Effective Health Service Delivery Research Articles

Classification of Drug Data Usage Using the K-Means Deep Algorithm to Minimize Drug Stock Shortages (Case Study: South Cikarang Community Health Center)

Efficient utilization of medicines is essential for effective health service delivery, especially in community health centers. This research explores the application of the K-Means clustering algorithm to categorize drug usage data and minimize stock shortages. This research, conducted at the South Cikarang Community Health Center, analyzed drug use patterns to identify drugs with high and low demand. Through data collection, cleaning, and pre-processing, medication use data is converted into a format suitable for clustering analysis. The clustering method approach can be applied to analyze the level of drug use produced by utilizing data sets to record the process of drug data results. The K-Means algorithm model applied has results that show new insights, namely grouping usage levels based on 2 clusters; cluster 1 (C0) is a high potential category consisting of 3.4 data from the tested dataset, and cluster 2 (C1) is Low Potential. Consists of 7.2 tested data, right? Collaborative testing can also produce collaborative testing results that show an average figure of 0.545.

Компаративный анализ подходов к инновационной политике в сфере здравоохранения в Российской Федерации, Европе и США

Innovations in health policy are critical to ensuring the delivery of high-quality, affordable and effective health services, consistent with the relevance of the research topic. The aim of this article is to determine the approaches to the interpretation of innovation policy in health care, as well as to consider specific problems of innovation policy of health care in the Russian Federation, European countries and the US. The study uses general scientific research methods: comparison, analysis, generalization, specification. Five directions of approaches to the definition of innovation policy in health care organizations are considered: systemic, market, patient-oriented, equity-oriented, as well as technological determinism. Specific problems of innovative healthcare policy in the Russian Federation, European countries and the USA are considered, and possible solutions to them are proposed. It is concluded that, regardless of the level of achievements in the field of innovation in health care, all countries are faced with a list of specific problems that require coordinated action in finding a joint solution for all stakeholders.

Utilization of routine health data and its determinants among healthcare workers in public health facilities of harari region, eastern Ethiopia

BackgroundRoutine health information is the pillar of the planning and management of health services and plays a vital role in effective and efficient health service delivery, decision making, and program improvement. Little is known about evidence-based actions to successively advance the use of information for decision making. Therefore, this study aimed to assess the level and determinants of routine health data utilization among health workers in public health facilities in the Harari region, Ethiopia.MethodsAn institutional-based cross-sectional study design was used from June 1 to July 31, 2020. A total of 410 health care providers from two hospitals and five health centers were selected using a simple random sampling technique. Data were collected through a structured questionnaire complemented by an observational checklist. The collected data were thoroughly checked, coding, and entered into Epi-data version 4.6 before being transferred to Stata version 14 for analysis. Frequency and cross-tabulations were performed. To measure factors associated with routine use of health data, bivariate and multivariate logistic regression analyzes were performed. The odds ratio with a 95% CI was calculated, and then a p-value of less than 0.05 was considered significant.ResultThe general utilization of routine health data was 65.6%. The use of routine health data was significantly associated with healthcare workers who had a positive attitude towards data [AOR = 4 (2.3–6.9)], received training [AOR = 2.1 (1.3–3.6)], had supportive supervision [AOR = 3.6 (2.1–6.2)], received regular feedback [AOR = 2.9 (1.7–5.0)] and perceived a culture of information use [AOR = 2.5 (1.3–4.6)].ConclusionsSixty percent of health professionals had used routine health data utilization. Training, supervision, feedback, and the perceived culture of information were independently associated with the use of routine health data utilization. Therefore, it is critical to focus on improving data utilization practices by addressing factors that influence the use of routine health data.

