Essential Health Care Research Articles

The role of pharmacogenomic testing in optimizing depression treatment in medically underserved communities: Implications for nurse practitioner practice.

Depression is a leading cause of disability worldwide, with treatment-resistant depression (TRD) affecting approximately 30% of patients who do not respond to standard antidepressants. In underserved and uninsured communities, where Nurse Practitioners (NPs) often provide essential mental health care, the challenges of managing TRD are compounded by limited access to specialized services. Pharmacogenomic testing offers a promising approach to overcoming these barriers by providing personalized medication recommendations based on a patient's genetic profile. This brief report examines the medical records of 46 patients from underserved communities who underwent genetic testing for TRD. Of the patients reviewed, 31 achieved remission within 2 months of receiving genetically guided treatment, resulting in a remission rate of 67.39%. Patients with specific genetic markers, such as poor metabolizers for CYP2D6 or CYP2C19, experienced the most significant benefits. These findings suggest that pharmacogenomic testing can significantly improve treatment outcomes for TRD in underserved populations, enabling NPs to provide more personalized, effective care. Further research is necessary to explore the long-term benefits and cost-effectiveness of integrating pharmacogenomic testing into NP-led practices, particularly in resource-limited settings.

Beyond illness: Understanding the social determinants in the life of a middle-aged Pakistani woman

Background: Poverty is both a cause and a consequence of poor health, and the scarcity of resources limits access to essential health care services. Aim: To highlight the implications on health of the often-neglected social determinants. Methods: We examined the experiences of Shahida Parveen, a middle-aged, unmarried woman, living in a resource-poor setting in Rawalpindi, Pakistan, and the interplay of the social determinants and inadequate safety nets on her health and wellbeing. Results: Shahida's narrative unveiled a poignant journey marked by health challenges early in her lifetime, her profound losses and the systemic barriers to accessing healthcare. Poverty, limited social support, and healthcare disparities emerged as central factors in shaping her health outcomes. Conclusion: This case report highlights the need for a more just and more inclusive healthcare system that guarantees comprehensive social safety nets and accessible health care services for vulnerable populations.

The Appropriate Translation of the Nurse Practitioner Will Foster Health Equity.

Background: In September 2020, Governor Gavin Newsom of California signed Assembly Bill 890 (AB 890) into law, which changed Title 16 of the Nurse Practice Act, granting California nurse practitioners (NPs) a stepwise approach to full practice authority. Written within the law, NPs are required to verbally identify themselves specifically to all Spanish-speaking patients, as enfermera(o) especializada (o). Local Problem: AB 890 requires NPs to identify themselves using inappropriate Spanish terminology. There are concerns regarding the translational accuracy of nurse practitioners under AB 890. To avoid confusion, it is essential to ensure the translation of the NP role is precise and unambiguous to ensure health equity. Context: This law has a significant impact on approximately 37,000 NPs in the state of California who provide essential healthcare services to the Spanish-speaking community. Critically, the Hispanic/Latino community accounts for almost 40% of California state's population, and Intervention: This literature review will delve into the current literature for the accurate Spanish terminology of the "Advanced Practice Nurse," "Advanced Practice Registered Nurse," and Nurse Practitioner." Outcome Measures: To accurately translate "Advanced Practice Nurse," "Advanced Practice Registered Nurse," and "Nurse Practitioner."

Critical Analysis of Foundational Healthcare Practices in Diverse Settings

Healthcare delivery systems vary depending on the economies, cultures, and infrastructures of the regions of the globe. Healthcare practices across various contexts should be used as building blocks of basic healthcare systems and concepts to design better healthcare systems. This paper critically evaluates essential healthcare practices in various contexts because it considers HICs, LMICs, and rural or remote regions. Based on a combination of case studies, review articles and evidence-based literature, this analysis assesses fundamental tenets of healthcare delivery: accessibility, quality, and sustainability. The paper focuses on modern and emerging healthcare modalities and discusses issues that are relevant today, including disparities and inequalities, shortage of resources, and human capital. This evokes a discussion of technology, public health policies, and global health programs before providing the authors’ suggestions for advancing health care globally.

