Advanced Health Facilities Research Articles

Phytotherapic Drugs for COVID-19 Treatment: A Scoping Review.

The rapid eruption of Coronavirus at the end of 2019 has caused global health crisis and significant loss to the economy and social well-being. This created a massive shortage of advanced health facilities with inadequate medicinal supply, further deteriorating human health conditions. On the basis of adverse effects of the ongoing pandemic, this review has been proposed to evaluate the antiviral efficacy of plant- based therapeutics, against SARS-CoV-2 (commonly called COVID-19) infection. It highlights the possible action of the mechanism of phytotherapeutic drugs against coronavirus inhibition, further validated by clinical trials on herbal formulas is reviewed. Though the experimental studies on COVID-19 treatment are limited, the undesirable side effects of herbal drugs and unidentified compounds cannot be ignored. We have made an effort to study the prospective plant-derived bioactive entities and their effectiveness in the treatment of COVID-19 and also emphasize on safety and regulatory concerns of phytomedicines. The methodology involves relevant studies on COVID-19 treatment based on herbal extracts and the purified bioactive metabolites. The e-literature survey has been done by downloading research articles available on PubMed (National Library of medicine), Elsevier, and Google scholar search engines. The keywords used are plant metabolites, natural bioactive, phytotherapeutic drugs, clinical trials, SARS-CoV-2, Coronavirus inhibitors and herbal extracts. The review pays particular attention to the etiological study of the COVID-19 virus and its inhibition using medicinal plant metabolites as immunomodulatory agents. The application of valuable bioactives like phenolic compounds, saponins, alkaloids, tannins, flavonoids and terpenoids in preparing herbal formula/drug has been focused on. The drug resistance of bioactive compounds and their side effects on human health were discussed for effective phytomedicine, thus, emphasizing the perspectives of phytotherapeutic drugs as a safe remedy to boost immunomodulatory functions and antiviral activity against COVID-19. Altogether, the review presents the action mechanism of plant extracts rich in bioactive compounds and depicted potential antiviral activity against SARS-CoV-2. These plant bioactive compounds can serve as lead molecules to develop phytomedicine, ensuring all safety regulations in the clinical trials to treat or prevent COVID-19 viral infections.

Livelihood vulnerability assessments and adaptation strategies to climate change: a case study in Tanguar haor, Sylhet

Abstract Bangladesh is very prone to climate-driven hazards due to its unique geographical location, high population density, and low climate resilience. Therefore, this study addresses the livelihood vulnerabilities and adaptation strategies in response to the climate change issues based on empirical evidence from wetland communities using the livelihood vulnerability index (LVI) in Tanguar haor, located in Sylhet, Bangladesh. The finding shows that people of the study area are switching their formal livelihood activities into alternative sources. Crop diversification, homestead gardening, erosion proofing, and cage aquaculture are commonly used by the studied communities to adapt to climate change impacts. The main driver of vulnerabilities was found to be lack of education, underdeveloped infrastructures, lack of advanced health facilities, and lack of alternative livelihoods during extreme events. Therefore, people living in and around the haor region need special consideration. Overall, the study suggests that policy or institutional arrangements are required to promote the better governance system for local communities to improve their living standard so that they can achieve resilience to the impacts of climate variability and change in this area.

Studi Implementasi Sistem Rujukan Berjenjang Antar Fasilitas Kesehatan Tingkat Lanjut di Era JKN di Provinsi Sulawesi Selatan

One of the determinants of achieving quality control and cost control is the implementation of tiered referral health. This research was motivated by the absence of research on the implementation of referrals from FKTP to FKTL. Data from RSUP Dr. Wahidin Sudirohusodo’s annual report showed in 2015 and first half of 2016, >60% cases in class A hospital were level 1 severity case which should still be handle in class D and C hospitals. This affects the accumulation of patiens in tertiary hospitals and inefficient use of resources. It is a qualitative research with phenomenology approach to determine the implementation of a tiered referral system between advanced health facilities in JKN era in South Sulawesi. The results shows most of referral were made due to facilities limitation and inavailability of specialist. There were referrals which made based on patients requests not based on clinical reasons. It is also found hospital staff who did not know about the existing of standard operational procedure of referral in the hospital. Some hospital staff has no knowledge on the referral regulation nor about hospital classification. This research is expected to be able to contribute to the development of science and can be used as input for hospitals and BPJS in an effort to improve the optimization of tiered referral services. Based on the results of the study it is recommended to improve facilities and infrastructure that can support the provision of referral services in hospitals.

