Formal Health Research Articles

Pengembangan Sumber Daya Manusia pada Produktivitas Kerja di Puskesmas

All individuals who operate actively and professionally in the health sector are considered health human resources, regardless of whether they have earned formal health education or not. The purpose of this study is to ascertain the Health Center's HR management implementation strategy. This study employed a descriptive qualitative methodology. Purposive sampling, nonprobability sampling, or a sampling strategy based on particular criteria were used to choose the study participants. Documentation, interviews, and observation are some of the data collection techniques. The study's findings show that the HR development management communication components and the recommendations for the Health Center HR development policy have been successfully applied. Even with the improvement in quality, there are still a number of barriers preventing resources from being used efficiently.

Aging in place or aging out of place? Family caregivers' perspectives on care for older Pakistani migrants in Norway.

The aging population in Europe is increasing, with growing ethnic diversity among older individuals due to migration. Public policies emphasize 'aging in place' to address financial challenges and reduce the burden on the healthcare system. However, research often overlooks the heterogeneity among older people, especially non-European migrants. Also, research on family caregivers' role in enabling 'aging in place' for older relatives with migrant backgrounds is limited, despite many older non-European migrants' preference for family care in comparison to long-term institutional care. This study aims to explore the experiences and perspectives of family caregivers in the context of formal and informal care and their preferences regarding the place of care for older family members with migrant backgrounds, particularly the Pakistani Ahmadiyya community in Norway. Eighteen semi-structured individual interviews and two group interviews were conducted in Urdu and English with nineteen female family caregivers of older relatives, ages 25-62, residing in Norway. The analysis yielded three main themes: (1) "Nursing homes are not for the ones who love their parents", (2) Preferences for home with the possibility of sharing care, and (3) Mismatch between family care needs and formal care. Family caregivers' perception of health services has a decisive impact on their older relatives' demand and use of formal health services, emphasizing the need for trust. Even though home care services were seen as a viable option, they should be adapted so that the family caregivers can use them and feel supported in enabling 'aging in place' for older migrants.

The Role of Formal Schooling, Literacy, and Health Knowledge in Addressing Domestic Violence Against Women in West Africa

When “education” is cited as a solution for domestic violence, different aspects of knowledge acquisition are often omitted. This study uses 2019 Demographic and Health Surveys from four West African countries (The Gambia, Liberia, Senegal, Sierra Leone) with a combined sample size of 12,480 women and generalized ordered logit regression to examine the effects of types of knowledge (years of schooling, literacy, and health knowledge) on domestic violence (physical abuse, emotional abuse, and control issues). The results suggest that literacy has the most reliable beneficial impact on domestic violence and was consistently associated with decreased odds of abuse. However, greater findings suggest that schooling, literacy, and health knowledge function as separate types of education and that their relationships are complex and context-specific. By neglecting to see these types of knowledge as separate entities that can operate together, it is possible that mitigation strategies for domestic violence are going undiscovered.

Role of traditional healers in the management of microbial keratitis in eastern Nepal.

Microbial Keratitis (MK) is a leading cause of corneal blindness due to infection and its consequences, with a higher incidence in resource-limited nations. Hospital-based patient records from different parts of Nepal suggest patients often use traditional eye medicine to treat MK. Traditional healers (TH) within the community are often the first point of care for MK management. Little is known of their practice, perceptions, and knowledge around MK management. We aimed to understand the role of traditional healers in the management of MK in south-eastern Nepal. A cross-sectional, mixed method, descriptive study was conducted in the Siraha district of Nepal. A total of 109 traditional healers consented to participate in a survey of knowledge, attitude, and practices. Some participants were also invited to participate in in-depth interviews and focus group discussions. Interviews and focus groups were conducted and recorded in the Maithili language by a native speaking interviewer and transcribed into English. Descriptive analysis was performed for the survey. Data saturation was considered the endpoint for qualitative data collection, and a thematic was analysis applied. Traditional healers believe that infection of the eye can be caused by trauma, conjunctivitis, or evil spirits. They were unclear about differentiating MK from other eye conditions. They provided various types of treatment. Some were confident that they could treat severe ulcers that had not responded to medical therapy, while others thought treating larger diameter ulcers would be difficult. Although there were mixed responses in referring patients with MK, the majority of TH were willing to refer. In a weak health system, traditional healers may help address barriers to healthcare access and reduce delays to definitive care, upon integration into the formal health system and referral pathway.

