Federal Health Minister Research Articles

Job stress among nurses in Ethiopia: A systematic review and meta-analysis

BackgroundAlthough job stress appears in all professions, jobs related to humans are associated with high levels of stress. Nurses are the most frequent medical staff who spend the largest amount of time with patients, cover all areas of the healthcare network, and experience serious job stress. To date, there have been no studies and protocols that estimated the pooled national prevalence of job stress among nurses in Ethiopia. Therefore, the primary purpose of this systematic review and meta-analysis is to determine the pooled national prevalence of job- related stress among Ethiopian nurses. MethodsDifferent database searching engines including PubMed, Scopus, Google Scholar, Africa journal Online, World Health Organization Afro library, and Cochrane review were systematically searched by using keywords such as “job-stress, occupational stress, work-related stress, job-related stress” and their combinations. Eight articles were finally selected with both published and unpublished observational studies that report the prevalence of job stress among nurses. The Preferred Reporting Items for Systematic Review and Meta-Analysis guideline was followed and, it is registered in the Prospero database (ID = CRD42020185450). Heterogeneity across the included studies was evaluated by the inconsistency index (I2). The random-effect model was fitted to estimate the pooled prevalence of job stress among Ethiopian nurses. All statistical analysis was done using R version 3.5.3 and R Studio version 1.2.5033 software for windows. ResultsThe pooled national prevalence of job stress among Ethiopian nurses was 49.6 % (95 % CI: 40.9, 58.3 %). This indicates that one out of two Ethiopian nurses had job stress. Based on subgroup analysis the prevalence of job stress among Amhara’s and Oromia’s region nurses was 44.9 % and 51.2 % respectively. ConclusionThe prevalence of job stress among Ethiopian nurses was high. Thus, our finding suggests that half of the Ethiopian nurses had job-related stress; therefore, managers, federal minister of health, and health policymakers should take effective measures and develop programs to reduce the prevalence of job stress among nurses.

Maturity of Integrated Care in Belgium

Introduction: As integrated care (IC) has been on the Belgian policy agenda for almost a decade, it was requested by the federal minister of health to perform a maturity check of IC, as perceived by the stakeholders and patients. To serve as input for a new inter-federal plan, we were asked to identify actions for further implementation of IC.
 Methods: The perception of the professionals was assessed using the Scirocco tool, which gauges the maturity of twelve dimensions of IC on a scale from 0 to 5. Professionals considered were healthcare professionals, social workers, project coordinators of pilot projects, patient representatives, policy makers or advisers, and researchers. Sixteen discussion groups (140 stakeholders) and 6 world cafés (82 experts) were then organised to identify potential actions for implementation of integrated care in Belgium.
 The experience of the chronic patients was surveyed via the PACIC instrument, an instrument with 20 items scored on a five-point scale from ‘never’ to ‘always’ created to assess whether provided care is congruent with the Chronic Care Model.
 Since data collection took place during the COVID-19 pandemic, all data collection was done online.
 Results: The Scirocco assessment of 865 professionals showed that for 9 dimensions the maturity was rated low (median score 1), and for the other three the median score was 2 ("Populational approach", "Evaluation methods" and "Process coordination"). Small differences were observed between regions.
 A convenience sample of 1 298 chronic patients completed the PACIC questionnaire online. For 16 items out of the 20, “never”, “generally not” or “sometimes” were scored. However, more than 60% of the respondents were, most of the time or always, satisfied with the organisation of care. 
 More than 500 action points were identified by the stakeholders suggesting the need for a phased approach instead of formulating a number of isolated, stand-alone actions. Experts highlighted the need for a clear framework shared by the relevant policy levels to be able to formulate actionable policy measures. The framework must be clear in terms of targeted population and sectors, including coherent territories, defining roles and tasks of governance structures, the legislative and financial initiatives/reforms as well as the possibilities on the availability of data. An incremental financial reform towards a mixed model financing system including fee-for-service with alternative methods of payment is needed to stimulate the patient-centred and population approach as it was perceived as a large barrier towards more IC. Moreover, education is seen as an important lever and extra research is needed to identify relevant measurable indicators (including patient-reported). 
 Conclusion: Integrated Care in Belgium is perceived to be in an early phase, explaining the need for a stepped approach of an agreed upon framework/plan by all relevant policy levels. As it is not easy to define the framework, scenario-analyses including budget impact is recommended to make political choices about further implementation of integrated care.