Chikungunya and COVID‐19 in Brazil: The danger of an overlapping crises

It is already widely known that the COVID-19 pandemic has added a heavy burden to the health care system in different parts of the world. In Brazil, the situation was no different. The uncontrolled increase in the contagion curve of the disease has tested the limits of the country's health system. This situation is aggravated by the coexistence of an outbreak of Chikungunya, which affects mainly the most vulnerable groups in the country. The overlap of these two crises can be a dangerous combination if urgent measures are not taken. This article is protected by copyright. All rights reserved.

Reducing Maternal Mortality: A Qualitative Study of Health Workers’ Expectation in Urban Area, Indonesia

BACKGROUND: Maternal mortality is a sentinel event used globally to monitor maternal health and the overall quality of reproductive health care. Globally, maternal mortality is mostly due to direct causes; apparently, it is not limited by the setting or geographic region. However, Indonesia has failed to achieve the Millenium Development Goals (MDGs) target for maternal mortality.
 AIM: This study aims to explore health workers' and stakeholders' expectations in maternal health services to reduce maternal mortality in urban areas.
 METHODS: It is qualitative research through naturalistic, conducted in one of the regencies in Indonesia, the urban area with the highest Maternal Mortality Rate (MMR) in one province by 2019. Data were obtained in the form of information from Focus Group Discussions (FGDs). FGDs were carried out with stakeholders at the Health Service level (n=3), first-level health facilities or public health centres (n=3), and advanced health facilities or hospitals (n=7). Data analysis in this study employed software (Nvivo Release 1.0) to utilise transcripts in coding and categorising.
 RESULTS: The expectations that emerged from health workers' perspectives in the field were an integrated system of collaboration between health facilities, affordability of Hospital with Comprehensive Emergency Obstetric Care (CEmOC) in action for maternal-neonatal referral urgency, and the skilled health workers as a golden opportunity.
 CONCLUSION: Health workers’ expectations can improve the quality of maternal health services in urban areas, thereby reducing the MMR with a system of collaboration between health facilities, the affordability of maternal-neonatal emergency referral facilities, and the availability of Obstetricians who standby.

Identifying exposures of health facilities to potential disasters in the Greater Accra Metropolitan Area of Ghana

The Health sector in Ghana has over the years received huge capital investments from the government, its partners and other private entities. These have resulted in the transformation, upgrade and provision of new health facilities across the country. Despite these efforts, the sector still faces challenges of inadequate infrastructure. Furthermore, the existing facilities may be threatened by the occurrences of disasters in the country. The Greater Accra Metropolitan Area (GAMA), which contains the most advanced health facilities in the country is one area perceived to be most vulnerable to disasters. Hence, this study uses a multiple approach to identify and assess health facilities highly exposed to hazards and may be vulnerable should disaster occur. It samples 60 health facilities from twelve municipalities in the GAMA area for the assessment. The study reveals flooding as a key threat to health facilities in the entire GAMA area but identifies Accra metropolitan area as a locality with most exposed health facilities. Furthermore, the study discovers that, many of the health facilities in GAMA are clustered in a highly vulnerable enclave of about 20 km radius and estimates that, occurrence of any \\disaster within this area could affect more than twenty facilities and deny healthcare services to over two hundred thousand people. It suggests collective efforts from all stakeholders to secure and protect these facilities as priority for resilience.

Changing Dimensions of National Power in Post Covid-19 World Order

COVID-19, began as a mere health concern has now become a major concern affecting the entire world at all levels and questions the applicability and relevance of traditional perspectives of national power. Against this backdrop, the study argues that, in the post COVID-19 world order, effective mechanism is set to become the most decisive element of power. The study reinstates that effective health mechanism goes beyond the traditional perspectives of health dealing with the possession of advanced health facilities and proposes the main aspects of an effective health mechanism.

