Health Manpower Research Articles

Comparative Analysis and Spatial Distribution of the Primary Health Care Centers and Health Manpower Across Saudi Arabia Using Shapiro-Wilk Test.

Due to the growing demand for better health services by the population pressure, Saudi Arabia is facing challenges in providing the required coverage in primary health care over all regions. The study aims to do a comparative analysis of the spatial distribution of the primary healthcare centers and health manpower across Saudi Arabia. This study deals with the analysis of the spatial distribution of the PHCCs and health manpower in Saudi Arabia regions during the period 2017-2021 by applying the Shapiro-Wilk test. This study relied on a dataset issued by the Ministry of Health (MoH). The variance of the spatial distribution of the dataset was also analyzed using the T-student and Binomial tests. This study found that PHCCs of 2020; the dentists of 2021; and Allied Health Personnel of 2017, 2020, and 2021 were normally distributed. However, the distribution of the population and all datasets of the other health indicators is a non-normal distribution. In addition, the correlation between the number of PHCCs and regions based on population is significant in all the regions. Moreover, The number of dentists showed a significant correlation with the population in most regions, except Riyadh, Makkah, and Jazan. However, the number of physicians, allied health personnel, nurses, and family medicine practitioners generally did not correlate significantly with the population, with exceptions for nurses in Tabuk and family medicine in the Northern Borders. Finally, the spatial distribution of the population shows the concentration in three major regions which are Riyadh, Makkah, and Eastern Province. Despite the expansion in the number of PHCCs and health workers and spread in all regions of Saudi Arabia, their spatial distribution still requires the establishment of more of them to provide the basic health services necessary to cover the actual needs of the population.

Clinico-socio demographic characteristics of neonates at NICU, Mediciti Hospital, Medchal, Telangana, India

Background: Children face the greatest risk of disease and death in their first 28 days. Improvements in basic neonatal care such as thermoregulation and breastfeeding have substantially reduced neonatal mortality and morbidity. There is still a need to strengthen the provision of advanced care for neonates. Identifying factors impacting neonatal mortality and morbidity and addressing them through a package of evidence-based interventions are essential to avoiding preventable deaths. Methods: The current study analyses data from a cross-sectional study in the rural outreach area of a tertiary hospital in Hyderabad, India to assess clinical and socio-demographic factors affecting neonatal morbidity. One hundred and fifty neonates admitted in neonatal intensive care unit and their mothers were included. A semi-structured questionnaire was used to obtain responses through face-to-face interview. Descriptive and inferential analyses were performed using R Statistical Software (version 4.3.2). Results: Among the 150 neonates, 99 (66%) neonates were admitted for respiratory distress. 39 (26%) males were low birth weight and 28 (18.67%) females were low birth weight. There was no significant association between low birth weight, high risk pregnancy and gender of the neonate. A significant association was obtained between low socio-economic status and low birth weight. Conclusions: Neonatal mortality and morbidity can be attributed to several factors including neonatal characteristics, maternal characteristics, health infrastructure and health manpower. However, prevalence of socio-demographic risk factors affecting neonates is disproportionately higher in low- and middle-income countries. A multi-pronged approach is required to address the multimodal causation of low birth weight and morbidity in neonates.

How to manage work-related stress in healthcare professionals: organizational and individual interventions.

IntroductionWorkplaces can be source of significant stress for employees, leading to a series of mental health problems, such as burnout syndrome. Healthcare professionals and other helping professions are especially vulnerable to work-related stress.ObjectivesThe aim of the present review is to assess available intervention aiming at improving work-related stress symptoms.MethodsWe conducted a thorough search of relevant articles on PubMed, APA PsycInfo, and Scopus databases, using specific keywords such as “occupational stress,” “stress,” “anxiety,” “depression,” “health personnel,” “health care facilities, manpower and services,” “prevention,” and “control.”Results Although significant methodological heterogeneity has been found among studies, regarding assessment tools, target population, and intervention types, we can still draw some satisfactory results. Healthcare professionals have access to various interventions to manage work-related stress symptoms, which can be classified into three categories: 1) individual cognitive-behavioral therapy approaches, 2) relaxation techniques at the individual level, and 3) organizational-level interventions. Mindfulness techniques, relaxation techniques, emotional freedom techniques, and integrated interventions have demonstrated effectiveness in alleviating work-related stress.ConclusionsTo prevent work-related stress among healthcare professionals, interventions should be targeted towards specific categories of healthcare workers based on factors such as age, tasks, and patient types. Well-structured and reliable randomized controlled trials focusing on the most promising interventions, such as mindfulness, need to be carried out in larger samples and with a solid methodology in order to confirm these evidences.Disclosure of InterestNone Declared

Effect of COVID-19 pandemic on utilization of maternal healthcare services in a rural area of Haryana - A record-based comparative study.

