Care Services In Areas Research Articles

Empowering Pregnant Women: A Community-Based Health Education Intervention to Promote Healthy Behaviors

Pregnant women in rural areas like Lubuk Alung often face barriers to accessing quality health information and care, leading to suboptimal health behaviors during pregnancy. This study aimed to evaluate the impact of a community-based health education intervention on pregnant women's knowledge, attitudes, and practices regarding healthy behaviors in Lubuk Alung. A quasi-experimental study was conducted with 150 pregnant women (75 intervention, 75 control) in Lubuk Alung. The intervention group received a 12-week program of structured health education sessions delivered by trained community health workers. Sessions covered topics such as nutrition, exercise, antenatal care, childbirth preparation, and breastfeeding. The control group received standard antenatal care. Pre- and post-intervention surveys assessed knowledge, attitudes, and self-reported practices related to healthy behaviors. The intervention group demonstrated significant improvements in knowledge about healthy behaviors (p<0.001), more positive attitudes towards these behaviors (p<0.01), and increased adoption of practices like consuming a balanced diet, engaging in regular physical activity, attending antenatal care visits, and exclusive breastfeeding (p<0.05). The control group showed minimal changes. In conclusion, community-based health education interventions are effective in empowering pregnant women in rural settings. They increase knowledge, shift attitudes, and promote the adoption of healthy behaviors during pregnancy. Such programs should be integrated into routine antenatal care services in areas like Lubuk Alung.

Glucovigilance in COVID-19.

The coronavirus disease (COVID-19) pandemic has influenced clinical care in unprecedented ways. There is an urgent need to share best practice in providing diabetes care services in areas affected by COVID. This is a brief review for clinicians managing diabetes in low-income countries based on currently available data. The data is rapidly evolving; however, people with diabetes and its related comorbidities have increased risk for severe disease, and prolonged recovery and mortality. This review is also informed by data from severe acute respiratory syndrome (SARS) caused by SARS coronavirus (SARS-CoV) and Middle East respiratory syndrome (MERS), caused by MERS coronavirus (MERS-CoV). These two viruses share similarities with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus with causes COVID-19. SARS-CoV-2 was also known as 2019-nCOV. We discuss glucovigilance in COVID-19, the challenges and the opportunities. We put a spotlight on investigational new drugs for treatment of COVID medications and virtual care. Diabetologists and clinicians handling high-volume diabetes clinics are at increased risk for contracting COVID-19.

Global Health Epidemic (Earthquake to Road Traffic Accident): Innovative Disaster Pedagogy Harnessing Technology

One of the significant driving factors behind global trauma morbidity and mortality is underdeveloped and underrepresented pre-hospital care services in areas of need.

Analysis of the use of outpatient nursing care services in areas with elderly population

Analysis of the use of outpatient nursing care services in areas with elderly population

Characteristics, sexual behaviour and access to health care services for sex workers in South Africa

Sex workers in Sub-Saharan Africa are vulnerable to a range of factors that dispose them to poor health outcomes. In particular, they are at high risk of violence, injury, rape, discrimination and a spectrum of human rights abuses. Their vulnerability to HIV and other STIs are many fold greater than the non-sex worker population of the same age. Health care systems world-wide, and particularly in Africa, are not adequately responsive to the needs of sex workers. As a result, many sex workers do not receive adequate health services, education or HIV prevention tools. While the literature on female sex work in Africa is fairly robust, troubling research gaps are evident on male and transgender sex work, as well as on the intersections of migration and sex work. Mega-sport events have been associated with increased anxiety about sex work and human trafficking, with few studies tracking the impact of such events on local sex work industries over time. These fears were prominent during the 2010 FIFA Soccer World Cup. This PhD project consisted of three research projects based in South Africa and Kenya. It aimed to evaluate the impact of social and behavioural factors on the health of sex workers. To achieve this objective, it examined the effects of sex worker characteristics, migration status, and their relationships with commercial and non-commercial partners on sexual behaviour and access to services. Such information may assist in designing more effective health policies in addition to providing insights into the structural factors that affect sex work settings and heighten sex worker vulnerability to ill-health. The first research project consisted of face-to-face surveys with 1799 male, female and transgender sex workers in Johannesburg, Rustenburg and Cape Town. The second research project involved telephonic interviews in three waves with 663 female sex workers who advertised online or in newspapers in South Africa. The third component was a prospective cohort of 400 female sex workers in Mombasa, Kenya. The research findings indicate the diversity of the sex industry and the people who work in it. Sex work is an important livelihood strategy that provides an income for sex workers and their extended network of dependents. Migration is a vital component for exploring and understanding how many sex worker lives and work are structured in South Africa. Sex workers are subject to violence from their non-commercial partners as well as from police, while unprotected sex with non-commercial partners emerges as an important risk factor for HIV. The PhD research detected little significant changes in the sex industry due to the 2010 Soccer World Cup, and documents how strategic opportunities were lost to alter some of the structural conditions of sex work during a time of heightened sex work awareness, funding and scrutiny. Moreover, this thesis highlights the shortcomings of health care services in responding to the needs of sex workers. It recommends the rolling-out of specialised, sex work-specific health care services in areas of sex work concentration, and sex work-friendly services in mainstream health care facilities in areas of lower sex work concentration. Non-judgemental and empathetic health workers are a key component of responsive services. Lastly and perhaps most importantly, it underscores the importance of decriminalising sex work in order to safeguard sex worker rights and to protect individual and public health.

