Current Healthcare Services Research Articles

Satisfaction With Virtual Consultation Services and Associated Factors Among Health Care Providers in Government Health Clinics in Selangor, Malaysia.

In Malaysia, virtual consultation services (VCSs) have been implemented by the Ministry of Health (MOH) since 2019 to complement current healthcare service delivery in government health clinics. Although the services have been proven to benefit patients, little is known about the satisfaction of healthcare providers (HCPs) who run the services. This study utilizes the extended Technology Acceptance Model to evaluate the satisfaction of HCPs with VCS and identify associated factors to further improve these services. In this study, we aimed to determine the proportion of HCPs who were satisfied with the VCS and identify factors contributing to this satisfaction. A cross-sectional study was conducted among 42 government health clinics in Selangor, Malaysia, using an online survey comprising a validated questionnaire of the extended Technology Acceptance Model. A total of 137 HCPs from various categories responded to the online survey. Data were analyzed using descriptive statistics and logistic regression. The majority of the respondents (72.3%) were satisfied with the VCSs, with a mean score of 14.47 ± 3.391. Two factors were found to be significantly associated with HCPs' satisfaction: perceived usefulness (adjusted odds ratio = 9.396; 95% confidence interval = 3.196-27.625) and behavioral intention (adjusted odds ratio = 8.311; 95% confidence interval = 2.494-27.694). Our results indicated a moderately high percentage of HCPs in government health clinics of Selangor who were satisfied with VCS (72.3%). Perceived usefulness and behavioral intention of HCPs were two strong determinants of satisfaction with VCS. Therefore, efforts should be directed towardimproving satisfaction with VCS by addressing these factors to ensure the sustainability of these services to best benefit patients.

Understanding the Retrospective and Current Health Care Needs and Service Experiences of Adult Survivors of Minor Sex Trafficking

Minor sex trafficking is an urgent public health problem, but we lack data about how such experiences impact health and health care access. Utilizing data collected from in-depth interviews with 35 adult survivors of minor sex trafficking across the U.S. we explored the physical and psychological healthcare access and healthcare experiences of adult survivors of minor sex trafficking. Negative healthcare experiences before, during, and following sex trafficking foster a lack of trust and confidence in healthcare systems as adults. Recommendations are provided to help overcome barriers to meeting healthcare needs and improving health care experiences for survivors of minor sex trafficking.

The extended impact of co-designed personalised aids for people living with chronic conditions: an exploratory study in a healthcare setting

Assistive technology has great potential to help individuals living with chronic health conditions, however devices often fail to align with the unique requirements of users. These results in device abandonment and missed opportunities to benefit people. This exploratory study aims to evaluate the short and longer-term satisfaction, psychological benefit, use and resources involved in co-designed customised assistive devices within a current healthcare service. Individuals with chronic health conditions identified daily living challenges. Eleven individuals completed the trial and were involved throughout the design process. Outcome measures evaluated the impact of the devices provided, healthcare utilisation, help required, and resources used. Nineteen custom assistive devices were produced for twenty-four challenges in daily living identified. At 3-months, eighteen devices were still being used. Daily challenges had become easier for individuals to complete and required less help from informal carers. Individuals were satisfied with the devices and service provided. Improvements in competence, adaptability and self-esteem were sustained long-term. The average clinician’s time required to produce a device was 5 h 55 min, with an average cost of £203.79. People with chronic conditions were able to benefit from the co-design process resulting in satisfaction and long-term utilisation of the device, and positive psycho-social benefits. The costs associated with embedding this approach in a healthcare service were calculated. Scaling up the co-design process reduced the associated costs per device compared to previous work. Further work is required to evaluate co-designing across larger samples and explore opportunities to further improve the cost-efficiency.

Person-Centred Care: A Support Strategy for Managing Non-Communicable Diseases.

