Development Of Healthcare Infrastructure Research Articles

Embarazo crítico en la altitud: una mirada en América Latina

Critical pregnancy at high altitudes increases morbidity and mortality from 2,500 meters above sea level. In addition to altitude, there are other influential factors such as social inequalities, cultural, prehospital barriers, and lack the appropriate development of healthcare infrastructure. The most frequent causes of critical pregnancy leading to admission to Intensive Care Units are pregnancy hypertensive disorders (native residents seem to be more protected), hemorrhages and infection/sepsis. In Latin America, there are 32 Intensive Care Units above 2,500 meters above sea level. Arterial blood gases at altitude are affected by changes in barometric pressure. The analysis of their values provides very useful information for the management of obstetric emergencies at very high altitude, especially respiratory and metabolic pathologies.

Critical pregnancy at altitude: A look at Latin America

Critical pregnancy at high altitudes increases morbidity and mortality from 2500 m above sea level. In addition to altitude, there are other influential factors such as social inequalities, cultural, prehospital barriers, and lack the appropriate development of healthcare infrastructure. The most frequent causes of critical pregnancy leading to admission to Intensive Care Units are pregnancy hypertensive disorders (native residents seem to be more protected), hemorrhages and infection/sepsis. In Latin America, there are 32 Intensive Care Units above 2500 m above sea level. Arterial blood gases at altitude are affected by changes in barometric pressure. The analysis of their values provides very useful information for the management of obstetric emergencies at very high altitude, especially respiratory and metabolic pathologies.

Socio-economic determinants of public healthcare

The main socio-economic mission of the healthcare system is to participate in the formation of workforce, strengthen the labor potential of society, and promote economic growth. The national health serves as an important economic resource. The COVID-19 pandemic has proven that losses due to illness and absence of employees from the workplace have negative economic consequences. The bibliometric study conducted via the VOSViewer bibliometric analysis of Scopus publications in 2014-2024 for the query “socio-economic determinants of public healthcare” allowed to structure the scientific work within 8 clusters. The latter showed leading researchers from the USA, the UK, India, Australia, Canada, Germany, Italy and Spain. In 2020-2023, due to the pandemic, publication activity in this area increased significantly. The article conducts a regression analysis of the impact of socio-economic determinants on the level of public healthcare. The public healthcare index is the population life expectancy. Among socio-economic determinants, there are nine components as factor attributes: current healthcare expenditures per capita; income shares of the richest and poorest – 10% and 20%; mortality rates up to 5 years and from suicide; number of people using at least basic sanitation and safe drinking water services, etc. The data for Ukraine from the World Bank statistical base for 2002-2019 were used as an information fundament. The multiple regression generation by the method of stepwise exclusion of variables was implemented using the MS Excel software. The article formulates a list of recommendations for increasing life expectancy. It includes measures to ensure the sanitary and epidemiological well-being of the population, development of healthcare infrastructure. The research also ensures availability of medical services to the population. The study educates and informs the population about the hygiene importance, proper use of sanitation and the consequences of inadequate sanitary conditions for health. Relevance of affordable sanitation improvement programmes for the poor is discussed.

Illuminating the Shadows: Exploring the Causes, Overcoming Challenges, and Advancing Solutions for Skin Cancers in Pakistan

