Health Services In Rural Areas Research Articles

Contribution of mobile health technologies to public health in rural areas: Accessibility and education methods

In today's rapidly advancing world, mobile health services have become influential in various aspects of our lives. It is anticipated that mobile applications, especially in rural areas, can play a significant role in the delivery of healthcare services. In this context, it is essential to examine the applications of mobile health services in rural areas and the education methods employed in these applications. The main objective of this study is to explore the contributions of mobile health services applications in rural areas to public health and to examine the education methods used in these services in light of current literature. The focus of this study is on how mobile health applications can be utilized in rural areas, the impact of this usage on public health, and the effectiveness of the education methods employed. The research was conducted through searches using key terms such as "mobile health" and "public health nursing" or "mobile health technologies" and "nursing" or "telehealth" on important academic databases like Google Scholar, PubMed free fulltext, Science Direct, Ebscohost, Sage, Scopus, and CINAHL. The information obtained from literature searches was analyzed to understand the impact of mobile health applications on public health in rural areas and the education methods employed. The study results indicate that the use of mobile health applications in rural areas can contribute significantly to public health. Advantages such as rapid diagnosis and treatment, effective monitoring of chronic diseases, and quick access to emergency services stand out among the potential impacts of mobile health applications. Mobile health applications can contribute significantly to public health in rural areas and increase their usage, particularly in primary healthcare services.

Including environmental and social sustainability in the planning process of healthcare services: A case study of cancer screening programs in an inner area in Italy

Healthcare systems plan their activities to achieve efficiency and effectiveness, without addressing environmental and social sustainability. This paper describes a new approach adopted in Italy to plan and deliver health prevention services in an inner area of the Tuscany region (in Italy) to guarantee proximity of care and environmental and social sustainability. The project examines the design and delivery of cancer screening programmes using a mobile screening unit to maximise social benefits while minimising environmental waste. A cost analysis was developed to estimate the difference in CO2 equivalent emissions, travel costs, and productivity losses, comparing the current screening programmes against the introduction of a comprehensive full-service mobile screening unit. The results indicate that the new service model reduces direct non-medical costs incurred by the population and improves environmental sustainability. This alternative can reduce, annually, over 95,000 euros in terms of travel costs and productivity losses, as well as 35 tons of CO2-equivalent travel emissions for a population of 59,000 inhabitants in a mountainous area with around 6000 people involved in the screening programme. The study supports the need to adopt a new planning methodology that considers environmental, social, and financial sustainability jointly in the provision of public health services in rural areas.

Mental Health Research Among Tribal Population in India

Tribals are the most marginalized social category in the country. There is little and scattered information on the actual burden and pattern of illnesses they suffer from. Tribal communities in general and primitive tribal groups are prone to disease. Also, they do not have required access to basic health facilities. They are most exploited, neglected, and highly vulnerable to diseases with a high degree of malnutrition, morbidity, and mortality. Research on the mental health of tribal people is not much in numbers. Few studies made on them have produced inconsistent results. This study aims to assess the mental health status of tribal communities. It was found that due to a lack of appropriate mental health services in rural areas, the tribal population is unable to access the needful services and treatment. There is a need to develop a psychosocial care program for tribal to promote positive social, physical, psychological, and emotional well-being. This study is the first of its kind to review research on mental health among STs. Mental health research conducted among STs in India is limited and is mostly of low-to-moderate quality. Determinants of poor mental health and interventions for addressing them need to be studied on an urgent basis.

Sociodemographic factors underlying lifetime fertility among ever-married Swazi women.

Fertility rates remain high in certain subgroups of the population, and there is limited research about the sociodemographic factors influencing fertility, particularly in Eswatini where women are often considered minors. This study aims to investigate the changes in lifetime fertility, and the associations between sociodemographic factors and lifetime fertility among ever-married women. The study used secondary cross-sectional data from the 2010 and 2014 Eswatini Multiple Indicator Cluster Surveys (MICS), with a sample size of 2,295 and 2,351 women, respectively. The data was analysed using descriptive statistics and multivariable Poisson regression. The results showed that fertility rates decreased from 3.47 to 3.21 children between 2010 and 2014. The study found that child loss and age (25+ years) were significant factors associated with higher fertility, while delayed age at marriage and sexual debut (20+ years), at least secondary education, and being rich were strong predictors of lower fertility rates. The study recommends creating awareness about and strengthening laws to abolish early sexual debut and marriage. It also suggests empowering women through education, encouraging the use of contraceptives, and providing maternal and child health services in rural areas where fertility rates tend to be higher.