Patients’ trust in health information sources as an antecedent of novel healthcare technology usage

Abstract Background As professional health information sources, healthcare maintenance organizations (HMOs) need to convince patients of the necessity, efficiency, and reliability of technology-based services to increase and optimize their usage. It raises the question of whether patients’ trust in health information sources shapes the use of technology-based services and, in return, increases their willingness to use novel healthcare services in the future. Methods Data were collected through an online close-ended survey among 668 adult Israeli citizens insured with Israeli health insurance (85% of them Jewish, 52.5% female, and in their early 40s, with half holding an academic degree). The survey explored actual use and willingness to use innovative healthcare technologies and the trust respondents attributed to various sources of health information. Data were analyzed by SPSS 28. Results Participants generally use healthcare technology primarily to schedule appointments, search for medical information, and make health-related requests. To quite an extent, they are willing to be treated with innovative healthcare technologies (e.g., for radiological purposes and personally tailored medication). Preliminary results suggest that trust in the measured formal health information sources (i.e., formal health providers, HMO, HMO online services) was positively associated with technology-based healthcare services usage (r=.14 - .20, p<.001). A positive association also emerged between the current use of healthcare technology and the willingness to use innovative medical technologies in the future (r=.23, p<.001). Conclusions HMOs, as key players, have the power to maximize the usage of advanced health services by establishing trusting relationships with their patients. This will increase the usage of healthcare technology-based services and generate positive patient experiences, which will result in the willingness to experience novel types of health services in the future. Key messages • Encouraging patients to use technology-based health services will maximize the potential inherent in the use of innovative health services and treatments in the future. • Nurturing trusting relationships with patients at any level in the health system will increase their compliance with health providers’ recommendations to use advanced health services.

Prevalence of Mental health and Receipt of Services in Latino Immigrants Living in Philadelphia

Abstract Background and Purpose Research shows that Latino populations are less likely to seek formal mental health services, these attitudes combined with difficulty finding affordable services impact the ability to receive a mental health diagnosis. This project examines mental health symptoms, utilization of mental health services, and socio-ecological barriers to receive mental health services among Latino immigrants, including region of origin, health insurance, immigration status, and English proficiency. Methods Data was collected between 2021-2022 by Drexel University’s CRISOL lab using a cross-sectional respondent-driven sample survey of Latinos born outside the U.S. mainland and residing in Philadelphia. The final sample included 420 Latino/a/e immigrants. Descriptive statistics and bivariate associations using Chi-square analyses were computed. Outcomes The findings revealed that 29.1% of the surveyed individuals exhibited signs of Depression, 36.1% experienced symptoms of Anxiety, 8.7% showed signs of PTSD, and 43.4% possessed one or more mental health conditions. The findings show that country of origin (p<.01), health insurance (p<.05), immigration status (p<.01), and language proficiency (p<.001) are significantly associated with whether an individual has received mental health services in the past year or in their lifetime. Of the survey population, only 39.5% of individuals with one or more mental issues had received mental health services in their lifetime. Conclusions Interventions to increase access to mental health services for Latino communities are needed. Solutions addressing disparities in access to mental health services must address systemic, cultural, and language barriers. Key messages • Region of origin, health insurance, immigration status, and English proficiency impact the utilization of mental health services. • Immigrant populations face stressors that increase the risk for mental health disease and experience multiple barriers to access mental health services.