The COVID-19 pandemic posed a challenge for the public health system, as all the health facilities and manpower were diverted for the delivery of COVID-19-related services. This affected the provision of routine health services, including maternal healthcare services. There is a paucity of data from rural and primary healthcare settings, as the earlier studies were either modelling-based or from tertiary care centres. This record-based study was conducted in 12 subcentres in the district Faridabad of Haryana. Data of pregnant women registered during 1 April to 30 September in the years 2017-2020 were retrieved. The utilization of maternal healthcare services among women registered during 1 April 2020 to 30 September 2020 was compared with those registered in the same period during the preceding 3 years (2017-2019). There was a significant decline in utilization of maternal healthcare services. Services like minimum four antenatal visits declined from 67.8% to 48.3% (P < 0.0001), at least 100 iron-folic acid tablets (45.4-20.9%; P < 0.001), and examination at each visit (90.8-72.3%; P < 0.001). The proportion of pregnant women who received full antenatal care decreased from 26.0% to 10.7% (P < 0.001). There was a significant increase in delivery in private health facilities (40.9-49.9%) and delivery by caesarean section (21.6-27.3%; P = 0.002). COVID-19 pandemic had an adverse effect on utilization of maternal healthcare services. Effective planning and coordination between different levels of government health facilities and primary care providers, including family physicians, can ensure uninterrupted provision of essential services during similar emergencies in future.

Competency and factor associated with recruitment of community public health professional personnel in public health organization in Thailand

Background: The development of health manpower is an important issue for the aim of the population to receive health services with quality, efficiency, and equity. Thus, it is necessary to have a plan to create public health academics who are capable in applying academic knowledge and managing tasks that are assigned to them effectively in planning, evaluation, and research development to be consistent with the changing situations at present. Objectives: This cross-sectional study was aimed to describe the situation, distribution, job characteristics, competency and identify factors associated with recruitment in public health organization of community public health professional in Thailand. Method: A total of 2,085 community public health professional staff were selected by multi-stage random sampling method to response the self-administered structured questionnaire. Multivariable analysis was performed to identify the factors associated with recruitment in public health organization among community public health professional in Thailand. Results: The results indicated that among 2,085 community public health professionals, factors associated with recruitment in public health organizations were; Bachelor of Public Health graduates (AOR=4.81, 95% CI: 2.99-7.76; P-value &lt; 0.001), Bachelor of Science (Public Health) graduates (AOR=3.46, 95% CI: 2.06 – 5.84; P-value &lt; 0.001), working in community hospital (AOR=1.99, 95% CI: 1.43 - 2.75; P-value &lt; 0.001), work characteristics were corresponds with their degrees (AOR=1.67, 95% CI: 1.12 - 2.47; P-value &lt; 0.001), graduated from public health college (AOR=5.27, 95% CI: 3.42 - 8.13; P-value &lt; 0.001), graduated from public university (AOR=3.71, 95% CI: 2.41 - 5.72; P-value &lt; 0.001), graduated from Rajabhat University (AOR=1.37, 95% CI: 1.00 - 2.02; P-value &lt; 0.001), organization had position (AOR=2.49, 95% CI: 2.05 - 3.04; P-value &lt; 0.001), organization employed correspondent with the graduated field (AOR=1.89, 95% CI: 1.17 - 3.04; P-value &lt; 0.001) and employed close to the graduated field (AOR=2.21, 95% CI: 1.43 - 3.40; P-value &lt; 0.001) respectively. Conclusion: Community public health professional personnel suggested that their profession development should be supported by promoting to a higher position with the same position code.

