Basic Coverage Research Articles

ANALISIS FAKTOR YANG BERHUBUNGAN DENGAN CAKUPAN IMUNISASI DASAR LENGKAP DI BAITUSSALAM, ACEH BESAR

The immunization program is included in efforts to reduce morbidity, disability and death in infants and toddlers. Complete Basic Immunization Coverage in Aceh Besar District has decreased every year, atleast is still below the national target of 85%. This study aims to determine the factors associated with complete basic immunization coverage at the Baitussalam Health Center in 2022. This research was conducted using a quantitative study with a cross-sectional approach with data collection using a questionnaire and analyzed univariately to describe the distribution and proportions, as well as bivariate using Chi Square and using multivariate analysis with linear regression. Result of the study showed more than half (57.4%) of mothers did not give complete immunization to their babies. This study found that there was a relationship between the provision of complete basic immunization and the mother's employment status (p value = 0.018), level of knowledge (p value = 0.484), family support (p value = 0.000), mother's trust (p value = 0.000). The most dominant factors affecting complete basic immunization coverage at the Baitussalam are factors of knowledge, trust, the role of health workers and health cadres.

Pentingnya Imunisasi Dasar Pada Bayi Di Kelurahan Bonto Kio Kecamatan Minasatene Kabupaten Pangkep

Immunization is an effort to create or actively increase a person's immunity to a disease so that if one day they are exposed to the disease they will not get sick or only experience a mild illness. The specific objectives of this program are to provide information about the importance of immunization for children, to achieve complete basic immunization coverage for infants according to village/kelurahan targets and to achieve advanced immunization targets for children under two years of age (baduta) and elementary school-age children. The method of implementing activities uses the planning stage and the implementation stage. PKM activities in the form of Health Education about Basic Immunization of Infants began with assessment and data collection of the number of families who have babies/toddlers, starting on May 8 2023. Meanwhile the counseling was carried out at Posyandu in the working area of the Minasatene Health Center in Bonto Kio Village, Minasatene District, Pangkep Regency. The results obtained after the implementation of this activity are: 1) increasing parents' knowledge about the importance of basic immunization in infants; and 2) increasing parents' understanding of the side effects that arise after being immunized and how to deal with these side effects.

Effect of Health Promotion on Immunization on Increasing Maternal Participation and Basic Immunization Coverage in The Village Tanjung Laong Working Area of Technical Implementation Unit of Muara Pahu Public Health Center

Introduction: Complete basic immunization is immunization given to children before the age of 1 year which consists of HB 0 immunization, BCG immunization, DPT-HB-HIB immunization, polio immunization, IPV immunization and measles immunization. The benefit of immunization is to provide immunity to infants in order to prevent illness and death of infants and children caused by frequently infectious diseases. Objective: This study aims to determine the effect of health promotion on immunization on increasing maternal participation and basic immunization coverage in tanjung Laong village, the working area of the Technical Implementation Unit of Muara Pahu Public Health Center Methods: The research design in this study was a quasi-experimental research design with one group pretest-posttest design. The study was carried out in March 2022. The population in this study were allmothers who had infants and toddlers aged 1-12 mounth in Tanjung Laong Village totaling 19 peolple. Results and Discussion: The effect of health promotion on immunization on increasing maternal participation was obtained pValue = 0.003 smaller than 0.05 and the effect of health promotion on immunization on basic immunization coverage obtained pValue = 0.001 smaller than 0.05. Conclusion: There is an effect of health promotion on immunization on increasing maternal participation and basic immunization coverage in Tanjung laong Village, the working area of Technical Implementation Unit of Muara Pahu Public Health Center

Exploring the factors contributing to low vaccination uptake for nationally recommended routine childhood and adolescent vaccines in Kenya