Cybersecurity Threats in Healthcare IT: Challenges, Risks, and Mitigation Strategies

The healthcare industry's reliance on digital technology to improve patient care, operations, and performance has exposed it to cybersecurity threats. The extensive capture, storage, and transmission of confidential data by healthcare institutions has led to a significant prevalence of cyber-attacks. The intersection of healthcare and information technology presents considerable challenges, with patient privacy, the security of medical devices, and the continuity of essential healthcare services all at risk. This study offers a contemporary contextual analysis of IT cybersecurity concerns within the healthcare sector. It employs a systematic methodology to delineate critical risk factors and threats, the strategies they might utilize to attain their compromise aims, and the repercussions they may impose on healthcare delivery. It also explores the measures and guidelines to address this risk. The study highlights the existence of many threats experienced by healthcare organizations, such as data theft and leakage, ransomware, cyber-attacks in different forms, and contaminated medical equipment. One prominent example is the WannaCry attack on the United Kingdom's National Health Service in 2017. According to the survey, there is a severe scarcity of qualified personnel in healthcare organizations who can defend against cyber threats effectively and efficiently, underscoring the urgent need for skilled professionals in cybersecurity. This analysis also discusses various considerations concerning achieving high availability and protecting data in healthcare businesses. It examines how emerging applications like IoMT enhance the quality of medical services for patients and the security challenges these devices pose. The report evaluates the sufficiency of existing regulatory guidelines in addressing emerging dangers, including HIPAA vulnerabilities. The current definitive framework underscores the critical importance of enhancing cybersecurity within healthcare IT. It elucidates optimal strategies for mitigating cyber hazards by promoting technological prevention, staff training, and adherence to organizational policies. The work emphasizes the necessity for ongoing research, the establishment of collaboration between medical professionals and IT security experts, and the formulation of effective strategies to protect patient information and ensure the continuity of healthcare delivery in the face of increasing cyber-attack threats in digitalization.

Strategic Policy Framework for Ensuring the Sustainability of Essential Healthcare in Korea

South Korea’s rapid economic growth over the past 50 years has significantly improved healthcare outcomes, with life expectancy rising from 62.3 years in the 1970s to 82.7 years in 2022. However, the sustainability of its high-performing healthcare system is increasingly uncertain. Healthcare expenditure as a percentage of GDP reached 9.7% in 2022, surpassing the OECD average, while the fertility rate dropped to 0.72, undermining the system’s demographic foundation. Challenges include freezing health insurance premiums despite rising costs, short-term fiscal injections without thorough evaluation, and expanding the physician workforce without accounting for demographic changes. These policies risk overburdening future generations and escalating systemic financial pressures. To ensure sustainability, a shift in healthcare policy is necessary; from expanding services to managing limited resources and controlling demand. South Korea must adopt a strategic, long-term framework that balances current needs with future sustainability, ensuring its healthcare system remains equitable and resilient.

Determinants of treatment-seeking behaviour and healthcare provider choice in Afghanistan in 2018: a cross-sectional study

IntroductionIn Afghanistan, remarkable achievements have been made in improving access to healthcare and health outcomes since the introduction of essential healthcare packages. Nonetheless, sociodemographic and geographical inequities persist, and out-of-pocket...