Gang Membership, Violence, and Psychiatric Morbidity

Gang members engage in many high-risk activities associated with psychiatric morbidity, particularly violence-related ones. The authors investigated associations between gang membership, violent behavior, psychiatric morbidity, and use of mental health services. The authors conducted a cross-sectional survey of 4,664 men 18-34 years of age in Great Britain using random location sampling. The survey oversampled men from areas with high levels of violence and gang activities. Participants completed questionnaires covering gang membership, violence, use of mental health services, and psychiatric diagnoses measured using standardized screening instruments. Violent men and gang members had higher prevalences of mental disorders and use of psychiatric services than nonviolent men, but a lower prevalence of depression. Violent ruminative thinking, violent victimization, and fear of further victimization accounted for the high levels of psychosis and anxiety disorders in gang members, and with service use in gang members and other violent men. Associations with antisocial personality disorder, substance misuse, and suicide attempts were explained by factors other than violence. Gang members show inordinately high levels of psychiatric morbidity, placing a heavy burden on mental health services. Traumatization and fear of further violence, exceptionally prevalent in gang members, are associated with service use. Gang membership should be routinely assessed in individuals presenting to health care services in areas with high levels of violence and gang activity. Health care professionals may have an important role in promoting desistence from gang activity.

Characteristics, sexual behaviour and access to health care services for sex workers in South Africa

Sex workers in sub-Saharan Africa are vulnerable to a range of factors that ill-dispose them to poor health outcomes. Their vulnerability to HIV and other STIs are many fold greater than the non-sex worker population of the same age. Health care systems world-wide are not responsive to the special needs of sex workers, and many sex workers do not receive adequate health services, education or HIV prevention tools. While the literature on female sex work in Africa is fairly robust, troubling research gaps are evident on male and transgender sex work, and the intersections of migration and sex work. A cross-sectional descriptive study was conducted with female, male and transgender sex workers in four sites in South Africa. The research results point towards the diversity of the sex industry and the people who work in it. Sex work is an important livelihood strategy for many, and provides an income for sex workers and their extended network of dependents. Migration is a vital component in how sex worker lives and work are structured. Moreover, the article highlights the shortcomings of health care services to respond adequately to the needs of sex workers, and recommends the rolling-out of specialized, sex work-specific health care services in areas of sex work concentration, and sex work-friendly services in mainstream health care facilities in areas of low sex work concentration.

A glaucoma equity profile: correlating disease distribution with service provision and uptake in a population in Northern England, UK

Glaucoma is a significant health problem, with associated inequalities. Equity profiles are an established public health tool to examine the scale of health inequalities and to imbed action into the commissioning cycle. This is the first equity profile conducted in the United Kingdom for an ophthalmic condition. This methodology also provides a model for use in other localities and for other eye conditions. Existing services were mapped and need identified. A wide variety of data sources were analysed. Mapping was undertaken using Mapinfo Professional Geographical Information Systems software. Statistical analysis was conducted using Microsoft Excel 2003. No single data source provided a fully informed perspective. A clear mismatch between areas of deprivation and location of optometry was observed. Secondary analysis of electronic patient records revealed a significant association between 'late presentation' and older age (mean age of late presenters=76.4 years, 95% CI=75.1-77.6 compared with earlier presenters, 72.4 years, 95% CI=71.7-73.1). Late presentation was also associated with living in an area of high deprivation (chi(2)=7.1, df, P<0.05). Ethnicity data was poorly recorded. Qualitative data provided invaluable insights. Increasing access to services involves collaboration with optometrists, ophthalmologists, public health, and commissioners. It is no longer acceptable to rely on private high street optometry to provide primary eye care services in areas of high need. Outreach services must be developed and evaluated in areas of relative deprivation if world class eye services are to be achieved.