Barriers to financial access of disabled people to health services in rural areas: A case study of Iran.

People with disabilities (PWDs) account for a significant percentage of the world's population, with a higher prevalence in less developed countries. Access to healthcare services is the main component of health systems performance, with lower access for PWDs living in rural areas. The current study aimed to investigate PWD's access to healthcare services in rural areas of Iran and, secondly, factors that contribute to this issue. Following a cross-sectional design, the current descriptive-analytical study is performed in the north of Iran. Using the quota sampling technique, 471 PWDs were recruited. Data were collected using a valid and reliable questionnaire, covering three dimensions of access, by face-to-face interview. Data analysis was administered using central tendency indicators and multiple regression by SPSS version 17. Statistical significance was considered when the P value <0.05. The mean score of PWD's access to healthcare services for dimensions of utilization, availability, and affordability was 8.91 (±6.86), 14.54 (±2.3), and 51.91 (±8.78), indicating very low, low, and moderate levels of access. All three regression models were significant (P < 0.05), and variables of gender, age, marital status, education level, residence status, the income of the household head, receiving financial aid, and house area showed a significant effect (P < 0.05). This study demonstrated the seriousness of paying attention to PWD's financial access to healthcare services, particularly in rural areas of Iran. Hence, policymakers should better focus on this problem, mainly regarding accessibility and utilization and factors that result in inequalities.

Rural revitalization background thinking of medical vocational colleges assisting the development of new rural health undertakings

With the steady progress of the Healthy China and the rural revitalization strategy, the development of health services in new rural areas has become a “concentric circle” . This is not only a practical need for building a healthy China but also an essential requirement for the Party and the State to implement rural revitalization. At present, the development of health services in new rural areas faces numerous challenges, such as a lack of medical resources, a lack of health knowledge dissemination, and backward medical service levels. The integration of medical vocational colleges in their actual efforts to assist the development of health services in rural areas is not only an important manifestation of vocational education serving society but also significantly contributes to further assisting the implementation of the rural revitalization strategy.

Probability of Inappropriate Complementary Feeding Practices on Children Aged 6-23 Months in Indonesia: Results of Indonesian Demographic Health Survey in 2017

Background: One of the causes of the double burden of nutrition problems in Indonesia is the early feeding of complementary feeding. The practice of providing complementary feeding in several countries, including Indonesia, has not reached the target and it is not yet known the magnitude of the probability of complementary feeding not following the recommendations in Indonesia based on national survey data. &#x0D; Objective. To identify the risk factors for the failure of Infant and Young Child Feeding (IYCF) practice in urban and rural NTT.&#x0D; Objectives: This study aims to determine the Probability of inappropriate complementary feeding practices in Children aged 6-23 Months in Indonesia and the factors that influence it. &#x0D; Methods: The research design uses cross-sectional studies. The data is sourced from the 2017 Indonesian Health Demographic Survey (IDHS) results. The sample was selected from women of childbearing age in IDHS 2017, namely women of childbearing age aged 15-49 years who had children aged 6-23 months who met the inclusion and exclusion criteria of 4,985 children. The data were analysed using multivariate logistic regression. &#x0D; Results: The practice of giving complementary feeding according to recommendations in children aged 6-23 months in Indonesia is only 55.53%. Socio-economic status is very poor (p= 0.000; OR=1.785; 95% CI 1.44-2.213), rural residence (p= 0.000; OR=1.168; 95% CI 1.025-1.33), lower education (p= 0.002; OR=1.398; 95% CI 1.149-1.702), and grande multipara parity (p= 0.001; OR=1.57; 95% CI 1.238-1.992) is significantly associated with the practice of giving complementary feeding not by the recommendations.&#x0D; Conclusions: The probability of the practice of giving complementary feeding is not by the recommendation of 86% due to the socio-economic status of very poor families living in rural areas, low maternal education levels, and mothers with grande-multipara parity. It is necessary to improve the socio-economics of the family through the empowerment of mothers and families, increase access to health services in rural areas, improve maternal education through various programs, and intensify family planning programs to limit the number of children in the family.