Evidence-based management and the nurse's decision-making process

The managerial decision-making process is a competence of nurses in the hospital and primary care context, which makes them a highly requested professional for solving problems involving the unit and the care provided to the user. Such a process must be informed by evidence, with a view to achieving the best results. To discuss the use of scientific evidence by nurses in the health management process. An integrative literature review, carried out in the PubMed/MEDLINE, LILACS, BDENF, and SciELO databases, through the DeCS/MESH "Evidence-Based Nursing" AND "Health Management" OR "Evidence-Informed Policy", 694 studies were identified and 07 were included. Evidence-based decision-making is important for the delivery of effective and cost-effective public health services, this decision-making process consists of the integration of the best available research evidence, along with consideration of local context, community and policy preferences, professional experience, and resources in public health decision-making. It is, therefore, crucial to improve the quality of management decisions, consequently improving service delivery, and increasing effectiveness and efficiency, in addition to contributing to patient safety. It is concluded that evidence-based management is essential to improve the quality of management decisions and, therefore, to improve the optimization and allocation of resources in the health system.

Transforming Dental Care in Saudi Arabia: Challenges and Opportunities.

This comprehensive review examines the dental healthcare system in Saudi Arabia, tracing its evolution, current status, and persisting challenges. The system has evolved significantly due to government initiatives and technological integration, yet it grapples with issues like professional shortages, financial constraints, and disparities in access. Despite improvements in accessibility, geographic and socio-economic disparities persist, and oral health promotion remains limited. The integration of technology faces resistance, and specialized care for people with disabilities requires targeted strategies. Cultural and social factors influence oral health, and the system's response to the COVID-19 pandemic showcases adaptability and patient-centered approaches. Addressing these challenges is crucial for ensuring equitable and effective oral health service delivery in Saudi Arabia.

Efficacy of Ultrasound for Sonologists, Sonographers and Nurses to assess high-risk conditions at Labor Triage in Pakistan

Healthcare problems that impede the effective delivery of health services, resulting in unequal access to care and suboptimal health outcomes, plague many countries. The absence of an expert medical personnel and diagnostic facilities are main causes of these problems. The worldwide ultrasound industry is still mainly unregulated, and national training policies and regulations that guarantee a minimal level of proficiency for safe practice differ. Requirements for reform and control of ultrasound usage have arisen since health professionals in many countries may perform ultrasounds with little to no training and without official certification. For this literature review, data from numerous search engines were obtained. The data for this study came from PubMed, Science Direct, NCBI, Medline, Medscape, and Google Scholar. It is a highly plausible alternative to teach nurses to do routine targeted obstetric scanning for the detection of high-risk pregnancies in order to make up for the lack of sonographers and sonologists in low-income countries. Therefore, sonologists are more effective than nurses in using ultrasonography to evaluate high-risk problems during labor triage.

Effective use of electronic health records system for healthcare delivery in Ghana

Introduction: In the pursuit of improving effective health service delivery, developing nations including Ghana are progressively integrating electronic health record systems into healthcare frameworks. This research explored the proficient utilization of an EHR called the Lightwave Health Information Management System used by healthcare professionals in Ghana.Material and Methods: A descriptive cross-sectional study design and a multi-stage sampling technique (stratified and simple random sampling) were used to recruit 1126 respondents for this study. Weighted averages were computed to determine scores for all the indicators measuring the effectiveness construct.Results: The study found that LHIMS improved productivity, patient data gathering, sharing of patient information among service providers, care continuity, data exchange among facilities, decision-making, and coordination/organization of care. Also, health professionals’ work experience, educational qualification, and training status were statistically significant predictors of effective use of the LHIMS at the multivariate level. Age and professional type were statistically significant only at the bivariate level.Conclusion: The study concludes that incorporating the LHIMS improves healthcare professionals' effectiveness in gathering patient information while reducing the likelihood of errors by promptly notifying them of any inaccuracies. The study emphasized the importance of training for effectively using the LHIMS.