BackgroundVaccination remains the most effective means of reducing the burden of infectious disease among children. It is estimated to prevent between two to three million child deaths annually. However, despite being a successful intervention, basic vaccination coverage remains below the target. About 20 million infants are either under or not fully vaccinated, most of whom are in Sub-Saharan Africa region. In Kenya, the coverage is even lower at 83% than the global average of 86%. The objective of this study is to explore the factors that contribute to low demand or vaccine hesitancy for childhood and adolescent vaccines in Kenya.MethodsThe study used qualitative research design. Key Informant Interviews (KII) was used to obtain information from national and county-level key stakeholders. In-depth Interviews (IDI) was done to collect opinions of caregivers of children 0–23 months and adolescent girls eligible for immunization, and Human papillomavirus (HPV) vaccine respectively. The data was collected at the national level and counties such as Kilifi, Turkana, Nairobi and Kitui. The data was analyzed using thematic content approach. A total of 41 national and county-level immunization officials and caregivers formed the sample.ResultsInsufficient knowledge about vaccines, vaccine supply issues, frequent healthcare worker’s industrial action, poverty, religious beliefs, inadequate vaccination campaigns, distance to vaccination centers, were identified as factors driving low demand or vaccine hesitancy against routine childhood immunization. While factors driving low uptake of the newly introduced HPV vaccine were reported to include misinformation about the vaccine, rumors that the vaccine is a form of female contraception, the suspicion that the vaccine is free and available only to girls, poor knowledge of cervical cancer and benefits of HPV vaccine.ConclusionsRural community sensitization on both routine childhood immunization and HPV vaccine should be key activities post COVID-19 pandemic. Likewise, the use of mainstream and social media outreaches, and vaccine champions could help reduce vaccine hesitancy. The findings are invaluable for informing design of context-specific interventions by national and county-level immunization stakeholders. Further studies on the relationship between attitude towards new vaccines and connection to vaccine hesitancy is necessary.

Basic Immunization Program Coverage of Minimum Service Standards (MSS) in Raja Aligas, Huta Bayu Raja District

Immunization is an effective way to provide immunity, especially to someone who is healthy, with the main goal of reducing morbidity and mortality due to various diseases that can be prevented by immunization. One of them is measles, which often attacks children under the age of five. The research objective was to determine the results of the basic immunization program coverage against the Minimum Immunization Service Standards. The research design used in this study is a descriptive study design. The number of samples in this study from the Raja Maligas in Silakkidir Village, Huta Bayu Raja District, Simalungun Regency was 47 people. with the sampling technique in this study using total sampling. Data analysis used is descriptive analysis. The results of the research on immunization coverage at Raja Maligas in Silakkidir Village showed that the majority of babies had received basic immunization HB 0, DPT/HB 1, DPT/HB 2, DPT/HB 3, POLIO 1, POLIO 2, POLIO 3 as many as 47 people (100% ) and a minority of infants received basic immunizations for BCG, POLIO 4, and MEASLES, respectively 95.7%, 97.9% and 95.7%. From the results of this study it is known that the coverage of the basic immunization program at the Raja Maligas has reached the Immunization Minimum Service Standards (SPM) in accordance with those set by the Government. So it is recommended that immunization officers at the health center continue to provide complete basic immunization services to every baby before the age of 1 year.

Perancangan Aplikasi Child Health Record Berbasis Android

According to the results of the Indonesia Nutrition Status Study (SSGI) in 2021, as many as 20.8% Baduta and 24.4% Toddlers were stunted/short. In addition to fulfilling nutrition for children, the immunization sector also shows the same thing. During the last 2 years from 2020-2021 the coverage of complete basic immunization for infants has fallen drastically. Researchers developed this application using the SDLC Waterfall model. The waterfall method has the advantage that when all systems can be fully and correctly defined at the beginning of the project, software engineering can run well without any problems. The data collection technique used was secondary data that had been previously collected by other parties using the internet, library research, and books related to research. The Child Health Record application is expected to be an application that can help parents control their children's health from an early age. The immunization feature in the application is expected to increase complete basic immunization coverage for children, increase parental awareness in fulfilling child nutrition, increase parental awareness of children's nutritional status and explore information related to knowledge about children's health. The use of the Child Health Record application can be used since children are 0 years old so that the monitoring process runs optimally. Application development can be developed into a personal health record that can be used as an adult or a family health record.