Over the last decade, the inadequacy and unsustainability of current healthcare services for managing long-term co-morbid and multi-morbid diseases have become evident. This study, involving 426 adults with at least one non-communicable disease in Slovenia, aimed to explore the link between quality of life, life satisfaction, person-centred care, and non-communicable disease management. Results indicated generally positive perceptions of quality of life, general health, and life satisfaction of individuals with non-communicable diseases. Participants assessed their physical health as the highest of the four quality of life domains, followed by the environment, social relations, and psychological health. Significant differences occurred in life satisfaction, general health, quality of life, and person-centred care for managing non-communicable diseases. But, there were no significant differences in person-centred care according to the living environment. The study revealed a positive association between person-centred care and effective non-communicable disease management, which is also positively associated with quality of life, general health, and life satisfaction. Person-centred care is currently the most compassionate and scientific practice conceived, representing a high ethical standard. However, implementing this approach in healthcare systems requires a cohesive national strategy led by capable individuals to foster stakeholder collaboration. Such an approach is crucial to address the deficiencies of existing healthcare services and ensure person-centred care sustainability in non-communicable disease management.

Secure Sharing of Electronic Medical Records Based on Blockchain

As network technology advances and more people use devices, data storage has become a significant challenge due to the explosive growth of information and the threat of data leaks. In traditional medical institutions, most medical data is stored centrally through cloud computing technology in the institution’s data center. This centralized storage method has many security risks, and once the central server is attacked, it will lead to the loss of medical data, which will lead to the leakage of patients’ private data. At the same time, electronic medical records are the most critical data in the current medical field. In the traditional centralized healthcare service system (HSS), there are data leakage problems and tampering with electronic medical records due to human factors. At the same time, each hospital is built independently, resulting in the current centralized healthcare service system having a data silo problem, making it difficult to share medical data between institutions securely. With the increase in the number of users in the system, the electronic medical record data in the system also increases gradually, resulting in the increasing overhead of decryption calculation. Therefore, this paper proposes a blockchain-based access control scheme with multiparty authorization to ensure the security of electronic medical records. The scheme uses an SM encryption algorithm to encrypt the medical data in the system. It adds the patient’s signature to ensure the confidentiality and security of the data, and the encrypted electronic medical records (EMRs) are stored in the InterPlanetary File System (IPFS) to realize the distributed storage of EMR. In addition, role-based multiauthorization access control is implemented through smart contract-based to ensure the security of EMR. We have analyzed the security of this paper’s solution and compared its performance with the existing schemes based on other cryptographic algorithms. The experimental results show that the proposed solution significantly improves the secure sharing of EMR and provides system performance.

Nurses’ perspectives on user-friendly self-sampling interventions for diagnosis of sexually transmitted infections among young women in eThekwini district municipality: a nominal group technique

BackgroundSyndromic management in the main non-laboratory-based management approach for sexually transmitted infections (STI) in most low- and middle-income countries (LMICs) but it has limitations. Self-sampling has been proven as a suitable alternative approach to help improve management STIs by improving access to diagnosis among vulnerable populations. We sought to determine health workers’ perspectives on user-friendly self-sampling interventions for STIs among young women in eThekwini District Municipality.MethodsHealthcare workers providing STI healthcare services in the study location participated in a nominal group technique (NGT) workshop. The NGT workshop was aimed enabling collaboration with key health providers in identifying user-friendly self-sampling interventions for diagnosis of STIs among young women. Data collection was conducted in two phases: phase 1 determined barrier that hinder young women from accessing current STI healthcare services and phase 2 focused on determining the key strategies for self-sampling interventions to diagnose STIs in young women. Thematic analysis and percentage form analysis were used to examine qualitative and quantitative data respectively.ResultsThe following barriers were identified: negligence; myths about STIs; fear of judgement; denial; operating hours; lack of knowledge of STI symptoms and safe sex practices; and stigma associated with STIs. The following strategies were suggested: hand out self-sampling kits at popular restaurants; collect self-sampling kits from security guard at primary healthcare clinics (PHCs); receive STI diagnostic results via SMS or email or the clinic for treatment; improve youth friendly services at PHCs; educate the public on proper use of the kits. Education about STIs and handing out self-sampling kits at clinics, universities, schools, pharmacies or via outreach teams were ranked high priority strategies.ConclusionsThe findings highlight the need to address stigma and fear of judgment and provide comprehensive education to improve healthcare-seeking behaviour in young women. Additionally, the study also indicates that using eHealth solutions could significantly enhance the accessibility and efficiency of STI healthcare services in LMICs.