Gaß: ‚Deep intervention in the hospital landscape‘

Back in February of this year, the German Hospital Federation (DKG) submitted a comprehensive structural and financing proposal to the current debate on a major hospital reform in Germany. As Federal Health Minister Karl Lauterbach and the government commission he had appointed had presented a comprehensive reform concept for hospitals in Germany, but neither the government commission nor the Federal Health Minister had presented a concrete impact analysis, the DKG commissioned the research institute Institute for Health Care Business (hcb) in cooperation with Vebeto to carry out such an analysis.

Sickle Cell Disease Management Practices across Nigeria: A Cross-Sectional Analysis

Introduction Of 300,000 children born with sickle cell disease (SCD) in the world, approximately 75% of these are born in Sub-Saharan Africa. Owing to the frequent painful vaso-occlusive and hemolytic episodes associated with this disease, irreversible multi-organ damage and premature mortality are common. For instance, in Nigeria, 490 deaths per 1000 births among children under 5 have been attributed to SCD; this is four times higher compared to mortality in children born without SCD. On the other hand, those with SCD who survive beyond childhood are faced with an estimated life expectancy of 21 years. To address these challenges, guidelines for SCD management were developed by the Nigerian Federal Health Ministry, National Heart, Lung, and Blood Institute (NHLBI), and the American Society of Hematology but their dissemination and implementation has been difficult. To better understand current management practices, we present a preliminary, descriptive analysis of hydroxyurea and blood transfusion practices for sickle cell disease management across Nigeria. Methods Using a cross-sectional design, we collected demographic and practice-related information from eligible clinicians that provide SCD care in Nigeria. The “SCD Knowledge, Attitudes, and Practices - Nigeria” survey was disseminated to pediatric and adult consultant physicians, resident doctors, and nurses through their respective professional communication platforms. SCD-related practices questions were based on the NHLBI recommendations for SCD management which informed the Nigerian Federal Ministry's National SCD Guideline. A 5-point Likert scale was used to answer each question on hydroxyurea use and blood transfusion. Descriptive analyses of current practices were used to characterize these results and bivariate analyses were conducted using Chi-square or Fisher's test as appropriate. Data analysis was performed using SAS 9.4 (SAS Institute; Cary, NC). Ethical approval was obtained from Duke University Institutional Review Board and the University of Nigeria, College of Medicine Health Research Ethics Committee. Results Analysis of SCD-related practices from the first 73 participants who have completed the survey, revealed most respondents to be female (62%), between 35-65 years old (77%), and adult hematologists or nurses (37% and 40% respectively). This group of clinicians provide care mainly to adults (47%), but 45% admitted providing care to both adults and children. Nearly half (45%) of this group provides care for 0-5 individuals with SCD weekly and 57 participants (78%) work in tertiary-level hospitals. Only 22 of those working in tertiary hospitals had a comprehensive SCD center in their hospital compared to those without an SCD center (39% vs. 61%, p=0.0148). SCD experts were also found in tertiary-level hospitals (75% vs. 25%, p<0.0001). General hematologist expertise was also common in tertiary care (88% vs. 12%, p=0.2424). Figures 1 and 2 report HU and blood transfusion practices. Although 73% confirmed hydroxyurea (HU) prescribing and 90% endorsed the use of simple blood transfusions, HU and blood transfusion practices varied greatly. Respondents indicated most educated patients about HU (frequently/always = 74%) and started HU for patients with >3 VOCs in past year (frequently/always = 62%), however, only 31% frequently/always begin at age 9 months (Figure 1). Most respondents reported prophylactic blood transfusions to reduce HbS below 30% (frequently/always = 71%) and 73% frequently/always performed transfusions for acute SCD complications, yet, 60% indicated they never/rarely match for RBC antigens. Conclusion The data highlights SCD-related expertise and specialty care are found more in tertiary-level hospitals. HU practices described may be attributed to the more conservative approach suggested by the Nigerian SCD Management Guideline compared to the NHLBI recommendations, however there is an important opportunity to expand HU prescribing. Blood transfusion, which has historically been considered difficult in this differently resourced setting, was common. However, chelation, leukoreduction/white blood cell filtration, and red blood cell antigen testing were not common. These preliminary findings represent an opportunity for a larger study and future studies to investigate strategies to increase uptake of existing SCD management recommendations.