Impact of the COVID-19 pandemic on direct medical costs of acute coronary syndrome admissions in Yogyakarta, Indonesia

The number of admissions, therapeutic management, and clinical results of acute coronary syndrome (ACS) have been extensively reported. However, the economic impact of ACS therapy has been ignored. This study examined the effect of the COVID-19 pandemic on direct medical costs for ACS hospitalizations in Yogyakarta, Indonesia. A retrospective study of patients with ACS admitted to one of three hospitals during March to August in 2019, 2020, and 2021 was conducted. Direct medical costs from a provider’s perspective were estimated using the charges. All costs were reported in Indonesian Rupiah (IDR) at a 2021 value. Multiple linear regression analysis was used to evaluate the impact of the pandemic on total direct medical costs. The total direct medical costs associated with ACS admission per patient during the pandemic period was approximately 40% higher than that during the pre-COVID period (28.41 vs. 20.33 million IDR or 1976.90 vs. 1414.65 USD). A substantial impact of the COVID-19 pandemic on total direct medical costs still remained after adjusting the ACS types, hospital types, length of stay, percutaneous coronary intervention, in-hospital mortality, and delay time of onset to first medical contact. Given the limited health budget, reallocation of health care resources must be prioritized to maintain the provision of essential health care for those who timely treatment is crucial.

Innovative cross-platform health applications to improve accessibility in underserved communities

The development of innovative cross-platform health applications has the potential to transform healthcare delivery in underserved communities by increasing accessibility, reducing disparities, and improving health outcomes. These applications are designed to operate across multiple devices and operating systems, ensuring that people in marginalized or remote areas with limited technological infrastructure can still access essential healthcare services. This study explores the development and implementation of cross-platform mobile health (mHealth) applications that provide features such as telemedicine consultations, remote patient monitoring, health education, and digital medical records. By leveraging cloud computing, artificial intelligence, and data analytics, these applications can offer personalized health solutions, support proactive health management, and facilitate timely medical interventions. Furthermore, cross-platform compatibility reduces barriers related to device ownership and connectivity, which are common challenges in underserved areas. This research also examines user adoption, challenges in technological integration, data privacy concerns, and potential strategies for achieving sustainable engagement within these communities. Through empirical analysis and case studies, the findings highlight how cross-platform health applications can bridge the gap in healthcare access, contributing to a more equitable healthcare system and supporting the United Nations Sustainable Development Goal of health for all. Keywords: Healthcare Accessibility, Digital Health, Cloud Computing, Health Equity, Sustainable Healthcare.

Assessment of Health Services in East Jerusalem: A Cross-Sectional Study

Aim: This study aims to evaluate healthcare service delivery and population indicators in East Jerusalem (EJ) for use in health planning, evaluation, and decision-making at both institutional and policy levels. Methods: A mixed-methods approach was adopted. The quantitative component involved a household survey that assessed health conditions and healthcare utilization across 3,747 households, covering 16,433 individuals. The qualitative component included semi-structured interviews with healthcare institution managers. Results: Among children, respiratory illnesses (0.50%) and cardiovascular diseases (0.30%) were the most common. In adults, diabetes (4.32%) and cardiovascular diseases, including hypertension (2.84%), were prevalent. The five hospitals in EJ, with a total of 651 beds, serve residents of EJ, the West Bank, and Gaza. In 2018, EJ hospitals treated over 80,000 inpatients and 240,000 outpatients. The Palestinian Ministry of Health referred 43,256 cases to EJ hospitals, accounting for 40% of all external referrals. Smoking prevalence among adults over 18 was 29.0%. Rehabilitation services were available in 55% of health centers, but mental health services were limited. Around 63% of patients expressed satisfaction with healthcare services, though language barriers and long wait times were issues when referred to Israeli hospitals. Conclusions: EJ hospitals operate near capacity, providing essential tertiary healthcare services and managing substantial referrals from the West Bank and Gaza. Key challenges include long waiting times, high competition among healthcare centers, and shortages in mental health, physiotherapy, and rehabilitation staff. Drug use, particularly in Shu'fat, is a significant social issue. Although patient satisfaction is high, Israeli hospitals are often preferred due to their advanced technologies. There is a clear need to invest in local healthcare centers, improve service quality, and increase specialized care availability, particularly in diagnostics, rehabilitation, and mental health services.

