Health Efforts Research Articles

Checking the changes over time and the impacts of COVID-19 on cockle (Cerastoderma edule) small-scale fisheries in Ria de Aveiro coastal lagoon, Portugal

Historical information on cockle landings and studies on local knowledge on cockle fishing, zoology, and ecology in the Ria de Aveiro remain incomplete. Due to the COVID-19 pandemic and the current conditions of artisanal fisheries in Europe, understanding the dynamics of this activity has become even more necessary. Therefore, this case study sought to investigate the changes that have taken place in recent cockle fishing decades and verify the degree of contentment of these fishers with the rules for cockle fishing during the current pandemic period. LEK showed a downward trend in cockle stock on a time scale of around 60 years. Members of these fishing villages have not experienced the shifting baseline syndrome. This traditional fishery proved susceptible to the intense fishing effort, increased fishers, decreased commercial-sized adult individuals, and increased incidence of biotoxins and diseases in the cockle. Fishers were not content with the measures and circumstances imposed on cockle fishing during the COVID-19 pandemic between 2020 and 2021. The main points related to the discontent were about income and government financial support to fishers. Synergistic initiatives covering all those involved with the cockle bioresource are essential for the sustainability of this resource of great socio-ecological importance for the Iberian Peninsula. Health efforts and governance are also recommended for the optimal functioning of this fishery during the pandemic period. The application of policies and rules coming from participatory governance can be a way for greater acceptance by fishers and better management of bivalve fisheries in the Ria de Aveiro lagoon.

Determinants of adolescent pregnancy in indigenous communities from the Peruvian central jungle: a case\u2013control study

BackgroundAdolescent pregnancy carries a high risk of severe health issues for both the mother and the newborn. Worldwide, 21 million adolescents give birth every year, with high percentages in Latin America. Most of the risk factors are met in indigenous communities, which is an underrepresented and poorly studied population. We aimed to assess the determinants of adolescent pregnancy in indigenous communities from the Peruvian central jungle.MethodsThrough a case–control study, female adolescents aged 13 to 19 years old from seven indigenous communities of the Peruvian central jungle were interviewed. Adolescents with (cases) and with no (controls) pregnancy history, such as current pregnancy, children and abortion, fulfilled our eligible criteria. Our instrument explored: sociodemographic, adolescent and family characteristics, as well as perceptions of adolescent pregnancy. We performed a penalized maximum likelihood logistic regression analysis to obtain Odds Ratios (OR) and their 95% confidence intervals (95% CI).ResultsWe enrolled 34 cases and 107 controls. Overall, 53.9% were 15 to 19 years old. We found a significant association of being 15–19 years old (OR = 6.88, 95% CI 2.38–19.86, p < 0.0001) and an elementary school level of instruction (OR = 5.59, 95% CI 1.95–16.06, p = 0.001) with the risk of adolescent pregnancy. A marginal statistical significance between having five to six siblings and adolescent pregnancy was also reported (OR = 2.70, 95% CI 0.85–8.61, p = 0.094). Furthermore, adolescents with sexual and reproductive health communication with parents had a lower risk of adolescent pregnancy (OR = 0.17, 95% CI 0.06–0.47, p = 0.001).ConclusionOur results suggest that public health and educational efforts should be age-specific focused within indigenous communities of the Peruvian central jungle, encouraging parents to talk about sexual and reproductive health topics with adolescents.

Pengaruh Pandemi Covid-19 Terhadap Kunjungan Balita Di Posyandu Desa Wanggudu Alaa Kecamatan Asera Kabupaten Konawe Utara

