bangladesh. In this study, we analyzed three rural retention policies: career development programs, compulsory services, and schools outside major cities - in terms of context, contents, actors, and processes. METHODS: Series of group discussions between policy-makers and researchers prompted the selection of policy areas, which were analyzed using the policy triangle framework. We conducted document and literature reviews (1971-2013), key informant interviews (KIIs) with relevant policy elites (n=11), and stakeholder analysis/position-mapping...
May 5, 2018: International Journal of Health Policy and Management
K A T M Ehsanul Huq, Michiko Moriyama, Khalequ Zaman, Mohammod Jobayer Chisti, Julie Long, Akramul Islam, Shahed Hossain, Habiba Shirin, Mohammad Jyoti Raihan, Sajeda Chowdhury, Md Moshiur Rahman
BACKGROUND: Early diagnosis of tuberculosis (TB) and involvement of the public-private partnership are critical to eradicate TB. Patients need to receive proper treatment through the National Tuberculosis Control Programme (NTP). This study describes various predictors for health seeking behaviour of TB patients and health system delay made by the different health care providers. METHODS: A cross-sectional study was conducted in a public health facility of a rural area in Bangladesh...
October 12, 2018: BMC Infectious Diseases
Abel Mukengeshayi Ntambue, Françoise Kaj Malonga, Michèle Dramaix-Wilmet, Tabitha Mpoyi Ilunga, Angel Nkola Musau, Charles Matungulu Matungulu, Karen D Cowgill, Philippe Donnen
OBJECTIVE: In the Democratic Republic of the Congo, insufficient state financing of the health system produced weak progress toward targets of Millennium Development Goals 4 and 5. In Lubumbashi, almost all women pay out-of-pocket for obstetric and neonatal care. As no standard pricing system has been implemented, there is great variation in payments related to childbirth between health facilities and even within the same facility. This work investigates the determinants of this variation...
2018: PloS One
Manmeet Kaur, Madhu Gupta, Vijin Pandara Purayil, Monica Rana, Venkatesan Chakrapani
This paper uses care pathway and delay models to better understand the possible social reasons for maternal deaths in a city with good public and private health infrastructure. The findings can inform programmes to reduce maternal mortality. During 2007-15, 136 maternal deaths were reported in Chandigarh, India. Using World Health Organisation's verbal autopsy questionnaire, interviews were conducted with primary caregivers of 68 (50%) of the 136 deceased women, as majority of the families had returned to their native places...
2018: PloS One
Hossam Hamdy
The complexity of medical education and healthcare systems is a 'wicked problem'. Change will be a continuous iteration between evaluation and revaluation. Medicine is a social science. It is about people, societies and human interaction and communication. Medical College of the future should be developed in the light of social constructivism theories. Students from year one, day one, should be embedded in the work environment. Academic Healthcare Systems will be the norm not the exceptional. The training of students will be in all healthcare related facilities in the community...
October 9, 2018: Medical Teacher
Clair Scrine, Angela Durey, Linda Slack-Smith
OBJECTIVE: To explore dental professionals' perceptions and experiences of providing oral health care for adults with mild to moderate mental health disorders (MHD) in Perth, Western Australia. METHODS: A grounded theory approach guided this research which comprised semi-structured interviews with oral health professionals working in private and/or public dental facilities attended by adults with MHD. An iterative analysis of transcripts identified emerging issues that were organized into categories under which key themes were noted, coded, compared, discussed, reviewed and revised independently by two researchers to ensure rigour...
October 8, 2018: Community Dentistry and Oral Epidemiology
Ngan Do, Young Kyung Do
Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physicians engage in private practice. It also examines the commitment of dual practitioners to the public sector. The analysis is based on a hospital-based survey of 483 physicians at 10 public hospitals in four provinces of Vietnam...
October 1, 2018: Health Policy and Planning
Stephen Maluka, Dereck Chitama, Esther Dungumaro, Crecensia Masawe, Krishna Rao, Zubin Shroff
BACKGROUND: Governments increasingly recognize the need to engage non-state providers (NSPs) in health systems in order to move successfully towards Universal Health Coverage (UHC). One common approach to engaging NSPs is to contract-out the delivery of primary health care services. Research on contracting arrangements has typically focused on their impact on health service delivery; less is known about the actual processes underlying the development and implementation of interventions and the contextual factors that influence these...
October 5, 2018: International Journal for Equity in Health
Lenka Benova, Mardieh L Dennis, Isabelle L Lange, Oona M R Campbell, Peter Waiswa, Manon Haemmerli, Yolanda Fernandez, Kate Kerber, Joy E Lawn, Andreia Costa Santos, Fred Matovu, David Macleod, Catherine Goodman, Loveday Penn-Kekana, Freddie Ssengooba, Caroline A Lynch
BACKGROUND: Uganda halved its maternal mortality to 343/100,000 live births between 1990 and 2015, but did not meet the Millennium Development Goal 5. Skilled, timely and good quality antenatal (ANC) and delivery care can prevent the majority of maternal/newborn deaths and stillbirths. We examine coverage, equity, sector of provision and content of ANC and delivery care between 1991 and 2011. METHODS: We conducted a repeated cross-sectional study using four Uganda Demographic and Health Surveys (1995, 2000, 2006 and 2011)...