Analysis Of The Needs For Health Human Resources Competence Development Through Education And Training At The Pinangsori Health Center Pinangsori District Tapanuli Central District Year 2020

The minimum condition that is expected to the activities in health centers can be carried out properly, one of them is the health personnel that is fulfilled as stated at Regulation of Health Department No. 75 of 2014, but the number of health worker at the health center is not currently in accordance with the minimum standard of labor in Regulation of Health Department, so the service at the health center is less optimal and there are multiple tasks.&#x0D; The purpose of the research was to analyze the state of competence of health workers and to analyze the need for competency development of health human resources through education and training at Pinangsori Health Center. This research is descriptive with a qualitative approach in determining the need for competency development for health workers in the health center. Methods of data collection used observation and in-depth interviews.&#x0D; The need result analysis of the health worker shows that there are 2 people who have competence based on administrator health to Regulation of Health Department number 75 of 2014. The result of the need analysis of competency for development shows that most of health workers who have high school degree need higher education at least Diploma III. On the job training such as guidance and discussion is required by health workers. Apart from that, off the job training is also needed such as emergency training (PTC, ATLS or GELS and PONED) is also required by the doctor; PPGDON training, CTU, Hypnobirthing, BBLR management is required by the midwife; BTCLS training, Nursing Communication and Ethics is required by the nurse.&#x0D; The recommendation of the research is to apply the needs to competency developing health through education and training in the other health centers and the availability of good information system of the workforce so that it can be a reference to take a policy in the planning of health manpower need and its development.

Quality of Public Services at the Social Security Agency of Health (Badan Penyelenggara Jaminan Sosial) Manpower Banjarmasin Branch Office

The study aimed to analyze the quality of public services at the Banjarmasin Branch Office of Employment BPJS (Social Security Agency of Health). The research method used by the researcher is a descriptive analysis method. Observation, interviews, and documentation carried out the data collection techniques in this study. The data analysis technique used in this research is qualitative. The results of the study show (1) The accuracy of the services provided by employees is good enough in explaining matters related to participant requirements, making participant cards, claiming processes, and other public service activities organized by BPJS Ketenagakerjaan, although often when performing public services outside the office the community asks the same questions over and over again, the employees still give good explanations, (2) The speed of service in overcoming problems that occur in public services is quite good, it is just that the number of employees when performing public services outside the office is quite good. Can reduce the level of community satisfaction, and (3) Hospitality is good with employees who are always ready to help the community's needs in the public service process.

Exploring the Presence of Humanoid Social Robots at Home and Capturing Human-Robot Interactions with Older Adults: Experiences from Four Case Studies

Social robots have the potential to bring benefits to aged care. However, it is uncertain whether placing these robots in older people's home is acceptable and whether human-robot interactions would occur or not. Four case studies were conducted to understand the experiences of older adults and family caregivers when humanoid social robot Ka Ka was placed in homes for two weeks. Four older adults and three family caregivers were involved. Older adults interacted with the social robot Ka Ka every day during the study period. 'Talking to Ka Ka', 'listening to music', 'using the calendar reminder', and 'listening to the weather report' were the most commonly used features. Qualitative data reported the strengths of Ka Ka, such as providing emotional support to older adults living alone, diversifying their daily activities, and enhancing family relationships. The voice from Ka Ka (female, soft, and pleasing to the ear) was considered as 'bringing a pleasant feeling' to older adults. In order to support aging-in-place and fill the gaps of the intensified shortage of health and social manpower, it is of prime importance to develop reliable and age-friendly AI-based robotic services that meet the needs and preferences of older adults and caregivers.