Revitalizing obstetrics and gynecology, a pathway to restoring medicine in Republic of Korea

Background: In February 2024, the Korean government introduced the “Essential Medical Package,” along with an increase in medical school admissions of 2,000 students, resulting in a total annual intake of 5,058 for the beginning of 2025. This sudden policy shift precipitated significant turmoil within the medical sector, prompting many resident doctors to resign and medical students to take leaves of absence. Despite numerous appeals for the revision of these policies, the government has widely disregarded these concerns and adopted more restrictive measures, thereby exacerbating tensions within the healthcare community.Current Concepts: Despite Korea’s doctor-to-population ratio being lower than the OECD average, Korea demonstrates remarkable positive health indicators, including low avoidable mortality rates and high life expectancy. Nevertheless, critical specialties, particularly obstetrics and gynecology, are facing significant challenges. These challenges are compounded by policies that offer public health services such as complementary prenatal screenings, which reduce revenue for private clinics. Nevertheless, critical specialties, particularly obstetrics and gynecology, are facing significant challenges, compounded by policies that offer public health services, such as complementary prenatal screenings, which reduce revenue for private clinics. Consequently, this situation has exacerbated the decline of private obstetric services, placing additional strain on the healthcare system.Discussion and Conclusion: To effectively address the challenges facing the Korean healthcare system, it is imperative to implement targeted reforms that prioritize increasing compensation and mitigating legal risks for high-risk specialties, rather than merely expanding medical school admissions indiscriminately. Furthermore, transparent and data-driven workforce planning is essential to foster sustainable improvements that support the efficiency and accessibility of healthcare services in Korea. Without these reforms, there is a significant risk that the quality of medical services will continue to decline, thereby adversely affecting future generations’ access to essential healthcare.

Patient privacy and the need for private consultation areas in Kuwait’s polyclinic pharmacies

Abstract Introduction In Kuwait, pharmacists provide essential medication counseling and education. However, the open layout of polyclinic pharmacies often compromises patient privacy, deterring individuals from seeking necessary consultations. Objective This study aims to assess how patients perceive the level of privacy in Kuwait’s polyclinic pharmacies and evaluate patients’ need for a private consultation area. Method A cross-sectional study was conducted among patients at polyclinic pharmacies in Kuwait. Convenience sampling was used to select the polyclinics. Patients were approached after collecting their medications and invited to participate in the study. Those who consented completed a questionnaire that included sections on demographics, six items assessing the privacy construct, four items evaluating the need for a consultation area, and an open-ended question for additional comments. Ethical approval was obtained from the Human Ethical Committee, Health Sciences Center, Kuwait University. Results The study included 210 participants, with a majority residing in the Capital Governorate (55.2%), and being female (70%). The median age was 43 years old (IQR=29-55). Over two-thirds of the participants held a university degree (69%). Most participants were collecting medication for themselves (83.8%), and were exempt from fees (84.3%). When measuring patients’ privacy satisfaction, a score was calculated and a scale was divided into good to excellent (24 - 30), fair (18 - 23), and poor (6 -17). In addition, when measuring the need for a private consultation area score, a scale was divided into high need (16-20), fair need (12-15), and no need (4-11). Regarding perceived privacy, only 20% of participants had a good to excellent score, while 41.9% had a fair score and 38.1% had a poor score. When asked about the need for a private consultation room, 63.8% expressed a high need, while 15.2% believed it was unnecessary. Participants who had lower privacy scores reported a higher need for private consultation areas. Discussion The findings provide valuable insights into patient perspectives and highlight the necessity of improving pharmacy practices in Kuwait. Enhancing privacy in pharmacies could significantly improve the public’s perception of pharmacists as essential healthcare providers. However, several limitations should be noted. The sample is not representative of the population, as the proportion of non-Kuwaiti participants is less than the actual population ratio. Consequently, the results cannot be generalized to the entire population. Future studies should aim for a more representative sample and consider a longer data collection period to address these limitations. Conclusion The results of this study reveal that a significant number of patients perceive privacy in Kuwait's polyclinic pharmacies as fair, with many expressing a strong need for private consultation areas. These findings underscore the importance of enhancing privacy measures in these settings1. Implementing private consultation rooms in polyclinic pharmacies could greatly improve patient satisfaction and the overall quality of healthcare services provided by pharmacists. Reference 1. Waheedi S, Marshall V, Alharbia H, Farris KB. Patients’ perceptions of privacy and the need for a private consultation area in community pharmacy. Poster Abstracts. International Journal of Pharmacy Practice. 2016;24:33–60