Measures to Narrow the Gap of Basic Medical and Health Services for Urban and Rural Residents

Health is the foundation of economic and social development, and people's health and longevity is an important symbol of national prosperity and national strength. Since the reform and opening up, our country has made remarkable achievements in the reform and development of health field. A sound medical and health service system is the basis for reducing the occurrence of diseases and ensuring residents' equal access to medical and health services. With the implementation of the "Healthy China 2030" Plan and a series of policies, promoting a healthy lifestyle and improving the level of basic medical and health services have become the fundamental direction of current medical and health development. Under the guidance of this development direction, in view of the inherent problems of basic medical and health services in rural areas of Hebei Province, it is necessary to fully investigate and understand the actual needs of residents in rural areas, increase the supply body of basic medical and health service resources, and solve the problem of insufficient total amount and uneven distribution of basic medical and health resources. Make up for the weak basic medical and health service foundation in rural areas of Hebei Province, strive to build a people-oriented basic medical and health service system that is balanced between urban and rural areas, and consciously transfer human, material and financial resources in urban areas to rural areas, so as to lay a solid foundation for protecting the health level of rural residents.

OUT-OF-POCKET EXPENDITURE ON OUT-PATIENT CARE IN EAG STATES: AN ANALYSIS BASED ON NSSO 75TH ROUND DATA

Regardless of their socio-economic status, everyone has the human right to receive healthcare. Since the Indian government spends so little on health care, healthcare spending has been a major source of concern. However, most of the literature in India on determinants of health spending has focused on hospitalization, and there are relatively fewer separate studies on health-seeking behaviour and expenditure in outpatient departments. The purpose of this study was to determine the patterns of health-care-seeking behaviour and the pattern of expenditure incurred by households during outpatient care in Empowered Action Group (EAG) States. The present study used secondary data from the latest 75th round of National Sample Survey (NSS) conducted from July 2017 to July 2018 on the key indicators of social consumption in India: Health. The finding suggest that the seeking behaviour of ailing persons as outpatients, across EAG states only limited population access to public sources of healthcare (36.8% in rural and 27.3% in urban). Rajasthan (46.7%), Madhya Pradesh (41.5%), Bihar (32.9% rural), and Uttar Pradesh (31.3%) have the highest percentage of outpatient who expressed dissatisfaction with the standard of public health services in rural areas. Among EAG states of urban areas, Uttar Pradesh (42.6%) have the highest percentage of not satisfied with the quality of care by government sources. Among EAG states, Significant inter-state variation was observed, with Rajasthan (Rs. 886) reporting the highest expenditure for outpatient treatment and Chhattisgarh (Rs. 350) reporting the lowest in rural areas. However, Uttar Pradesh (Rs. 1194) reported the highest and Odisha (Rs. 508) reported the lowest expenditure incurred on outpatient care by ailing persons in urban areas. The amount that each state spends on healthcare varies greatly, which causes inter-state differences in the cost of outpatient treatment in EAG states. As a result, the government needs to control the cost of medications and diagnostic tests and ensure that plans for outpatient care include coverage. KEYWORDS: Outpatient care, out-of-pockect expenditure, EAG states,

Time's ticking! Effects of deadline on the utilization of health services: Evidence from a cluster-randomized controlled trial

The low utilization of health services in rural areas is an essential factor affecting the health level of rural residents. Based on insights from behavioral economics, this study evaluates the average treatment effect of imposing a deadline on vision-care vouchers (i.e., the voucher-deadline intervention) on the utilization of health services. Using the vision health as a case study, a non-masked cluster-randomized controlled trial was conducted in 13 rural schools of a county in Shaanxi Province of China during 2018–2019. Among 1270 baseline sample students with myopia, 610 students from 6 schools were randomly assigned to receive vouchers with no deadline (i.e., the Control group), and 660 students from 7 schools to receive vouchers with a 30-day deadline (i.e., the Deadline group). The results showed that the voucher-deadline intervention significantly improved the vision-center visiting rate by 13.2 percentage points within 30 days and shortened the interval between visits (i.e., increased timeliness) by 18.7 days. In comparison, the vision-center visiting rate and the interval between visits among the control group were 16.7% and 30.5 days, respectively. However, considering a longer time frame (6 months), we found that intervention only shifted students' utilization to before the voucher expires without improving overall utilization rate. The loss aversion and time pressure induced by the voucher deadline are possible explanations for the treatment effects. This study suggests insights from behavioral economics can enhance the design of public health programs to improve the utilization and the cost-effectiveness of health-service programs. Trial registrationisrctn.org Identifier ISRCTN03252665.