50 Years Ago in TheJournalofPediatrics: Pediatric Nurse Practitioners: 50 Years of Partnering for Children's Health

Silver HK. A blueprint for pediatric health manpower for the 1970's: the 1972 George Armstrong Lecture. J Pediatr 1973;82:149-56. Dr Henry Silver's lecture to the Ambulatory Pediatric Association is as resonant today as it was 50 years ago. He noted that there was an inadequate supply of pediatric health care providers and recounted a few rejected solutions, such as shortening the medical school curriculum. The focus of his lecture, however, was emphasizing the importance of nurse practitioners (NPs) in providing care for children. The first NPs in the US graduated from Dr Silver's program in 1965 after 4 months of postnursing training. Dr Silver found that both pediatricians and parents were satisfied with care received from the NP when using a combined model: having a NP provide care with a physician available for consultation as needed. NPs showed the potential to provide quality health care in primary are settings, and Dr Silver proposed that their roles could be expanded into the community by providing care in school-based clinics. The role of the NP has continued to evolve, and training has become more intense since Dr Silver's “blueprint for pediatric health manpower” lecture. NPs can select a master's program that can be completed in 2-3 years and, for those interested in educational advancement, a post-master's doctoral program that can be completed in 2-3 years. They also have the option to select the primary care or acute care tracks. The primary care track focuses education within the primary care setting, specialty clinics, or in the community, whereas the acute care track focuses on the care of hospitalized patients. Today, NPs have a presence in a variety of settings fulfilling their roles in the “diagnosis and management of acute and chronic illness, health promotion, disease prevention, health education and counseling.”1American Association of Nurse PractitionersDiscussion Paper: Standards of Practice for Nurse Practitioners, 2019 update.https://storage.aanp.org/www/documents/advocacy/position-papers/StandardsOfPractice.pdfDate accessed: October 11, 2020Google Scholar NPs play critical roles partnering with pediatricians in the care of children in primary care offices, school-based health centers, neonatal intensive care units, as members of surgical teams, and many other areas. Dr Silver was prescient in his call for enhancing the care for children by partnering with NPs, yet the shortage of health care providers is likely to continue. By the year 2030, there is estimated to be 76.3 million children in the US, with a decreasing number of pediatricians and only 1025 pediatric NPs becoming licensed yearly.2Gigli K.H. Beauchesne M.A. Dirks M.S. Peck J.L. White Paper: Critical shortage of pediatric nurse practitioners predicted.J Pediatr Health Care. 2019; 33: 347-355Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar It remains as important as ever for pediatricians and NPs to continue working together and encourage ongoing development of both workforces.

Impact of COVID-19 pandemic on reproductive, maternal, newborn, and child health care services in Phuentsholing General Hospital: A retrospective descriptive study.

COVID-19 pandemic has derailed health care services. The health resources and manpower were prioritized and diverted to curb the COVID-19 infections at the cost of routine medical services to the people. The impact of the COVID-19 pandemic on maternal and child health is unknown. This study aimed to assess the impact of the Covid-19 pandemic on maternal and child health care services in Phuentsholing General Hospital. A descriptive retrospective study was conducted at Phuentsholing General Hospital from January1toJune30, 2022. The patient medical records were reviewed for the prepandemic years 2018, and 2019, and the pandemic years 2020, and 2021. The medical records of all the female patients and newborns who came to the Maternal and Child Health Unit (MCH), those who were admitted to the gynecology ward, and who underwent obstetrical and gynecological surgeries were reviewed. The data were analyzed using SPSS version 23. Descriptive statistics such as frequencies and percentages were used to describe the study variables. The line graph and bar graph were used to determine the trends and to compare the impact of COVID-19 on MCH services between the pre-pandemic and pandemic years. During the COVID-19 pandemic, the total admission dropped by 10% to 14.4%; the total deliveries dropped by 16.1%; Cesarean section rate dropped to 12.9%; and fewer gynecological surgeries were performed (13.9% from 20.6%). There was a significant drop in antenatal and postnatal follow-up visits (31.5% and 24.51%) respectively; Pap smear dropped by 93% and colposcopy by 52%. The overall immunization coverage has dropped drastically during the pandemic period. The pregnant mothers and newborn babies missed antenatal and postnatal follow-up visits, missed immunization, and women were not able to be screened for cervical cancers during the pandemic. These negative impacts of the COVID-19 pandemic on maternal and child health care were profound.

Post-graduate Psychiatry Teaching and Training in India

In India, the history of psychiatry is approximately 80 years of post-graduate education. The first psychiatrist who received an MD degree from an Indian medical institution was Late Prof. L.P. Verma, who received his degree in 1941 from Patna Medical College, Bihar.1 In India, a post-graduate course in psychiatry is taught in two forms (MD in Psychiatry and DNB in Psychiatry). MBBS is the minimum educational requirement to be eligible for pursuing MD or DNB Psychiatry course. The duration of the post-graduate course in psychiatry is three years in India. A recent study revealed that the post-graduate degree courses in psychiatry are unequally distributed in the country, which might be responsible for the not-so-equitable distribution and generation of mental health manpower in the country.2 In India, general hospital psychiatry units (psychiatry units attached to medical colleges) play an instrumental role in training post-graduate students of psychiatry. Other than this, mental hospitals also provide teaching and training facilities for post-graduate psychiatry trainees.