The comparison of the unit cost of hemodialysis with ina cbg rates in Muhammadiyah Siti Aminah Hospital

Health services in Indonesia have led to the National Health Insurance. Hospitals that serve BPJS participants are paid using a package system based on INA CBG rates. Payment of claims to advanced health facilities is differentiated by type of hospital. Type D hospitals have the lowest INA CBG rates, so they must calculate the unit cost of each procedure given based on the diagnostic group. The purpose of this study was to determine the comparison of the unit cost of hemodialysis measures with INA CBG rates and to find out if there are non-value-added activities in services. This type of research was a qualitative case study. The subject of the study was Muhammadiyah Siti Aminah General Hospital. The object used was all activities that support the occurrence of hemodialysis outpatient services. Data analysis used Activity Based Costing Baker modification. The results shows a unit cost of HD action in 2018 of Rp. 724.725. INA CBG rate for hemodialysis action in Type D Hospital is Rp. 737.700,-. So that a positive difference is obtained between the INA CBG rate and the HD unit cost of Rp. 12,975 -. RSUMSA has not been able to conduct supporting examinations in accordance with the specified standards because the costs incurred will be very high and will cause losses because they exceed INA CBGS tariffs and no potential non-value added activities are found.
 Keywords: Unit Cost; Hemodialisis; Tarif INA CBG

Demand for family planning satisfied with modern methods and its associated factors among married women of reproductive age in rural Jordan: A cross-sectional study.

A novel indicator, 'percentage of women of reproductive age who are sexually active and who have their demands for FP satisfied with modern contraceptive methods (mDFPS)', was developed in 2012 to accelerate the reduction of unmet needs of family planning (FP). In Jordan, unmet needs for modern contraception remain high. To address this situation, this study measured the mDFPS and identified its associated factors in rural Jordan. This cross-sectional study included married women of reproductive age (15-49 years) from ten villages in Irbid Governorate, Jordan, where advanced health facilities are difficult to reach. A two-stage stratified sampling with random sampling at the household stage was used for this field survey which was conducted between September and October 2016. Univariate analysis was used to assess the differences between mDFPS and unmet mDFPS groups. Logistic regression analysis was performed to identify the correlates of mDFPS. Of 1019 participants, 762 were identified as needing modern contraception. mDFPS coverage accounted for 54.7%. The most significant factors associated with mDFPS were the husband's agreement on FP (adjusted odds ratio [AOR]: 15.43, 95% confidence interval [CI]: 5.26-45.25), knowledge of modern contraceptives (AOR: 8.76, 95% CI: 5.72-13.40), and lack of awareness of the high risk of conception in the postpartum period (AOR: 2.21, 95% CI: 1.41-3.47). Duration of current residence, receipt of FP counselling at health centres and number of living children were also correlated. In addition, 95.3% of local women were aware of the presence of health centres that were mostly located in a 10-minute walking distance. To increase mDFPS, this study suggested that accelerating male involvement in FP decision-making is necessary through community-based health education. Furthermore, expanding FP services in village health centres and improving the quality of FP counselling in public health facilities are required to correct misconceptions about modern methods among rural women.

Performance and Attitude of Dental Poly Officers with Patient Satisfaction on JKN Era in Panembahan Hospital Bantul Yogyakarta

Panembahan Senopati Hospital is a referral hospital. In the government program in the form of the National Health Insurance (JKN), most people who seek treatment at Panembahan Senopati District Hospital have health insurance. The ineffectiveness of the referral system in Indonesia has an impact on the accumulation of patients in advanced health facilities, resulting in a decline in the quality of health services provided. The main indicator of knowing hospital standards is patient satisfaction with services from the hospital. Various facts show that there are serious problems in the quality of health services in Indonesia. This is due to the absence of the best quality control system that can be applied. To determine the level of satisfaction of National Health Insurance (JKN) patients with the quality of health services provided by dental clinic officers at Panembahan Senopati Hospital. Descriptive analytic observational with a cross sectional study design. The population in this study were patients who received dental and oral health services. Samples were taken using 86 accidental sampling techniques. Data was collected using a questionnaire consisting of 14 structured question items based on the performance and attitude of dental clinicians. Data analysis using the Chi-Square test followed by logistic regression test. From the results of multivariate analysis, the P value of 0.035 performance is significant and has a greater chance of 10,588 times compared to performance that is not appropriate. P value of 0.023 attitude is significant and has a 4.315 times the opportunity compared to attitudes that do not include 3 components. Factors related to satisfaction include intelligence, skills. emotional stability, a person's characteristics include attitudes, personal traits, physical traits, desires and motivation. There is a relationship between the performance and attitude of dental clinicians that performance is a variable X which is more influential with a value of P = 0.035 compared with attitude with a value of P = 0.023 to the variable Y about patient satisfaction of dental dentists.