Enhancing emergency preparedness and disaster management: perceptions from high-fidelity simulation workshops for pharmacy students

Abstract Introduction As climate change intensifies, natural disasters like floods and disease outbreaks increase, straining communities worldwide. During emergencies, healthcare professionals are crucial for ensuring essential healthcare services despite limited access to medicines and facilities. Pharmacists are vital in safeguarding medicine supply chains, providing pharmaceutical care, and aiding in emergency response, which emphasizes the need for thorough preparation during their training1,2. However, little is currently taught on emergency preparedness in undergraduate pharmacy curricula3. Therefore, two emergency preparedness workshops, on a flood scenario and bioterrorism with anthrax, were co-created between academics and 3rd year students from Master of Pharmacy (MPharm) Programme at the University of Nottingham. These workshops were offered as a volunteer learning opportunity and final year and 3rd year MPharm students were invited. Aim The study aimed to explore final-year and 3rd year MPharm students’ perspectives on the high-fidelity simulation workshops of emergency preparedness. It seeks to assess their perceived readiness for pharmacy practice in emergency scenarios and how the workshops contributed to enhancing confidence and competence in disaster response. Methods Data were collected through a focus group, with semi-structured questions. All attendees of the co-created emergency preparedness workshops were invited to the focus group right after the workshops. With their consent, the focus group discussion was audio-recorded and transcribed verbatim, and analysed using thematic analysis. The discussions focused on the participants' opinions of the high-fidelity simulation workshops and their perceived preparedness for pharmacy practice in emergencies. This study does not require ethical approval. Results The study included five participants: three final-year and two 3rd year MPharm students. Five themes were developed, including: 1. ‘High engagement’: Participants defined workshops as enjoyable, highly engaging, with diverse, hands on, student-led activities. 2. ‘Upskilling by immersion’: Exploration of the pharmacist’s role during disaster scenarios was seen as helpful for participants' preparedness, especially in decision-making and facing ethical dilemmas. 3. ‘Lack of realism’: As a perceived challenge, they noted that high-fidelity simulations mirrored regular MPharm training, lacking the pressure of real emergencies. They recommended more closely simulating real disaster scenarios, particularly in the flood workshop. 4. ‘Insufficient briefing/debriefing’: Participants missed a briefing providing details about the activities, such as specifics of the disaster scenario, and feedback on performance to boost confidence. 5. ‘Partial confidence’: Despite improved preparedness, students lacked full confidence in handling emergencies. They emphasized the need for additional training, alongside the realism and feedback enhancements previously suggested, to bolster their confidence further. Discussion / Conclusion Incorporating high-fidelity simulations into pharmacy education is important for preparing students to manage real-life emergencies. MPharm students regularly experience realistic simulations in common pharmaceutical practices, which shapes their perception of the workshops. This familiarity raises their expectations but also provides a solid basis for evaluation. They found the workshops highly engaging and beneficial for developing essential skills. However, they identified gaps in realism and debriefing processes that impacted their confidence and perceived readiness. Addressing these issues and providing repeated training could significantly boost students' confidence and competence in emergency preparedness, ultimately strengthening their role in disaster response.