WEB BASED MEDICAL CONSULTING INFORMATION FLOW FOR HOSPITAL OUT-PATIENTS USING MACHINE LEARNING TECHNIQUES

Medical consulting today is characterized by numerous demanding tasks that are prone to illness and need to be efficiently managed by medical practitioners using emerging techniques and solutions. Although there are concerted efforts by both the doctors and other medical stakeholders aimed at improving the condition, human errors abound. Sequel to this, the level of management bottlenecks recorded in the hospitals on a daily basis abound, such as the unordered information flow in the outpatients department (OPD); thus, effective health service delivery is being stifled. In this regard, the application of natural language-based medical consulting information flow cannot be undermined. This work seeks to develop a natural language-based medical consulting information flow for hospital outpatients using machine learning techniques. The architecture of the system was modeled using universal modeling language (UML) tools. The medical information flow is processed using machine learning techniques (MLT), which are named Word Rank. The word rank positions and sorts all sentences accordingly in an input corpus of a patient case report and is presented in a summarized version of the word. So, the word-rank algorithm generates a summary of the patient’s record based on the input corpus. The implemented system can be deployed in the Nigerian Electronic Health Records (NEHR) used in hospitals to ensure efficient information flow for patients in the outpatient department of every hospital. The system would therefore reduce the effort expended by the medical practitioners in comprehending a case report and offering various medical services since it would be very easy to view the salient parts promptly, resulting in a reasonably smooth information flow, an easier consultation process, and a reduction in patient waiting time. Cosine similarity Identify the applicable funding agency here. If none, delete this. is used as the metric to evaluate the accuracy of the output from the algorithm when weighted against the traditional information flow in the outpatient department.

“One Health Approach” Towards Effective Health Services Delivery in Sixty Years of Independent Tanzania

The year 2021 marked sixty years of Tanzania’s independence. Tanzania passed through different phases of development and attempted innumerable interventions, including a series of "development alternatives" to fight poverty, hunger, and infectious diseases. These efforts towards effective health services provision treated humans, animals, and environmental health separately. Due to the increase in human, livestock, wildlife, and environment interactions, the efforts did not result in the anticipated health outcomes. This prompted the government to search for an alternative approach. Cognizant of this, the government introduced the "One Health Approach (OHA)", which recognizes health as one, without a dividing line between humans, animals, and environmental health. This paper, therefore, analyzes (i) the debates for advancing effective health services delivery sixty years after independence; (ii) an emerging approach for interdisciplinary collaboration for human, animal, and environmental health, which is considered to have the potential for effective delivery of health services; and, (iii) the relevance of the OHA towards minimizing the undesirable impacts of human, livestock, and wildlife interactions on health. A documentary analysis (documentary research method) was employed to gather the information for the study. OHA is at its infancy stage, though this initiative signifies an essential landmark towards dealing with health-related challenges reflected at the convergence of humans, animals, and the environment. The milestone is outstanding as it leads to building fundamental capacities concerning public health, particularly regarding preparedness and response as per International Health Regulations. The OHA underscores the need for collaborative working efforts involving human, livestock, wildlife, and environmental health professionals for optimal human, animal, and environmental health attainment. There is a need to upscale the OHA and further understand the consequences of the interactions for optimum human, animal, and environmental health. Therefore, it conveys the idea that it is necessary to expand and enhance the OHA and the importance of comprehending the implications of the interactions for the well-being of humans, animals, and the environment.

English

Lack of inter-professional collaboration and practice among Health care professionals could impede effective HIV health services delivery leading to poor health outcomes in people living with HIV. Adopting Inter-professional Education by using innovative teaching methods such as the jigsaw technique could foster collaboration among health care professional. The School of Nursing Sciences at the University of Zambia in Lusaka implemented the Strengthening Interprofessional Education for HIV project whose purpose was to integrate innovative approaches that will systematically leverage and strengthen HIV training and professional networks targeted at improving outcomes for people living with HIV. An interactive case based training workshop was conducted with 61 final year undergraduate students from different health professional disciplines at the University of Zambia and Lusaka Apex Medical University in accordance with the jigsaw technique based on cooperate learning. A pre and post-test were administered and data obtained were evaluated using descriptive statistics. From the first training, an improvement was recorded in knowledge scores from 60.5% on pretest to 81.3% on posttest, while an average of 31% improvement was recorded on clinical confidence and inter-professional education. The Jigsaw technique appears to improve knowledge and self-confidence among health care professionals in HIV care. Therefore, inter professional education using the Jigsaw technique could be promoted and in cooperated into the preservice curricular of health care professionals  in order to have strong HIV management teams that could achieve better patient outcomes. Key words: Inter-professional Education, Impact, HIV course, Jigsaw technique.