Public Health Challenges for 2050 in the Netherlands

Abstract Every 4 years, the National Institute for Public Health and the Environment (RIVM) carries out the Dutch Public Health Foresight Study, commissioned by the Ministry of Health. The ninth edition (PHFS-2024) compiles an outlook on future public health and the health care system in the Netherlands. It combines a business-as-usual Trend Scenario with literature study and a range of qualitative and mixed-methods approaches. The Trend Scenario comprises projections up to 2050 for a broad range of epidemiological indicators. Such as (healthy) life expectancy, disease burden, life style factors. The qualitative and mixed methods approaches supported an incremental intersubjective process. Methods were a focus groups study, stakeholder sessions and workshops. An important innovation in this study was the Citizen Council and Panel. The outcomes show that demographic development, in particular growth of the group people at high age with multimorbidity, will lead to high pressure on the formal and informal health care system but also on e.g. mental health. A life course approach applied shows that decreasing mental health of youth will have long term consequences. Also, overweight will deeply impact older people’s health in the future. Lastly, climate change in combination with e.g. energy transition will deeply affect our society and living environment. Next to these challenges, there will also be opportunities to improve health. Building a climate-proof living environment that also stimulates healthy life styles and social interaction is one of them. However, improving health has linkages with policy areas outside the traditional public health domain as well and requires, firstly, a Health in/for All Policies approach. Secondly a whole-of-society approach in which companies and civil organizations take action is needed. All these efforts can only be effective if people and communities are put at the core of all health policies.

The paradoxical surplus of healthcare workers in Africa: the need for research and policy engagement

Abstract Background In many countries in Africa, there is a paradoxical surplus of under and unemployed nurses, midwives, physicians and pharmacists which exists amidst a shortage of staff within the formal health system. By 2030, the World Health Organisation Africa Region may find itself with a shortage of 6.1 million healthcare workers (HCWs) alongside 700,000 un- or underemployed health staff. This study aims to bring the nature and consequences of an existing paradoxical surplus of HCWs in low income countries into the HCW migration debate and to explore novel solutions. Methods The study draws on a rapid review of the literature and deeper insights from expert information, using examples from Uganda, Kenya and Niger. Results In Niger, between 2010-2014, 55% of health graduates were unable to find permanent work in the sector leaving 15 000 HCWs unemployed or in precarious jobs. In Sudan, an 8-fold increase of the number of places at medical colleges (between 1996-2012) was not accompanied by a commensurate investment in physician positions leading to increased unemployment and brain drain. In Kenya, in 2021, 27243 HCWs were un or under-employed. In Uganda, 20590 nurses and midwives were reported as unemployed in 2023. Despite this, the emphasis in policy debates about the healthcare workforce crisis in most national and global levels is on staff shortage and the need to train more HCWs. In contrast, an existing surplus HCWs and their association with patterns of migration are largely unknown. Little time is given over to understand the economic, political and social factors that have driven their emergence and the governance challenges and potential interventions to improve employment rates. Conclusions The results highlight the complexity of migration, labour market conditions and health systems, in particular in low income countries in Africa. Both qualitative and quantitative data is necessary for policy makers to find effective solutions to the problem.

Determinants of health-seeking behaviour in rural district of Jasikan, Ghana: a cross-sectional study