Optimization of Fraud Potential Prevention in Implementation of National Health Insurance at Puskesmas Abeli

Fraud actions at institutions can catapult health costs. Globally, the potential loss due to fraud is estimated at 7,29% every year. Increasing the number of referrals in advanced health facilities FKTL is an indication of fraud behavior. In Southeast Sulawesi, the referral rate is high, reaching 17% with the maximum ideal standard for the average referral rate of first level health facilities(FKTP) to advanced health facilities(FKTL), not more than 5%. While in Kendari City in 2015, the referral rate from Puskesmas to Abunawas General Hospital was also still high at around 9.5% in 2015 and an increase of 15.3% in 2016. One of the puskesmas that provided referrals was Abeli ​​Community Health Center. This study aims to analyze the potential for fraud prevention in the implementation of National health insurance(JKN) at Abeli ​​Health Center. This study using observational analytic using one group pre test and post test design. Research was conducted at Abeli ​​Health Center and technique used was cluster random sampling with 28 respondents. From the statatistic test results obtained, there were differences in knowledge before and after the intervention with a mean gap value of 0, 21429 with a lower limit of 0.05226 and an upper limit of 37631 and a p value<α (0.011 <0.05). The suggestion in this study is to the health centers and hospitals to increase more understanding of fraud in the implementation of the JKN program by having socialization.

FAKTOR YANG MEMENGARUHI RUJUKAN PASIEN PENGGUNA JKN-PBI KE FASILITAS KESEHATAN TINGKAT LANJUT DI PUSKESMAS PANCUR BATU KABUPATEN DELI SERDANG TAHUN 2019

BPJS complains that the puskesmas still carry out unnecessary referral actions (non-specialized diseases) to hospitals. The purpose of this study is to analyze the factors that influence the referral of PBI JKN patient patients to advanced health facilities. This is quantitative research with survey method through cross sectional approach. The research was conducted at Pancur Batu Puskesmas Deli Serdang District. The study population was 18,459 people and the sample was 186 people with purposive sampling techniques. Data analysis used univariate analysis, bivariate analysis with chi-square, and multivariate analysis using multiple logistic regression tests. The results showed that the factors that influenced were knowledge, availability of infrastructure and information about referrals, p < 0.05. Variables that do not affect are distance, motivation, attitudes of health workers, p > 0.05. The variable that has the greatest influence in this study is the variable availability of infrastructure with the value of Exp (B) / OR = 6.810 means that respondents who stated that the availability of infrastructure in hospitals was adequate, had the chance to be referred to 6.8 times higher than respondents who stated the availability of infrastructure facilities in hospitals is inadequate. It is recommended that the Pancur Batu Puskesmas repair some Puskesmas infrastructure facilities that are considered incomplete and less satisfying for some patients so that patients do not ask for referrals for diseases that can be treated at the Puskesmas.

Faktor - Faktor yang Mempengaruhi Komitmen Dokter di Puskesmas untuk Tidak Merujuk Kasus Non-Spesialistik Pasien BPJS di Kota Semarang

Patients who should be able to be treated at the health center (puskesmas) but because of some matters referred to and handled in a hospital, it is a waste of health costs. Hence, BPJS will pay more according to INA CBG's tariff. 3 Advanced Health Facilities, in this case a hospital, is also object to having to deal with non-specialist cases, while the case can actually be completed at the first health facility. Handling non-specialist cases in hospitals leads to health services being less well targeted. The hospital will be very busy handling patients who are not supposed to, while patients who really need treatment in the hospital can be neglected. 2 This study aims to analyze factors which influence the commitment of doctors not to refer to non-specialist cases in health centers in the city of Semarang The study was conducted with a cross sectional quantitative research design. The data were collected by calculating the total results of the questionnaire measurements on each variable with a Likert scale on 73 doctors in 37 health centers spread across the city of Semarang. The study was conducted during March to May 2018. The results showed that the number of non-specialist cases of BPJS Health participant patients was still relatively high. This has to do with the commitment of doctors at the health center not to refer to non-specialist cases. The most influence factor to the commitment of doctors not to refer to non-specialist cases was the doctor's perception of the completeness of facilities and infrastructure and the doctor's perception of his competence

