Health Sector Management Research Articles

The impact of perfectionism on suicidal ideation among medical residents in Iran: the mediating role of psychological distress.

Among medical residents, suicide is the second most prevalent cause of mortality. In Iran, the suicide of medical residents has become one of the most important challenges. This study aimed to investigate the mediating role of psychological distress in the relationship between perfectionism and suicidal ideation among medical residents in Iran. This research was a descriptive-correlational study based on structural equation modeling. The statistical population of the present research included all the residents in Shahid Beheshti University of Medical Sciences (SBMU) in 2023, of whom 277 people were selected as a sample using the available sampling method. The Beck Scale for Suicidal Ideation (BSSI-1997), the Tehran Multidimensional Perfectionism Scale (TMPS-2007) and the Depression, Anxiety and Stress Scale (DASS-21-1995) were used to collect the data. Data was analyzed using structural equation modeling with SPSS and Amos software version 22. Out of 277 participants, 30% (N = 83) were male and 70% (N = 194) were female. The findings showed that the research model had goodness of fit. There was a significant relationship between perfectionism and psychological distress (β = 0.76, P < 0/001) and between psychological distress and suicidal thoughts (β = 0.66, P < 0/001). However, there was no direct relationship between perfectionism and suicidal ideation (P > 0.01), but perfectionism played a role in residents' suicidal ideation through psychological distress (β = 0.50, P < 0/001). In other words, perfectionism led to suicidal ideation by increasing the psychological distress of the residents. In addition, perfectionism and psychological distress were able to explain 42% of the variances of suicidal ideation (R2 = 0/42). The results highlighted the crucial role of psychological distress in suicidal ideation of medical residents. Accordingly, substantial support from health-sector managers and policymakers is essential to meet the requirements of medical residents.

Readiness of big health data analytics by technology-organization-environment (TOE) framework in Ethiopian health sectors

BackgroundBig health data is a large and complex dataset that the health sector has collected and stored continuously to generate healthcare evidence for intervening the future healthcare uncertainty. However, data use for decision-making practices has been significantly low in developing countries, especially in Ethiopia. Hence, it is critical to ascertain which elements influence the health sector's decision to adopt big health data analytics in health sectors. The aim of this study was to identify the level of readiness for big health data analytics and its associated factors in healthcare sectors. MethodsA cross-sectional study design was conducted among 845 target employees using the structural equation modeling approach by using technological, organizational, and environmental (TOE) frameworks. The target population of the study was health sector managers, directors, team leaders, healthcare planning officers, ICT/IT managers, and health professionals. For data analysis, exploratory factor analysis using SPSS 20.0 and structural equation modeling using AMOS software were used. Result58.85 % of the study participants had big health data analytics readiness. Complexity (CX), Top management support (TMS), training (TR) and government law policies and legislation (GLAL) and government IT policies (GITP) had positive direct effect, compatibility (CT), and optimism (OP) had negative direct effect on BD readiness (BDR) ConclusionThe technological, organizational, and environmental factors significantly contributed to big health data readiness in the healthcare sector. The Complexity, compatibility, optimism, Top management support, training (TR) and government law and IT policies (GITP) had effect on big health data analytics readiness. Formulating efficient reform in healthcare sectors, especially for evidence-based decision-making and jointly working with stakeholders will be more relevant for effective implementation of big health data analytics in healthcare sectors.

Sustainable Projects Based on the Intersection of Clean Energy with the Health Sector: A Bibliometric Review

The objective of this work was to develop a bibliometric analysis of academic production related to sustainable projects based on clean, green and renewable alternative energies and their interaction with the health sector and health management on a global scale. To do this, a documentary research process based on bibliometric tools was proposed. The research is limited to the period between 2003 and 2023, executing the following search equation: (TITLE-ABS-KEY ("clean energy" ) OR TITLE-ABS-KEY ( "alternative energy" ) OR TITLE-ABS -KEY ("solar energy" ) OR TITLE-ABS-KEY ( "green energy" ) OR TITLE-ABS-KEY ( "renewable energy" ) AND TITLE-ABS-KEY ( "health sector" ) OR TITLE-ABS-KEY ( "healthcare sector" ) OR TITLE-ABS-KEY ( "public health service" ) OR TITLE-ABS-KEY ( "health management" ) ). The years with the highest production were 2020 (21), 2021 (23), 2022 (30) and 2023 (34), while the countries that have contributed the most to the topic are China (111), the USA (97) and the United Kingdom (71), which together contributed 57.76% of all publications. Of 145 sources found that published on the topic, the 18 main sources concentrate 48% of the publications. The three most cited articles were EMADIAN SM, 2017, WASTE MANAGE, WATTS N, 2018, LANCET and FULLER R, 2022, LANCET PLANET HEALTH, with a total of 1567 citations. Among the most relevant institutions in relation to the topic of study, UNIVERSITY COLLEGE LONDON stands out above all with 19 publications, followed by TSINGHUA UNIVERSITY (9) and WUHAN UNIVERSITY (8); between the three institutions they account for 20.57% of the publications found. This analysis provided critical insights for academics and professionals and underscored the relevance and dynamism of this research area in addressing clean energies and sustainable projects related with health management and health sector worldwide.