Factors associated with the choice of supplementary hospital insurance in Switzerland – an analysis of the Swiss Health Survey

BackgroundSwitzerland has universal coverage via mandatory health insurance that covers a generous basket of health services. In addition to the basic coverage, the insured can buy supplementary insurance for the inpatient sector. Supplementary hospital insurance in Switzerland provides additional services during inpatient stays. Little is known about which factors are associated with the choice of semi-private and private hospital insurances. However, this is of importance to policy makers and the insured population, who might be concerned about a “two-class” inpatient care system. Therefore, the aim of the paper was to explore the factors associated with supplementary hospital insurance enrolment in Switzerland.MethodsWe used the five most recent waves of the representative Swiss Health Survey (1997, 2002, 2007, 2012, 2017) to explore which factors are associated with supplementary hospital insurance enrolment in adults aged 25 or older. We estimated the same probit model for all five surveys waves and computed average marginal effects.ResultsOur study shows that in all cross-sections the likelihood of enrolling in supplementary hospital insurance increased with higher age, education, household income and was higher for people with a strong preference for unrestricted choice of a specialist and with a higher-than-default deductible choice. The likelihood of supplementary hospital insurance enrolment was lower for the unemployed relative to their inactive counterparts and those living in rural areas relative to comparable urban residents. Ever-smoker status was not statistically significantly associated with supplementary hospital insurance choice. However, our findings indicated differences in estimates over the years regarding demographic as well as insurance-related variables. For example, women were more likely to choose supplementary hospital insurance than comparable men in earlier years.ConclusionMost importantly, our results indicate that factors related to socioeconomic status – such as education, labour market status, and income – consistently show significant associations with the probability of having supplementary hospital insurance for the entire study period, as opposed to demographic variables – such as nationality and sex.

Functional or selective policy? - Research on the relationship between government intervention and enterprise innovation in China

Innovation is an important driving force for achieving high-quality economic development. Low-quality innovation has strong imitation characteristics and is more dependent on external resource support. Therefore, functional government policy, as a more market-friendly policy, will promote innovation output of high-quality innovation enterprises to a greater extent, while selective government policy is the opposite. Based on the panel data regression of the data of Chinese listed companies from 2009 to 2020, this paper studies the relationship between listed enterprises' innovation output, innovation quality, and government's functional and selective policies. The findings indicate that functional policies have a stronger promotion effect on the innovation output of enterprises engaged in high-quality innovation activities, and this effect is prominent in the more basic and broader coverage of policies. It is also found that the promotion effect of selective policies on the innovation output of enterprises engaged in high-quality innovation activities will be weakened, and this effect is prominent in the more selective policies. This result is more prominent in south China, non-state-owned enterprises and high-tech industries by expanding the discussion of enterprises with different regions, enterprise attributes and industry technology attributes.

Taking on the Medical Director Role: Risk Management Considerations

Back to table of contents Previous article Next article Government & LegalFull AccessTaking on the Medical Director Role: Risk Management ConsiderationsGloria Umali, R.N., M.S., C.P.H.R.M.Gloria UmaliSearch for more papers by this author, R.N., M.S., C.P.H.R.M.Published Online:25 Feb 2023https://doi.org/10.1176/appi.pn.2023.03.3.18AbstractBeing a medical director as well as a treating psychiatrist may be an exciting career move, but it raises a number of liability issues that you need to think through before accepting the position.iStock/SinenkiyIt is not uncommon to hear of psychiatrists taking on a medical directorship role while providing direct care to their own patients. Psychiatrists have many reasons for assuming this role; however, the passion to serve, loyalty to and a strong connection with an organization, and financial freedom are often cited as the main motivators.While being a medical director is undoubtedly rewarding, there are aspects of the role that psychiatrists need to consider from a medical malpractice standpoint. It is imperative that psychiatrists understand the legal, regulatory, and professional liability coverage issues associated with being a medical director. Although the role of a treating psychiatrist and the role of a medical director both fundamentally require clinical training and competency, each role may differ. Psychiatrists performing a dual role may believe that the coverage from the existing professional liability insurance policy automatically extends to their role as a medical director without realizing that certain arrangements compound their liability exposures and therefore leave an unintended gap in coverage.Furthermore, what it means to be a medical director and how to acceptably stay within the agreed-upon scope of responsibilities can be confusing and tricky to navigate. To decrease the risk of practicing outside of scope, psychiatrists need to understand the usual responsibilities of a medical director and take the time to thoroughly review the scope of responsibilities outlined in their specific contract. A medical director’s typical responsibilities include administrative duties such as management of medical staff matters, development of organizational policies, oversight of clinical operations and compliance with regulatory requirements, and quality improvement activities. Depending on the arrangement, it may not be easy to discern that a medical director might also be held accountable for everything that happens in the facility.If you are thinking about taking on a medical directorship role, here are some points for your consideration:Ensure you have insurance coverage for the dual role as a medical director and treating psychiatrist.Identify duties and responsibilities not covered under your basic professional liability coverage agreement to delineate the coverage necessary for the medical directorship role.Do not assume that your medical professional liability insurance policy covers your actions as a medical director. Notify your medical malpractice carrier if considering a medical directorship position to review possible changes in the current coverage.Confirm that the duties and responsibilities outlined in the contract are within your scope of practice and expertise.Delegate and oversee only those medical tasks and clinical operations that are consistent with your scope of practice and specialty.Verify that your contractual arrangements do not violate state or federal laws.Conduct proper due diligence by performing research on the facility’s quality rating, care standards, and performance before accepting the position.Ensure resources are available to adequately fulfill and execute your assigned duties and responsibilities. Being a medical director is both an honor and a privilege. It gives psychiatrists the perfect opportunity to satisfy the passion for serving their patients while fulfilling civil community responsibilities. However, performing the dual role as a psychiatrist and a medical director requires due diligence to avoid needless risk and liability exposures. ■This information is provided as a risk management resource for Allied World policyholders and should not be construed as legal or clinical advice. This material may not be reproduced or distributed without the express, written permission of Allied World Assurance Company Holdings, Ltd, a Fairfax company (“Allied World”). Risk management services are provided by or arranged through AWAC Services Company, a member company of Allied World. © 2023 Allied World Assurance Company Holdings, Ltd. All Rights Reserved.Gloria Umali, R.N., M.S., C.P.H.R.M., is assistant vice president of the Risk Management Group of AWAC Services Company, a member company of Allied World. Risk Management services are provided as an exclusive benefit to insureds of the APA-endorsed American Professional Agency Inc. liability insurance program. ISSUES NewArchived

