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Apr 2021
Asadzandi MinooCorresponding author
PhD. Assistant Professor, Research fellow. Medicine, Quran and Hadith Research Center, Head of the spiritual health workgroup of Baqiyatallah University, Baqiyatallah University of Medical Sciences. Member of the Department of Spiritual Health of the
Background COVID-19 as an infectious disease, and deadly biological crisis, threatens the bio-psycho-social- spiritual health of the people. Spiritual health from the perspective of Islam, means having a sound heart, living in the present time with sense of peace, security, patience and gratitude, safe from the fear and anxiety of future, grief and regret for the past events. It affects other dimension of health. This study was conducted to investigate the spiritual health services in the face of the COVID-19 pandemic in a Muslim society. Methods This qualitative study was conducted from March 1, 2020 to the end of May 2020 in Tehran by using the Schwartz and Kim's hybrid model concept analysis with a deductive / inductive analysis approach, in three stages: 1- Theoretical review of religious and scientific evidence, 2- Field research 3- Final analysis. Data collection was done in hospitals and hospices by semi-structured interviews, taking notes, websites and social networks search. Data were analyzed by "Contractual Content Analysis Method". Results Despite the fact that spiritual health services (spiritual care and counseling) are not taught in Iranian universities, but in this biological crisis, spiritual health services, based on religious beliefs of health system employees were implemented. The Muslims’ belief in divine test, healing power of God, helping the people as highest worship, aroused spiritual awakening and enthusiasm in the health care team. Spiritual health services at prevention levels were provided with the aim of helping the patient, family and clients, in an inter-professional model based on the jurisprudential rules derived from the religious evidences (Verses and Hadiths), in line with holistic approach, community-based care, spiritual self-care, home-care, family participation. The involvement of non-specialists in the provision of medical services was prevented. According to, preserving the human dignity in Islam, Islamic rituals were performed by the treatment team and volunteer clerics for dying and dead people. Conclusion Considering the impact of religious spirituality on Muslims’ lifestyle and health behaviors, it seems that the use of Islamic health guidelines can improve the quality of health care services and help improve the spiritual health of people in biological crises.
Apr 2020 DOI 10.14302/issn.2641-4538.jphi-20-3286
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
This article describes access to health services among migrants in Italy, summarizing barriers, policy context, and recommendations to improve equitable care.
Mar 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3231
Patel NaiyaCorresponding author
University of Louisville, Department of Health management and Policy
Health services research is a multidisciplinary field which involves policy makers, health care providers, as well as quality outcomes professionals of the health services provided in an organizational setting to name some. Using qualitative research methodology to get insights of both the provider and patient experience down the pipeline can help strengthen what is lacking. Bridging the gap of translation research by not just surveys 1 might be an appropriate research methodology, however, inclusion of case studies, ethnographies might help stakeholders in the field, to visualize in depth phenomenon occurring in health services research field. Telly medicine, commercial digital health status trackr might be some of the inetrventions to improvise health care services, however, knowing what are the actual needs at individual level might efficiently help in redistribution of resources or policy laws. Recruiting for clinical trials through story telling communication technology2,3, might help in recruitment for novel drug therapies to explore possibilities, however, exploring the barriers to enroll for the clinical trials, or why the drug might work effectively in some cultural population and why not on others, can only be efficiently explored through qualitative research methodologies.
Jun 2019 DOI 10.14302/issn.2474-9273.jbtm-19-2854
Joyce OmoaregbaCorresponding author
Consultant Psychiatrist at Federal Neuropsychiatric Hospital Uselu, PMB 1108, Benin City, Nigeria.
Objective Just like their patients, mental health service providers also face stigma. Internalisation of these negative stereotypes could lead to the development of affiliate stigma, reduce their compassion satisfactionand reduce their effectiveness in delivering quality health care to their patients. This study investigated the relationships between affiliate stigma and compassion satisfaction in frontline mental health service providers in a mental health facility in Nigeria. Method This was a cross-sectional study which recruited 183 mental health service providers working in a mental health facility in Nigeria, and who completed questionnaires on affiliate stigma and compassion satisfaction. Results Affiliate stigma among mental health service providers in this study was relatively high (41.5%), and psychiatrists were significantly more likely A to report higher levels of affiliate stigma compared to the psychiatric nurses (p=0.03, OR=0.38,95% CI=0.15 – 0.94). Psychiatrists and Psychiatric nurses who worked for longer hours (> 42 hours per week) reported significantly lower Affiliate stigma (t=2.148, df=28, p=0.04; t=2.118, df=135, p=0.04 respectively). Psychiatrists with high levels of affiliate stigma were more likely to have lower compassion satisfaction, but this was not true of Psychiatric nurses. Mental health service providers who endorse the psychosocial aetiology of mental illness, are significantly more likely to report having experienced high affiliate stigma (F=3.980, df=2, p=0.03). Conclusion The levels of affiliate stigma among mental health service providers in this study was relatively high, particularly among the professional group of psychiatrists. There is an urgent need to address internalization of negative stereotypes among mental health service providers in order to prevent experiences of discrimination among their patients.