Strengthening Prehospital Trauma Care in the Absence of Formal Emergency Medical Services

The article by Jayaraman, Mbweijano, Lipnick et al. represents an important contribution to the literature because it addresses one of the most significant and difficult issues in care of the injured [1]. This is the issue of how to improve prehospital trauma care services in areas of lowand middle-income countries that are beyond the reach of any formal emergency medical services (EMS). This issue is of great significance for several reasons: Most of the injured who die do so in the field, before there is any chance of hospital care. In lowand middle-income countries the proportion of prehospital deaths is much higher than in high-income countries. For example, one study showed that of all trauma patients who die, 81% die in the field in a low-income setting (Ghana) compared with 72% in a middle-income setting (Mexico), and 59% in a highincome setting (USA). This difference in prehospital deaths is a major contributor to the overall higher case fatality rates for severely injured persons in lowand middleincome countries. Furthermore, it has been roughly estimated that some 50–75% of the world’s people live in areas with no access to formal EMS [2, 3]. In brief, this paper is of great relevance to the field of trauma care, as it addresses the situation in which many— possibly most—fatal injuries occur: in the field, in a lowor middle-income country, in an area with no formal EMS. This scenario has scarcely been addressed by the field of trauma care research, thus far. Given these factors, the question then arises of how to improve access to prehospital trauma care in the setting of lowand middle-income countries, especially in areas where no formal EMS currently exists. The World Health Organisation (WHO) publication Prehospital Trauma Care Systems gives guidance on two complementary approaches, designated tier 1 and tier 2 care. Tier 1 implies care by first responders, often not as part of a formal system, whereas tier 2 implies formal EMS, such as with an ambulance service [4]. There is evidence from several locations worldwide that each approach may be useful, depending on the circumstances. One study from Brazil has documented the effects of a new ambulance service (i.e., tier 2) started where none had previously existed: The mortality rate among victims of motor vehicle crashes decreased from 7.1% (before) to 5.9% (after) [5]. However, starting new formal EMS should be approached with caution, given the potential high cost. An economic analysis from Kuala Lumpur, Malaysia, suggested that upgrading that city’s existing basic EMS to a high-income model would cost $2.5 million per year, with only an additional 7 lives per year saved [6]. Whether one agrees with the specifics of this economic analysis or not, certainly the caution these authors urge is warranted. Hence, there is a need not only to consider the creation of new formal EMS, but also alternatives that will increase local access to basic first aid measures (i.e., tier 1 care). In some cases these might be considered as adjuncts to formal EMS, allowing ambulance services to extend their reach through networks of first responders. In other cases, these might be standalone efforts, especially in circumstances where formal EMS would be impractical or too costly. Often, these efforts to increase access to basic first aid The author is a staff member of the World Health Organization. He alone is responsible for the views expressed in this publication and they do not necessarily represent the decisions or policies of the World Health Organization.

Resource allocation modelling for home-based health and social care services in areas having differential population density levels: a case study in Northern Ireland.

This project arose from deliberations within the Department of Health and Social Services (DHSS) in Northern Ireland concerning the acceptability of the revenue resource allocation methodology they were using. One problem with the method being used had been the absence of a component that adequately reflected the relative costs associated with the differential population densities of the four health boards into which the Province is divided. This study investigates a particular element of this issue, viz differences in the travelling distances and times of those health and social service professionals who provide visiting services to patients in their own homes. A modelling approach has been developed and used in conjunction with a comprehensive spatial and geographical information system for Northern Ireland. An important outcome of the study has been estimates of the targets that should be set for the annual health and social care travelling distances and times per head of population in the boards, for a range of home-based services. Also, the project has contributed to decisions made by the DHSS in Northern Ireland concerning the annual financial compensations required by boards for costs associated with their relative population densities.

Social provision and service delivery: Problems of equity, health, and health care in rural Australia

A neglected area of Australian geographical research relates to the issue of how to ensure an equitable provision of services to inhabitants of rural areas. Equity, however defined, is a procedural concept, requiring the implementation of rules about how to allocate and distribute scarce resources. Equity, as a distributional principle, is an important consideration both in determining the actual amount and nature of resources available and in deciding who will get how much of what is available. Compared with other social goods, there is a particular insistence on equity with respect to health care services. This article outlines the problems characterizing health care provision in rural Australia. It evaluates fiscal equalization as one means by which the Federal Government attempts to ensure at least some equity in the provision and distribution of health care resources to areas of dispersed population. The findings reveal that fiscal equalization alone is unable to ensure equity. This is because of problems of how to assess the needs for and costs associated with providing health care services in areas of dispersed population, confusion between equality and equity, problems related to the differentiation of government functions in a federal system, and inadequacies associated with using hospital services as the basis for resource allocation. This article concludes that equity is more likely to be achieved when policy is oriented to health care rather than medical care and when provision and distribution of resources relates more to service outcomes than to service inputs.