An integrated service post or often called posyandu is a health effort that is sourced from community resources, managed and organized from, for, by and with the community. The aim of the research is the influence of the Covid-19 pandemic on visits by toddlers to the posyandu in Alaa Wanggudu Village, Asera District, North Konawe Regency. The type of research used is a Cross Sectional Study. The samples in the research were all mothers with toddlers who came to the Alaa Wanggudu Village Posyandu, totaling 32 toddlers. The results of the research show that there is an influence of the COVID-19 pandemic on visits by toddlers at the posyandu in Alaa Wanggudu Village, Asera District, North Konawe Regency (p value = 0.039 &lt; ? value = 0.05,) there is an influence of education on visits by toddlers to the posyandu in Alaa Wanggudu Village, District Asera, North Konawe Regency (p value = 0.031 &lt; ? value = 0.05), there is an influence of anxiety level on toddler visits at the posyandu in Alaa Wanggudu Village, Asera District, North Konawe Regency (0.032 &lt; ? value = 0.05), there is an influence of work on toddler visits at the posyandu in Alaa Wanggudu Village, Asera District, North Konawe Regency (p value = 0.027 &lt; ? value = 0.05). The conclusion is that there is an influence of the COVID-19 pandemic, anxiety levels, work, education on visits by toddlers at the posyandu in Alaa Wanggudu Village, Asera District, North Konawe Regency. Suggestion: Mothers should continue to regularly take their children to the posyandu while still implementing health protocols.

LEADERSHIP STYLE, WORK LOAD, MOTIVATION AND STRESS ON THE PERFORMANCE OF NURSES OF CENTRAL SURGICAL INSTALLATIONS OF ORTHOPEDI PROF SOEHARSO HOSPITAL SURAKARTA

Health services are health efforts that are carried out to achieve the highest possible health status for individuals and the community. This study has purpose to determine and analyse the relationship between leadership style, workload, motivation and stress on nurse performance. This study was conducted at Prof. Soeharso Orthopedic Hospital, Surakarta. This study was conducted using an associative quantitative research with a non-experimental research design, called as a survey design. The population in this study were 45 nurses in the central surgical installation room who worked at Orthopedic Hospital Surakarta. The sampling technique was done using saturated sampling techniques. The instrument used in this study was a questionnaire. The results showed that: 1) leadership style affects employee performance, 2) workload affects employee performance, 3) motivation affects employee performance, and 4) stress affects employee performance at a significance level of 0.05. Keywords: leadership, workload, motivation, stress.

The Knowledge of Traditional Medical Treatment (Namalo) in Batak Toba Community (at Tambunan Lumban Gaol Village, Balige District, Toba Samosir Regency)

This study examines the knowledge of Traditional Medical treatment (Namalo) in Toba Batak community at Tambunan Lumban Gaol Village. The purpose of this study was to determine the process of traditional medical treatment by Namalo and to know the perception of the community regarding traditional medical treatment performed by Namalo. In this research, the method used is ethnographic method and uses a qualitative approach to see the phenomenon of traditional medical treatment, especially Namalo, with data collection techniques through in-depth interviews and observations, where the authors go directly to the field to obtain accurate information from the community. The results of the study show that the traditional treatment carried out by Namalo is still visited by many people today because it does not conflict with religious teachings and traditional medical treatment is more affordable than medical treatment. Traditional medical treatment is a health effort in a different way from medical science, rooted in traditions derived from habits by previous ancestors. We need to preserve traditional medical treatment and continue to develop it because it is beneficial for society.

The RELATIONSHIP OF CLEAN AND HEALTHY LIFE BEHAVIOR TO ILLNESS IN TODDLERS

Background: Childhood is susceptible to disease. One cause of illnesses in infants is due to unhealthy environmental conditions. Therefore, health efforts need to be done to prevent the emergence of diseases caused by the environment by behaving clean and healthy (PHBS). Method: observational analytic case control design. The number of samples was 142 toddlers with 71 respondents each in the case and control groups selected by consecutive sampling technique. Data were collected using questionnaires and illness reports from the health center. Data analysis used Chi Square with. Results: Chi Square test results with 5% α indicated delivery assisted by health workers (cannot be analyzed), exclusive breastfeeding (p=0.00), washing hands with soap and water (p=0.00), eradicating larvae once a week (p=0.00), not smoking at home (p=0.00), and healthy life behavior (p=0.00). Conclusion: there was a relationship of exclusive breastfeeding, washing hands with soap and water, eradicating larvae once a week, and not smoking in the house to the incidence of illness in infants

Mitigating the Impact of Reemergence From a Pandemic on Healthcare.