Dec 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1788
Lesinskiene SigitaCorresponding author
Vilnius University, Faculty of Medicine, Clinic of Psychiatry, Email: [email protected]
Integration of music therapy into medical treatment facilities is very uneven in different countries. Scientific evidence of successful examples and sharing of good practices between countries is essential for the further development of music therapy and the improvement of the quality of complex medical services. The goal of this study was to analyse the situation of music therapy implementation into the health services in Lithuania. Analysis of historical background, legislation and overview on music therapy training has been made. Music therapy in Lithuania has gone through more than thirty years of development. Acqaintance and acceptance of music therapy as a relevant and fruitful component to the complexity of the existing medical services was long but successful process. Overview of current initiatives and achievements of the implementation of music therapy into clinical practice and research has shown promissing positive results in developmental pediatrics, psychiatry, special education, neurology, neonatology, oncology, somatic and preventive medicine, rehabilitation. The Music Therapy Master program in Lithuania is being implemented. Possibilities to use music therapy as an inovative service and resourse in various medical settings are in the process of the rapid growth. Collaboration involving music therapists in interdisciplinary teams would help to achieve a comprehensive, versatile patient-centered and health-centered complex service.
Jan 2017 DOI 10.14302/issn.2577-137X.ji-16-1139
O’Connor L.Corresponding author
Health Protection Surveillance Centre, 25-27 Middle Gardiner St., Dublin 1
We describe seasonal influenza-like illness (ILI) outbreaks in long-term care facilities in the Health Service Executive (HSE) East area of Ireland in the 2013/2014 influenza season, risk factors associated with outbreak duration and attack rates, and management challenges. Separate questionnaires were distributed to 28 facilities who reported an outbreak and to public health specialists leading outbreak management, with a 79% response rate. Mean outbreak duration (21 vs 17 days; p=0.046) was longer in facilities with staff vaccination rates of <40%. Facilities with a high attack rate (≥50%) were less likely to have an outbreak plan (p=0.03). Smaller facilities (under 50 residents) had a higher attack rate (50% vs 23%, p=0.003) even when controlled for staff vaccination rate (p=0.01). Prior to the outbreak, resident vaccination rates were high (82%, above the World Health Organization target of 75%) but staff vaccination rates were low (39%). Reported challenges to ILI outbreak management in long term care facilities included visitor restrictions, staff education issues, outbreak notification delays and lack of outbreak lead in facilities. Targeted public health-assisted planning, training and response, comprising of staff vaccination, education, written policies, with early notification and prompt response would facilitate a more co-ordinated approach to the management of outbreaks, and reduction in infection rates and consequent morbidity.
Sep 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1195
Joyce OmoaregbaCorresponding author
Consultant Psychiatrist at Federal Neuropsychiatric Hospital Uselu, PMB 1108, Benin City, Nigeria.
Background: Mental health service providers sometimes suffer burden resulting from their care of mentally ill individuals, and this burden could be modulated by the coping mechanisms they adopt. Objective: This study aimed to investigate the relationships between gender, coping strategy and compassion fatigue of mental health service providers in a mental health facility in Nigeria Method: This was a cross-sectional study which recruited 234 mental health service providers working in a mental health facility in Nigeria, and they completed questionnaires (the Coping Strategy Inventory modified by Addison, Campbell-Jenkins & Sarpong and the Compassion Fatigue subscale of the Professional Quality of Life developed by Stamms. Results: Majority of the mental health service providers surveyed were at risk of compassion fatigue (75.2%), gender did not significantly impact on compassion fatigue (t =-0.111; p>0.05), and coping strategies jointly predicted compassion fatigue (F = 11.927; p<0.05; r=0.417). However, when analyzed separately, only the subgroup of emotional focused engagement coping and emotional focused disengagement coping strategies independently predicted compassion fatigue, (β =0.246, t= 3.3.511, p<0.05) and (β =0.226, t= 3.698, p<0.05) respectively. Conclusion: Mental health service providers have high risk of compassion fatigue and the emotional based coping strategies are associated with this. Measures are suggested to mitigate compassion fatigue among this professionals, to reduce the effect on them and their patients.