Digitalization in Healthcare - Mobile Health (M-Health) Applications

Nowadays, the rapid and effective delivery of health services is a very important issue. The integration of health services into technology-based systems has ensured the integration of the health field with an innovative style. With the development of technology and the diversification of technological tools, important steps have been taken in the digitalization of health services. These steps are taken for the digitalization of health services offer great opportunities for the health sector. The fact that health institutions follow the digitalization process closely and adapt quickly to this process has brought many advantages. This process provides great convenience in terms of providing better health services for both individuals who want to benefit from health services and all other stakeholders, as well as health personnel working in private or public institutions. Moreover, the concept of digital health, which has gained importance with the digitalization of health services, has many applications in itself. These are wearable technologies, virtual reality technologies, tele-medicine, e-health, 3d printers and m-health applications. Among these applications, mobile health technology makes a significant contribution to the delivery of health services. İndividuals witness new developments in technology day by day and adapt easily to these developments. İncreasing demand for smartphones/devices is a result of these developments. Therefore, mobile health applications that enable remote access and can be easily downloaded to smart devices are actively used by many users. İt is possible to say that mobile health applications have positive effects as well as negative effects, especially on privacy and trust. Examples of these mobile health applications developed by the Turkey Ministry of Health are applications such as “Hayat Eve Sigar”, “Korona Onlem”, “E-Nabız”, “MHRS (Central Physician Appointment System)” which have been popular recently. İn this study, it is aimed to examine the positive and negative effects on health services by giving information about mobile health applications developed by the Turkey Ministry of Health for both citizens and health personnel.

Health services for aboriginal and Torres Strait Islander children in remote Australia: A scoping review.

In Australia, there is a significant gap between health outcomes in Indigenous and non-Indigenous children, which may relate to inequity in health service provision, particularly in remote areas. The aim was to conduct a scoping review to identify publications in the academic and grey literature and describe 1) Existing health services for Indigenous children in remote Australia and service use, 2) Workforce challenges in remote settings, 3) Characteristics of an effective health service, and 4) Models of care and solutions. Electronic databases of medical/health literature were searched (Jan 1990 to May 2021). Grey literature was identified through investigation of websites, including of local, state and national health departments. Identified papers (n = 1775) were screened and duplicates removed. Information was extracted and summarised from 116 papers that met review inclusion criteria (70 from electronic medical databases and 45 from the grey literature). This review identified that existing services struggle to meet demand. Barriers to effective child health service delivery in remote Australia include availability of trained staff, limited services, and difficult access. Aboriginal and Community Controlled Health Organisations are effective and should receive increased support including increased training and remuneration for Aboriginal Health Workers. Continuous quality assessment of existing and future programs will improve quality; as will measures that reflect aboriginal ways of knowing and being, that go beyond traditional Key Performance Indicators. Best practice models for service delivery have community leadership and collaboration. Increased resources with a focus on primary prevention and health promotion are essential.

The Veterans Health Administration's integrated model of care increases accessibility and delivery of mental health services.