Rights and responsibilities: Women leadership for health in Kyrgyzstan.

The World Health Organization (WHO) is committed to empowering countries by implementing a gender, equity, and human rights approach in the health sector. The objective of this gender and inclusion analysis is to assess potential gender disparities of health sector management in the Kyrgyz Republic. The employed mixed-method approach takes advantage of data triangulation. Besides information from the literature and policy documents available at the international and national levels, the analysis includes interviews and data from the self-assessment of health services managers in the Kyrgyz Republic. A convenience sample of 75 health managers was taken and after up to three reminders a commendable response rate of 80% was achieved which resulted the final sample size of N = 60. A factor analysis using quartimax orthogonal rotation was applied to investigate the correlation between Teaching Qualification, Digitalization, Training Usefulness, Computer Workplace, and Gender Equality. In 2021, the Kyrgyz Republic adopted a new Constitution, which provides a sound legal framework to support gender equality and promote women's empowerment. However, according to a survey, only 42.9% of the respondents felt that equal rights and opportunities were integrated into their job descriptions. Similarly, only 40.7% believed that their institutions' written documents reflected a commitment to equal rights and opportunities for both genders. Two factors were identified as influencing gender equality: (1) personal and (2) technical aspects. Regarding personal aspects, gender equality, teaching qualification, and training usefulness were found to be significant. Regarding technical aspects, the computer workplace was related. In recent years, the Kyrgyz Republic has been developing a culture of gender equality. Political will is essential to promote and make organizational change possible. It is important to create a written mid-term policy that affirms a commitment to gender equality in organizational behavior, structures, staff, and management board compositions. Healthcare institutions need to prepare strategic and operational plans that incorporate gender equality principles.

Exploring the barriers and facilitators to implementing electronic health records in a middle-income country: a qualitative study from South Africa.

As more countries are moving towards universal health care, middle-income countries in particular are trying to expand coverage, often using public funds. Electronic health records (EHR) are useful in monitoring patient outcomes, the performance of providers, and so the use of those public funds. With the multiple institutions or departments responsible for providing care to any individual, rather than a single record, an EHR is the interface through which to view data from a digital health information eco-system that draws on data from many different sources. South Africa plans to establish a National Health Insurance fund where EHRs will be essential for monitoring outcomes, and informing purchasing decisions. Despite various relevant policies and South Africa's relative wealth and digital capability, progress has been slow. In this paper, we explore the barriers and facilitators to implementing electronic health records in South Africa. In this qualitative study, we conducted in-depth interviews with participants including academics, staff at parastatals, managers in the private health sector, NGO managers and government staff at various levels. The Western Cape provincial government over a 20-year period has managed to develop a digital health information ecosystem by drawing together existing data systems and building new systems. However, despite having the necessary policies in place and a number of stand-alone population level digital health information systems, several barriers still stand in the way of building national electronic health records and an efficient digital health ecosystem. These include a lack of national leadership and conflict, a failure to understand the scope of the task required to achieve scale up, insufficient numbers of technically skilled staff, failure to use the tender system to generate positive outcomes, and insufficient investment towards infrastructural needs such as hardware, software and connectivity. For South Africa to have an effective electronic health record, it is important to start by overcoming the barriers to interoperability, and to develop the necessary underlying digital health ecosystem. Like the Western Cape, provincial governments need to integrate and build on existing systems as their next steps forward.

Barriers and facilitators to maternal death surveillance and response at a busy urban National Referral Hospital in Uganda.