Mar 2014 DOI 10.14302/issn.2372-6601.jhor-13-352
O’ Sullivan JMCorresponding author
Department of Haematology, Cork University Hospital, Cork, Ireland
Variation in the lower and upper limits of haemoglobin (Hb) ranges will alter diagnosis and referral rates of anaemia or erythrocytosis. The haemoglobin ranges for adults in Irish laboratories were applied in the context of haemoglobin levels of a representative sample of Irish adults (SLAN). Between 2.8% and 8.5% of men would be diagnosed with anaemia in different laboratories for lower limit between 130-140g/L. For women, diagnosis of anaemia would range from 0.7% to 7.3% for the lower limit between 110-125g/L. Similar reference range variations occur in UK laboratories. A suggested “normal reference range” is extrapolated from the SLAN cohort.
Feb 2026
DeRoche ChristinaCorresponding author
The current research assessed gaps and barriers related to perinatal mental health service access by parents during COVID-19, as well as service providers’ knowledge and provision of PMAD services, in one Northern community, where rural and remote healthcare is a daily reality, and recruitment and retention of qualified professionals is a significant issue. Two mixed-methods surveys were designed, one to assess PMAD knowledge and service provision via a volunteer sample of service providers, and another to assess PMAD service need and access among a volunteer sample of new parents. Results indicated that many parents waited too long for services, and some parents in need of PMAD services didn’t receive them. Interestingly, higher-income parents were more likely than lower-income respondents to desire services and support for PMADs. Although most providers screened for, were trained in, and treated and/or referred patients with PMADs, they reported feeling as though they were working in silos, unaware of what other providers offered.
Dec 2025
Tariku Belay YilkalCorresponding author
Background Research and drug development industries have multiphase drug screening procedures, which can be debated. As a result, harmful products may still reach for public health service delivery due to vulnerabilities in the process. Main body A wide range of test compounds have delayed manifestation of undesired effect on the study subject, with the time to undesired effects after acute exposure being weeks and months. Acute toxicology in a preclinical trial also has limited clinical value as its lethal dose is the endpoint for a conclusion, and death sometimes occurs after a scheduled period of acute toxicology. Countless resources are wasted, and numerous new drugs are introduced into the pharmaceutical market with assumed safety analysis every year due to vulnerable multi-procedures in preclinical trials. The principal use of collected data from a preclinical trial is to support regulatory categorization and harmful labelling decisions. However, the data can also be used to derive safe use threshold levels, which may lead to the use of unsafe material. The criteria for classification and labelling also differ among countries, sometimes among authorities within the same country. The fundamental concept of toxicology states that ‘all chemical substances are potential poisons depending on the amount and duration of exposure. However, the toxic property of a test compound cannot be created or eliminated by simply the amount administered to study animals. Conclusion All xenobiotics are poisons at any amount with different severity that can be calculated using biological parameters.
Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5852
Anirudhan RanjaniCorresponding author
South Asian female college students in the United States face mental health challenges shaped by intersecting experiences of discrimination and violence. This study examined how discrimination and violence contribute to depression in this population. An anonymous, cross-sectional, web-based survey (N=673) was distributed nationally through South Asian organizations, listservs, and social media. Validated measures assessed day-to-day discrimination, college-based discrimination, experiences of violence during college, and depression (PHQ-9). Bivariate analyses and multivariate linear regression examined associations, adjusting for sociodemographic factors. Over half of participants (51.1%) reported college-based discrimination, 66.1% reported experiencing violence during college, and 25.7% met the criteria for depression. In adjusted models, day-to-day discrimination (β=0.261, p<0.001) and college violence (β=0.207, p<0.001) were significant predictors of depression. Bisexual and questioning/unsure students also reported higher depression scores than heterosexual peers. Discrimination and violence are key social determinants of mental health among this population. Findings underscore the need for culturally responsive mental health services, intersectional campus policies, and evidence-based interventions to promote health equity among minority women in higher education.