Mental healthcare access among resettled Syrian refugees in Leipzig, Germany

Abstract Our aim was to examine mental health needs and access to mental healthcare services among Syrian refugees in the city of Leipzig, Germany. We conducted a cross-sectional survey with Syrian refugee adults in Leipzig, Germany in 2021/2022. Outcomes included PTSD (PCL-5), depression (PHQ-9), anxiety (GAD-7) and somatic symptom (SSS-8). Descriptive, regression and effect modification analyses assessed associations between selected predictor variables and mental health service access. The sampling strategy means findings are applicable only to Syrian refugees in Leipzig. Of the 513 respondents, 18.3% had moderate/severe anxiety symptoms, 28.7% had moderate/severe depression symptoms, and 25.3% had PTSD symptoms. A total of 52.8% reported past year mental health problems, and 48.9% of those participants sought care for these problems. The most common reasons for not accessing mental healthcare services were wanting to handle the problem themselves and uncertainty about where to access services. Adjusted Poisson regression models (n = 259) found significant associations between current mental health symptoms and mental healthcare service access (RR: 1.47, 95% CI: 1.02–2.15, p = 0.041) but significance levels were not reached between somatization and trust in physicians with mental healthcare service access. Syrian refugees in Leipzig likely experience high unmet mental health needs. Community-based interventions for refugee mental health and de-stigmatization activities are needed to address these unmet needs in Leipzig.

How to improve the capacity of general practitioners? – a Flemish approach

“Barely any region left with freely accessible primary health care in Flanders.” This is one of the many newspaper headlines that was recently published to emphasize the fact that more and more general practitioners refuse to take in new patients, because they run out of capacity to provide patients with proper health care. Where does it go wrong? 
 Accessibilty to general practitioners is a hot topic for the Flemish policymakers. An aging population and an increase of mental health problems asks a lot from the general practitioners, as well as the shift of tasks from hospitals towards primary health care and the growing attention for prevention. However, is there a real shortage in general practitioners? Looking abroad learns that the number of general practitioners might not be the major cause of the capacity problem, but that the true bottleneck might lie in the way of organizing primary health care capacity and accessibility. Embedded in a landscape of health care where general practitioners mostly work on a self-employed base, and the fragmented governmental structure in Belgium as an extra obstacle makes this a major challenge for the near future.
 A dialogue between policy makers from all Belgian governments was opened to create a common approach: each government will take actions within their own authorities. The Flemish government worked out a plan to counter this massive challenge in primary health care through different initiatives, in cooperation with representatives of the general practitioners on the field, local authorities and umbrella organizations.
 Flanders commits itself by installing three major fundaments which can create change in the way general practitioners are organized: a first step is to create an accurate and up-to-date database of the current available general practitioners health care services compared with the local care need; in parallel the funding of general practitioners will be expanded in a way which stimulates interdisciplinary collaboration and optimizes health care capacity; on top of that the Flemish government is experimenting with new forms of primary care practices in which integrated care is the keystone and which are supported by local authorities and in close connection with welfare services. 
 These projects described above are in full development. On the working field more and more general practitioners are willing to put their shoulders under these initiatives to create solid solutions for the future. 
 The international audience of this lecture might recognize similar issues they encounter in their own countries and will be able to see similarities and differences compared to the Flemish context. By drawing these parallels one can have a broader view on the approach of improving health care capacity and accessibility. 
 These Flemish projects will be brought together with the initiatives from the other Belgian governments at a roundtable discussion to align all the initiatives on primary health care capacity and create a future proof primary health care capacity in Belgium.