BackgroundThe Ghana Health Service aims to ensure the health of all Ghanaians. Understanding the factors that influence people’s health-seeking behaviour will help the Ghana Health Service evaluate and enact policies that will enable it to achieve set targets. This research aimed to determine the factors that influence the health-seeking behaviour of the residents of Jasikan District and ascertain the importance of the well-being clinic in this context.MethodsThe study design was a community-based cross-sectional study using a mixed method of data collection. A stratified sample of 295 respondents from the five [5] sub-districts of the target population was obtained. Cramer’s V statistic was used to assess the effect size and significance of the association between categorical variables. Further, multiple binary logistic regression was used to determine significant predictors of health-seeking behaviour. Health seeking behaviour was categorised as appropriate or inappropriate. The health seeking behaviour of participants was considered appropriate if they sought health care at public health facilities, private health facilities, and licensed Pharmacies/OTCMS and inappropriate when participants sough care at traditional/faith healers, engaging in self-medication, and not taking action during an illness episode.ResultsThe mean age of participants in the study was 37.49 ± 15.74 years. Females comprised the majority of study respondents (160; 56.3%). When they fell ill, 61% of respondents chose formal public health institutions as the first port of call. A significant proportion of respondents (245; 83%) preferred appropriate health-seeking behaviour, with age (p = 0.045) and health insurance status (p < 0.01) significantly influencing where respondents sought care. More than half of respondents indicated that affordable service (59.9%), readily available drugs (54.5%), and good services (52.0%) are key characteristics of respondents’ preference for service in healthcare. The educational level significantly correlated with service characteristics when people seek health care (p = 0.035). The severity of illness (9; 28.1%), perception of a facility as the best place (7; 21.9%), well-trained staff (4; 12.5%), and professionalism (3; 9.4%) influenced respondents’ choice of health care. More than half (78%) of respondents agreed with the need for a well-being clinic in a hospital. The binary logistic regression indicates that religion is a significant predictor the appropriateness of participants’ health seeking behaviour, but the overall model could not improve the overall prediction rate of the constant model.ConclusionThe health-seeking behaviour of the people of Jasikan is good. The participants’ sex, good service, affordability, and availability of medicines are critical service characteristics that influence the choice of healthcare providers. Managers of health facilities should consider these characteristics to remain competitive and drive positive health-seeking behaviour in the community. Facilities are encouraged to set up a functional well-being clinic and open it to the public.

COMMUNITY INTERVENTIONS TO REDUCE MATERNAL MORTALITY IN LOW-RESOURCE AREAS

Maternal mortality, defined as the death of women during pregnancy, childbirth or in the postpartum period, continues to be a serious public health problem, especially in low-resource areas. Factors such as limited access to quality healthcare, lack of infrastructure, shortage of qualified professionals and socio-economic inequalities contribute to high mortality rates. In many of these regions, community interventions have been key to reducing maternal mortality by providing direct assistance to pregnant women, promoting health care education and strengthening the link between communities and medical services. This study seeks to analyze community interventions implemented in low-resource areas to reduce maternal mortality, evaluating their strategies, challenges and the results obtained in improving maternal survival rates. This study is a systematic review that investigates the effectiveness of maternal health interventions in low- and middle-income countries, focusing on skilled birth attendant programs, community transport, and technological innovations. The analyses were carried out in databases such as PubMed, BMC Pregnancy and Childbirth and African Journal of Reproductive Health, using data from articles published between 2015 and 2021. Community interventions to reduce maternal mortality range from health education programs, training traditional birth attendants and strengthening maternal and child support networks. One of the main approaches involves training community health agents, who work directly in communities, providing basic prenatal care, referral to medical services in cases of risk and promoting knowledge about signs of pregnancy complications. These actions are especially important in remote areas, where access to health facilities is limited. Another key aspect of these interventions is the promotion of safe practices during childbirth and the strengthening of emergency transport systems, ensuring that pregnant women at risk can be transferred to health centers equipped to deal with complications. The introduction of simple technologies, such as clean delivery kits and essential medicines, has shown promising results in reducing infections and hemorrhages, which are primary causes of maternal mortality. Awareness campaigns also play a crucial role, educating the population about the importance of prenatal care, proper nutrition and birth assistance in controlled environments. These initiatives aim not only to improve knowledge about maternal health, but also to combat cultural and social barriers that can prevent pregnant women from seeking medical care in a timely manner. It is concluded that community interventions have proven to be an effective approach to reducing maternal mortality in low-resource areas. Training health workers, implementing safe delivery practices and raising awareness about antenatal care are strategies that have contributed significantly to improving maternal health outcomes. However, for these interventions to be sustainable and scaled up, continued public policy support, adequate funding and the integration of these actions with formal health systems are essential.

The role of indigenous healers in treating surgical conditions in the rural Eastern Cape of South Africa.