May 2022 DOI 10.14302/issn.2641-4538.jphi-22-4185
Rutayisire ErigeneCorresponding author
Department of public Health, Mount Kenya University Rwanda Kigali Rwanda
This study aims to assess reproductive health knowledge and services utilization among adolescents from Rwamagana District. A community based cross-sectional study was carried out in Rwamagana district. A sample of 392 adolescent aged 15-19 participated in the study. Simple random sampling was used to select respondents. Data was collected by using a questionnaire adopted from previous studies. Data was checked for completeness, cleaned, coded and entered into excel sheet, and then exported to SPSS version 22.0 for further analysis. Frequencies and percentage was used to summarize descriptive statistics. To determine the association between different factors associated with reproductive health knowledge and services utilization, a logistic regression model was employed. Ethical clearance was obtained from the Ethical committee of Mount Kenya University. It was observed that the majority of adolescents in Rwamagana District knew the sign of maturity. Overall the majority of adolescents 91.8% in Rwamagana District had good knowledge about reproductive health services. The majority of adolescents in Rwamagana District (66.8%) had ever utilized reproductive health services at health facility. It was observed that adolescents who live with their parents were more likely to use reproductive health services compared to those who do not live with parents (aOR=2.161, 95%CI: 1.162-4.021, p=0.015). Moderate reproductive health services utilization was observed among adolescents. There is a need to increase adolescent’s awareness on the available services at health facilities.
Jul 2021 DOI 10.14302/issn.2641-4538.jphi-21-3897
Pamela NanaCorresponding author
Interstate center in public health in Central Africa (CIESPAC)
Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.
May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3824
Munharo StevenCorresponding author
University of Suffolk, Ipswich, UK
Zimbabwe like many other sub-Saharan African states has been struggling to provide a quality health service delivery system. Nations with rampant corruption and ineffective bureaucracy made worse, the response towards the fight against COVID-19, Coronavirus Disease 2019. Despite the Zimbabwean government setting out protocols with international agencies such as WHO, World Health Organization to mount an effective response against COVID-19, the health system has been overstretched with lack of personal protective equipment, shortage of drugs and essential equipment and wanton corruption practices coupled with shortage of staff. Timely delivery of orders is still a challenge due to strict bureaucratic measures when transporting goods and the existing competition between countries. Manufacturers and donors are shifting their focus to their countries leaving the Zimbabwean health service underfunded and under-resourced. However, among the challenges experienced the country has been given a chance to revisit its priorities and strategize how best the government and organizations can move essential medical goods, utilize current trade agreements such as ACFTA, African Continental Free Trade Area and local drug manufacturers to produce essential medicines. Launching an efficient mechanism to end corrupt practices in procurement and supply as well as improve interagency cooperation and communication may help improve efforts to end COVID-19 in Zimbabwe.
Feb 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3727
Keshavarz VajihehCorresponding author
Department of Occupational Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.
Nov 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3501
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background A well-functioning drug supply management is the corner stone for any meaningful health service. However, Pharmaceutical supply systems in many developing countries have severe problems, including inefficient selection, procurement and use of drugs. The magnitude and extent of the problem is huge and chronic in the Ethiopian health care system for a long time. Objective To evaluate auditable pharmaceutical transaction service process in Seka primary hospital, Jimma zone south west Ethiopia. Evaluation Methodology Case study design involving both quantitative and qualitative methods was conducted in Seka primary hospital. The focus of this evaluation was on the process of Auditable pharmaceutical transaction service. The evaluation was focused on process part of the program with dimensions; availability, compliance and client satisfaction in the dimension of accommodation. Resource inventory, document review; key informant interviews and observations were conducted. Client satisfaction was assessed through exit interview; with sample size of 326. The qualitative data was analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 23 software. Results In Seka primary hospital, percentage availability of the 32 selected Key medicinewas 10.7(82.0%) and there were no expired drugs found on their shelves. The availability of 17 of the required 20(85%) professionals was adequate according the Auditable pharmaceutical transaction service. The average lead time was found to be less than five days. The average counselling and dispensing time were 5:43 minutes and 1:17 minutes, respectively. The average number of drugs per prescription was 2.0. The 1154(97.9%) of drugs prescribed by generic name and 1175(99.7%) of prescribed drugs on Essential Drug List indicates prescribers ‘adherence to facility specific List. Conclusion This evaluation revealed that (based on the pre-set judgment criteria) the achievement of the Auditable pharmaceutical transaction service in Seka primary Hospital was GOOD 82.6 % (achieved 355.2 of 430 weight given), i.e. even though it is Good achievement ,there are areas that needs improvement. Areas for improvement identified were: Pre- and in-service training for all health workers involved in store room and dispensary to improve on the medium counselling time, poor record keeping and the extremely poor labelingof drugs which this all improve the overall client satisfaction.