Private equity investment in Germany's primary care sector

Abstract Background A major reform of the primary care sector in Germany that included a new law on health system financing in 2004 introduced new tools to be used by “entrepreneurial doctors”. These new tools provided opportunities for corporate investments into primary care, including through private equity funds (PEFs). Since then, there has been a stark increase of private investments. Methods A review of academic and grey literature, media reports and relevant organizational websites. Results Investments by PEFs in Ambulatory Health Care Centres (in German: Medizinische Versorgungszentren, MVZs) have increased continuously in recent years, and latest estimates suggest that in 2020 about 750 of overall 3800 MVZs were owned by PEFs. However, exact and robust data on how many MVZs are owned by PEFs do not exist, as there are no (legal) requirements for disclosures of these investment and ownership structures in Germany. Often, investors are located in tax havens, making the identification of ownership difficult. In addition, a PEF investing into an MVZ may include one health care facility, several dozens or over 100, depending on how well developed the network is (sometimes including long-term care facilities), further complicating an understanding of ownership status. The public debate on private equity investments in Germany's health system has been intensifying in recent years and a number of concerns have been raised, leading to calls by medical chambers for stricter regulation. Federal Minister of Health, Karl Lauterbach, announced in late 2022 that a law prohibiting private equity acquisitions of MVZs would be forthcoming in 2023. Conclusions The involvement of PEFs in Germany's ambulatory health care centres has increased substantially in recent years, leading to increasing public concerns and calls for stricter regulation.

Nísia Trindade: Brazil's Federal Minister of Health

Nísia Trindade: Brazil's Federal Minister of Health

Multilevel analysis of place of delivery among reproductive age women in Ethiopia

AbstractIntroductionThe place where the mother gives birth majorly affects the birth outcome and the mother's well‐being; this is because most maternal mortality, morbidity, and neonatal death occur during the time of labor and delivery and immediately after birth. This study was aimed to identify factors associated with the place of delivery among reproductive age women.MethodSecondary analysis was done using the 2019 Mini Ethiopian Demographic and Health Survey data. A multi‐stage sampling technique was used to select a total of 5527 weighted representative samples of women to include in the analysis. To identify factors associated with the place of delivery, a multilevel mixed effect binary logistic regression model was fitted to consider the hierarchical nature of the data. Statistical significance was declared at p‐value < 0.05.ResultThis study found that women aged 35 to 49 years, mothers with primary and secondary and above, educational status, and women from households with higher wealth index, and participants who had at least one antenatal care visit had higher odds of giving birth in a health facility. Women with two and three and more birth order, who live in rural areas, and women living in communities with higher poverty levels have lower odds of institutional delivery.ConclusionIncreased maternal age, increased maternal educational status, having at least one antenatal care visit, women's household wealth index, increased birth order, rural residence, and higher community poverty level were found to be factors that significantly associated with the place of delivery. Hence, Ethiopia's Federal Minister of Health and another stakeholders should amplify their efforts to increase the accessibility and availability of healthcare facilities and quality maternal health service delivery.