Trends and inequalities in the use of deworming medication during pregnancy in Sierra Leone, 2008–2019

BackgroundIntestinal worm infections are a significant public health concern for pregnant women in low- and middle-income countries. These infections can lead to anaemia, malnutrition, and adverse pregnancy outcomes, including premature birth and low birth weight. Deworming medication during pregnancy is a safe and effective strategy to prevent these complications and improve maternal and child health. This study aims to investigate the trends and inequalities in the use of deworming medication during pregnancy among women in Sierra Leone between 2008 and 2019.MethodsThe study utilised data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. We used the Health Equity Assessment Toolkit developed by the World Health Organisation to calculate various measures of inequality, including difference, ratio, population attributable risk, and population attributable fraction. An inequality assessment was conducted for five stratifiers: age, economic status, level of education, place of residence, and sub-national province.ResultsThe prevalence of deworming medication during pregnancy was 43.8% in 2008, 72.4% in 2013, and 83.5% in 2019 in Sierra Leone. There was a decrease in age-related inequality from a difference of 3.7% in 2008 to −0.8% in 2019. Economic-related inequality increased from a difference of −8.5% in 2008 to −8.2% in 2019. Both population attributable fraction and population attributable risk were zero in all survey years for economic status, indicating no improvement in the setting average without economic-related inequality. Inequality in education increased from a difference of -8.9% in 2008 to −8.4% in 2019 and decreased from a difference of −2.6% in 2008 to –5.5% in 2019 for place of residence. Provincial inequality decreased from a difference of 29.5% in 2008 to 11.8% in 2019. The population attributable risk for province reveals that the setting average could have been 10.5 percentage points lower in 2008, 8.2 percentage points lower in 2013, and 5.9 percentage points lower in 2019 without provincial inequality.ConclusionThe prevalence of deworming medication use during pregnancy substantially increased from 2008 to 2019 (43.8% to 83.5%) in Sierra Leone. This suggests a positive public health trend in maternal healthcare access and education. Inequalities related to economic status and education increased slightly while age-related, place of residence and provincial inequalities decreased. This indicates an inequitable distribution of this essential healthcare intervention across these stratifiers. The government and policymakers should continue efforts to raise awareness and promote the use of deworming medication during pregnancy.

Review on pharmaceutical supply chain resilience: strategies for managing disruptions and ensuring continuity

The pharmaceutical supply chain is critical to ensuring the availability of life-saving medications and healthcare products. However, it is highly vulnerable to disruptions, including natural disasters, economic and political instabilities, supply chain vulnerabilities, and technological failures. This review explores strategies for enhancing resilience within the pharmaceutical supply chain, focusing on risk management, supplier diversification, inventory management, and the integration of advanced technologies such as IoT, AI, and block chain. Case studies, including the impact of the COVID-19 pandemic, natural disasters like Hurricane Maria, and geopolitical challenges like the US-China trade war, are analyzed to extract valuable lessons and strategies that proved effective in maintaining supply chain continuity. The review also looks ahead to future trends, emphasizing the importance of digital transformation, sustainability, and ethical sourcing in building a more robust and adaptable pharmaceutical supply chain. The findings underscore the need for proactive disruption management, strategic diversification, and sustainable practices to ensure the uninterrupted delivery of essential healthcare products.

Travel distances from institutions designated to detain women and girls to procedural (surgical) abortion facilities in Australia: A geospatial analysis

Women are a fast growing population in prisons in Australia. The growing number of women in prisons challenges the ability of correctional services to meet gendered healthcare needs. People in prisons for women face a number of barriers accessing essential sexual and reproductive healthcare needs, including access to abortion. Distance is one potential barrier to accessing care. The purpose of this study was to create a directory of all institutions of incarceration designated to detain women or girls in Australia (including state-based correctional centres, youth detention centres, immigration detention centres, and secure forensic hospital); create a directory of all known procedural abortion facilities listed in state and territory-based abortion service directories and; measure the distance in kilometres and travel time between institutions of incarceration designated for women or girls and procedural abortion facilities. Among the 49 identified institutions designated to incarcerate women or girls, we identified distances between institutions of incarceration and procedural abortion services ranging from 0.4 to 2604 km, with the largest distances observed in Western Australia. The majority of institutions of incarceration were located between 20 and 100 km away from a procedural abortion facility. Despite decriminalization, the availability of procedural abortion varies greatly across Australia, and inequities may be exacerbated for people in state or youth correctional centres, immigration detention centres, and secure forensic hospitals or rehabilitation units. Distance represents just one barrier to accessing essential reproductive healthcare, and further research is needed to identify additional barriers and implications for health equity, reproductive justice and reproductive autonomy.