Oct 2020 DOI 10.14302/issn.2768-0207.jbr-20-3568
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
The Coronavirus emergency represents an epochal challenge for all world health organizations. In these times of profound destabilization of healthcare organizations, become urgent some thoughts on how to deal with the organization and re-engineering process as well as on concepts, relatively new, such as "resilience" and "business continuity". The company management need having to predict, design and plan a profound process of change in their Clinical and Corporate Governance. With the implementation of phases 2 and 3 of management of the pandemic and the coexistence of doctors and citizens with the new Coronavirus, it has become a priority to develop territorial models of assistance to established or suspected Covid patients, starting with the creation of monitoring networks based on the model of the “sentinel” general practitioner. One of the main concerns of Healthcare, since the beginning of the Covid-19 emergency has been to get closer to the citizen-patient. It is therefore necessary to find stimuli to restart with new methods of care, new health and social-health services, moving the current care paradigm for Covid-19 from the hospital to the territory, optimizing the constituent elements of the districts, primary care and general practice in a multidisciplinary approach.
Sep 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3545
Ezinna E EnwerejiCorresponding author
Department of Public Health, College of Medicine, Abia State University, Uturu, Nigeria
Public health professionals working in rural communities are aware of the health disparities which result from lack of physicians, limited services, and income during the pandemic. Also they are aware that some populations are more vulnerable than others. People in the rural areas are experiencing problems on their physical, social and economic life styles because the pandemic is exacerbating some inequities. Individuals especially women and children in the rural areas are facing barriers in accessing health care services due to lack of resources and availability of health care providers in the communities. With COVID-19, women are less likely to seek services, including sexual and reproductive health services. Such services may be postponed to limit exposure to COVID-19 infection. This is particularly disturbing because in addition to the women maintaining their own health, they are also responsible for taking care of the mental, emotional and physical health needs of their families as well as all domestic responsibilities. As such, women in rural settings face special challenges as a result of these significant roles they play. Therefore, the impacts of COVID-19 are exacerbated on women by virtue of their sex and the roles they play in the family. This is a qualitative study that reviewed the reports of the 36 health care professionals under the aegis of members of COVID-19 committee working in partnership with state government to control, prevent and cushion the effects of COVID-19 in the society. This study is therefore, a summary of the observations of the COVID-19 committee members made up of 10(27.8%) females and 26(72.2%) males. The study focused on exploring how individual lifestyles in the rural areas have been affected in the face of COVID- 19 pandemic by identifying the vulnerabilities in social, political and economic systems which can amplify the impacts of the pandemic. Findings showed that preventive measures like lockdown and social distancing rules, wearing of face mask, hand washing with soap, and environmental cleanliness were not observed. The study noted that health seeking behaviours, sexual and marital life including income, education, employment and social interactions were all negatively affected. Most hospitals were battered and health care professionals boycotted the hospitals for fear of being infected. It was found that lack of health workers in the hospitals caused a good number of individuals to engage in self-medications. Also most pregnant women delivered their babies at home and few with traditional birth attendants. Some of the women who had deliveries at home experienced complications during and after delivery. Unfortunately, the report showed that governments’ financial supports to these women and their family members were insignificant as the government was more concerned with mitigating the spread of COVID-19 than assisting women to have safe deliveries. Therefore, the vulnerable groups especially women, children, and the elderly who experienced threats to their safety and wellbeing as a result of the services that were disrupted during the pandemic, should be assisted so as not to lose their lives to preventable diseases.
Jul 2020 DOI 10.14302/issn.2641-5526.jmid-20-3493
I. Kheder SalahCorresponding author
Faculty of Pharmacy, National University, Khartoum, Sudan
Background Rational drug management has become an increasingly important topic in order to make optimal use of the drug budget to offer health services of the highest possible standard. It is important that continuous assessment for rational prescribing and use of drug have to be carried. Objective of this study was to gather data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing indicators as described by the WHO. Method Observational, cross-sectional, prospective study was designed and conducted to evaluate the performance of hospital and community pharmacies in Khartoum state, related to rational drug use and prescribing and dispensing practices during the period from November 2018 to March 2019. 297 Hospital and community pharmacies from public and private sectors were contacted for carrying out this study survey and the collected data were analysed against WHO standards for core drug use indicators. Results The average number of drugs per encounter was 3.98 drugs. Hospital pharmacies had a higher (4.18±1.516) number of drugs prescribed than community pharmacies (3.87±1.331) with significance difference between mean of two types of pharmacies (P = 0.015). The percentage of antibiotic per prescription was (53.7%). Antibiotic prescribing was much higher (54.0%) in the hospital pharmacies compared to (48.6 %) in community pharmacies. The average percentage of injections per prescription at the facilities was found to be (57.6%). The percentage of prescription with written diagnosis was (26%.0) and the percentage of prescriptions with written dose was (78%.0). The average dispensing time was (1.75) minutes, The Percentage of drugs actually dispensed was (55.99%), the average adequacy of labelling of drugs was (30.4%). Overall prescribing and dispensing indicators were higher than WHO standard. Conclusion The degree of poly pharmacy was greater than of WHO criteria. The completeness and rationality of prescription was found suboptimal and components were missed.