Perceived work-ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022

BackgroundNurses with reduced work ability had a high risk of disability pension, sickness absences, retirement intention, and leave their job and profession early. Nurses frequently suffer from job related stress, occupational fatigue and sleep problems, which can further compromise their work ability.Aims of the studyThe aim of this study was to assess perceived work ability and its associated factors among nurses working in the Northwest of Amhara regional state Referral Hospitals, Northwest Ethiopia, 2022.MethodsA multicenter, an institutional based, cross-sectional study was conducted among 410 nurses working in five selected Referral hospitals, found in the Northwest of Amhara regional state, Northwest Ethiopia, 2022. The data were collected using a structured, self-administered questionnaire and entered using Epi info version 7.2.5 software, analyzed using SPSS version 25. Summary statistics (median or IQR for continuous data and frequency and percentage for categorical variables) were used. The ordinal logistic regression was used to assess’ the presence of association between dependent and independent variables.ResultsThe findings of this study revealed that 59.0% of nurses had poor level of work ability, whereas 34.4% and 6.6% of nurses had sub-optimal and optimal level of work ability respectively. Multivariable ordinal logistic regression revealed that being male [AOR = 2.43; 95% CI (1.52, 3.91)], being BSC nurse [AOR = 0.21; 95% CI (0.08, 0.51)], nurses who had poor sleep quality [AOR = 0.34; 95% CI (0.12, 0.98)] and nurses who had chronic disease [AOR = 0.18; 95% CI (0.08, 0.41)] were significantly associated with nurses’ level of work ability, p-value < 0.05.ConclusionsIn this study, the prevalence of poor level of work ability among nurses was high. Nurses with a female sex, nurses who had chronic disease, BSC holders and nurses who had poor sleep quality had a poor level of work ability. The federal Minister of health and the study hospitals collaborative with concerned stakeholders to design strategies to enhance work ability among nurses.

Major maternal related determinants of non-breastfeeding among mothers in Ethiopia: A multilevel analysis from DHS Ethiopia 2016.

In Ethiopia, the burden of non-breastfeeding is still high despite substantial improvements in breastfeeding. However, the determinants of non-breastfeeding were poorly understood. Therefore, the aim of this study was to identify the maternal -related factors associated with non-breastfeeding. An in-depth analysis of data from the Ethiopian Demographic and Health Survey 2016 (EDHS 2016) was used. A total weighted sample of 11,007 children was included in the analysis. Multilevel logistic regression models were fitted to identify factors associated with non-breastfeeding. A p-value < of 0.05 was used to identify factors significantly associated with non-breastfeeding. The prevalence of non-breastfeeding in Ethiopia was 5.28%. The odds of not breastfeeding were 1.5 times higher among women aged 35to 49 years (AOR = 1.5 CI: 1.034, 2.267) than among women aged 15to 24 years. The odds of not breastfeeding were higher among children whose mothers had BMIs of 18.5-24.9 (AOR = 1.6 CI: 1.097, 2.368) and 25-29.9 (AOR = 2.445 CI: 1.36, 4.394) than among women with BMIs of < 18.5. In addition, not breastfeeding was also significantly associated with ANC follow-up, where mothers who had 1-3 ANC follow-up had a 54% decreased odds (AOR = 0.651 CI: 0.46,0.921) compared to mothers who had no ANC follow-up. Demographically, mothers from Somalia region were five times (AOR = 5.485 CI: 1.654, 18.183) and mothers from SNNP region were almost four times (AOR = 3.997 CI: 1.352, 11.809) more likely to not breastfeed than mothers residing in Addis Ababa. Although breastfeeding practices are gradually improving in Ethiopia, the number of children not breastfed remains high. Individual-level characteristics (women's age, body mass index, and ANC follow-up) and community-level characteristics (geographic region) were statistically significant determinants of non-breastfeeding. Therefore, it is good for the federal minister of Health, planners, policy and decision- makers, and other concerned child health programmers to prioritize both individual and community factors.