Factors associated with full immunization coverage among under-2 years children in Nepal

Background: Immunization is a cost-effective intervention; countries committed to improving child health and well-being by 2030 and assessing overall progress towards the sustainable development goals are required to reduce vaccine-preventable illness and deaths, which profoundly rely on immunization. Methods: Cross-sectional study was carried out in Nepal using secondary data from the Nepal Demographic and Health Survey 2016 to fulfil the objective and find out the factors associated with full immunization coverage among under two years children in Nepal. This study was conducted in 21 districts based on a low human development index. Results: Among the 306 respondents, this study found that full immunization coverage was (42.2%) and male respondents 51 % were more vaccinated as compared to female 49% of respondents. Similarly, there were mother occupations statistically associated with full immunization coverage. Instructional deliveries (51.7%) were not statistically associated with full immunization coverage. Agriculture and services were 1.6 times more likely to be immunized as compared to not working women [OR 1.6 (0.99-2.56)]. Child age was statically associated with full immunization and children aged 12-23 months were 39 (19.51-79.17) and 24 (17.99-64.23). Conclusions: Immunization is the most cost-effective and universal public health weapon. The overall full basic immunization coverage was still lower than the global target. BCG coverage was high; however, only half of the respondents received the second dose of measles. Complete basic immunization was significantly associated with child age, child sex, and mother’s occupation.

Healthcare coverage affects survival of EGFR-mutant Thai lung cancer patients.

Despite significant benefits of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in patients with EGFR-mutated NSCLC, access remains limited in Thailand and elsewhere. Retrospective analysis of patients with locally advanced/recurrent NSCLC and known EGFR mutation (EGFRm) status treated at Ramathibodi Hospital (2012-2017). Prognostic factors for overall survival (OS), including treatment type and healthcare coverage, were analyzed using Cox regression. Of 750 patients, 56.3% were EGFRm-positive. After first-line therapy (n=646), 29.4% received no subsequent (second-line) treatment. EGFR-TKI-treated EGFRm-positive patients survived significantly longer than EGFRm-negative patients without EGFR-TKIs (median OS [mOS] 36.4 vs. 11.9 months; hazard ratio HR=0.38 [95%CI 0.32-0.46], P<0.001). Cox regression indicated significantly longer OS in patients with comprehensive healthcare coverage that included reimbursement of EGFR-TKIs, versus basic coverage (mOS 27.2 vs. 18.3 months; adjusted HR=0.73 [95%CI 0.59-0.90]). Compared with best supportive care (BSC; reference), EGFR-TKI-treated patients survived significantly longer (mOS 36.5 months; adjusted HR (aHR)=0.26 [95%CI 0.19-0.34]), and versus chemotherapy alone (14.5 months; aHR=0.60 [95%CI 0.47-0.78]). In EGFRm-positive patients (n=422), relative survival benefit of EGFR-TKI treatment remained highly significant (aHR[EGFR-TKI]=0.19 [95%CI 0.12-0.29]; aHR(chemotherapy only)=0.50 [95%CI 0.30-0.85]; reference:BSC), indicating that healthcare coverage (reimbursement) affected treatment choice and survival. Our analysis describes EGFRm prevalence and survival benefit of EGFR-TKI therapy for EGFRm-positive NSCLC patients treated from 2012-2017, one of the largest such Thai datasets. Together with research by others, these findings contributed evidence supporting the decision to broaden erlotinib access on healthcare schemes in Thailand from 2021, demonstrating the value of local real-world outcome data for healthcare policy decision-making.