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3375
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
The world of chronicity is an area in progressive growth that involves a considerable commitment of resources, requiring continuity of assistance for long periods of time and a strong integration of health services with social ones and those requiring residential and territorial services often not sufficiently designed and developed. The fundamental aim of the treatment of chronic systems is to keep as much as possible the patient at home and prevent or reduce the risk of institutionalization. GP could put their expertise to good use in the Complex of Primary Care Units and Territorial Functional Aggregations, reducing the costs of the health service.
Nov 2019 DOI 10.14302/issn.2328-0182.japst-19-3066
Yousif Babiker MazinCorresponding author
Department of Pharmacology, International University of Africa, Sudan.
Introduction Pharmacists and pharmaceutical care services are among the most important tools in providing health services to the society. Pharmacists as the key players in presenting health services, critically impact on the health of the society and if they suffer low job satisfaction, their dissatisfaction may relatively threaten health in the society. This study was conducted to determine Sudanese community pharmacists’ job satisfaction and additionally, some causes of dissatisfaction among community pharmacists and their impact on providing pharmaceutical care services have been evaluated. Method The questionnaire was designed after reviewing relevant Literature in addition, The Job Satisfaction survey was used to measure the level of community pharmacists’ satisfaction with their current jobs, and the Toronto Alexithymia Scale (TAS-20) was used to evaluate emotional experience and awareness. Results and Discussion Generally low scores of job satisfaction were concluded among pharmacists while most of them were highly satisfied with being pharmacist. Conclusion Low levels of job satisfaction which were found among Sudanese community pharmacists could be considered as a deficiency of health system in Sudan. Fortunately, inherent interest in the pharmacy profession found among Sudanese pharmacists is an optimistic point at which policy-makers could develop their modifying policies. Health policy-makers must endeavor to take other steps to issue solutions for this current problem.
Aug 2018 DOI 10.14302/issn.2690-4721.ijcm-18-2217
Samaras ShivanthiCorresponding author
Molecular Microbiology, School of Allied Health Sciences, Faculty of Health & Life Sciences, Hawthorn Building, The Gateway, De Montfort University, Leicester, LE1 9BH United Kingdom
Background Overuse of beta-lactam antibiotics has lead to selection for extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, a major cause of antibiotic resistant urinary tract infections (UTIs). Standard detection methods are time-consuming, with disputed accuracy. This study describes a novel real-time PCR method to detect CTX-M, SHV, OXA and TEM. Methods 179 Enterobacteriaceae isolates from UTIs were collected from the Leicester Royal Infirmary, UK. A multiplex Plexor®-based real-time PCR assay detected ESBLs using their specific amplicon melting temperature, during each cycle, removing the need for a melt-curve analysis. Validation was achieved by end-point PCR and disk diffusion. Results The method was able to produce rapid and accurate results, achieving a sensitivity and specificity of 94.9% and 72% respectively, and the assay can differentiate between the different ESBL genes, with ease. Conclusions With further investigation, a Plexor®-based assay could form the basis of a high-throughput kit that health services could use to detect ESBLs or other antibiotic resistance genes.
May 2018 DOI 10.14302/issn.2640-690X.jfm-18-2088
Yao Gbagbo FredCorresponding author
University of Education Winneba, Department of Health Administration & Education. P.O. Box 25 Winneba, Ghana.
Background: Despite liberal abortion laws and wide availability of contraceptives in Ghana, declining Post Abortion Contraception remains a public health challenge due to early unplanned pregnancies and recurrent abortions. The development of this model was therefore to address challenges of low contraception following induced abortion in health facilities within the capital city of Ghana. Method: The development of this model was an outcome of a nested study title: ‘decision making for induced abortion in Accra metropolis, Ghana’ in 2014. This model was piloted for four years using Marie Stopes, Ipas and Ghana Health Service trained abortion providers with family planning skills in one hundred purposively selected health facilities comprising 90 private and 10 Non-Governmental Organization mandated by law to provide safe abortion care services in the capital city of Ghana. The model mainly focused on contraceptive products, pricing, placement, promotion and people. Results: There was an increase (90% average) in Post Abortion Contraception across the selected facilities following the intervention using the model. Conclusion: The study concludes that an integration of products, pricing, placement, promotion and people with options counselling prior to an induced abortion are key considerations for an improved post abortion contraception uptake in developing countries.