HIV self-testing: what GetaKit can tell us about Canada’s $8 million one-time investment

At the 16th International AIDS Conference in Montreal, Canada’s Federal Health Minister announced that the Government of Canada will invest $17 million to increase access to HIV testing, $8 million of which would be used to purchase and distribute HIV self-tests. While HIV testing, and subsequent diagnoses, is a critical first step to achieving the updated UNAIDS goals of 95-95-95, testing on its own does not guarantee linkage to treatment or prevention services. In other words, it does not alone guarantee progress toward the 95-95-95 goals. GetaKit, Canada’s first HIV self-test mail-out project, has demonstrated that a preliminary risk-assessment consistent with US CDC and PHAC screening guidelines ensures targeted uptake among communities most affected by HIV, thus minimizing the risk of false positive results and poor positive predictive values. Furthermore, HIV self-testing must link not only individuals with positive results to treatment, but also persons with negative results to pre-exposure prophylaxis (PrEP) along with re-testing as required. However, both access to treatment and PrEP remain inconsistently available across Canada. Therefore, while this one-time investment of funding to increase HIV testing is encouraging, without clear instructions as to who should be prioritized for testing and definitive next steps to ensure that individuals are successfully linked to care, Canada risks wasting resources, further exacerbating pre-existing inequities.

Stalemate: What's holding up a new health accord?

Federal and provincial health ministers agree privately about how to improve health care in Canada, but their hands are tied until the prime minister and premiers strike a new funding deal. Federal Health Minister Jean-Yves Duclos and his provincial counterparts have met 12 times in 2022 to discuss

BC's Five Years of Drug Failure, Visualized: The anniversary of the province's overdose emergency declaration is nothing to celebrate

Since the start of the opioid epidemic in 2016, the Downtown Eastside community of Vancouver, Canada, has lost many pioneering leaders, activists and visionaries to the war on drugs. The Vancouver Area Network of Drug Users (VANDU), the Western Aboriginal Harm Reduction Society (WAHRS), and the British Columbia Association People on Opiate Maintenance (BCAPOM) are truly concerned about the increasing overdose deaths that have continued since 2016 and have been exacerbated by the novel coronavirus (SARS-COVID-19) despite many unique and timely harm reduction announcements by the British Columbia (BC) government. Some of these unique interventions in BC, although in many cases only mere announcements with limited scope, are based on the philosophy of safe supply to illegal street drugs. Despite all the efforts during the pandemic, overdose deaths have spiked by over 100% compared to the previous year. Therefore, we urge the Canadian federal government, specifically the Honorable Patty Hajdu, the federal Minister of Health, to decriminalize simple possession immediately by granting exemption under the Controlled Drugs and Substances Act. The Canadian federal government has a moral obligation under Sect. 7 of the Canadian Charter of Rights and Freedoms to protect the basic human rights of marginalized Canadians.

Pressure Injury Surveillance and Prevention in Australia: Monash Partners Capacity Building Framework.

A hospital-acquired pressure injury (HAPI) is a common complication across the globe. The severity of HAPI ranges from skin redness and no skin breakdown to full skin and tissue loss, exposing the tendons and bones. HAPI can significantly impact the quality of life. In addition to the human cost, this injury carries a high economic burden with the cost of treatment far outweighing the preventative measures. The HAPI rates are a key indicator of health services performance. Globally, healthcare services aim to reduce its incidence. In Australia, the federal health minister has prioritised the need for improvement in HAPI surveillance and prevention. Capacity building is vital to optimise pressure injury (PI) surveillance and prevention in acute care services. In this perspective article, we provide a framework for capacity building to optimise HAPI prevention and surveillance in a large cross-sector collaborative partnership in Australia. This framework comprises six key action areas in capacity building to optimise the HAPI outcomes, such as research, organisational development, workforce development, leadership, collaboration, and consumer involvement.