Coverage and Quality of Maternal and Infant Health Services in Rural Area of District Kanpur Nagar

Introduction: Most maternal deaths are preventable because there are proven medical procedures to prevent, diagnose, and treat problems. Basic maternal services help reduce and manage pregnancy complications and reduce preventable deaths. Aim and Objective: To assess the quality and extent of maternal and infant health services provided. Material and Methods: The present cross-sectional study was conducted by the Department of Community Medicine, GSVM Medical College Kanpur, using a multistage random sample including women with children less than one year of age and infants (less than one year of age) born to these women in rural blocks of Kanpur Nagar district to assess maternal and infant care services from February 2021 to September 2022. Results: Weight and height were measured in 86.58% of participants, abdominal examination was performed in 81.52% of participants, and blood pressure was checked in 86.84% of participants. Hb test was done in 91.65% participants, urine test for proteinuria was done in 28.35% participants, majority of the study participants received counseling on danger signs (79.49%), dietary counseling (86.58%), newborn care (94.43%), family planning (87.84%). Similar results to NFHS-5 in rural Uttar Pradesh were found in previous published research. Conclusion: The percentage of 4 ANC visits was found to be low in the present study along with low consumption of iron and folic acid.

Changes in Children and Youth's Mental Health Presentations during COVID-19: A Study of Primary Care Practices in Northern Ontario, Canada.

Recent research suggests that children and youth are at increased risk of anxiety and depression due to the indirect effects of the COVID-19 pandemic. In Canada, children and youths may face additional hurdles in accessing mental health services in rural areas due to socioeconomic disadvantages and healthcare provider shortages worsened by the pandemic. Our study aimed to assess changes in primary healthcare utilization related to depression and anxiety among children and youth aged 10-25 years in Northern Ontario, Canada. We analyzed de-identified electronic medical record data to assess primary healthcare visits and prescriptions for depression and anxiety among children and youth aged 10-25 years. We used provider billing data and reasons for visits and antidepressant/antianxiety prescriptions compared with 21 months pre-pandemic (1 June 2018 to 28 February 2020) and 21 months during the pandemic (1 April 2020 to 31 December 2021). Our interrupted time series analysis showed an average increase in visits by 2.52 per 10,000 person-months and in prescriptions by 6.69 per 10,000 person-months across all ages and sexes. Females aged 10 to 14 years were found to have the greatest relative change in visits across all age-sex groups. The greatest relative increases in antianxiety and antidepression prescriptions occurred among females and males aged 10 to 14 years, respectively. These findings indicate that there were increased anxiety and depression presentations in primary healthcare among children and youths living in northern and rural settings during the COVID-19 pandemic. The increased primary healthcare presentations of anxiety and depression by children and youths suggest that additional mental health resources should be allocated to northern rural primary healthcare to support the increased demand. Adequate mental health professionals, accessible services, and clinical recommendations tailored to northern rural populations and care settings are crucial.

Side Effects of the Coexistence of Tradition Medicine with Biomedicine in Primary Health Service Delivery in Rural Areas of Tanzania

It is approximated that 60-80 per cent of Tanzanians use Traditional Medicine (TM) as their primary source of health services alongside biomedical services. However, there is little information on the side effects of the co-existence of TM with biomedical system to primary health services delivery in Tanzania. By using Helmke and Levitsky’s Model of co-existence of formal and informal institutions in comparative politics, this article argues that the coexistence of TM and biomedicine undermine the delivery of primary health services in rural areas of Tanzania due to abrupt stoppage of using biomedicine among users, concurrent use of TM and biomedicine services, poor environment where Traditional Health Practitioners (THPs) practice and selling of counterfeit medicine to the people. The study was carried out in Bukoba District of Tanzania, data were collected through observations, documentary review and interviews which were qualitatively analysed. The study involved 11 THPs, 30 household respondents, four (4) key respondents and five (5) biomedical practitioners who were purposively included in the study. Findings of the study call for the Government to register THPs who provide services to people while they are unregistered and to provide education on proper usage of TM among health services users in rural areas.