Nov 2017 DOI 10.14302/issn.2641-5526.jmid-17-1762
F. Phillips JamesCorresponding author
Columbia University Medical Center, Heilbrunn Department of Population and Family Health, Mailman School of Public Health, 60 Haven Avenue, B-2 ,New York, NY 10032 USA
Despite widespread use of Geographic Information System (GIS) technology to strengthening health systems, the application of GIS to health systems strengthening in resource-poor Sub-Saharan Africa remains rare. Over the June 2012 to December 2013 period, the Ghana Health Service (GHS) conducted a pilot application of GIS to health systems development in one rural impoverished district of the Upper East Region (UER). Workers were deployed to gather coordinates of health care facilities throughout the UER. Coordinates were linked to routine health information data, and utilized to generate maps for guiding task prioritization. For example, geocoded Community-based Management of Severe Acute Malnutrition (CMAM) program data were used to target services in communities where the prevalence of childhood acute malnutrition was relatively high. GIS was pivotal in tracking and responding to infectious disease morbidity from causes such as diarrheal diseases and tuberculosis. UER Regional Health Administration (RHA) authorities are currently utilizing GIS to map antenatal care coverage, skilled birth deliveries, neonatal mortality, still births, family planning service caseloads as well as for targeting programmatic action. Experience emerging from this trial attests to the value of GIS in contributing to efforts to strengthen health systems in rural impoverished regions of Africa.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1489
NE PhilipCorresponding author
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, Kerala, India
We aimed to find the population coverage, health service utilization and out-of-pocket spending among the elderly who are insured under Comprehensive Health Insurance Scheme (CHIS), Kerala through a longitudinal study of 600 non-rich households for nine months. The study found that only 57.7% the elderly were insured under CHIS which is lower than the population average of 80%. Single elderly from a socially backward caste, living alone in kutcha or semi-pucca houses were excluded from CHIS. Even though insured elderly had more episodes of hospitalization, only 38.4% of the elderly could make use of CHIS smart card for payment during hospitalization and 43.6% of the episodes were covered by CHIS. The mean indirect out-of-pocket expenses among insured elderly who had used smart cards for hospitalization (INR 7679.25) was higher than that for the un-insured (INR 4455.26), p = 0.027. The mean monthly drug expenditure (INR 1105.09) was also significantly higher among the insured as compared to the un-insured elderly (INR 650.03), p=.004. More than 80% of the hospitalized households had to use distress finance mechanisms to meet health- related expenses. We found that population coverage among elderly did not translate into service coverage and thus financial risk protection was not achieved even in a state like Kerala which is considered to be well-performing in terms of health insurance coverage. This study points out that elderly being a vulnerable group with special needs require a more comprehensive service package including chronic disease care, and a higher level of financial coverage.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-16-1354
Frumence GastoCorresponding author
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania.
Tanzania is among the developing countries experiencing rapid growth of an ageing population, which has an implication in healthcare expenditure especially in resource poor settings where majority of elderly people cannot afford to pay for the cost of accessing health services. The country has developed the Tanzania National Health Policy (2007) and National Ageing Policy (2003), which, among other things, recognize the importance of having a healthcare system that provides free basic services to the vulnerable elderly population. This study aimed at exploring health service providers’ and managers’ perspectives on the factors facilitating or prohibiting access to health services among elderly people in Tanzania. The study adopted a qualitative approach and data were collected using semi-structured interviews. A total of 24 in-depth interviews were conducted with district healthcare managers, heads of public healthcare facilities, and health service providers. The data generated were analysed for themes and patterns. The results show that Tanzania’s healthcare system has made some efforts to implement the national exemption policy to ensure better access to health services for the elderly. Some of these efforts include: having in place a system to identify and exempt elderly people from paying for health services and giving them special priority during treatment. However, there are some barriers hindering elderly people’s access to health services. Among others include: lack of specific consultation rooms and doctors for serving the elderly, and lack of sufficient drugs and other medical equipment in most government-owned healthcare facilities. In summary, the healthcare system has created a good environment for the implementation of exemption policy aiming at enhancing accessibility of health services among the elderly population in the country. However, such environment cannot function effectively without addressing the identified barriers. It is recommended that the government should allocate adequate human and non-human resources to the healthcare system to enable it to function effectively, including the provision of health services to the elderly.