Measuring the needs of dementia patients' caregivers: An assessment study from King Abdul-Aziz Medical City, Jeddah, Saudi Arabia

Background Globally, dementia is estimated to become more prevalent as the population is aging. Patients with dementia are demanding on the long-term care from their caregivers. In order to maintain their well-being and minimize the impacts of long-term care, caregivers need comprehensive and supportive health services. This study aimed to improve and redesign the current healthcare service by assessing the needs of Saudi dementia patients’ caregivers using carers’ needs assessment for dementia (CNA-D). Methods Through a cross-sectional design and convenient sampling technique (non-probability Sampling), this study was carried out in two Saudi home care centers. The caregivers who fulfilled the inclusion criteria (n=276) were enrolled in the study and completed the interview questionnaire. Data collection lasted for two months (September and October 2022). A Chi-square test was performed to determine the statistical significance between participants’ responses and their demographic data. Results The majority of caregivers were females (76%). Their mean age was 38 years, ranging from 21 to 67 years. Two-thirds of caregivers spent more than one year on direct caregiving. About 60% of patients were male, and half were grandparents. Most caregivers (71%) did not live with their patients in the same household. Although caregivers rated all the addressed 13 needs in the present study as important, knowing more about the diseases was most important among caregivers of high education level. Further, long-term care gave caregivers more experience and reduced the need for practical support services. Conclusion The results show that the principal caregiver in Saudi families were females, and a large proportion of dementia patients were males. There were variations in rating the importance of the addressed needs, which were associated with caregivers’ demographic characteristics. The findings of this survey demonstrate the importance of assessing the needs of family caregivers when developing social and healthcare services.

Supportive eHealth Technologies and Their Effects on Physical Functioning and Quality of Life for People With Lung Cancer: Systematic Review.

Despite advancements in treatment and early diagnosis, people with lung cancer are not living as long as those with other cancers. The more common symptoms of lung cancer, such as breathlessness, fatigue, and depression, can be alleviated by improving patients' physical functioning. Therefore, good symptom management and improved health-related quality of life (HRQoL) are priorities in this patient group. However, current health care services have limited capacity to provide this support. One way to address this issue of health care resources is to empower patients to self-manage their condition using eHealth technologies. The purpose of this review was to identify and assess available research on technologies that support persons with lung cancer to improve or maintain their physical functioning, HRQoL, or both. Six databases-PubMed, Web of Science, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO-were searched from January 1, 1990, to April 30, 2023. Studies were suitable for inclusion if the participants included people with lung cancer aged >18 years who had been exposed to a physical activity, exercise, or training intervention that was delivered via an electronic or web-based application with or without a comparator. Furthermore, the study had to report on the impact of the intervention on physical functioning and HRQoL. Studies that focused on telemedicine without a digital intervention were excluded. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the included papers. Due to the heterogeneity of the studies, a narrative synthesis was undertaken. This review is reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 794 papers were initially identified through our search, of which, after screening, 8 (1%) were confirmed suitable for inclusion in the review. As 2 (25%) of the 8 papers reported on different stages of the same study, we included only 7 studies in our analysis. The studies were undertaken between 2010 and 2018 across multiple countries and aimed to develop a technology and test its feasibility or acceptance. The 7 technologies identified included web-based applications, mobile apps, and gaming consoles. The studies demonstrated impact on walking distance, muscle strength, balance, dyspnea symptoms, and cancer-related fatigue. HRQoL scores also showed improvement. The findings indicate that eHealth technologies can positively impact physical functioning and well-being for people with lung cancer, but there are limited studies that demonstrate the impact of these digital interventions over longer periods. None of the studies reported on the implementation or adoption of a mobile health or eHealth intervention in routine clinical practice, highlighting the need for further research in this area. PROSPERO CRD42023414094; https://tinyurl.com/39hhbwyx.