Determinan Keikutsertaan Ibu Sebagai Akseptor Metode Kontrasepsi Jangka Panjang Pasca Persalinan (Studi Kasus di Fasilitas Kesehatan Tingkat Lanjutan Kabupaten Dharmasraya)

Postpartum family planning programs are effective and efficient measures to reduce maternal mortality and infant mortality due to unwanted pregnancies which have the potential to cause direct maternal death (abortion, eclampsia and prolonged labor) and indirectly to one component "4 Too "(too young, too old, too much and too close). The Sungai Dareh is the only advanced health facility in Dharmasraya Regency in Dharmasraya Regency with acceptors of long-term contraceptive method acceptors in a very slow or stagnant condition. The purpose of this study was to determine the most dominant factors related to the participation of postpartum mothers using long-term contraceptive methods. The research design was cross sectional. Primary data is taken during 2017, which is between February and Desember with a sample of 99 people in the Maternity Room at the regional public hospital Sungai Dareh. The analysis model used is a regression of the backward likelihood ratio method. The sampling technique uses purposive sampling. Based on the test results, the variables of poverty level, number of surviving children, health status, age level of respondents, level of education, purpose of using family planning methods, husband support and attitudes have a significant relationship with the participation of postpartum long-term contraceptive methods. While unrelated factors are the age of first marriage and the level of knowledge of the respondents. From the regression model produced, husband's support is the most dominant factor (p = 0.001, OR = 19.591 (95% CI: 3.227 - 118.927), so it can be concluded that husband's support influences the wife's decision in the participation of the postpartum contraceptive method.

Analisis Kebijakan Regionalisasi Rujukan terhadap Jumlah Kunjungan dan Kepuasan Peserta Jaminan Kesehatan Nasional

This research was conducted to know the difference of visit number and satisfaction level before and after referral regionalization policy. The research type is quantitative with cross sectional study approach. This study uses secondary data of JKN participants at the Hospital Bantul District. Data analysis using paired t-test paired test and analysis of variance (Anova). Based on the test of normality's output that visit data and satisfaction are normally distributed. The research data was taken in seven hospitals because it has complete data about JKN participants' satisfaction data in Advanced Health Facility Advanced Facility (FKRTL) before and after the policy was enacted.

Analysis of Interest in the First health Facility to Refer Patients to Jombang general hospital as Advance health Facility and the Influence Factors

The purpose of this research is to know interest of First Health Facility to refer patient to Jombang General Hospital as Advanced Health Facility and influencing factors. The design of this research is analytic correlation with cross sectional approach, with the population of all First Health Facility in Jombang area using proportioned stratified random sampling obtained 61 respondents. Data collected using questionnaires were analyzed by logistic regression test with α = 0, 05. The result of logistic regression analysis obtained perception factor (p-value = 0, 048 α = 0.05 so that H0 accepted and H1 rejected which means there is no influence between non-medical motivation of First Health Facility interest to refers patient to Jombang general hospital as Advanced Health Facility.

Enhancing collaboration in BIM-based construction networks through organisational discontinuity theory: a case study of the new Royal Adelaide Hospital

ABSTRACTThis paper discusses a case study of Australia’s most technologically advanced health facility to address an identified gap in the body of the knowledge. That is, no comprehensive study has hitherto attempted to draw upon virtual team working theories to enhance collaboration in BIM-based construction networks (BbCNs). In response to this, the present study seeks to raise awareness of organisational discontinuity theory (ODT) as a recent theory for virtual teams, which enables BbCNs to embrace collaboration. To this end, the major challenges encountered and corresponding solutions adopted on a mega-project have been closely monitored and investigated. The study contributes to the field through the conceptualisation of typical barriers to collaboration in BbCNs from the perspective of ODT. Additionally, the discussions presented outline practical implications by demonstrating how the identified issues of collaboration in BbCNs could be effectively dealt with.