Spatial distribution of complete basic childhood vaccination and associated factors among children aged 12-23 months in Ethiopia. A spatial and multilevel analysis.

Complete childhood vaccination considerably aids in the reduction of morbidity and mortality from vaccine-preventable childhood diseases. Understanding the geographical disparity of complete basic childhood vaccination and Identifying associated factors is vital to designing appropriate interventions. This study aimed to assess the spatial distribution and associated factors of complete basic childhood vaccination among children aged 12-23 months in Ethiopia. A two-stage stratified sampling technique was used based on the 2019 Ethiopian mini demographic and health survey data. A total weighted sample of 1,028 children was included in the analysis. ArcGIS version 10.8 software was used to visualize the spatial distribution of complete basic childhood vaccination. The Bernoulli-based model was used to detect significant clusters of areas using SaTScan version 9.6 software. To identify associated factors, multilevel logistic regression analyses were used, and all variables with a p-value less than 0.05 were reported as statistically significant predictors. Complete basic childhood vaccination among children aged 12-23 months had a significant variation in Ethiopia (Moran's I = 0.276, p<0.001). The spatial scan analysis identified the most likely significant primary clusters with low complete basic childhood vaccination coverage in the Somali region's Afder, Liben, Shabelle, and Nogobe zones; the Southern Nation Nationality and Peoples Region's (SNNPR) Gedeo and Sidama zones; and the Oromia region's Bale and Guji zones. The second significant cluster was found in the Afar region's zones 1, 4, and 5, as well as the northern Somali region's Siti zone. In the multivariable multilevel analysis, maternal age 20-24, 25-29, 35-39, and 40-44 years, delivery at a health facility, four or more antenatal care (ANC) visits, orthodox religion fellowship, maternal primary education, Muslim religion fellowship, living in the Afar, Somalia, and Oromia regions, and living in rural areas were all found to be significantly associated with complete basic childhood vaccination. A geographically significant variation of complete basic childhood vaccination was observed. Maternal age, maternal education, religion, place of delivery, ANC visit, region, and residence were significantly associated with complete basic childhood vaccination. Developing immunization campaigns targeting areas that had low basic vaccination coverage and designing healthcare programs that can motivate facility-based delivery and ANC follow-up is recommended.

Access to Drinking Water, Sanitation, and Hand Hygiene Facilities in the Peri-Urban and Informal Settlements of Hosanna Town, Southern Ethiopia.

Access to water, sanitation, and hygiene (WASH) facilities and practices have been extensively studied in urban and rural areas. However, there is a paucity of information on the coverage of water, sanitation, and hygiene facilities in the peri-urban and informal settlement areas, which could potentially exacerbate the spread of water, sanitation, and hygiene-related diseases. Therefore, this study was designed to examine access to drinking water, sanitation, and hand hygiene facilities and their determinant factors in the peri-urban and informal settlements of Hosanna town. A community-based cross-sectional study involving 292 households was conducted in 3 kebeles of Hosanna town. The primary data was collected using a pretested structured questionnaire and an observational checklist. Bivariate and multivariable logistic regressions were used to analyze the data. All the households (100%) had access to piped water on and off-premises, but the reliability of the water sources was a big challenge. Findings revealed that only 35.1% and 16.8% of the households had basic sanitation and basic handwashing facilities, respectively. Households with a middle income were identified as a determinant factor for the presence of piped water on premises (AOR = 2.23; 95% CI = 1.24-4.00), improved sanitation (AOR = 2.17; 95% CI = 1.17-4.03) and handwashing facilities (AOR = 4.36; 95% CI = 1.98-9.62). Piped water on premises was also another strong predictor of the availability of improved sanitation (AOR = 3.34; 95% CI = 1.99-5.62) and handwashing facilities (AOR = 8.18; 95% CI = 4.08-16.42). The majority of the studied households living in the selected peri-urban and informal settlements had access to unreliable drinking water sources. The study also revealed that households had poor access to basic sanitation and basic handwashing facilities. Hence, the findings call for solid government interventions to improve the reliability of the drinking water sources, basic sanitation coverage, and availability of basic handwashing facilities.