ROLE OF REHAB PROFESSIONALS IN COVID-19 CRISES

The covid-19 pandemic has put healthcare professionals worldwide in an unprecedented situation, with difficult decision options and intense pressure for maneuvers. The World Health Organization (WHO) has classified the coronavirus epidemic as a global public health emergency of international concern and with the number of cases increasing by 13 times in 2 weeks1.Pakistan has also been severely affected by this pandemic. Federal Health Minister of Pakistan confirmed two cases on 26 February 2020, and within 15 days, the total number of COVID 19 positive test reached 202. WHO has expressed its concern that Pakistan is facing a major challenge of COVID-19. Physical and social activities of people has prominently affected due to restrictions imposed by government on social gathering. Financial instability, loss of loved ones and social disruption presents great challenge to public health. Marked increase in psychological and emotional distress is observed owing to restricted activities at home and high exposure to stressful media news; this has amplified interpersonal violence such as verbal and physical expression of abuse, rage, hostility and resentment.

Socio-economic impact on involuntary admissions and coercive measures in psychiatric hospitals in Germany

ObjectiveThe present study aimed to characterize involuntary psychiatric admissions and coercive measures within psychiatric hospitals regarding their temporal development and processual aspects. Moreover, the influence of socio-economic factors on involuntary admissions and coercive measures was investigated. MethodsDifferent data sets from the federal state of North-Rhine Westphalia (NRW) were used in this study. In addition to a survey in which n = 33 hospitals responded (40.7%), official data from the Federal Health Ministry were analysed over a decade regarding involuntary admissions and coercive measures. These data were available for all n = 54 districts, respectively, all n = 81 psychiatric hospitals in NRW. Datasets were mainly analysed comparing different socio-economic clusters. ResultsThe hospital admission rate increased significantly over time (from 1.12 to 1.34 per 1000 inhabitants) within ten years. However, whereas the admission rates differed significantly between socio-economic clusters, the amount of coercive measures used in the hospitals did not. Compared to general psychiatry and addiction medicine, geriatric psychiatry had the highest amount of involuntary admissions (12.2% under public law, 14.1% under civil law). Furthermore, most coercive measures lasted at least an hour. ConclusionIt seems that, despite intense discussions and enhanced efforts to reduce coercion, there are still some neglected aspects, such as the need for coercive measures and their duration, particularly in the geriatric psychiatric setting. In addition, the results show that further approaches to prevent involuntary admissions are needed to address other stakeholders beyond the hospitals and further aspects of the socio-economic environment.

Optimal Cancer Care for Aboriginal and Torres Strait Islander People: A Shared Approach to System Level Change.

PURPOSETo improve cancer outcomes for Aboriginal and Torres Strait Islander people through the development and national endorsement of the first population-specific optimal care pathway (OCP) to guide the delivery of high-quality, culturally appropriate, and evidence-based cancer care.METHODSAn iterative methodology was undertaken over a 2-year period, and more than 70 organizations and individuals from diverse cultural, geographic, and sectorial backgrounds provided input. Cancer Australia reviewed experiences of care and the evidence base and undertook national public consultation with the Indigenous health sector and community, health professionals, and professional colleges. Critical to the OCP development was the leadership of Aboriginal and Torres Strait Islander health experts and consumers.RESULTSThe OCP received unanimous endorsement by all federal, state, and territory health ministers. Key elements of the OCP include attention to the cultural appropriateness of the health care environment; improvement in cross-cultural communication; relationship building with local community; optimization of health literacy; recognition of men’s and women’s business; and the need to use culturally appropriate resources. The OCP can be used as a tool for health services and health professionals to identify gaps in current cancer services and to inform quality improvement initiatives across all aspects of the care pathway.CONCLUSIONThe development of the OCP identified a number of areas that require prioritization. Ensuring culturally safe and accessible health services is essential to support early presentation and diagnosis. Multidisciplinary treatment planning and patient-centered care are required for all Aboriginal and Torres Strait Islander people, irrespective of location. Health planners and governments acknowledge the imperative for change and have expressed strong commitment to work with Indigenous Australians to improve the accessibility, cultural appropriateness, and quality of cancer care.