PROBABILITAS PRAKTEK PEMBERIAN MAKANAN PENDAMPING AIR SUSU IBU (MP-ASI) PADA ANAK USIA 6-23 BULAN DI INDONESIA: STUDI CROSS-SECTIONAL

The cause of the double nutritional burden problem in Indonesia is one of the reasons for giving complementary food to ASI (MP-ASI) earlier (&lt;6 months). The practice of giving MP-ASI in several countries, including Indonesia, has not yet reached the national target and the influencing factors are unknown based on national survey data. This study aims to determine the practice of giving MP-ASI to children aged 6-23 months in Indonesia and the influencing factors based on IDHS 2017 data. Research design using a cross-sectional study. The data comes from the results of the 2017 IDHS. The population is all mothers aged 15-49 years who have children aged 6-23 months. The sample is mothers aged 15-49 years who have children aged 6-23 months of 4,985 children. Data analysis used multivariate logistic regression. The practice of giving MP-ASI according to recommendations is 55.53%. Socioeconomic status (p= 0.0001; OR=1.172), place of residence (p= 0.0001; OR=1.168), education (p= 0.002; OR= 1.126), and parity (p= 0.001; OR=0.982) are significantly related to the practice of giving MP-ASI to children aged 6-23 months in Indonesia. The most dominant factor related to the practice of giving MP-ASI is socio-economic status. The probability that the practice of giving MP-ASI is not in accordance with recommendations based on risk factors is 86%. Socioeconomic status, place of residence, education, employment, parity as determinants of the practice of giving MP-ASI to children aged 6-23 months. Need to strengthen strategies to reduce poverty and increase education levels, increase access to health services in rural areas, increase visits of pregnant women and toddlers to posyandu, and improve strategies for family planning programs.

Implementation of the Early Warning Application Program for Pregnant Women to Support Health Services in Rural Areas

The development process of digital technology has affected many fields. One of them is health field. Number of health application appears. They can be accessed easily by smartphone or tablet device. For instance, in developed countries, doctors examine and diagnose children's ears using smartphone. He provides the appropriate treatment for their patients through the device. The growing number of mobile applications in health will certainly facilitate patient care. There are currently about 13,000 digital health applications. Nowadays, patients have gradually followed this trend. Rock Health, as a provider of digital health ecosystem services, explains the power of mobile health care as well as the health effects of technology. The digital health care industry has a significant impact on healthcare providers. In this research, the researchers design tools or web-based applications and or sms gate way. The main objective is to monitor early health for expectant mothers and infants who are less likely to receive direct medical care.

Perception of medical interns after visiting selected public health institutes in central India

Visits to institutes that work for public health help broaden the vision of interns so that they think of rural health care also. Therefore this study was planned to evaluate the effect on the minds of interns after visiting such places with objectives 1. To know the things learnt by interns during visit to institutes working in area of public health services in rural areas, 2. Based on the inputs given by the interns suggest recommendations for internship program. It was a cross-sectional descriptive qualitative study. A focus group discussion of interns was conducted to understand their interest in learning the low cost services being provided in these rural areas and various things learnt during the visit to public health importance institutes. Total 28 interns participated in the study in 3 batches included 6(21.42%) females and 22(78.57%) males. The age range was 23 to 27 years and all were unmarried. More than 2/3 interns belonged to Chhattisgarh and few from outside the state. Interns were motivated by the faculties to work for rural health care and were sensitized about the health care needs work challenges in remote inaccessible areas.

A study on utilization of maternal and infant health services in rural area of district Kanpur Nagar

Background: There is a pressing need to identify and address the grass root determinants of maternal health care utilization to steer the health services toward achieving the ambitious SDG target of reducing the global MMR to &lt;70 per 100 000 births by 2030. Objective of current study was to assess the utilization of health services provided to mothers and infants. Methods: The present cross-sectional study was conducted by the department of community medicine GSVM Medical College Kanpur using multistage random sampling technique including women having children less than 1 years of age and Infant (less than one year) born to these eligible women in rural blocks of district Kanpur Nagar for evaluation mother and infant care services from February 2021 to September 2022. Results: 94.17% participants had at least one antenatal visit, 85.06% of delivery were take place at CHC, 83.80% post natal care provided by doctor, 30.76% infant were treated properly for Acute respiratory symptom 21.31% infant received ORT and Zinc for treatment of diarrhea. Similar results were found as per NFHS-5 in rural Uttar Pradesh in previous published research work. Conclusions: Utilization of health care services require more improvement for infant disease treatment.