October 4, 2018: BMC Health Services Research
Yves Lafort, Malica Sofia Ismael de Melo, Faustino Lessitala, Sally Griffin, Matthew Chersich, Wim Delva
BACKGROUND: Female sex workers (FSWs) in many settings have restricted access to sexual and reproductive health (SRH) services. We therefore conducted an implementation study to test a 'diagonal' intervention which combined strengthening of FSW-targeted services (vertical) with making public health facilities more FSW-friendly (horizontal). We piloted it over 18 months and then assessed its performance. METHODS: Applying a convergent parallel mixed-methods design, we triangulated the results of the analysis of process indicators, semi-structured interviews with policy makers and health managers, structured interviews with health care providers and group discussions with peer outreach workers...
October 3, 2018: BMC Health Services Research
M Lindsay Grayson, Andrew J Stewardson, Philip L Russo, Kate E Ryan, Karen L Olsen, Sally M Havers, Susan Greig, Marilyn Cruickshank
BACKGROUND: The National Hand Hygiene Initiative (NHHI) is a standardised culture-change programme based on the WHO My 5 Moments for Hand Hygiene approach to improve hand hygiene compliance among Australian health-care workers and reduce the risk of health-care-associated infections. We analysed its effectiveness. METHODS: In this longitudinal study, we assessed outcomes of the NHHI for the 8 years after implementation (between Jan 1, 2009, and June 30, 2017), including hospital participation, hand hygiene compliance (measured as the proportion of observed Moments) three times per year, educational engagement, cost, and association with the incidence of health-care-associated Staphylococcus aureus bacteraemia (HA-SAB)...
September 28, 2018: Lancet Infectious Diseases
Dalia Almaghaslah, Abdulrhman Alsayari, Rayah Asiri, Najla Albugami
BACKGROUND: Saudi Arabia has shown rapid growth in its pharmacy workforce and pharmacy education over the last decade. The health indicators demonstrate an increased need for medications and, thus, the accessibility of pharmacies. Since pharmacists are considered the most accessible health care professionals, the country has experienced a continuous demand to produce more pharmacists. OBJECTIVES: The objectives of the study are to evaluate the pharmacy workforce in Saudi Arabia and to identify pharmaceutical manpower issues...
September 28, 2018: International Journal of Health Planning and Management
Olumuyiwa Omotola Odusanya, Modupe Rebekah Akinyinka, Esther Oluwakemi Oluwole, Babatunde Adeniran Odugbemi, Omowunmi Qubrat Bakare, Adeyinka Adeniran
Background: The perception of healthcare workers (HCWs) by community members is dependent on the quality of services rendered by HCWs and contributes to utilisation. The objective of the study was to assess the perception of health workers in both public and private facilities by residents of Lagos State. Materials and Methods: A descriptive cross-sectional study was conducted using mixed-methods approach. Respondents (n = 2000) were selected using a multistaged sampling technique from four local government areas...
July 2018: Nigerian Postgraduate Medical Journal
Innie Chen, Newton Opiyo, Emma Tavender, Sameh Mortazhejri, Tamara Rader, Jennifer Petkovic, Sharlini Yogasingam, Monica Taljaard, Sugandha Agarwal, Malinee Laopaiboon, Jason Wasiak, Suthit Khunpradit, Pisake Lumbiganon, Russell L Gruen, Ana Pilar Betran
BACKGROUND: Caesarean section rates are increasing globally. The factors contributing to this increase are complex, and identifying interventions to address them is challenging. Non-clinical interventions are applied independently of a clinical encounter between a health provider and a patient. Such interventions may target women, health professionals or organisations. They address the determinants of caesarean births and could have a role in reducing unnecessary caesarean sections. This review was first published in 2011...
September 28, 2018: Cochrane Database of Systematic Reviews
Nanlesta Pilgrim, Maurice Musheke, H Fisher Raymond, Ryan Keating, John Mwale, Lunda Banda, Drosin Mulenga, Lyson Phiri, Scott Geibel, Waimar Tun
HIV epidemic control requires improving access and uptake of HIV services by key populations (KPs). In Zambia, the behaviors of female sex workers (FSWs), men who have sex with men (MSM), and people of who use drugs (PWUD) are criminalized, and little information exists about their HIV/STI service use. Using a quality of care (QOC) framework, we compared barriers to and opportunities for HIV/STI service access and uptake among the three KPs. We conducted in-depth interviews and focus group discussions with 314 KP members between July 2013 and September 2015 in eight districts...
September 27, 2018: AIDS Care
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