ABSTRACTHealthcare workers have never faced a medical crisis that compares to the coronavirus disease-2019 pandemic. This modern-day pandemic fight draws parallels to a war. Because of these similarities, it would make sense that the experiences frontline providers have when transitioning to a normal healthcare routine would emulate experiences service members voice when reintegrating home from a battlefield. These common experiences include a unified mission, an exhausting, adrenaline-packed responsibility, and a celebrity-like status to the public. The pandemic response consumed healthcare with one united mission, but as we reemerge from the pandemic and restore other aspects of our healthcare system, multiple missions develop and compete. Returning to a common routine and regular status can manifest feelings of disappointment in healthcare workers’ everyday lives and career choices and lead to a reexamination of priorities and professions. As an organization with a focus on high reliability, mitigating the harm to staff and delivery system may be our new priority. The risk of not facing this situation head on is a potential exodus of seasoned professionals contemplating their future and selecting other career paths, thus draining the current institutional knowledge and potentially deterring future generations from healthcare. Leaders in the healthcare industry need to take a proactive stance in addressing this reemergence. Integrated, proactive programming is needed utilizing evidence-based resiliency training from professional organizations such as the National Alliance on Mental Illness, the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration, as well as the existing Department of Defense programs. The Veterans Affairs has the backbone to develop and offer these programs and make a positive difference with Employee Whole Health efforts. Organized, evidence-based programming such as second victim education, mindfulness, and other personal skill building could be key to improving the lifelong well-being of our caregivers.

PENYULUHAN TENTANG MENSTRUASI SEBAGAI UPAYA MENINGKATKAN KESIAPAN PSIKOLOGIS REMAJA PUTRI PRA PUBERTAS (KELAS V) DALAM MENGHADAPI MENARCHE DI SDN 05 DALUNG

Adolescence are a transition from childhood to adulthood. During this period major and essential changes occurred regarding the maturity of spiritual and physical functions, especially sexual functions. Sign of maturity of reproductive organs in young women is the occurrence of menstruation. Menstruation is first called menarche. Lack of knowledge of young women about menarche can cause psychological changes such as anxiety. Health efforts that can be implemented to increase knowledge to obtain correct information about menarche for young women, one of which is health promotion through counseling. The purpose of this activity is to prepare psychologically prepubertal girls (grade V elementary school) in facing menarche at SDN 05 Dalung. The benefits of this activity as a means of increasing information and knowledge for young women to better prepare themselves to face physical and psychological changes in themselves, especially in the face of menarche, while for the manager of SDN 05 Dalung, as a material for consideration and evaluation for teachers and principals in programming adolescent reproduction counseling for students.

Assessment of Oral Health Care and Knowledge amongst University Students

Objectives: Good oral heath not only promotes an individual to look and feel good, it also helps in preserving oral functions. The study was carried out to assess oral health knowledge and practices, attitudes as well as their oral hygiene habits among university students in the UAE. Method: A structured and revised questionnaire was distributed to 300 university students that were randomly sampled from the selected universities of the UAE. The questionnaires were answered anonymously by the students and paper consisted of questions to study and assess the prevalence of oral diseases amongst these students. The answers were then subjected to statistical analysis to determine if there is a significant correlation between oral health knowledge and attitude. Results: Data showed a positive correlation with a Pearson coefficient value of 0.4 given at a positive gradient when plotted as a linear graph. The students had good knowledge on the basic oral health measures but still students had poor oral health practices they brush their teeth once daily and brushed for less than the optimal time of two minutes. Lack of time and cost were reported to be the most common causes that prevented visiting the dental clinic. While some students reported no importance to visit the dentist if there is any pain as the second most common reason. Conclusion: Students had good knowledge on the basic oral health measures but efforts towards spreading proper dental education is very important to minimize and prevent the escalation of oral diseases that may develop due to lack of correct dental knowledge. Oral health education programs should be conducted with reinforcement to close the gap between knowledge and practice.