Skin cancer poses a significant and growing public health concern in Pakistan, with rising incidence rates and a burden that weighs heavily on individuals, families, and healthcare systems. Understanding the causes, addressing the challenges, and implementing effective solutions are critical steps in combating this escalating issue.1 In this editorial, we shed light on the complexities of skin cancers in Pakistan, exploring the underlying causes, the challenges faced, and the pathways to advancing solutions for prevention, early detection, and treatment. The primary cause of skin cancers, including melanoma and non-melanoma types, is excessive and prolonged exposure to ultraviolet (UV) radiation from the sun1. Pakistan's geographical location, with abundant sunshine and a predominantly sunny climate, places its population at a heightened risk of developing skin cancers. Cultural practices, such as limited sun protection measures and a preference for fair skin, further contribute to increased UV exposure and vulnerability to skin cancers.1 Public awareness campaigns and education on the importance of sun protection practices, such as wearing protective clothing, using sunscreen, and seeking shade during peak sun hours, are crucial for reducing UV-related risks. Another significant challenge in combating skin cancers in Pakistan is the lack of comprehensive and consistent data on the incidence, prevalence, and mortality rates. Limited national registries and fragmented data collection systems impede accurate assessment and hinder evidence-based decision-making.2 Strengthening surveillance mechanisms, establishing cancer registries, and promoting data sharing and collaboration among healthcare institutions and researchers are pivotal in obtaining a comprehensive understanding of the burden and trends of skin cancers. Access to healthcare services, particularly in rural areas, poses a significant obstacle to early detection and timely treatment of skin cancers. Limited healthcare infrastructure, inadequate training of healthcare professionals and financial constraints restrict access to dermatological expertise, specialized diagnostics, and appropriate treatment modalities. Investment in dermatology services, the training of healthcare professionals, and the establishment of skin cancer centers can enhance early detection, diagnosis, and treatment accessibility for all individuals across Pakistan.3 Community engagement and health education programs play a pivotal role in raising awareness about skin cancers, dispelling misconceptions, and encouraging early detection behaviors4. Collaboration with community leaders, schools, and local organizations can facilitate the dissemination of information on risk factors, warning signs, and the importance of regular self-examinations4. By empowering individuals to recognize suspicious lesions and seek timely medical attention, we can promote early diagnosis and improve treatment outcomes.4 Furthermore, innovative technological solutions, such as telemedicine and mobile health applications, have the potential to bridge the geographical gaps and improve access to dermatological expertise in remote areas. Telemedicine platforms enable dermatologists to remotely assess and diagnose skin lesions, providing guidance on further evaluation and treatment options. Integrating these digital solutions into the healthcare system can greatly enhance dermatology services and improve outcomes for individuals with skin cancers.5 Collaborative research efforts and partnerships between academia, healthcare institutions, and governmental bodies are vital in advancing the understanding of skin cancers in Pakistan.6 Research studies focused on epidemiology, genetic factors, environmental influences, and treatment outcomes can provide valuable insights into the unique characteristics of skin cancers in the Pakistani population. These insights can inform the development of tailored prevention strategies, treatment guidelines, and targeted interventions. In conclusion, addressing the rising burden of skin cancers in Pakistan requires a multifaceted approach that encompasses awareness, prevention, early detection, treatment accessibility, and research collaboration. By illuminating the shadows cast by skin cancers, we can create a comprehensive framework that combines public education, healthcare infrastructure development, technological innovations, and research advancements. Together, we can combat this growing epidemic and improve the lives of individuals affected by skin cancers in Pakistan.7-10 How to Cite This: Rani B. Illuminating the Shadows: Exploring the Causes, Overcoming Challenges, and Advancing Solutions for Skin Cancers in Pakistan. Isra Med J. 2023; 15(1):35-36. DOI: https://doi.org/10.55282/imj.ltr35

A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center.

The elderly population in India is expected to increase to 319 million by 2050. Managing critically ill elderly patients in intensive care units (ICUs) is a difficult task. Proper planning and development of healthcare infrastructure are of prime importance to face this challenge. To study the clinical profile and outcomes of elderly patients admitted to the medical ICUs. A time-bound, prospective observational study on elderly patients admitted to medical ICUs for more than 48 hours was conducted from March 2019 to September 2020. The demographic, biochemical, hematologic, and microbiological data on antibiotic susceptibility patterns on various organisms and procalcitonin (PCT) reports were collected. Acute Physiology and Chronic Health Evaluation II (APACHE II) score was calculated. Various treatment modalities, such as mechanical ventilation, inotropes, hemodialysis, antibiotics, culture report in sepsis patients, and length of ICU stay were collected. The age of the patients and the length of their ICU stay were not significantly associated with outcomes. Sepsis and APACHE II scores are significantly associated with outcomes. Receipt of mechanical ventilation, vasopressor support, and hemodialysis are significantly associated with mortality (p < 0.001). The patients' ages were not significantly associated with outcomes. The most common cause of death among elderly patients was found to be sepsis, followed by pneumonia. In elderly ICU patients, gram-negative organisms are the most common causative agents in bloodstream infections. The APACHE II score, sepsis, receipt of mechanical ventilation, vasopressor support, and hemodialysis are significantly associated with mortality. Prabhudev P, Ramamoorthi K, Acharya RV. A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center. Indian J Crit Care Med 2023;27(3):166-175.