Background: Preventable maternal and newborn deaths remain a global concern, particularly in low- and- middle-income countries (LMICs) Timely maternal death surveillance and response (MDSR) is a recommended strategy to account for such deaths through identifying contextual factors that contributed to the deaths to inform recommendations to implement in order to reduce future deaths. Implementation of MDSR is still suboptimal due to barriers such as inadequate skills and leadership to support MDSR. With the leadership of WHO and UNFPA, there is momentum to roll out MDSR, however, the barriers and enablers for implementation have received limited attention. These have implications for successful implementation. The aim of this study was: To assess barriers and facilitators to implementation of MDSR at a busy urban National Referral Hospital as perceived by health workers, administrators, and other partners in Reproductive Health. Methods: Qualitative study using in-depth interviews (24), 4 focus-group discussions with health workers, 15 key-informant interviews with health sector managers and implementing partners in Reproductive-Health. We conducted thematic analysis drawing on the Theory of Planned Behaviour (TPB). Results: The major barriers to implementation of MDSR were: inadequate knowledge and skills; fear of blame / litigation; failure to implement recommendations; burn out because of workload and inadequate leadership- to support health workers. Major facilitators were involving all health workers in the MDSR process, eliminate blame, strengthen leadership, implement recommendations from MDSR and functionalize lower health facilities (especially Health Centre -IVs). Conclusions: The barriers of MDSR include knowledge and skills gaps, fear of blame and litigation, and other health system factors such as erratic emergency supplies, and leadership/governance challenges. Recommendation: Efforts to strengthen MDSR for impact should use health system responsiveness approach to address the barriers identified, constructive participation of health workers to harness the facilitators and addressing the required legal framework.

Intention to Leave Nursing Profession and Its Associated Factors Among Nurses: A Facility Based Cross-Sectional Study.

Nurses' intention of leaving their profession is the main challenge for healthcare and hospital administrators in many countries. It has significant impact on the performance, stability and productivity of health facilities. However, there is limited evidence on the nurses' intention to leave their profession and associated factors among nurses in developing countries including Ethiopia. This study was aimed to assess intention to leave nursing profession and its associated factors among nurses working in West Shoa Zone public Hospitals, Oromia region, Central Ethiopia, 2020. Institution based cross-sectional study was conducted among 393 nurses working in West Shoa zone public hospitals, Ethiopia from May 1 to 30, 2020. Simple random sampling technique was used to select the study participants. Structured self- administered questionnaire was used to collect data. Data were cleaned and entered into Epi-data version 3.1 then exported to SPSS version 25 for analysis. Descriptive statistics such as frequency mean and standard deviation was computed to describe variables of the study. All covariates that were significant at P value <0.25 in bivariate logistic regression analysis were considered for further multivariable logistic regression analysis. Backward stepwise logistic regression model was fitted, crude ratio and odds ratio were calculated for factors at 95% confidence interval (CI). Level of statistical significance was declared at P value <0.05. In this study, the overall nurses' intention to leave nursing profession was 61.3% [95% CI (56.5%, 66.2%)]. Nurses' educational status, age, working experience, working position, professional commitment, job stress, job satisfaction and organizational factor were significantly associated with nurses' intention to leave their profession. The overall nurses' intention to leave their profession was high. Reducing this level of leaving intention needs collaborative intervention related to factors like safety of working environment, job related stress, job satisfaction, professional commitment and education opportunities which are a big homework for managers on health sectors of West Shoa zone public Hospitals and higher level health sector managers.

Barriers and facilitators to maternal death surveillance and response at a busy urban National Referral Hospital in Uganda

Background: Preventable maternal and newborn deaths remain a global concern, particularly in low- and middle-income countries. Timely maternal death surveillance and response (MDSR) is a recommended strategy to account for such deaths through identifying contextual factors that contributed to the deaths to inform recommendations to implement in order to reduce future deaths. With the leadership of WHO and UNFPA, there is momentum to roll out MDSR, however, the barriers and enablers for implementation have received limited attention. These have important implications for successful implementation. The aim of this study was: To assess barriers and facilitators to implementation of MDSR at a busy urban National Referral Hospital as perceived by health workers, administrators, and other partners in Reproductive Health. Methods: Qualitative study using in-depth interviews (24), 4 focus-group discussions with health workers, 15 key-informant interviews with health sector managers and implementing partners in Reproductive-Health. We conducted thematic analysis drawing on the Theory of Planned Behaviour (TPB). Results: The major barriers to implementation of MDSR were: inadequate knowledge and skills; fear of blame and litigation; failure to implement recommendations; burn out because of workload at the National Referral Hospital and inadequate leadership- to support health workers. Major facilitators were involving all health workers in the MDSR process, eliminate blame, strengthen leadership, implement recommendations from MDSR and functionalize lower health facilities (especially Health Centre -IVs). Conclusions: The barriers of MDSR include knowledge and skills gaps, fear of blame and litigation, and other health system factors such as erratic emergency supplies, and leadership/governance challenges. Efforts to strengthen MDSR for impact should use health system responsiveness approach to address the barriers identified, constructive participation of health workers to harness the facilitators and addressing the required legal framework.