Chronic respiratory disease disparity between American Indian/Alaska Native and white populations, 2011\u20132018

BackgroundAmerican Indian/Alaska Native (AI/AN) populations have been disproportionately affected by chronic respiratory diseases for reasons incompletely understood. Past research into disease disparity using population-based surveys mostly focused on state-specific factors. The present study investigates the independent contributions of AI/AN racial status and other socioeconomic/demographic variables to chronic respiratory disease disparity in an 11-state region with historically high AI/AN representation. Using data from the Behavioral Risk Factor Surveillance System (BRFSS) spanning years 2011–2018, this work provides an updated assessment of disease disparity and potential determinants of respiratory health in AI/AN populations.MethodsThis cross-sectional study used data from the BRFSS survey, 2011–2018. The study population included AI/AN and non-Hispanic white individuals resident in 11 states with increased proportion of AI/AN individuals. The yearly number of respondents averaged 75,029 (62878–87,350) which included approximately 5% AI/AN respondents (4.5–6.3%). We compared the yearly adjusted prevalence for chronic respiratory disease, where disease status was defined by self-reported history of having asthma and/or chronic obstructive pulmonary disease (COPD). Multivariable logistic regression was performed to determine if being AI/AN was independently associated with chronic respiratory disease. Covariates included demographic (age, sex), socioeconomic (marital status, education level, annual household income), and behavioral (smoking, weight morbidity) variables.ResultsThe AI/AN population consistently displayed higher adjusted prevalence of chronic respiratory disease compared to the non-Hispanic white population. However, the AI/AN race/ethnicity characteristic was not independently associated with chronic respiratory disease (OR, 0.93; 95% CI, 0.79–1.10 in 2017). In contrast, indicators of low socioeconomic status such as annual household income of <$10,000 (OR, 2.02; 95% CI, 1.64–2.49 in 2017) and having less than high school education (OR, 1.37; 95% CI, 1.16–1.63 in 2017) were positively associated with disease. These trends persisted for all years analyzed.ConclusionsThis study highlighted that AI/AN socioeconomic burdens are key determinants of chronic respiratory disease, in addition to well-established risk factors such as smoking and weight morbidity. Disease disparity experienced by the AI/AN population is therefore likely a symptom of disproportionate socioeconomic challenges they face. Further promotion of public health and social service efforts may be able to improve AI/AN health and decrease this disease disparity.

General and infant mortality trends in Chile from 1909 to 2017

During the twentieth century, Chile experienced an important reduction in general mortality. To describe both general and infant mortality of Chile from 1909 to 2017. Analysis of information about births and deaths published by the Chilean National Institute of Statistics for the period between 1909 and 2017. Both general and infant mortality rates declined sharply from the 1930s to the late 1990s. However, during the last few years, general mortality rates increased slightly. This is the first increase in over a century. Another positive aspect is that there was a dramatic decrease in mortality rate gaps across Chilean regions, for both general and infant mortality. However, intraregional inequalities in infant mortality continue to be a detrimental factor. Public health efforts should be carried out to further reduce socioeconomic and regional gaps in adult and infant mortality in Chile.

Corporate Application of Health Literacy.

Background:The growing concern of low health literacy in populations combined with the interest of companies to develop cultures of health and the emerging interest in the workplace as an arena for improving health literacy is increasingly acknowledged. This study aimed to explore how companies currently apply the concept of health literacy as part of their health efforts in the work sphere.Methods:A systematic literature review was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines. The search was performed in the databases PubMed, Science Direct, and Directory of Open Access Journals from July 2019 to August 2019 and included the search terms “health literacy,” “health literate,” and “health competence” combined with the search terms “company/companies,” “corporation/corporates,” “workplace,” “business,” and “organization.” Studies were eligible for inclusion if they (1) were written in English or German, (2) were concerned with employers/employees, companies, corporations, or organizations, (3) dealt with health literacy in particular, and (4) were formatted as journal articles, systematic literature reviews, or book chapters.Key Results:The search identified 20 articles. A thematic analysis resulted in 5 clusters with 2 to 3 sub-themes illustrating the characteristics of how corporations apply health literacy. The clusters entailed the conceptualization of health literacy, its measurement, and the application of health literacy in strategies, interventions, and training.Discussion:The literature review reveals that the application of health literacy by companies is in its infancy. More research and practical experience are warranted on how companies can mobilize and facilitate a health literate workforce. [HLRP: Health Literacy Research and Practice. 2021;5(3):e218–e225.]Plain Language Summary:This literature study explored the role of advancing health literacy in companies. Five aspects were identified as important, including the understanding of the concept, its measurement, and its integration into strategies, interventions, and training. The involvement of management and the staff was crucial for success.