Enhancing Maternal and Infant Health: Improving Healthcare Access through Cultural Sensitivity and Community Engagement in Tigalingga, Dairi Regency

This research investigates the state of maternal and infant health in Tigalingga, Dairi Regency, emphasizing the significance of reducing mortality rates among mothers and infants in this underserved community. Employing a mixed-method approach, the study combines quantitative analysis and qualitative insights to understand the multifaceted landscape of healthcare challenges. Utilizing regional health records, interviews, and community engagement, the study unveils critical disparities, cultural influences, and barriers to healthcare access. The findings showcase higher-than-desired maternal and infant mortality rates, underscoring the urgency for targeted interventions. The Health Assistance Program, a focal point of the research, demonstrates promising outcomes in reducing mortality rates. The program's success is attributed to improved healthcare access, culturally sensitive interventions, and community engagement. Recommendations derived from the study advocate for sustained efforts in healthcare infrastructure development, enhanced community involvement, and cultural adaptation in healthcare initiatives. The implications of the research extend to public health policy, emphasizing the importance of equitable healthcare access, culturally competent interventions, and community-driven strategies. The research underscores the critical need for tailored healthcare interventions, respecting cultural practices and addressing healthcare disparities, to improve the health outcomes of mothers and infants in Tigalingga. The findings serve as a foundation for informed decision-making and the development of targeted interventions not only within the region but also for similar vulnerable communities globally

A Review on the Development of Healthcare Infrastructure Through the History of Islamic Civilization.

The current healthcare systems across the world are well established with the use of information and communication technologies. However, the developments of healthcare systems during the early Islamic and medieval ages have contributed to the establishment of various procedures and practices which are still relevant today. In addition, the research related to the history of medicine in the Arab world mainly focused on the medical literature and very few practices; whereas the healthcare infrastructure and management were undermined. In order to address this gap, this study focuses on reviewing the healthcare systems and infrastructural developments through the history of Islamic civilization, which spread across the Middle East, Africa, Spain, and West Asia. The findings are presented systematically under the categories of types of care centers, management and human resources, medical education system, and medical ethics, and then discussed.

Underlying premises in medical mission trips for Madiha (Kulina) Indigenous people in the Brazilian Amazon

This article proposes two premises that underlie biomedical health care delivery provided through medical missions to Madiha (Kulina) Indigenous Amazonian people living in forest villages. First, that health care is implemented through a set of detached transferable goods and services. Second, that health is a condition that requires the importation of knowledge and resources. The premises were induced through qualitative research on the Brazilian government’s medical missions that provide biomedical care to Madiha (Kulina) in the southwestern Amazon as part of the national health care system. Despite policy rhetoric, delivery practices disregard embedding health and health care in local infrastructure and cultural conditions. There is little or no collaboration with Indigenous healers, capacity building of the local (Indigenous) health care system, education of resident lay health monitors, or extensive and lasting infrastructural development. The article recommends reorientation of delivery to prioritize local health care infrastructure development.

Public-Private Partnership as a Tool of Health Infrastructure Development in Digital Economy

The article is devoted to analyze the digitalization process in the development of public-private partnership mechanism in informational healthcare infrastructure. The importance of information asymmetry problem is shown in the health insurance market, and the mechanisms that can minimize it are analyzed: public-private partnership and concession. Based on the analysis of report “The Development of Digital Economy in Russia”, the importance of the digitalization process was identified for the social sphere, and the main directions were outlined for the development of the digital economy in Russia. Aim of the article is to analyze the features of public private partnership mechanism in healthcare related to the process of digitalization of the economy. The object of study is the public-private partnership mechanism. Subject of the study include economical, organizational and social relations arising in the process of applying the PPP mechanism for the development of digitalization. The analysis method made it possible to comprehend the main trends of the digitalization process in relation to the healthcare sector. The method of synthesis helped to find the relationship between these trends. Comparative analysis allowed comparing two key models of health insurance. The article allows understanding the key trends of the digitalization process in health care. Аs a result, it will be useful for experts involved in the development of healthcare infrastructure based on the PPP mechanism.

Healthcare infrastructure development in rural India: a critical analysis of its status and future challenges

At present, the development of healthcare infrastructure in India is poor and needs fundamental reforms in order to deal with emerging challenges. This study surveys the growth of the healthcare infrastructure. The development of infrastructure and health care facilities, the position of the workforce, and the quality of service delivery are important challenges that are confronting healthcare centres in rural India. This article critically analyses the future challenges of Indian healthcare infrastructure development in rural areas, discussing the burden of disease, widespread financial deficiency, the vaccination policy and poor access to health care as some of the main issues. Life expectancy, literacy and per capita income are further considerations.