Modified K-Nearest Neighbour Using Proposed Similarity Fuzzy Measure for Missing Data Imputation on Medical Datasets (MKNNMBI)

Early disease diagnosis is a burning problem in health sector, medical domain and disease management. During analysis, quality of the data can be achieved only if the data is complete. Missing values reduces the efficiency of data analysis task. Researchers proposed various imputation methods but always there was a need for a better imputation method. This paper objective is to propose a method for imputation using proposed similarity fuzzy measure through which we can impute missing values by finding k similar instances called as Modified k-Nearest Neighbour for imputation of missing data (MKNNMBI). The proposed imputation method outperformed when compared with other existing imputation methods MV EM, MV BPCA, MV Ignore, MV KMeans, MV FKMeans, MV KNN, MV MC, MV WKNNimpute, MV SVDimpute, MV SVMimpute, CBC-IM-FUZZY. These imputation methods were studied on different benchmark datasets and tested for performance on different classifiers like C4.5, SVM, kNN, NB and found that the proposed method leads to accurate imputation and improves the accuracy.

INVESTIGATION OF THE EFFECT OF FINANCIAL LITERACY ON MANAGEMENT SKILLS: ADIYAMAN HEALTH SECTOR EXAMPLE

In this study, general financial literacy levels of managers working in the health sector, lower, middle and upper management levels in Adıyaman province and its districts were determined. The relationship between the determined general financial literacy level and management skills, and the effect of financial literacy on management skills have been revealed. In addition, it was also discussed whether the general financial literacy and management skills levels of managers differ in terms of their personal, generational, educational and managerial characteristics. In addition, another distinguishing feature of this work is that it is three-dimensional: First; measuring general financial literacy and management skills, second; measuring the effect of general financial literacy level on management skills and the third dimension is making these measurements in an area where very valuable resources are transferred, such as the health sector.

Community-based health insurance, healthcare service utilization and associated factors in South Gondar Zone Northwest, Ethiopia, 2021: A comparative cross-sectional study.

Community-based health insurance schemes are becoming increasingly recognized as a potential strategy to achieve universal health coverage in developing countries. Ethiopia has implemented community-based health insurance in piloted regions of the country. The scheme aims to improve the utilization of healthcare services by removing financial barriers. There is a dearth of literature regarding the effect of the insurance scheme on the utilization of healthcare services. A community-based comparative cross-sectional study was conducted in the south Gondar Zone. Six hundred fifty-eight participants were selected using a systematic random sampling method. Data were entered into EPI data version 4.4.1 and exported to SPSS version 25 for analysis. Binary logistic regression was used to measure the association of factors with the outcome variable. The result of the final model was expressed in terms of Adjusted Odd Ratios (AOR) and 95% CI. Two hundred twenty-three (67.8%) and 111 (33.7%) of the respondents reported that their family members went to health institutions within three months among CBHI users and non-users respectively. The presence of under-five children (AOR = 2, 95% CI = 1.6-2.4), CBHI scheme membership times (AOR = 3, 95% CI = 2.6-3.4), household wealth index rich (AOR = 4, 95% CI = 2.3-6.3), household wealth index medium (AOR = 3, 95% CI = 1.8-5.8) and presence of chronic illness (AOR = 0.5, 95% CI = 0.2-0.8) was associated with health care service utilization. Households who were enrolled in CBHI were more likely to use healthcare services than households who were not enrolled. Households who were enrolled in CBHI were more likely to use healthcare services than households who were not enrolled. Therefore, health sector leaders and managers in the study area should strengthen their efforts for increasing the enrollment of the community into CBHI.

Role of nongovernmental organizations in Iran's health system: What do they do and what can they do?