PENYULUHAN TENTANG KUALITAS LAYANAN FARMASI DI RUMAH SAKIT GRANMED LUBUK PAKAM

The hospital is one of the health facilities where health efforts are carried out. Health efforts are every activity to maintain and improve health, aiming to realize optimal health degrees for the community. Pharmaceutical services as one element of the main services in hospitals, are an inseparable part of the service system in hospitals that are oriented to patient care, providing quality drugs, including affordable clinical pharmacy services for all levels of society. The practice of pharmacy services is an integrated activity, with the aim of identifying, preventing and solving problems related to drugs and health. Hospital pharmacy services are one of the activities in hospitals that support quality health services. This is explained in the Decree of the Minister of Health Number 1333/Menkes/SK/XII/1999 concerning Hospital Service Standards, which states that hospital pharmacy services are an inseparable part of the hospital health service system that is oriented to patient care, drug provision. quality, including clinical pharmacy services, which are affordable for all levels of society. Currently, pharmacists who work at the Granmed Lubuk Pakam Hospital are required to be able to provide patient-oriented clinical pharmacy services. The aim is to improve patient safety. Pharmacists are required to play a role in improving patient safety, especially for drug-related problems.

Evaluating the contribution of a wildlife health capacity building program on orangutan conservation.

One Health is increasingly being used as a tool in ecosystem protection. The Orangutan Veterinary Advisory Group (OVAG) is working to address One Health concerns in Pongo spp. (orangutan) welfare and conservation. Orangutans are vital contributors to the ecosystem health of their range areas. Strengthening national capacity is crucial to make a lasting difference in the currently bleak outlook for orangutan species survival. OVAG is a capacity strengthening and expertise network that brings together all those working with orangutans, in- and ex-situ, to share knowledge, skills, and to collectively learn. Using the One Health paradigm embedded to enhance professional development, the OVAG network is successfully supporting conservation outcomes and impact. As part of our adaptive management approach, and to assess individual and organizational change attributable to the capacity strengthening work of OVAG, we evaluated technical skill test data, program satisfaction data, and asked participants to complete a self-reflective survey. This pilot study of our work demonstrates statistically significant improvements in conservation medicine (t = 5.481, p < 0.0001) and wildlife clinical skills knowledge (t = 3.923, p < 0.001) for those in the OVAG program. Most consider OVAG participation to be either critical or very useful in their conservation medicine decision-making process, with a perceived positive impact on their skills at handling multiple situations. Additionally, participant feedback shows a sense of being able to drive positive change locally and nationally (within their own countries) as a consequence of OVAG participation. The authors hope the OVAG model including its associated capacity support mechanisms and pedagogical approaches can be used as a template for other One Health efforts.

The Effect of Back Massage For Health: Literature Review

Health is a state of overall being, no just disease and weakness. Health efforts must be directed so that every human being has adequate health, pharmacological and non-pharmacological treatments can be one of the efforts to maintain health. Non pharmacological therapy that can be used is back massage. Back massage in the complementary therapy of manipulation practice because touch and pressure provide health effect. This study aimed to determine the use of back massage for health. This study use Literature review with a prisma approach amounting to 9 journals. The results of this study that have been analyzed show back massage is very effective for health, especially can improve sleep quality, reduce pain intensity, accelerate milk production, and improve cognitive. Giving back massage is very effective for non-pharmacological therapy

Association of Cancer Screening Deficit in the United States With the COVID-19 Pandemic