May 2017 DOI 10.14302/issn.2474-9273.jbtm-16-1180
A. Chen JessicaCorresponding author
Department of Psychology, University of Washington
Current psychological treatment approaches that rely on time-intensive, face-to-face psychotherapy are not capable of meeting the demand for mental health services. Mental health interventions that promote self-regulation and self-management of symptoms will play an increasingly important role in the well-being of millions of individuals. Self-monitoring is a core assessment and intervention component of many mental health interventions and an obligatory first step in the self-regulation process. The present paper reviews prominent theories of self-regulation and describes classic studies spanning clinical, social, cognitive, and personality psychology, which identify potential mechanisms underlying self-monitoring. At the empirical level, we describe the use of self-monitoring across a range of behavioral interventions directed at mental health and physical outcomes, identify factors that influence the effects of self-monitoring, and suggest ways in which technology can be incorporated into these interventions to improve the reach of psychological interventions.
Jun 2014 DOI 10.14302/issn.2374-9431.jbd-13-330
Grappasonni IolandaCorresponding author
University of Camerino. School of Pharmacy. Via Madonna delle Carceri,
Background: Health practitioners of different disciplines (physicians, paramedic personnel, pharmacists) should possess adequate ICT (Information and Communication Technology) skills and practical competence on these technologies. Pharmacy practice requires a relevant flow of information, collection and handling of which could be facilitated by ICT. The correct use of ICT requires a proper knowledge by professionals offering a public service. The purpose of this paper was to assess basic informatics background and computer uses in pharmacists practicing in Italy, with the aim to identify educational interventions for increasing their informatics abilities. Methods: A questionnaire was proposed to pharmacists working in Italian community pharmacies. The survey was articulated into 35 questions concerning computer basic knowledge, ICT facilities, computer skills, habits, and uses in pharmacy practice. Results: The questionnaire was completed by ~45% (No. 224) of responders, the 96.9% of which used computer. Only 7.8% of interviewed people employed e-mail to communicate with health authorities and less than 2% used it to be in contact with physicians or other health professionals. Less than 40% used ICT for training courses. The results revealed a relevant percentage (90.8%) of self-learners to computer use, while only 9.2% was trained by specific courses. Conclusion: Basic knowledge of community pharmacists on ICT technological infrastructure is quite low. Although pharmacists play an essential role in health services, they have apparently limited computer skills. This suggests the need of educational and training efforts for enlarging computer and ICT resources competent use in daily pharmacy practice.
Nov 2013 DOI 10.14302/issn.2328-0182.japst-13-185
WS WaringCorresponding author
Acute Medical Unit, York Hospital, York, UK
Background: Antidepressant agents are commonly implicated in drug overdose, and the toxicological profile varies between agents. Clinical data concerning overdoses are not systematically sought or evaluated in pharmacovigilance. The present study sought to examine the feasibility of collecting Emergency Department data concerning antidepressant overdose. Methods : Presentations to York Hospital due to intentional antidepressant overdose were studied between 2010 and 2011. Data collected were the type of antidepressant, dose, co-ingested drugs, duration of hospital stay, and need for critical care. Community National Health Service prescription data were evaluated across York and North Yorkshire region. Results : There were 250 overdose episodes. These involved a selective serotonin reuptake inhibitor (SSRI) in 183 (73.2%), and a tricyclic in 45 (18.0%), equivalent to 24 episodes per 100,000 prescription items (95% CI 21-28 per 100,000) and 11 per 100,000 (8-15 per 100,000) respectively (P<0.0001). Citalopram was the most commonly prescribed, and associated with 22 overdose episodes per 100,000 (17-27 per 100,000). Fluoxetine was associated with 32 overdose episodes per 100,000 (24-41 per 100,000) (P=0.032 versus citalopram), whereas the lower rates were observed for amitriptyline (13, 9-17 per 100,000) (P=0.004) and dosulepin (2, 0-10 per 100,000) (P=0.001). Conclusions : A higher than expected number of overdose episodes involved an SSRI based on National Health Service primary care prescribing, and fewer episodes involved a tricyclic antidepressant. Clinical outcomes differed between agents, indicating the feasibility of using Emergency Department data to detect different patterns of toxicity between antidepressants. Further work is required to examine whether systematic collection of clinical toxicology data might enhance existing pharmacovigilance systems.