Effectiveness of a concise malaria training program on knowledge, attitudes and practices among patent medicine vendors: A study protocol

Despite several regional and global containment efforts by various government and non-governmental agencies, malaria still continues to ravage populations. Most notable is Africa, which accounts for 90% of the global cases and corresponding estimated total deaths. High mortality and morbidity have been associated with a shortage of health manpower, with the disease having overburdened the health systems. Patent Medicine Vendors (PMVs) are common sources of over-the-counter medicines and services throughout sub-Saharan Africa, thanks to their already established close-to-client infrastructure. Many people patronize PMVs as an alternative to formal health institutions. However, various literature has shown evidence that the knowledge, attitudes, and practices (KAP) of PMVs are grossly poor and insufficient to qualify them to fill the manpower gaps. The aim of this paper is to outline the study protocol of a trial to test the efficacy of malaria knowledge, attitude, and practice training among PMVs. A single blinded, randomized, controlled community trial was conducted at Yobe South Senatorial District among 292 respondent PMVs by comparing an intervention to a placebo-controlled arm. Four assessments were performed using self-administered questionnaires. The primary outcome measured was an expected increase in KAP at follow-up assessments compared to baseline assessments. Analysis of the data was conducted using SPSS version 26. The study tested the efficacy of a randomized controlled trial on malaria KAP involving various health promotion methods. It is hoped that the developed module will offer effective training that could serve as a model to reduce the scourge of malaria in all of sub-Saharan Africa.

Correctional Officers' Health Literacy and Practices for Pulmonary Tuberculosis Prevention in Prison.

Tuberculosis (TB) prevention in prisons remains a problem that requires advocacy and partnership action. A correctional officer (CO) is responsible for enforcing the rules and maintaining routines at a prison and has the authority to support TB prevention under the limitations of health manpower in prisons. The objective of this cross-sectional study was to determine the health literacy (HL) and practices of TB prevention and their association among Thailand’s COs. A total of 208 COs participated using a random sampling method. A self-administered questionnaire on HL and TB prevention practices was used for data collection. Descriptive statistics, Pearson’s chi-square test, and binary logistic regression were used for the association analysis. The majority of the participants were male (71.2%), married (60.1%), had a bachelor’s degree (60.6%), and had never been trained in TB prevention (90.9%). In total, 63.0% had adequate HL, whereas 78.4% had good practices, and this corresponded with personal prevention (75.5%) and work prevention (74.6%). Significant associations were identified for education, and communication, decision-making, and self-management skills (p < 0.05). The probability (adjusted odds ratio [95% CI]) of good practices was higher among participants with adequate communication skills (7.92 [2.15–29.24]), adequate decision-making skills (6.00 [1.86–19.36]), bachelors’ degree or higher-level education (3.25 [1.12–9.39]), and adequate self-management skills (2.95 [1.08–8.11]). The study findings show that most of the COs have adequate HL which is associated with good practices in TB prevention. Prisons should support HL development among COs for partnership and sustainable TB prevention under the constraint of health personnel.

Predictive Maintenance Model for IIoT-Based Manufacturing: A Transferable Deep Reinforcement Learning Approach

The Industrial Internet of Things (IIoT) is crucial for accurately assessing the state of complex equipment in order to perform predictive maintenance (PdM) successfully. However, existing IIoT-based PdM frameworks do not consider the influence of various practical yet complex system factors, such as the real-time production states, machine health, and maintenance manpower resources. For this reason, we propose a generic PdM optimization framework to assist maintenance teams in prioritizing and resolving maintenance task conflicts under real-world manufacturing conditions. Specifically, the PdM framework aims to jointly optimize the edge-based machine network uptime and the allocation of manpower resources in a stochastic IIoT-enabled manufacturing environment using the model-free deep reinforcement learning (DRL) methods. Since DRL requires a significant amount of training data, we propose and demonstrate the use of the transfer learning (TL) method to assist DRL in learning more efficiently by incorporating expert demonstrations, termed TL with demonstrations (TLDs). TLD reduces training wall time by 58% compared to baseline methods, and we conduct numerous experiments to illustrate the performance, robustness, and scalability of TLD. Finally, we discuss the general benefits and limitations of the proposed TL method, which are not well addressed in the existing literature but could be beneficial to both researchers and industry practitioners.