Cost-effectiveness of FOLFOX6+Bevacizumab Versus FOLFOX6+Cetuximab in Stage IV Colorectal Cancer Patients in Shiraz, Iran.

Colorectal cancer is one of the most common cancers in the world, with about one million cases diagnosed annually. Various treatment methods can be used to treat colorectal cancer, including chemotherapy with different drug regimens. Considering the need to opt for more effective and less expensive drugs in the treatment of this disease, the present study aimed to compare the cost-effectiveness of FOLFOX6+Bevacizumab with FOLFOX6+Cetuximab in patients with stage IV colorectal cancer referred to medical centers in Shiraz, Iran, in 2021. Using a decision tree, the cost-effectiveness and cost-utility of the 2 drug regimens were compared in all studied patients through the census method. Having a societal perspective, this study considered direct medical costs, direct non-medical costs, and indirect costs. The effectiveness indicators included the rate of major response to the drug combination used and the Quality-adjusted Life Year (QALY). The data were analyzed using Treeage 2011 and Excel 2016 software. In order to ensure the robustness of the results, one-way and probabilistic sensitivity analyses were performed as well. The results showed that the expected costs, the effectiveness (major response rate), and the QALYs of the FOLFOX6+Bevacizumab drug regimen were $16746.13(USD), .49, and .19, respectively, and those of the FOLFOX6+Cetuximab regimen were, respectively, $15191.05 (USD), .68, and .22. Therefore, FOLFOX6+Cetuximab compared to FOLFOX6+Bevacizumab was less costly and more effective and had a greater QALY, thus being considered as the dominant option. Also, the results of the sensitivity analyses showed that there was a bit of uncertainty. Considering that the FOLFOX6+Cetuximab regimen was more cost-effective, it is suggested to be prioritized in preparing clinical guidelines for Iranian colorectal cancer patients. In addition, increasing the basic and supplementary insurance coverage for this drug combination as well as the use of remote technology to guide patients by oncologists can be solutions to reduce direct and indirect costs of the patients.

Universal Health Coverage in Morocco: The Way to Reduce Inequalities: A Cross-sectional Study

Background: Morocco launched an appeal in 2002 to develop a fundamental law on Basic Medical Coverage. Two systems have been put in place: Compulsory Health Insurance (AMO) based on solidarity and social security contributions; and a Medical Assistance Scheme based on the principle of social protection. The objective of these systems is to achieve Universal Health Coverage (UHC) to attain equity and equality in access to health care. In the international trend, access to economic and social rights has become a significant concern in public policies. This concept, based on the value of “equity” is now essential in evaluating equal opportunities in social and health systems. More importantly, there is a need to clarify the difference between the terms equality and equity in health. In most cases, reference is made to the definition used in Anglo-Saxon literature (equity, equality, fairness). Therefore, not all inequalities are inequities. The difference between equality and equity lies in that the first term gives the result of comparison without value judgment, while the second makes a judgment that qualifies the result as fair or unfair. Our study aims to analyze the specific problems related to the healthcare policy focused on allocating the supply of care, and efforts to improve financial accessibility specifically by developing medical coverage. We will present results that reflect the availability and quality of care in Morocco and shed light on the problem of not seeking healthcare for financial, geographical, and other reasons. In addition, we will discuss the difficulties related to the use of care by Moroccan citizens. The findings of this paper can potentially inform national healthcare policy and add to the small but growing literature on this subject in Morocco. Methodology: The methodology is based on research &amp; data taken from official institutional publications from Morocco &amp; United Nations organizations (gray literature) and data derived from articles published in scientific journals. Results: Morocco continues to suffer from disparities in the distribution of health practitioners due to an imbalanced distribution of health infrastructure and human resources between rural and urban areas. The Health Map developed by the Ministry of Health and Social Protection in 2016 is a very good tool to monitor the distribution of public health needs in each region, plan the delivery of care, regulate spending, and consolidate regionalization policy to ensure equity in supply and access to health care. At the end of 2021, the national average ratios were 7.3 physicians and 10 beds per 10000 inhabitants. In 2018, more than 60% of the Moroccan population enjoyed basic medical coverage and the Moroccan Government is committed to reaching 100% of Universal Health Coverage (UHC) by 2030. Conclusion: The health map will make it possible to control health expenditure by allocating human and financial resources according to needs and will determine the future location of health facilities to establish equity in the offer and access to health care.