Knowledge of danger signs in pregnancy and their associated factors among pregnant women in Hosanna Town, Hadiya Zone, southern Ethiopia.

Danger signs in pregnancy can warn of maternal health problems. In developing African countries, including Ethiopia, the rate of maternal mortality is high. There is little knowledge of danger signs during pregnancy and their associated factors at the community level in the study area. A community-based, cross-sectional study was conducted to assess knowledge about danger signs among pregnant women in Hosanna Zuria Kebeles between 30 June and 30 July 2021. A simple random sampling method was used to select eligible pregnant women. The sample size was proportionally allocated based on the number of pregnant women in each kebele. Data were collected in face-to-face interviews using a pretested questionnaire. The descriptive results were presented as proportions, whereas the analytic results were presented as adjusted odds ratios (AOR). The prevalence of good knowledge of danger signs in pregnancy was 259/410 (63.2%, 95% confidence interval (CI) 58.3-67.8). The most common known danger signs during pregnancy were severe vaginal bleeding (n = 227, 55.4%), followed by blurred vision (n = 224, 54.6%). In the multivariable analysis, the age of the respondent (AOR = 3.29, 95% CI 1.15-9.38), the tertiary education of the mother (AOR = 5.40, 95% CI 2.56-11.34), and the number of live births (AOR = 3.95, 95% CI 2.08-7.48) were statistically significant factors. There was an adequate prevalence of knowledge of danger signs in pregnancy among pregnant mothers compared with different studies in Ethiopia and different countries. Advanced maternal age, the respondent's level of education, and the number of live births were found to be independent determining factors for the level of knowledge on danger signs in pregnancy among pregnant mothers. Health facilities and healthcare providers should focus on antenatal care and the age and parity of the mother when giving information about danger signs in pregnancy. The Ministry of Health should provide reproductive health services in rural areas and encourage education for women. Further studies need to be conducted and include danger signs in the three trimesters using a qualitative study design.

Spatial Accessibility of Primary Care in the Dual Public-Private Health System in Rural Areas, Malaysia.

Disparities in access to health services in rural areas represent a global health issue. Various external factors contribute to these disparities and each root requires specific remedial action to alleviate the issue. This study elucidates an approach to assessing the spatial accessibility of primary care, considering Malaysia's dual public-private system specifically in rural areas, and identifies its associated ecological factors. Spatial accessibility was calculated using the Enhance 2-Step Floating Catchment Area (E2SFCA) method, modified as per local context. Data were secondary sourced from Population and Housing Census data and administrative datasets pertaining to health facilities and road network. The spatial pattern of the E2SFCA scores were depicted using Hot spot Analysis. Hierarchical multiple linear regression and geographical weight regression were performed to identify factors that affect E2SFCA scores. Hot spot areas revolved near the urban agglomeration, largely contributed by the private sector. Distance to urban areas, road density, population density dependency ratios and ethnic composition were among the associated factors. Accurate conceptualization and comprehensive assessment of accessibility are crucial for evidence-based decision making by the policymakers and health authorities in identifying areas that need attention for a more specific and localized planning and development.

Rural Perspectives on Health Services for Transgender and Gender Diverse Youth.

As the world grows more diverse, physicians and public health practitioners must become adept at providing care to everyone, including people who identify as transgender or gender diverse (TGD). Although this population is growing in all age demographics, there is a large increase in young TGD individuals who require pediatric health care providers to improve their practices. While a few comprehensive care clinics have been established to serve the TGD community, they are mostly located in urban areas. In addition to the unique barriers faced by rural TGD youth, providers must care for their patients with limited resources. In this commentary, we offer a set of recommendations to improve provider education, build connections between the health system and community, address the fragmentation of health services in rural areas and improve the transition from pediatric to adult health care.