Indigenous knowledge healers (IKHs) provide alternative healthcare to formal health services in rural South Africa, but there is a gap in knowledge regarding their treatment of surgical conditions. This study evaluated IKH surgical care and described their perspective of the dual health system. A cross sectional survey of IKHs in the Madwaleni Hospital catchment of the Eastern Cape, South Africa was conducted. Topics included the training and experience of IKHs, treatment of nine common surgical conditions, referral patterns, disease origin beliefs, benefits and limitations of care, and collaborative opportunities between the two health systems. Thirty-five IKHs completed the survey. IKHs were consulted by persons with all nine surgical conditions. The most common forms of treatment were application of an ointment on the affected site (88%) and oral medication (82%). Operative treatment was only done for abscess. Referrals to the formal healthcare sector were made for all surgical conditions. IKHs reported that they were limited by their lack of training and resources to perform operations. On the other hand, they perceived the treatment of the spiritual aspect of surgical disease as a benefit of their care. Thirty-five (100%) IKHs were interested in closer collaboration with the formal health sector. IKHs treat surgical conditions but refer to the formal health sector when diagnostic and operative services are needed. More research is needed to determine the potential advantages and disadvantages between the formal health sector and IKH collaboration.

A phenomenological investigation of kinship involvement in the lives of children whose parents have mental illness

ABSTRACT Background and Purpose Mental health services rarely reach children whose parents have mental illness despite their poor outcomes. There is a need to consider how mental health practitioners can prioritize the needs of these children and their families. This study examined kinship involvement in the lives of children whose parents have mental illness. Methods A phenomenological design was used, interviewing 20 children (aged 10–17 years) in families with parental mental illness (PMI) in Ghana. The interview data was analysed to attain the essential features of what kinship support looks like for children and their families. Results The essential feature of kinship support for children and families with PMI is characterized by uncertainty. However, there is an overall impression that kinship is generally supportive to these families, providing respite services, assistance with daily living, emotional support and advice to children and families. Yet, there is a sense that kinship may not always be helpful to these families. Conclusions Kinship support is integral in countries where formal mental health services are inadequate and should be explored/harnessed by mental health practitioners. The study provides directions into ways practitioners can utilize kinship as a resource when working with these families.

Assessing the Impact of Community Health Workforce on the Efficiency and Accessibility of Healthcare Delivery

The role of Community Health Workers (CHWs) in improving healthcare delivery, particularly in low- and middle-income countries (LMICs), has garnered increased attention due to their ability to bridge the gap between formal health systems and underserved communities. This study assesses the impact of CHWs on healthcare accessibility, efficiency, and quality. CHWs have been instrumental in expanding healthcare access, especially in rural and remote areas, by providing primary care, maternal and child health services, and chronic disease management. Additionally, CHWs enhance health system efficiency by alleviating the burden on overworked health professionals, enabling them to focus on more specialized care. However, challenges remains regarding the sustainability of CHW programs, including inadequate training, compensation, and integration into formal healthcare systems, which can affect the quality of care. Addressing these challenges through sustained investment, political support, and better integration is critical for maximizing the potential of CHWs to transform healthcare delivery, reduce health disparities, and promote health equity.