Willingness to pay for Community Health Insurance among taxi drivers in Kampala City, Uganda: a contingent evaluation.

BackgroundCommunity Health Insurance (CHI) schemes have improved the utilization of health services by reducing out-of-pocket payments (OOP). This study assessed income quintiles for taxi drivers and the minimum amount of premium a driver would be willing to pay for a CHI scheme in Kampala City, Uganda.MethodsA cross-sectional study design using contingent evaluation was employed to gather primary data on willingness to pay (WTP). The respondents were 312 randomly and 9 purposively selected key informants. Qualitative data were analyzed using conceptual content analysis while quantitative data were analyzed using MS Excel 2016 to generate the relationship of socio-demographic variables and WTP.ResultsClose to a half (47.9%) of the respondents earn above UGX 500,000 per month (fifth quintile), followed by 24.5% earning a monthly average of UGX 300,001–500,000 and the rest (27.5%) earn less. Households in the fourth and fifth quintiles (38.4% and 20%, respectively) are more willing to join and pay for CHI. A majority of the respondents (29.9%) are willing to pay UGX, 6,001–10,000 while 22.3% are willing to pay between UGX 11,001 and UGX 20,000 and 23.2% reported willing to pay between UGX 20,001 and UGX 50,000 per person per month. Only 18.8% of the respondents recorded WTP at least UGX 5,000 and 5.8% reported being able to pay above UGX 50,000 per month (1 USD=UGX 3,500). Reasons expressed for WTP included perceived benefits such as development of health care infrastructure, risk protection, and reduced household expenditures. Reasons for not willing to pay included corruption, mistrust, inadequate information about the scheme, and low involvement of the members.ConclusionThere is a possibility of embracing the scheme by the taxi drivers and the rest of the informal sector of Uganda if the health sector creates adequate awareness.

The problems of the providing the regions with health care infrastructure in conditions of increase of migratory mobility

Subject matter of the article is a question of the providing the newcomers to regions of the Russian Federation with healthcare infrastructure facilities. The purpose of the research is an assessment of level of this providing. On the basis of calculation of the integrated indicators of the development of health care infrastructure and the providing the population with healthcare infrastructure facilities the grouping of regions is carried out. By means of the two-dimensional analysis, we made a comparison of regions on indicators of arrival of the population and the above-named settlement indicators. The analysis of dynamics of the number change of healthcare infrastructure facilities during its reforming from 2005 to 2011 is performed. As a result of the research, the following conclusion is drawn: the level of investment into the regions as well as in its health care infrastructure do influence on the intensity of migratory flows, however, distribution of investments into health care facilities in regions does not take in to account the directions of migratory flows and poorly considers the population size of territories. This article may be interesting to the experts dealing with issues of development of regions.

Adherence to HIV antiretroviral therapy

AbstractNear perfect adherence to ART is required to prevent treatment failure in the individual and to prevent the spread of drug-resistant viruses. Factors that influence adherence to ART can be divided into factors related to the treatment regimen; social and psychological factors; institutional resources; and personal attributes.The treatment regimen should be kept as simple as possible and be tailored to the patient's lifestyle. Untreated side effects are one of the strongest predictors of non-adherence. Mental disorders and drug/alcohol abuse should be addressed before initiating treatment. The patient's attitude towards medication and health beliefs could adversely influence adherence. The development of healthcare infrastructure should be a high priority and services should be patient orientated. Few personal attributes are consistently associated with adherence. Healthcare workers are poor at predicting adherence. The South African guidelines therefore focus on providing comprehensive adherence s...

Enhancing rural economic development: crafting a health care revolving loan fund.

Community development efforts in economically depressed rural areas are often hampered by poor access to health care. One barrier to rural provider availability is the difficulty of obtaining capital for rural health care infrastructure development. Commercial lending institutions are limited in their ability to respond to these needs due to traditional lending criteria--creditworthiness, equity, experience, management ability, and profits or cash flow. This paper describes a rural health care revolving loan fund crafted to address these needs for capital while addressing the goal of improving health care access in rural Arkansas. The Arkansas Rural Health Revolving Loan Fund is a model for other states interested in two processes that work synergistically: (1) increasing access to capital to strengthen the rural primary health care infrastructure and (2) making health care more economically viable by integrating the fund's efforts with those of other community development initiatives.