The impact of healthcare industry convergence on the performance of the public health system: a geospatial modeling study of provincial panel data from China.

This paper examines the impact of healthcare industry convergence on the performance of the public health system in the eastern, central, and western regions of China. Public health performance was measured by a composite index of three standards: average life expectancy at birth, perinatal mortality, and maternal mortality. The healthcare industry convergence was measured using a coupling coordination degree method. The spatial lag, spatial error, and spatial Durbin models were used to estimate the effect of healthcare industry convergence on public health system performance and this effect's spatial dependence and heterogeneity across eastern, central, and western China using panel data from 30 Chinese provinces from 2002 to 2019. The convergence of the healthcare industry significantly promotes regional public health [ =0.576, 95% CI: (0.331,0.821)]. However, the convergence does not have a spatial spillover effect on the public health system at the national level. Additionally, analysis of regional heterogeneity shows that the direct effects of healthcare industry convergence on public health are positive and statistically significant for Eastern China, statistically insignificant for Central China, and positive and statistically significant for Western China. The indirect effects are negative, statistically significant, positive, statistically significant, and statistically insignificant for these three regions, respectively. Policy efforts should strengthen the convergence between the healthcare industry and relevant industries. It can produce more current healthcare services to improve public health and reduce regional health inequality.

Outcomes of Health Care Services Provided to Egyptian Patients with Type 1 Diabetes Mellitus Attending Pediatric Diabetology Unit, Children's Hospital, Ain-Shams University

Background Efforts in treating patients with type 1 diabetes are targeting strict glycemic control to prevent long- and short-term adverse health outcomes. Aim of the Work to evaluate the current health care services provided to patients with type 1 diabetes registered in Pediatric and Adolescent Diabetology Unit (PADU), Children's hospital of Ain-Shams University, in terms of metabolic control and complications encountered. Patients and Methods This retrospective cross-sectional study was conducted on all patients attending diabetology clinic during the period between May 2017 and July 2018. Patients' data was extracted from patients records of clinic including baseline and follow up examination and investigations. Results The mean age of patients was 12.63 ± 3.41 years with mean diabetes duration 5.54 ± 3.07 years. The mean HbA1c was 8.75 ± 1.94 %, with mean number of blood glucose monitoring (SMBG) 2.43 ± 0.64 times/day. Patients with more than 5-year-diabetes duration have significantly higher cholesterol level (167.58 ± 38.02 versus 163.23 ± 35.54 mg/dl), higher LDL (100.23 ± 29.49 versus 95.70 ± 28.11 mg/dl), presence of celiac antibodies (5 cases versus 4 cases) and lower number of SMBG (2.24 ± 0.66 versus 2.58 ± 0.57 times/day), (p < 0.05). Conclusion Patients with more diabetes duration have significantly higher incidence for microvascular complications and have less satisfaction than others with less duration of diabetes.

Measuring the needs of dementia patients' caregivers: An assessment study from King Abdul-Aziz Medical City, Jeddah, Saudi Arabia

Background: Globally, dementia is estimated to become more prevalent as the population is aging. Patients with dementia are demanding on the long-term care from their caregivers. In order to maintain their well-being and minimize the impacts of long-term care, caregivers need comprehensive and supportive health services. This study aimed to improve and redesign the current healthcare service by assessing the needs of Saudi dementia patients' caregivers using carers' needs assessment for dementia (CNA-D). Methods: Through a cross-sectional design and convenient sampling technique (non-probability Sampling), this study was carried out in two Saudi home care centers. The caregivers who fulfilled the inclusion criteria (n=276) were enrolled in the study and completed the interview questionnaire. Data collection lasted for two months (September and October 2022). A Chi-square test was performed to determine the statistical significance between participants' responses and their demographic data Results: The majority of caregivers were females (76%). Their mean age was 38 years, ranging from 21 to 67 years. Two-thirds of caregivers spent more than one year on direct caregiving. About 60% of patients were male, and half were grandparents. Most caregivers (71%) did not live with their patients in the same household. Although caregivers rated all the addressed 13 needs in the present study as important, knowing more about the diseases was most important among caregivers of high education level. Further, long-term care gave caregivers more experience and reduced the need for practical support services. Conclusion: The results show that the principal caregiver in Saudi families were females, and a large proportion of dementia patients were males. There were variations in rating the importance of the addressed needs, which were associated with caregivers' demographic characteristics. The findings of this survey demonstrate the importance of assessing the needs of family caregivers when developing social and healthcare services.