7281 Increased Incidence Of Fracture And Predicted Fracture Risk In Patients With Mild Autonomous Cortisol Secretion

Abstract Disclosure: R. Sagar: None. A. Saadulla: None. A. Abbas: None. Background: Mild autonomous cortisol secretion (MACS) is common in patients presenting with adrenal incidentalomas (AI) and has been associated with cardiovascular and metabolic co-morbidities. Whilst there is growing evidence to support the increased risk of cardiometabolic co-morbidity in this cohort, the bone health effects are less well characterised. Our study evaluated the prevalence of fragility fracture and fracture risk in patients with AI and MACS compared with a cohort of patients with benign, non-functional AI. Methods: Retrospective observational data were collected on 391 patients with MACS and an AI along with 626 patients with a benign, non-functional AI. Demographic, biochemical, radiological and bone health data were recorded. FRAX, a validated fracture risk stratifying tool, was used to calculated risk scores for all patients aged between 40 and 90 and risk category according to national guidance were also recorded. Results: MACS cohort (mean age 69±10 and 53% female) had a mean cortisol on overnight dexamethasone suppression test of 76.6±21nmol/l. Benign, non-functional patients had a mean age 61.4±12 and 57% female. Both cohorts had predominantly unilateral lesions (76% in MACS versus 84%). Patients with MACS had a significantly higher prevalence of all fragility fractures, 15.9% compared with 6.7% in the benign, non-functional group, p&amp;lt;0.0001. Patients with MACS had a significantly higher 10-year risk of major osteoporotic fracture (10.6±3.8% versus 7.1±5.4%, p&amp;lt;0.0001) and also hip fracture (7.2±4.1% versus 1.9±2.7%, p&amp;lt;0.0001). 17% of MACS cohort were classed as either high or very high fracture risk, with a further 28% classed as intermediate risk requiring further assessment of bone health compared with 3% high/very high risk in the non-functional group. Despite this only 31% of the MACS group had undergone DEXA scan to assess bone mineral density compared to 13% of the non-MACS group. Only 5% of MACS patients were on osteoporosis treatment (3% in non-MACS cohort). Conclusions: Patients with MACS make up a large proportion of those presenting with adrenal incidentaloma. Our study suggests an increased prevalence of fragility fractures along with increased fracture risk in patients with MACS compared to those with non-functional AI. However, we also demonstrate an unmet need, with less than 1/3 of patients with MACS undergoing formal bone health assessment and just 5% of the total cohort on treatment for osteoporosis despite a significant proportion meeting intervention thresholds. Presentation: 6/1/2024

Fatalism or vigilance? Exposure to infant and maternal deaths and subsequent use of maternal health services in Malawi

In developing contexts, where formal health services are still expanding, understanding what factors discourage individuals from using health services is critical to advance population health. A long theorized, but rarely investigated, conjecture is that in high-mortality contexts, exposure to death can beget fatalism, or even foster distrust of formal healthcare, locking families into cycles of low use of health services. A counter perspective, however, suggests exposure to death can encourage individuals’ health vigilance, corresponding with their higher use of health services. We test these competing ideas by analyzing the associations between women’s intimate exposure to death in the context of pregnancy and delivery via (1) a sister’s maternal death and (2) an infant child’s neonatal death, and their subsequent use of maternal health services. We focus on the context of Malawi, a setting that features high maternal and infant mortality rates, similar to those observed across much of sub-Saharan Africa, as well as persistent gaps in service use. Specifically, we use Malawi Demographic and Health Survey (2015–16) data to examine if a sister’s maternal death or a child’s neonatal death corresponds with a woman’s odds of attending full antenatal care during a subsequent pregnancy or delivering the pregnancy at a formal health facility. Given the qualitatively distinct nature of losing one’s only or first child, we also assess if the effect of a child’s neonatal death varies by birth order. The results show that maternal and neonate death exposures correspond generally with women’s higher use of maternal health services, challenging the notion that exposure to death fosters fatalism or distrust. Although the results vary in significance, the nuanced findings highlight women’s vigilance in the face of health threats, emphasizing their resilience amid a high burden of familial loss.

Knowledge and perceptions of health literacy among pharmacists in Ohio in 2013 and 2021

BackgroundThere is limited existing literature on pharmacists' knowledge of health literacy and the interventions pharmacists use to address limited health literacy. ObjectivesThe primary objectives of this study were to evaluate pharmacists' knowledge and perceptions of the impact of limited health literacy on patients and their practice, and to review the techniques used to care for patients. MethodsWe conducted a cross-sectional, web-based survey of registered Ohio pharmacists in 2013 and repeated the survey in 2021. The Nursing Professional Health Literacy Survey was adapted and employed to assess 1) general knowledge; 2) health literacy in the workplace; and 3) demographics. Changes in pharmacists' knowledge and perceptions of health literacy, self-reported use of communication techniques, and methods for assessing a patient’s health literacy were evaluated. ResultsResponse rates were 12.4% (N = 62) in 2013 and 3.5% (N = 174) in 2021. Awareness of the term health literacy increased, rising from 82.3% to 89.7% (P = 0.127). Less than 41% of pharmacists in both cohorts had received formal health literacy training; a regression model indicated that pharmacists with more years of practice were less likely to have had such training (P < 0.05). Most pharmacists admitted they never formally assess health literacy (79.0% in 2013 and 81.6% in 2021; P = 0.875) but reported often relying on their gut feeling to gauge a patient's health literacy (37.1% in 2013 and 41.4% in 2021; P = 0.658). The percentage of pharmacists who orally reviewed written instructions with patients, used layman’s terms, and had patients demonstrate instructions significantly increased (P < 0.05) between 2013 and 2021. ConclusionGaps remain in pharmacists' knowledge and practices related to health literacy. From 2013 to 2021, there were improvements in how pharmacists communicate with patients who have limited health literacy, but no significant change in the methods used to assess health literacy.