Optically Transparent Antennas: A Review of the State-of-the-Art, Innovative Solutions and Future Trends

The requirement of mounting several access points and base stations is increasing tremendously due to recent advancements and the need for high-data-rate communication services of 5G and 6G wireless communication systems. In the near future, the enormous number of these access points might cause a mess. In such cases, an optically transparent antenna (OTA) is the best option for making the environment more appealing and pleasant. OTAs provide the possible solution as these maintain the device aesthetics to achieve transparency as well as fulfill the basic coverage and bandwidth requirements. Various attempts have been made to design OTAs to provide coverage for wireless communication, particularly for the dead zones. These antennas can be installed on building windows, car windscreens, towers, trees, and smart windows, which enables network access for vehicles and people passing by those locations. Several transparent materials and techniques are used for transparent antenna design. Thin-film and mesh-grid techniques are very popular to transform metallic parts of the antenna into a transparent material. In this article, a comprehensive review of both the techniques used for the design of OTAs is presented. The performance comparison of OTAs on the basis of bandwidth, gain, transparency, transmittance, and efficiency is also presented. An OTA is the best choice in these situations to improve the aesthetics and comfort of the surroundings with high antenna performance.

SUPPLY CHAINS: BECOMING AND MANAGEMENT PROBLEMS IN MODERN CONDITIONS OF DIGITALIZATION

The article substantiates changes in the current crisis state of the economy in Ukraine and the world as a result of cyclical fluctuations in economic processes, which is confirmed by studies of the classics of economic thought, in particular, the teachings of M.D. Kondratiev about economic waves, and reflects the current state of the economy. The connection of Kondratiev cycles with technological systems was studied and it was shown that the current state of the economy in the world corresponds to the fifth system predicted by the scientists with its features and corresponding characteristic conditions. It is proved that the development of the economy at its current stage corresponds to the predicted trends, that is, the development of the world economy and some countries (such as, for example, Ukraine) has reached a level where globalization processes, including global warming, an ecological component, the level of socio-economic development of mankind, cannot develop as separate entities, but is an integral system of the development, where integral connections can be managed only as part of it. The system, in turn, is managed largely thanks to information communications, information technologies, etc. It was determined that the production, distribution, movement and consumption of goods (including such a specific product as information), works, services is no longer possible by conventional means; the previously established logistical routes cannot keep up with changes in the modern dimension (especially in the period from December 2019, from the beginning of the COVID-19 pandemic, and from February 24, 2022, with the beginning of the military aggression of the russian federation against Ukraine), therefore the use of tools, methods , the means offered by the digitalization of the modern economy are to a greater extent ways of solving issues that require immediate intervention. It was noted that a number of problems arise when implementing digitalization in the modern economy, and even more so in the conditions of an aggravating economic crisis. These include: sharp deterioration of logistics service, disruption of established supply chains, lack of typical ready-made models for the use of information and communication technologies for companies, enterprises, and small businesses; lack of basic Internet coverage in some areas, insufficient number of computers in farms, ignorance of managers and insufficient number of specialists. Areas of comprehensive systemic overcoming of the mentioned problems have been identified, which will contribute to improving the situation in the modern economy. The key to solving these issues should be logistics, which combines all the elements of the economic system into supply chains, and only their management in the modern economic conditions of digitalization will allow the economy to get out of the global crisis and enter a new cycle of its development.