The COVID-19 pandemic led to sharp declines in cancer screening. However, the total deficit in screening in the US associated with the pandemic and the differential impact on individuals in different geographic regions and by socioeconomic status (SES) index have yet to be fully characterized. To quantify the screening rates for breast, colorectal, and prostate cancers associated with the COVID-19 pandemic in different geographic regions and for individuals in different SES index quartiles and estimate the overall cancer screening deficit in 2020 across the US population. This retrospective cohort study uses the HealthCore Integrated Research Database, which comprises single-payer administrative claims data and enrollment information covering approximately 60 million people in Medicare Advantage and commercial health plans from across geographically diverse regions of the US. Participants were individuals in the database in January through July of 2018, 2019, and 2020 without diagnosis of the cancer of interest prior to the analytic index month. Analytic index month and year. Receipt of breast, colorectal, or prostate cancer screening. Screening for all 3 cancers declined sharply in March through May of 2020 compared with 2019, with the sharpest decline in April (breast, -90.8%; colorectal, -79.3%; prostate, -63.4%) and near complete recovery of monthly screening rates by July for breast and prostate cancers. The absolute deficit across the US population in screening associated with the COVID-19 pandemic was estimated to be 3.9 million (breast), 3.8 million (colorectal), and 1.6 million (prostate). Geographic differences were observed: the Northeast experienced the sharpest declines in screening, while the West had a slower recovery compared with the Midwest and South. For example, percentage change in breast cancer screening rate (2020 vs 2019) for the month of April ranged from -87.3% (95% CI, -87.9% to -86.7%) in the West to -94.5% (95% CI, -94.9% to -94.1%) in the Northeast (decline). For the month of July, it ranged from -0.3% (95% CI, -2.1% to 1.5%) in the Midwest to -10.6% (-12.6% to -8.4%) in the West (recovery). By SES, the largest screening decline was observed in individuals in the highest SES index quartile, leading to a narrowing in the disparity in cancer screening by SES in 2020. For example, prostate cancer screening rates per 100 000 enrollees for individuals in the lowest and highest SES index quartiles, respectively, were 3525 (95% CI, 3444 to 3607) and 4329 (95% CI, 4271 to 4386) in April 2019 compared with 1535 (95% CI, 1480 to 1589) and 1338 (95% CI, 1306 to 1370) in April 2020. Multivariable analysis showed that telehealth use was associated with higher cancer screening. Public health efforts are needed to address the large cancer screening deficit associated with the COVID-19 pandemic, including increased use of screening modalities that do not require a procedure.

National Seroprevalence of Coxiella burnetii in Chile, 2016-2017.

Coxiella burnetii is an intracellular bacterium and the cause of the zoonotic infection, Q fever. National surveillance data on C. burnetii seroprevalence is currently not available for any South American country, making efforts of public health to implement strategies to mitigate infections in different at-risk groups within the population extremely challenging. In the current study, we used two commercial anti-C. burnetii immunoassays to screen sera collected from a sample of the Chilean population as part of a 2016–2017 national health survey (n = 5166), nationwide and age-standardized. The seroprevalence for C. burnetii for persons ≥ 15 years was estimated to be 3.0% (95% CI 2.2–4.0), a level similar to national surveys from The Netherlands (2.4%) and USA (3.1%), but lower than Australia (5.6%). A linear increase of C. burnetii seropositivity was associated with an individual’s age, with the peak seroprevalence 5.6% (95% CI 3.6–8.6) observed in the ≥65 years’ group. C. burnetii seropositivity was significantly higher in the southern macro-zone 6.0% (95% CI 3.3–10.6) compared to metropolitan region 1.8% (95% CI 0.9–3.3), the former region being home to significant livestock industries, particularly dairy farming. These data will be useful to inform targeted strategies for the prevention of Q fever in at-risk populations in Chile.

ANALISIS INDEKS KEPUASAN MASYARAKAT DALAM PENERAPAN UNSUR-UNSUR PROGRAM INDONESIA SEHAT DI PUSKESMAS WILAYAH KERJA DINAS KESEHATAN KOTA PEKANBARU