Depression and posttraumatic stress disorder (PTSD) are two of the most common mental health conditions experienced by veterans. It is unclear what individual and system level factors are associated with receiving mental health treatment for these concerns. Using a national sample of Gulf War Era veterans who endorsed lifetime diagnoses of either depression or PTSD (N = 425), regression analyses were used to predict past-year treatment utilization. Predictor variables were those indicated in the behavioral model of health care utilization, including predisposing demographic variables (e.g., age, race), enabling variables (e.g., service connection, enrollment in Veterans Health Administration [VHA]), and need-based variables (e.g., current symptom severity). VHA enrollment was associated with a three- and five-times higher odds of being treated for depression or PTSD, respectively. Income and symptom severity were also positively associated with treatment utilization. Among individuals with diagnoses of depression and/or PTSD, VHA enrollment was the strongest predictor of receiving mental health treatment for these diagnoses, controlling for all other variables in the model including recent contact with the health care system, current symptom severity, and the presence of other enabling resources. Results suggest that the VHA's integrated model of care increases accessibility and delivery of effective mental health services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

LOCAL GOVERNMENT ENVIRONMENTAL HEALTH SERVICES: FUNDAMENTALS FOR EFFECTIVE MUNICIPAL SERVICE DELIVERY AND PREVENTIVE HEALTH OUTCOMES

One of the main reasons proposed for the widespread community protests in South Africa has been ineffective service delivery by local municipalities. The growing frustration of citizens has led to violent unrest, damage to infrastructure, service payment boycotts and litigation. Official reports have highlighted weaknesses including flawed governance, financial management, operational processes, and inter-governmental relations. This also applies to environmental health services (EHS) which is an intrinsic part of municipal health services, despite being the first line of defence in protecting the population against environmental risks. This grounded theory study, which forms part of a PhD dissertation, applied an integrative literature review to identify the fundamentals of effective environmental health service delivery. Four factors emerged: mandate cognisance; mandate execution; leadership support; and community satisfaction. Using the Schutte-dendrogram technique, the prerequisites for effective preventive environmental health services were explored and a conceptual model with sub-components was constructed. Viewing the model through a systems theory lens underscored the relational aspect of effectiveness. Rather than each factor independently contributing to effective service delivery, the interconnections and reliance on collaboration, communication, and contingencies among them lead to success. A strength or inadequacy in one of the four fundamental domains affects all the others, allowing progress or deterioration to permeate the entire system to enhance or weaken goal achievement. Improving the effectiveness of local government basic services thus requires a holistic view of the organisational system and the relational nature thereof.

The case to improve technologies for pharmacists' prescribing.

Increased healthcare needs during the COVID-19 pandemic and recent natural disasters have highlighted the value of community pharmacists in the efficient and effective delivery of health services. In Australia, legislative amendments have enabled pharmacists to extend the supply of certain prescription medicines to better address their community’s needs in emergency situations.[1] Authors have argued for longer term and broader expansion of nonmedical prescribing to maintain these efficiencies and enhance the public’s timely and equitable access to essential prescription medicines.[2] This Commentary argues that expanded and fully integrated pharmacist prescribing will require greater access to a range of health information communication technology (ICT) platforms to assist pharmacists’ clinical decision-making and to meet legal and ethical obligations in relation to clinical documentation. Specifically, we call for a tailored evaluation framework for health ICT to support contemporary pharmacy practice and prescribing roles of pharmacists.

Effect of Supply Chain Disruption in Dental Practice During Covid-19 Pandemic: An Indian Perspective

Disruption during Covid-19 pandemic highlighted the need for healthcare supply chain management in order to achieve effective delivery of health services. Though considerable efforts have been undertaken on managing the healthcare supply chain disruptions in India but there is a paucity of literature that documented the effect of supply chain disruptions in dental practices during a covid-19 pandemic. During a pandemic, the disruptions in production and distribution of dental products were seen in India. Indian dental market is largely dependent on imports and there is a scarcity of local production units. The main dental companies reported a significant decline in production during the first wave of Covid-19. The increase in demand for dental supplies was seen with a shutdown, shortage of labor, and scarcity of raw materials. Disruption rippled through the supply chain and this was caused by a large distortion in demand. This phenomenon led to the bullwhip effect. This bullwhip effect crisis led to increased costs in dental practices. Covid19 has shown a significant lack of resilience in the Indian dental healthcare supply chain. This study identified a few loopholes in the dental supply chain and suggested a way forward for managing the supply chain disruptions. It seems that there is a need for more comprehensive research on dental supply chain resilience from an Indian perspective to prevent disruptions, particularly in emergent situations.