Vaccination, Autonomy, Complexity, Solidarity - Ethical analyses of a German policy discourse

Abstract Background Currently, measles immunization is high on the agenda of academic and public discourses - on both sides of the Atlantic. In Germany, the discussion of mandatory (measles) immunization was intensively publicly discussed in Spring 2019. Many stakeholders, including federal politicians, plea for mandatory measles immunization. In our paper we analyse the discourse from an ethical point of view. Methods Statements and arguments from German stakeholders in the public debate in 2019 are analysed (among them statements of the federal minister of health, the German Medical Association, NGOs and the National Ethics Council). A vaccination ethics framework and a public trust framework are applied in the analysis. Results Politicians and other public stakeholders debate (measles) immunization and increasingly demand mandatory (measles) vaccination. However, frequently it is unclear which vaccinations or immunization programmes they refer to. They often do ignore the epidemiological situation of immunization rates in Germany, regional differences, relevant target groups and implementation mechanisms, including potential sanctions. This way they simplify the complex problem and offer (populist) simplistic solutions. Normative arguments of stakeholders repeatedly use conceptions of ’autonomy’ and ’harm’; but sometimes also ’solidarity’ is mentioned. Conclusions The call for mandatory measles immunization of school and kindergarten children is offering no adequate and sufficient solution to the problem of elimination of measles. Nevertheless, it contributes to reducing infection risks for the children in care and schooling facilities. Rather, the problem has to be understood in its complexity before discussing the ethical challenges and making effective policy recommendations. When discussing ways to increase immunization rates, ethical values like public trust and solidarity have to be in the foreground - not (only) the debate of autonomy and its restriction. Key messages In German policy discourses 2019, the discussion of “mandatory (measles) vaccination” often shows inaccuracies regarding definitions and facts. These have to be clarified before ethical analysis. Ethical issues regarding the voluntariness of measles vaccination relate also to the ethical concepts of solidarity and public trust and not only to autonomy.

Welcome Address

Welcome Address

The Child Health Protection Act: advocacy must continue.

KEY POINTS In 2015, Canada’s prime minister mandated the federal minister of health to restrict commercial marketing of unhealthy food and beverages to children. In early 2016, the Standing Senate Committee on Social Affairs, Science and Technology recommended a ban on the advertising of food and

Reduction of hospital stay at maternity unit: an evaluation of the impact on maternal and neonatal readmission

In June 2015, the Belgian federal minister of public health imposed a reduction of 1 day in hospital stay at the maternity unit. This retrospective cohort study evaluated data of all patients who delivered between January 01 2010 and November 30 2015. Neonatal readmissions during the first 28 days postpartum and maternal readmissions during the first 6 weeks postpartum were studied. In total, 6009 births were included. The neonatal readmissions significantly increased (4.8% versus 6.9%, p value = .04) after June 2015. There was no significant difference in maternal readmissions between groups. In conclusion, hospital stay reduction at the maternity unit was linked with an increase of neonatal readmissions in the first 28 days postpartum, but did not have an effect on the maternal readmissions.Impact StatementWhat is already known on this subject? Many studies have evaluated the impact of early discharge on maternal and neonatal morbidity since 1950. Nevertheless, there are still concerns regarding the advantages and inconveniences of this policy. This retrospective cohort study took place in a tertiary referral centre in Belgium (CHU Tivoli) and evaluated data of all patients who delivered between January 01 2010 and November 30 2015.What the results of this study add? The readmissions for icterus increased significantly after the introduction of the reduced stay. There was no significant difference in maternal readmissions between groups.What the implications are of these findings for clinical practice and/or further research? A shorter hospital may be linked with an increase of neonatal readmissions in the first 28 days postpartum, but does not seem to have an effect on the maternal readmissions. Further prospective studies are needed in order to validate this hypothesis and also elucidate the reasons leading to a higher neonatal readmission rate.