BACKGROUND:Nongovernmental organizations (NGOs) as entities out of the health sector can play various roles and functions at different levels of the health systems. The present study was conducted to investigate NGOs’ potential and actual functions in Iran's health system.MATERIALS AND METHODS:This exploratory study was carried out in two parts from April 2020 to December 2020 in Tehran, Iran. For the first part, the statute of 65 NGOs was used for document review, and in the second part, the required data were collected using semi-structured interviews with 26 key informants from the governmental sector and NGOs. Data were analyzed using the framework analysis method and MAXQDA software.RESULTS:According to data analysis, the results of this study were classified into two sections of NGOs’ current functions and expected functions in Iran's health system. The current functions of NGOs in Iran's health system include service delivery, educational, research, and information activities, financing, supportive and facilitation activities, and advocacy. Other functions in which NGOs could play a role include health system management, education, and service providing and support activities.CONCLUSION:In this study, the various roles of NGOs in Iran's health system were explained. NGOs can act actively as the consulting and executive hand alongside the public sector in the lowest to the highest levels of Iran's health system. Hence, health sector managers and policymakers must facilitate NGOs’ involvement in the health sector and use their capacities and capabilities to improve health and increase public access to health-care services.

Social support, anxiety symptoms, and depression symptoms among residents in standardized residency training programs: the mediating effects of emotional exhaustion

BackgroundAlthough studies indicate that social support is related to emotional exhaustion, depression symptoms, and anxiety symptoms, the underlying mechanism between those variables remains unknown.MethodsBased on a sample of 254 residents in standardized residency training programs, two mediation models were tested in which emotional exhaustion served as a mediator in the relationship between social support and anxiety symptoms/depression symptoms. We used the following self-reported questionnaires as instruments to collect data: zung self-rating depression scale, zung self-rating anxiety scale, social support rating scale, and emotional exhaustion scale.ResultsIn the final study sample, the mean age of the residents was 25.92 years old (SD =1.88), and a total of 41.3% were male, and 58.7% were female. This current study suggested that social support was proven to be a relevant factor affecting anxiety symptoms and depression symptoms. Particularly, the results also indicated that emotional exhaustion partially mediated the impact of social support on anxiety symptoms and depression symptoms among Chinese residents in the standardized residency training program.ConclusionsOur study signifies that enhancements in social support and reduction of emotional exhaustion can directly or indirectly affect anxiety symptoms and depression symptoms among Chinese residents in the standardized residency training program. These findings will offer insight for health-sector managers to develop programs aimed at social support and adopt individual-level interventions and organization-level interventions to reduce emotional exhaustion.

Management of case with aphasia by three track reasoning

Clinical reasoning is the thinking and decision-making processes associated with cognitive process and clinical practice of the health professionals. The main purpose of the study is management of case with aphasia by the three-track reasoning. Clinical reasoning is central to effective, efficient clinical practice and professional autonomy. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, caregivers, health sector managers, policy-makers and colleagues. An important aspect of this responsibility is the ability to clearly articulate and justify management decisions in a manner appropriate to the audience. However, clinical reasoning is not a skill that can be simply explained, understood and recalled because of its rapid, complex and often subconscious nature. For providing diagnosis and providing intervention as well as socially rehabilitate to the patient three reasoning is very important.

Examining health sector application and utility of program-based budgeting: County level experiences in Kenya.

IntroductionIn 2012, Kenya enacted a new Public Finance Management Act to guide the public‐sector planning and budgeting process. This new law replaced the previous line item budgeting, with a new program‐based budgeting (PBB) process. This study examined the experience of health sector PBB implementation at the county level in Kenya.MethodsWe carried out a review of the literature documenting the health sector application and utility of PBB in low‐ and middle‐income countries. We then collected empirical data to examine the experience of health sector application of PBB at County Level in Kenya.ResultsIn the financial year 2017/18, counties utilised the PBB approach for health sector planning. The PBB approach was perceived by key stakeholders; to have improved the alignment of technical priorities with budgetary allocation, and to have increased transparency, accountability and openness of the process. Its challenges included lack of clear tools and guidelines to support implementation, low capacity at county level, political interference and the organisation of the public sector electronic financial management system around line item budgeting system.ConclusionPBB is potentially a useful tool for aligning health sector planning and budgeting and ensuring the Annual Work Plan is more result oriented. However, realisation of this goal would be enhanced by the developing clear tools and guidelines to support its implementation, building capacity for county health sector managers to better understand the PBB application, and reforming the public‐sector budgetary management system to align it with the PBB approach.

Challenges in providing surgical procedures during the COVID-19 pandemic: Qualitative study among Operating Department Practitioners in Pakistan.