Examining the Impact of the COVID-19 Pandemic Among Staff and Consumers at Florida Centers for Independent Living

BackgroundPeople with disabilities (PWD) face health disparities due to barriers that limit their access to essential healthcare services. During the COVID-19 pandemic, health disparities among PWD increased as stay-at-home mandates and other safety measures interrupted access to healthcare and social services. Community-based and consumer-driven Centers for Independent Living (CILs) attempt to reduce disparities faced by PWD by providing information and referrals, peer counseling, and advocacy. ObjectiveDespite funding to utilize public health workers to respond to the COVID-19 pandemic and prepare for future crises, the literature currently lacks examinations of the impact of the COVID-19 pandemic on CIL consumers and staff. MethodsThis qualitative study employed a directed content analysis to evaluate 6 consumer focus groups (N=35) and 4 staff focus groups (N=14). ResultsThrough data analysis, staff themes included Resource Gaps, COVID-19 Concerns, Impact on Independence, Impact on Health, Work Demand Changes, and Work/Life Balance. Among consumers, themes of CIL Service Experiences, CIL Benefits, COVID-19 Concerns of Using CILs, COVID-19 Barriers to Using CILs, Impact on Independence, Impact on Health, Resource Gaps, and Recommendations for CILs were present. ConclusionsThis study demonstrates the diverse experiences among PWD during the COVID-19 pandemic. However, there are similarities in the impact of environmental factors on the severity of disability experienced by consumers and staff. This study highlights the benefits of independent community living resource centers and the need to better understand the experiences of PWD to prepare for future pandemics.

Kabiraj Laxman Mishra: A pioneer of Ayurveda and social welfare in Odisha

Abstract Kabiraj Laxman Mishra, a prominent figure in the field of Ayurveda in Odisha, India, dedicated his life to serving patients from low socio-economic backgrounds throughout the region. Born in January 1900 into a Brahmin family, he received his foundational education at Satyabadi Vana Vidyalaya, renowned for its emphasis on moral values and formal learning. He subsequently graduated from Ravenshaw College in Cuttack and began his career in the police department during British rule in Odisha. However, his profound passion for Ayurveda and his fascination with the healing properties of herbs used by tribal communities inspired him to explore and promote traditional herbal medicine for the benefit of ordinary individuals. After retiring from government service, Mishra authored several books in the Odia language addressing various ailments and their Ayurvedic remedies. He established his pharmacy to prepare medicines based on his extensive experience and tested herbal combinations. His legacy continues through his son, the late Kabiraj Ganesh Mishra, and his wife, Dr. Smt. Sailabala Devi, who currently provides treatment at their residence in Puri. In addition to his contributions to Ayurveda, Kabiraj Laxman Mishra played a significant administrative role within the Temple Administration of the Sri Jagannath Temple in Puri. He served as the President of the Governing Body Council of Gopabandhu Ayurveda Mahavidyalaya and as Chairperson of the Governing Body Council of Samanta Chandra Sekhar College of Puri. In recognition of his impactful work, he was awarded the title of Ayurveda Siromani in 1987 by the Nikhila Utkala Ayurveda Baidya Sammilani. A committed social worker, Mishra also organized free medical camps to provide essential healthcare services to individuals from low socio-economic backgrounds.

Abortion in South-Africa: Does a liberal legislation really impact safe access and use?