Trusted networks: a study of communication flow and access to abortion information in Argentina.

In December 2020, Argentina approved a new abortion law following decades of feminist and social advocacy. This paper presents qualitative findings from interviews and focus group discussions with people in local communities focusing on how individuals of reproductive age access and communicate sexual and reproductive health information, particularly regarding abortion. Sixteen in-depth interviews were conducted with key informants working in the field of SRHR and four focus group discussions took place with cisgender women and girls, transmasculine people and non-binary people of reproductive age. We found that information exchange and communication about sexual and reproductive health issues, particularly abortion, took place mainly through informal social networks engaging with activists and feminist grass-root organisations. These informal social networks were built on trust as a collective affect that enabled open communication about abortion. Information sharing through word of mouth, in person and via digital means using different social media platforms, is an important means of information sharing and communication in Argentina. Monitoring the implementation of abortion policies in this country should include investigating the impact of people accessing abortion through informal social networks in terms of abortion pathways and intersections with the formal health system.

Examining the roles and relationships of actors in community health systems in Nigeria through the lens of the expanded health systems framework

BackgroundCommunity health system (CHS) exists through the actions and activities of different actors within and outside communities. However, these actors, their roles and their relationships with one another have not...

The Role of Mental Health Literacy in Shaping Help-Seeking Behaviors among High School Students in Vietnam

Background: Mental health issues, such as stress, anxiety, and depression, are becoming more common among high school students, yet cultural stigma and inadequate mental health literacy impede effective help-seeking in Vietnam. Adolescents sometimes encounter obstacles in identifying mental health issues and obtaining suitable resources, particularly in environments where professional services are inadequate and mental health is stigmatized. Purpose: This study aims to address the comprehension of mental health awareness and help-seeking behaviors among Vietnamese high school students. Methods: The study involved 422 high school students from four cities in Vietnam. The Depression Anxiety Stress Scales (DASS-21) and Mental Health Literacy Scale (MHLS) were employed to evaluate mental health awareness and behavior, with data processed utilizing SPSS version 22.0. Result: Students exhibited the greatest awareness of bipolar disorder (M = 4.43, SD = 0.844). Students experience a moderate to high level of anxiety when they become aware of potential mental health issues (M = 3.50, SD = 1.296). In order of priority, students actively seek information about mental health professionals (M = 3.88, SD = 0.645). Students are highly critical and thoughtful in comparing different sources of advice before deciding on a mental health strategy (M = 4.27, SD = 0.925). Students are slightly more likely to participate in these programs compared to other formal mental health resources (M = 1.44, SD = 0.469). Some students turn to online communities for support and guidance in managing their mental health issues (M = 1.63, SD = 0.483). Conclusion: This investigation underscores numerous critical developments in the mental health awareness and help-seeking behaviors of students in high schools. Students exhibited a deliberate approach to evaluating mental health resources and a strong awareness of bipolar disorder.

Community empowerment through home care training to improve the quality of life of patients

Community empowerment is one of the effective strategies to improve patient's quality of life by increasing the capacity of families and communities to provide home care. This service aims to evaluate the impact of home care training on the quality of life of patients with chronic health conditions treated at home. The methods used in the training include theory, practical simulations, and group discussions. The evaluation results showed that the trainees experienced an increase in knowledge and skills in providing home care, which positively impacted patients' quality of life. The program empowers families to treat patients more effectively and reduces the burden on the formal health system by optimizing care at home. This activity concludes that home care training is an effective strategy for community empowerment to improve patients' quality of life and support the sustainability of health care in the community