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.

Employee attitudes on TQM implementation and job satisfaction in public health sector

The quality of service in the public health sector is an essential aspect that influences patient satisfaction. Providing quality in public health sector means delivering health service in an affordable, safe and effective manner, with minimal risk and harm for patients. In other words, it means fulfilling patients’ needs and surpassing their expectations. In order to provide patients with good-quality and satisfactory service, many public health organizations implement quality standards that contribute with many benefits and advantages, among which employee satisfaction stands out. The objective of the research was to evaluate the attitude of employees in public health institutes towards the dimensions of job satisfaction and their perception of the level of TQM implementation, with regard to the employees’ sociodemographic characteristics. In order to achieve this objective, ANOVA was used to test the hypotheses and determine the difference between observed sociodemographic characteristics with regard to the dimensions of job satisfaction and the application of TQM principles in research. Beside that, correlation coefficient was used to test the connection between overall job satisfaction and the level of TQM implementation (overall TQM principles). The findings suggest that level of education and the length of service have a significant effect on the differences in assessments among employees, while position in the workplace affects within certain dimensions of job satisfaction, as well as within their perception of the TQM implementation. Results have also shown that there is a statistically significant relationship between job satisfaction and the level of implementation of TQM principles. The present study provides valuable guidelines for public health sector managers since the results of the research indicate the level of perception of the implementation of TQM principles and job satisfaction dimensions with which employees are the most and the least satisfied, thus pointing out to management in public health sector institutions the areas in which certain improvement measures should be implemented. As this study focuses specifically on Institutes of Public Health, future research could be expanded to encompass other public health institutions such as hospitals and private clinics as well as other sectors.

Descentralização e resultados na saúde infantil no Brasil

Over the past decade, Brazil experienced a sharp increase in the decentralization of public health services. Given the possibility of heterogeneous responses and distributional consequences, it was sought to verify the general and regional effects of the decentralization of public health services on child health outcomes across Brazilian states during the period 2000-2013. For this, I constructed a measure of fiscal decentralization of the health sector does not explored in national literature and the two-way fixed effects model approach was applied with state-specific trends and robust standard errors. The results showed that the fiscal decentralization of actions and public health services had, during the period in analysis, a substantial statistically impact on reducing the infant and child mortality rates in Brazil. However, the effects of decentralization are different given the regional development level, with superior impacts in more developed regions (South region, -0.598). Meanwhile, the institutional capacity of health sector management of states and municipalities in the Northern region of Brazil (null effect) needs to be reexamined.

Digital applications for nutrition counselling (Lavinia) and cardiovascular risk assessment (WIWE) – intelligent devices of prevention

Abstract Significant state-sponsored efforts have recently successfully elaborated general purpose information systems for the global Hungarian health sector management. However, there is still a significant need for easy-to-use smartphone-based equipment and applications to help citizens directly in achieving healthy nutrition habits and/or monitor people living with elevated health risk. This paper outlines a new generation of intelligent mHealth systems developed in the past few years to improve nutritional habits and quantitatively monitoring risk factors of stroke and the development of the necessary substrate of sudden cardiac arrest. According to the expectations, these solutions may achieve a significant share in the growing world market of smart health instruments.

A Mathematical Model for Locating the Medical and Emergency Centers considering the Failure Probability of Centers

Enhancing the amount of industrial and chemical production is one of the most important effects of increasing rural people’s migration to cities, which leads to many abnormalities in the healthcare domain. In this regard, one of the most important tasks of health sector managers is designing and implementing some programs to monitor and control the level of community health, which is one of the health organizations’ strategic planning. On the other hand, the location of service centers is one of the most important problems in the area of strategic planning by any organization because selecting an appropriate site for constructing facilities can have a significant effect on reducing costs and increasing the coverage level. However, an appropriate site to construct the facilities must also have maximum reliability in addition to reducing costs and increasing the coverage level. This problem is important because many factors, such as natural disasters, result in failure of centers and influence the confidence level of system performance. Therefore, it is necessary to consider maximizing reliability in locating centers. For this purpose, an integer mathematical model is presented in this paper to select the optimum site for constructing the medical and emergency centers by considering the failure probability of each center. The research model’s objective function minimizes the system costs, including the costs of construction, patient transfer, and failure of medical and emergency centers. Finally, a numerical example is designed and reviewed by real-world problems to ensure the performance accuracy of the proposed model.