Utilization of artificial intelligence for tuberculosis screening in Nepal

Backgrounds: Tuberculosis (TB) is an infectious disease that needs to be diagnosed and enrolled for treatment. Artificial intelligence for TB (AI4TB) software screens TB suspected cases at the point of care and helps in quick diagnosis. This study aims to explore the significance and usefulness of AI4TB by comparing its performance with different diagnostic test results. MethodsA cross-sectional study was conducted among 197 participants who had symptoms suggestive to TB. The chest X-ray images were analyzed by AI4TB software and human expert readers. The bacteriological test results were obtained, and Kappa test was applied to calculate the inter-reader reliability. The sensitivity, specificity, positive predictive value and negative predictive value was calculated and ROC curve was generated. ResultsAmong 85 sputum smear microscopy, about 21% of the had sputum positivity rate. At 0.4 threshold: 62.4%, at 0.5 threshold: 58.4% and at 0.6 threshold: 50.3% symptoms suggestive cases were identified having abnormal X-ray images. Reader-I identified 28.4% and Reader-II identified 37.1% of the symptoms suggestive cases of TB as positive cases. There was a significant substantial agreement between two human expert readers (k-0.783, p-value: <0.001). The ROC curve explored the fair sensitivity accuracy of the AI4TB test results at 0.5 threshold level (AUC = 0.72) and at 0.6 threshold level (AUC = 0.77). ConclusionThe sensitivity of the AI4TB was higher compared to different human readers. AI4TB can be the relevant screening tool for the TB symptoms suggestive cases prior to the laboratory test in the countries like Nepal with deficient health manpower.

Health and Wellness Centres as a strategic choice to manage noncommunicable diseases and universal health coverage

Noncommunicable diseases (NCDs) are the leading cause of death globally. On its road to ensuring universal health coverage (UHC) for its population, India initiated the Ayushman Bharat mission in 2018. Under this flagship initiative, the primary health care component is being implemented by establishing Health and Wellness Centers (HWCs) across the country. HWCs are being established by converting and upgrading the primary health centers and subhealth centers. The unmet need for NCDs at the primary care level is high. Under the HWCs, NCD services are being expanded at the community and facility levels. States have brought local innovations in the NCD management. NCD ticker bags, an innovation to ensure treatment adherence, follow-up, and reduce drop-outs, are being done under the HWCs. Gaps in NCD management include a lack of awareness about NCDs' risk factors and management in rural areas and an erratic supply of NCD drugs and diagnostics. Challenges in the NCD management in the primary care settings include capacity building of the health manpower in NCD management, the flow of information for ensuring a continuum of care, and low community participation in the screening and management of NCDs. The challenges that remain in operationalizing the envisaged package in the HWCs must be acknowledged and worked upon. This will enable us to continue on the path toward UHC, stick to the action plan on NCDs, and assist us in achieving the NCD-related targets.

Survey of Traditional Birth Attendants in Sagbama and Southern Ijaw Local Government Areas of Bayelsa State

The indigenous people of Ijaw in Southern Nigeria are endowed with a deep culture of Traditional birth attendance, and they make use of medicinal plants in their practice to assist in ante- and post-natal cares. It is therefore imperative to document their rich knowledge to avoid its extinction. The work was performed with the aim of identifying and documenting the botanicals employed by the traditional birth attendants in some Ijaw tribes of Bayelsa State. The study was carried out by employing semi-structured questionnaires amidst personal interviews which were administered to forty-five traditional birth attendants (TBAs) between April and August 2019 to obtain information. Thirty-six medicinal plant species belonging to thirty-five genera within twenty- four families were mentioned by the TBAs mostly for labour induction (22.04%). Female fertility (14.47%) threatened abortion (13.49%) and foetal development (10.20%) were treated with Ageratum conyzoides (L.) L. (Compositae), Vernonia amygdalina Delile (Compositae), Bryophyllum pinnatum (Lam.) Oken and Acanthaceae, respectively making the Compositae the most important family. Of these, V. amygdalina was the most cited plant by the TBAs with frequency index (FI) of 44.44, while B. pinnatum ranked the next with FI=40.00. The survey provides an authentic data from TBAs for documentation which will be helpful for researchers in drug development as well as preserving the cultural heritage towards increasing the health manpower of the country.

Urban health and nutrition day or only immunisation day? barriers and bottlenecks in implementing Urban health and nutrition day in an Urban primary health centre of Nagpur, Central India.