Program Indonesia Sehat dilaksanakan untuk meningkatkan derajat kesehatan masyarakat melalui upaya kesehatan dan pemberdayaan masyarakat yang didukung dengan perlindungan finansial dan pemerataan pelayanan kesehatan. Pelaksanaan program Indonesia Sehat diselenggarakan melalui pendekatan keluarga. Tujuan penelitian ini adalah untuk menganalisis kepuasan masyarakat dalam penerapan unsur-unsur program Indonesia sehat di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Pekanbaru. Penelitian ini bersifat deskriptif korelasi dengan desain analytik cross sectional. Sampel penelitian sebanyak 346 responden dengan metode purposive sampling. Hasil analisis univariat menunjukkan nilai indeks kepuasan masyarakat dalam penerapan Program Indonesia Sehat di Puskesmas Wilayah Kerja Dinas Kesehatan Kota Pekanbaru yaitu 3,014 dengan nilai konversi 75,36. Artinya Mutu Pelayanan yang diberikan pada pasien termasuk kategori B (baik). Secara statistic terdapat hubungan unsur-unsur pelayanan PISPK terhadap kepuasan masyarakat di wilayah kerja Puskesmas Kota Peknbaru Tahun 2019. Disarankan pada institusi perlunya peningkatan kualitas sumber daya manusia melalui program pelatihan dan seminar dalam rangkan peningkatan kompetensi dan kapasitas petugas.

Working towards universal health coverage: a qualitative study to identify strategies for improving student enrolment for the pre-service training of nurses, midwives and community health workers in Nigerian health training institutions

BackgroundStudent enrolment processes and practices can affect the quality of pre-service training programmes. These processes and practices may have serious implications for the quality and quantity of students within health training institutions, the quality of education for prospective health workers and consequently health workforce performance. This study assessed current student enrolment processes and practices for nurses, midwives and community health workers within health training institutions in two Nigerian states, so as to identify strategies for improving student enrolment for these key cadres of frontline health workers.MethodsThis study was carried out in Bauchi and Cross-River States, which are the two Human Resources for Health (HRH) project focal states in Nigeria. Utilizing a qualitative research design, 55 in-depth interviews and 13 focus group discussions were conducted with key stakeholders including students and tutors from pre-service health training institutions as well as policy-makers and public sector decision-makers from Ministries of Health, Government Agencies and Regulatory Bodies. Study participants were purposively sampled and the qualitative data were audio-recorded, transcribed and then thematically analysed.ResultsStudy participants broadly described the application process to include the purchase, completion and submission of application forms by prospective students prior to participation in entrance examinations and oral interviews. The use of ‘weeding examinations’ during the student enrolment process, especially in Bauchi state, was identified as a useful quality assurance mechanism for the pre-service training programmes of frontline health workers. Other strategies identified by stakeholders to address challenges with student enrolment include sustained advocacy to counter-cultural norms and gender stereotypes vis-à-vis certain professions, provision of scholarships for trainee frontline health workers and ultimately the development as well as effective implementation of national and state-specific policy and implementation guidelines for the student enrolment of key frontline health workers.ConclusionWhile there are challenges which currently affect student enrolment for nurses, midwives and community health workers in Nigeria, this study has proposed key strategies which if carefully considered and implemented can substantially improve the status quo. These will probably have far-reaching implications for improving health workforce performance, population health outcomes and efforts to achieve universal health coverage.

Tanggung Jawab Rumah Sakit Swasta Dalam Pelayanan Kesehatan Bagi Peserta BPJS Kesehatan di Kota Mataram

Health services are provided through the form of medication and care. Health workers, medical and non-medical, are responsible for providing optimal service. Medical personnel, in this case doctors, have responsibility for the treatment that is being carried out. Treatment actions and determining needs in the treatment process are the authority of the doctor. In accordance with the formulation of the problem and the research objectives, this legal research uses a normative or dogmatic approach to law as its main approach, with the aim of examining its positive law in the sense of collecting, presenting, systematizing, analyzing, interpreting and assessing positive legal norms that protect people's rights. BPJS health participants. Health effort is any activity to maintain and improve health, which aims to create an optimal health plan for the community. The community has the same rights in gaining access to resources in the health sector, for this reason government hospitals and private hospitals are responsible for providing health services to the community. Private hospitals in collaboration with BPJS Kesehatan are required to provide health services to BPJS Kesehatan participant patients without discriminating against BPJS Kesehatan participants who are referred by first level health facilities, namely puskesmas and family doctors according to their interests