Inter-professional collaboration and knowledge management practices among clinical workforce in Federal Tertiary Hospitals in Nigeria

Effective health service delivery hinges on the interface between professionals rendering health services to the sick and the injured. This paper examined the inter-professional collaboration and knowledge management practices among the clinical workforce in Federal Tertiary Hospitals in three Geopolitical Zones of Nigeria. The study employed a non-experimental survey design. 550 questionnaires were administered out of which 479 were completed for analysis comprising 204 Medical Doctors, 180 Nurses and 95 Health Information Management Officers, which resulted into 87% response rate. Findings from the study revealed that knowledge acquisition was the most practiced, closely followed by knowledge application. In addition, cooperation was the most practiced form of inter-professional collaboration, next to it is partnership. The study revealed a significant relationship between inter-professional collaboration and knowledge management practices. It shows that only cooperation significantly influenced knowledge management practices while knowledge capturing and knowledge dissemination significantly influenced inter-professional collaboration. The study concluded that Federal Tertiary Hospitals in Nigeria will perform better if they can sustain the culture of knowledge management practices and inter-professional collaboration.

Situational Analysis of Human Resource and Material Management Skills of Middle Level Health Care Managers at Primary Health Centres of Valsad, Gujarat: Identifying Barriers and Suggesting an Action Plan

Background: Management of Human resources in health has been a major challenge. Availability of manpower and material are the key ingredients required for efficient and effective delivery of health services. Removing the barriers related to it can help to improve functioning of PHCs Objectives: 1. To analyze Human resource and Material management skills at PHCs by middle level healthcare managers. 2. To understand the constraints for effective management at PHCs. Materials and Methods: A cross sectional study was conducted amongst 38 Medical officers who were selected by simple random sampling method. Data collection was done using a semi structured and scale-based questionnaire adopted from NIHFW, India. Results: Almost half medical officers had experience of less than one year. Only 10.5% PHC/CHCs have full staff. 47.3% health facilities were lacking AYUSH MOs. 63.2% health facilities faced stock out of at least one item in last six months; Lack of manpower (34.8%) and overburden of work (27.9%) are major barriers. Conclusions: 90% PHCs have one or more posts vacant. Material management need to be improved for better provision of services. Major barriers are lack of Manpower, Infrastructure and Multitasking.

Leveraging big data for improving the estimation of close to reality travel time to obstetric emergency services in urban low- and middle-income settings.

Maternal and perinatal mortality remain huge challenges globally, particularly in low- and middle-income countries (LMICs) where >98% of these deaths occur. Emergency obstetric care (EmOC) provided by skilled health personnel is an evidence-based package of interventions effective in reducing these deaths associated with pregnancy and childbirth. Until recently, pregnant women residing in urban areas have been considered to have good access to care, including EmOC. However, emerging evidence shows that due to rapid urbanization, this so called “urban advantage” is shrinking and in some LMIC settings, it is almost non-existent. This poses a complex challenge for structuring an effective health service delivery system, which tend to have poor spatial planning especially in LMIC settings. To optimize access to EmOC and ultimately reduce preventable maternal deaths within the context of urbanization, it is imperative to accurately locate areas and population groups that are geographically marginalized. Underpinning such assessments is accurately estimating travel time to health facilities that provide EmOC. In this perspective, we discuss strengths and weaknesses of approaches commonly used to estimate travel times to EmOC in LMICs, broadly grouped as reported and modeled approaches, while contextualizing our discussion in urban areas. We then introduce the novel OnTIME project, which seeks to address some of the key limitations in these commonly used approaches by leveraging big data. The perspective concludes with a discussion on anticipated outcomes and potential policy applications of the OnTIME project.

Precursory Prevention: Togetherness for Better Health

Precursory Prevention: Togetherness for Better Health