Investigating the Relationship between Misery Index and Patients' Out-of-pocket Payments in Iran's Health System

Background: One of the criteria for measuring the performance of governments and their survival is the degree of success in reducing and stabilizing the misery index. The misery index is obtained from the sum of inflation and unemployment. Inflation and unemployment are the most important factors affecting family's income. If the misery index is high, families will have less money to buy their consumer goods, including the use of healthcare services and treatment. Therefore, this research has evaluated the relationship between misery index and patients' out-of-pocket payments in Iran's health system.&#x0D; Methods: Using time series data of 1998-2019, this study has investigated the relationship between misery index and patients' out-of-pocket payments in Iran's health system. For this purpose, the Dickey-Fuller test was used to check the durability of the variables, the Todayamamoto causality test was used to check the causality relationship between the variables, and the autoregression method with distribution breaks was used to check the existence of a long-term relationship. In addition, the data and results were analyzed using Eview 9 software.&#x0D; Results: The results showed that there was a bi-directional causal relationship between the misery index and the out-of-pocket payments of patients in the health system. Furthermore, with increasing 1 unit of misery index 1.27 units of out-of-pocket payments increased. The correction error coefficient was 0.312, which meant this amount was adjusted each period by 0.312 from short-term imbalance to achieve long-term balance. In other words, it takes more than 3 years and less than 4 years to eliminate the short-term imbalances and reach its long-term relationship.&#x0D; Conclusion: As the misery index increases, patients' out-of-pocket payments also increase. Therefore, the government should reduce the out-of-pocket payments of patients in the health system by adopting appropriate policies to reduce unemployment and inflation. Basic insurance coverage for essential services for patients should be increased. The extent of complementary medical insurance should be increased at the community level, especially in the lower deciles. In fact, the government should bear the cost of this part of the insurance for the four lower deciles. This is done in order to reduce the patients' out-of-pocket payments.

Studi Fenomenologi: Pengalaman Ibu dalam Mendapatkan Imunisasi Dasar pada Bayi di Masa Pandemi Covid-19

During the Covid-19 pandemic in 2020 basic immunization coverage in Indonesia decreased compared to last year. This study aims to find out a picture of the mother's experience in getting basic immunization for an infant during the Covid-19 pandemic in the Sawangan Healthcare Service Center, Depok City. Qualitative research design with phenomenological approach model, data collection with in-depth interviews of 7 participants with snowball sampling data collection method. The results found 6 themes including 1) An overview of the meaning of basic immunization, 2) a Negative maternal response to getting basic immunization in an infant during the Covid-19 pandemic, 3) a Positive maternal response to getting basic immunization for an infant during the Covid-19 pandemic, 4) Sources of maternal support in getting basic immunization for an infant during the Covid-19 pandemic, 6) Maternal barriers in getting basic immunization during the Covid-19 pandemic, 7) Mothers' expectations in basic immunization services for an infant during the Covid-19 pandemic. The enthusiasm of the mothers was extraordinary in their efforts to continue to get immunizations for the infants. However, government policies and regulations regarding immunization services during the Covid-19 pandemic have had a huge impact on the completeness of basic immunization coverage for infants during the Covid-19 pandemic, so this becomes a new threat and problem, especially the increase in diseases that can be prevented by immunization. Mothers with babies aged 0-12 months must improve their information technology skills to find out basic immunization service programs during the Covid-19 pandemic.

Analysis of Sub-Regional Drinking Water Services in Africa, 2000-2020

Safe drinking water is a basic necessity of life. However, meeting this need has been a major challenge in most countries in Africa. This study analyzed the sub-regional drinking water services in Africa from 2000-2020. The study sourced data from the Joint Monitoring Programme (JMP) reports for 2017 and 2021. The 2000 and 2020 estimated national basic drinking water coverage, disaggregated for rural and urban (RU) areas of African countries were extracted and analyzed. The findings revealed that basic water services in Africa were poorly provided in the sub-regions, particularly in the rural area, where the population not served was high. The results of the t-test (t4 = -8.078, p = 0.001, α = 0.05) and (t4 = -4.375, p = 0.012, α = 0.05) revealed that significant differences exist in basic water services between RU areas in 2000 and 2020, respectively. Similarly, the t-test (t4 = -6.668, p = 0.003, α = 0.05) also shows that significant progress exists in basic water services from 2000-2020 in the sub-regions. However, the national annual rate of service provision lag behind expected progress for the attainment of the drinking water target, as the projected 2030 coverage in the sub-regions fell short of the expected 100% coverage. Therefore, to achieve target 6.1 in the sub-regions, basic water services have to improve at least four-fold.