Quality management of the newborn screening network: the Chinese experience.

Quality management of the newborn screening network: the Chinese experience.

Effectiveness of digital care platform CMyLife for patients with chronic myeloid leukemia: results of a patient-preference trial

BackgroundTwo most important factors determining treatment success in chronic myeloid leukemia (CML) are adequate medication compliance and molecular monitoring albeit still being suboptimal. The CMyLife platform is an eHealth innovation, co-created with and for CML patients, aiming to improve their care, leading to an increased quality of life and the opportunity of hospital-free care.ObjectiveTo explore the effectiveness of CMyLife in terms of information provision, patient empowerment, medication compliance, molecular monitoring, and quality of life.MethodsEffectiveness of CMyLife was explored using a patient-preference trial. Upon completion of the baseline questionnaire, participants actively used (intervention group) or did not actively use (questionnaire group) the CMyLife platform for at least 6 months, after which they completed the post-intervention questionnaire. Scores between the intervention group and the questionnaire group were compared with regard to the within-subject change between baseline and post-measurement using Generalized Estimating Equation models.ResultsAt baseline, 33 patients were enrolled in the questionnaire group and 75 in the intervention group. Online health information knowledge improved significantly when actively using CMyLife and patients felt more empowered. No significant improvements were found regarding medication compliance and molecular monitoring, which were already outstanding. Self-reported effectiveness showed that patients experienced that using CMyLife improved their medication compliance and helped them to oversee their molecular monitoring. Patients using CMyLife reported more symptoms but were better able to manage these.ConclusionsSince hospital-free care has shown to be feasible in time of the COVID-19 pandemic, eHealth-based innovations such as CMyLife could be a solution to maintain the quality of care and make current oncological health care services more sustainable.Trial registrationClinicalTrials.gov NCT04595955, 22/10/2020.

Core Values in the Traditional Provision of Hearing Health Care.

Untreated hearing loss is a significant public health issue affecting the quality of life of millions of Americans. Barriers to treatment invite novel and innovation solutions, but as these solutions create new treatment delivery models, they also may-purposefully or accidentally-challenge the values of the field. Value-sensitive design methodology is used in this study to identify the values in current hearing health care service delivery. We performed qualitative content analysis of questionnaires, clinical practice guidelines, and professional ethics documents that represent the intended and enacted values in audiology. The result is a comprehensive list of values that can be used as a structured codebook for systematic textual analysis of materials representing current best practices in the provision of hearing health care services. A secondary result is an analysis of the relative importance of values in audiology, inferred from the frequency of references to each value. Subjective benefit, professional duties, and self-efficacy were the core values identified in the current provision of audiologic care, and these values should be central to considerations for new hearing health care models and technologies.

Care Cycle to Prevent and Treat a Breast Tumour: Where is The Opportunity for Technology to Cut Health Costs?

One of the main challenges of current health systems is the improvement of the services provided without increasing the existing costs or decreasing costs without worsening the quality of the provided care services. Given the complexity of current health care services, the accurate calculation of the actual costs is an arduous task, which requires knowledge of the various elements involved in the health care cycle provided to a patient with a certain medical condition.With this investigation, we aim to study the care cycle provided to a patient, from breast tumour prevention to treatment. Through this study we seek to understand, within the current care cycle provided, where there are opportunities for technology to help reduce the costs currently existing.To achieve this research objective, we performed a documental analysis of articles, books, and other sources of information on medical procedures performed by a patient with a breast tumour.Based on this analysis, the result obtained was a better understanding of the care cycle, which encompasses the different stages and elements involved in the possible process carried out in the case of a breast tumour.With this investigation, it is possible to systematize different phases of this care cycle and perceive the opportunities for intervention to increase its efficiency, namely with the use of communication and image technologies. This preliminary study provides knowledge and the basis to prepare the survey that will be applied to physicians responsible for breast cancer units around Europe, as well as the perception of the existing opportunities to introduce technology to help to reduce the current costs.