The World Health Organization (WHO) considers comprehensive abortion care as part of their essential healthcare service package, which includes the provision of information, abortion management, and post-abortion care. The WHO estimated that globally, 45% of all induced abortions were unsafe, and it noted that nearly half of all the abortions occurred under the least safe circumstances in Africa. Abortion has been legal in South Africa since the implementation of the Choice of Termination of Pregnancy (CTOP) Act (No. 92 of 1996), which was a significant departure from the country's previously restrictive abortion laws. While the CTOP Act (1996) has made provision for access to safe abortion services and pre- and post-abortion counselling, this has not been effectively implemented into effective service delivery. It's estimated that between 52% and 58% of abortions take place in informal medical settings, and that only 7% of the public health facilities in South Africa were performing abortion services in 2017. The WHO noted that the lack of access to safe, affordable, timely, and respectful abortion care, and the stigma associated with abortion pose risks to women's physical and mental well-being throughout the life-course. The aim of this paper was to explore how women in South Africa experience and cope with induced abortion. Additionally, this research looks at how religion, culture and stigma, impact abortion and mental health post-abortion of South African's women. This study utilises data from the latest South African Demographic and Health Surveys (SADHS), in 2016, which includes data from 8514 women aged 15-49 years. This study highlights the need for more data and research related to challenges and experiences of South African women around mental health and the nature of abortion within the country. In this interview conducted by Professor Jean-Pierre Bouchard, population analysts Robynn Ashely Hera and Siposethu Nojoko together with demographer Professor Nancy Stiegler from the University of the Western Cape discuss safe and unsafe abortion incidence and access and the psychological effects thereof.

Impact of COVID-19 on essential healthcare services in Addis Ababa, Ethiopia: Implications for future pandemics.

Responding to the COVID-19 pandemic has presented an unprecedented challenge to health systems, with countries needing to balance the demands of responding directly to the pandemic, while simultaneously continuing provision of essential health services. This study aimed to explore the impact of COVID-19 on essential healthcare services in Addis Ababa, Ethiopia. A facility-based retrospective study was undertaken in 30 health centers in Addis Ababa which were selected using simple random sampling. Secondary data were extracted for 22 indicators on maternal and child health, communicable and non-communicable diseases, and outpatient services for the period spanning between July 2019 and October 2020. These indicators were selected based on the WHO operational guidance on maintaining essential health services during an outbreak guide, essential packages of health services in Ethiopia and expert consultation. The difference in the trends of services before and during COVID-19 was compared using linear-by-linear tests and the difference of magnitude across the indicators was compared using Autoregressive Integrated Moving Average (ARIMA) interrupted time series analysis at a 5% significance level. Overall, more than 1.7 million people visited the studied facilities for outpatient services, and 18,325 mothers attended skilled delivery in the study period. The present study found that the mean number of patients treated for TB declined by 35 patients (β: -34.62; 95%CI: -50.29, -18.95) compared to the pre-COVID-19 era while the number of new patients enrolled for ART decreased by 71 patients (β: -70.62; 95%CI: -107.19, -34.05). Regarding maternal health services, the number of women who received post-natal care decreased by about 215 mothers (β: -214.87; 95%CI: -331.57, -98.17). Similarly, the mean number of clients served at inpatient services declined by 34 (β: -33.72; 95%CI: -68.55, 1.05). On the other hand, the mean number of patients screened for diabetes and hypertension during the pandemic increased by more than 1014 (β: 1014.5; 95%CI: 103.07, 1925.92) and 610 patients (β: 611.21; 95%CI: 302.42, 919.99), respectively. However, changes with regard to antenatal care, skilled birth delivery, and children immunization services did not show a statistically significant change after COVID-19 was reported in Ethiopia. Despite the notable efforts to sustain essential health services amidst the COVID-19 pandemic, our study revealed that there were disruptions in these services. This reinforces the need to adapt strategies to ensure sustainable provision of essential health services when pandemics of COVID19 magnitude cause disruptions of the health services.