BackgroundThis study was carried out to evaluate the implementation status of Urban Health and Nutrition Day (UHND) and to explore barriers and bottlenecks as perceived by community-level service providers in the selected city of Nagpur, Maharashtra.Material and methodsThis mixed-method study was conducted using a triangulation design. An initial gap assessment was carried out quantitatively using an observation checklist. Focus group discussion among ASHAs and interviews among frontline health workers involved in community mobilisation were carried out to understand the bottlenecks and barriers.ResultsSupplies of drugs and logistics, like paediatric iron and folic acid tablets, calcium tablets, and weighing machines, were inadequate. Services like distribution of conventional contraceptives, testing for malaria, urine albumin/sugar, haemoglobin estimation, screening for diabetes and hypertension, sputum collection, and qualitative iodine test kits are not available in any of the UHND sessions. Major challenges in the implementation of UHND were found to be as follows: unserved areas and left-out urban slum pockets; the distribution paradox of UHND location with an ill-defined geographic boundary; restriction of range of services to antenatal registration and immunisation with gross neglect of other components; suboptimal training of staff; insufficient availability of space, logistics, and health manpower; non-involvement of community members and Urban Local Bodies; and poor monitoring and supervision.ConclusionThe conduct, use, and list of services offered in UHND are far from the desired goal. For optimal use, reallocation of the UHND sessions, preferably in unserved and underserved slums, need to be carried out after suitable vulnerability assessment. Integration of the Health, Women, and Child Department and Urban Local Bodies is required for convergent planning, monitoring, and supervision.

Time Motion Study to analyse the Medication Management from Prescription to Administration in a Private Hospital at East India

Indian healthcare systems have passing through a state of transition and especially tertiary hospitals face daunting challenges, like evolving technologies and reimbursement policies, and a worsening skilled workforce shortage. A reconsideration of skilled health manpower and work processes holds the potential to affect the efficiency and effectiveness of health care delivery for the foreseeable future. The time and motion study are to understand the time taken in several work stations and used for performance, evaluation, and planning of any process. The Hospital under study was facing some issues of Medication management and there by Patient satisfaction and patient safety was under risk. This is a Cross sectional Observation study. It starts from Medication prescription to Indenting, arranging, dispensing, and finally to administration to the patient. Three Volunteers were recorded the data One at Ward level, One at Pharmacy Level and One at Transportation Level. A total of 80 prescriptions were tracked from different Wards or ICU areas. A total six time were recorded and six duration were found namely D1 (Prescription to Indent Time), D2(Indent to Dispense Time), D3(Dispense to Delivery Time), D4(Delivery to Receiving Time), D5(Receiving to Administration Time) &amp; D6 (Prescription to Administration Time).It was found that average time taken for various process are as D1 – 236 minutes (3 Hrs 56 mints), D2 -120minutes (2 Hrs), D3 – 162 minutes (2 Hrs 42 mints), D4 - 38 min, D5 – 535minutes (8 Hrs 55 mints), &amp; D6 – 1091minutes (18 Hrs 11 mints). In all areas average distribution of five duration are D1(22%), D2(11%), D3(15%), D4(3%) and D5(49%). On detail discussion over interview, it was found that Pharmacist and Nursing Manpower may need optimization. Although an age-old technique, Time Motion study can be used to analyse any process flow to detect the bottlenecks and find the suitable solution to the problems.

Family Physicians Working at Hospitals: A 20-Year Nationwide Trend Analysis in Taiwan

Family physicians play an essential role as gatekeepers in primary health care. However, most studies in the past focused on the geographic maldistribution of family physicians, and few studies focused on the distribution of family physicians between private practices and hospitals. This study aims to analyze the trends in practice locations of family physicians in Taiwan between 1999 and 2018, using the databases of the Taiwan Association of Family Medicine and Taiwan Medical Association. Although the annual number of physicians registered as family physicians had steadily increased from 1876 in 1999 to 3655 in 2018, the ratio of family physicians practicing in hospitals to total family physicians remained stable around 40% in the study period. Even after eliminating the trainees who were entirely registered at hospitals, the proportion of hospital-based family physicians still accounted for about one-third of the total in each year. In conclusion, family physicians had been continuously demanded by hospitals in Taiwan. If the supply of primary care-oriented family physicians is insufficient outside hospitals, health manpower planning would require urgent adjustments.