The impact of COVID-19 on the mental health workforce: A rapid review.

The COVID-19 pandemic led to significant adaptations to healthcare. Provision of mental healthcare in a changing environment presented healthcare workers with unique challenges and demands, including changes in workload and expectations. To inform current and future healthcare service responses, and adaptations, the current review aimed to collate and examine the impact of the pandemic on mental healthcare workers (MHWs). We conducted a rapid systematic review to examine the overall impact of the COVID-19 pandemic on MHWs. Searches were conducted in Ovid Medline and PsycInfo and restricted to articles published from 2020. Inclusion criteria specified articles written in English, published in peer-reviewed journals, and that examined any outcome of the impact of COVID-19 on MHWs; 55 articles fulfilled these criteria. Outcomes were categorized into 'work-related outcomes' and 'personal outcomes'. Mental healthcare workers worldwide experienced a range of work-related and personal adversities during the pandemic. Key work-related outcomes included increased workload, changed roles, burnout, decreased job satisfaction, telehealth challenges, difficulties with work-life balance, altered job performance, vicarious trauma and increased workplace violence. Personal outcomes included decreased well-being, increased psychological distress and psychosocial difficulties. These outcomes differed between inpatient, outpatient and remote settings. The COVID-19 pandemic significantly altered the delivery of mental healthcare and MHWs experienced both work-related and personal adversities during the COVID-19 pandemic. With the continuation of changes introduced to healthcare in the initial stages of the pandemic, it will be important to maintain efforts to monitor negative outcomes and ensure supports for MHWs, going forward.

Evaluation of primary health care system in Yangon Region, Myanmar: a mixed-method approach

Abstract Background Many low- and middle-income countries and international organizations have invested resources to strengthen primary health care services. Despite efforts from the Ministry of Health on primary health care, barriers to accessing health care services and health inequality in Myanmar still exist. This study aimed to identify the challenges and unmet needs in the current primary health care services by assessing the experiences and perceptions of healthcare workers and local leaders in three townships (Htantabin, Hmawbi, and Taikkyi) in Yangon, Myanmar. Methods The study was conducted among healthcare professionals and community leaders in three townships. By adopting a mixed-method approach, a cross-sectional health needs assessment survey was conducted for quantitative data (n = 66), and focus group discussions (15 group discussions) were conducted online for qualitative data. Results As a result of the survey regarding six domains; hygiene, primary medical care, maternal and child health, infectious diseases, non-communicable diseases, and leadership, enhancing the management and leadership capacity had the lowest average score on the current achievement (2.81 out of 5), while strengthening infectious disease control service and accessibility was perceived as the highest mean on the priority of intervention (4.28 out of 5) and the impact of the intervention (4.7). The focus group discussions revealed that while specific infrastructures and equipment necessary for the category were addressed, the need for financial support has been the recurrent theme throughout the discussions. Conclusions Utilizing the World Health Organization’s six-building block framework, our findings suggest that a long-term targeted financial investment in the primary health care system is critical in Myanmar by increasing health care expenditure per capita. At the same time, related barriers and facilitators should be considered to optimize the effectiveness of prioritized interventions. Key messages • Health care providers and local leaders perceived the management and leadership capacity as the lowest current achievement. • A long-term targeted financial investment in the primary health care system is critical in Myanmar.

Assessing the value of precision medicine health technologies to detect and manage melanoma.

Assessing the value of precision medicine health technologies to detect and manage melanoma.