Health Stations Research Articles

The Service Capability of Primary Health Institutions under the Hierarchical Medical System.

Background: Primary health institutions (PHIs) are the foundation of the whole health system and the basic link to achieve the goal of all people enjoying primary health care. However, the service capability of primary health institutions is not under the hierarchical medical system. Method: Data were collected from the China Health Statistics Yearbook between 2014 and 2020. PHIs included community health centres, community health stations, and township hospitals in our study. The service capability of primary health institutions was analysed from the perspective of structure, process, and results. Structure capability was evaluated using the number of beds, number of personnel, number of health technicians, and proportion of the number of personnel in PHIs accounting for the total number of health personnel. Process capability was evaluated using the number of general practitioners. The number of outpatients and inpatients, medical income, the proportion of drug income, and the average number of patients and beds served by physicians in PHIs per day were employed to evaluate the resulting capability. Results: From 2014 to 2020, the number of community health service centres/stations increased, while the number of township health centres decreased. In the aspect of structure capability, the total number of personnel and health technicians in community health centres/stations and township hospitals both increased during 2014 and 2020. However, the increasing rate in PHIs was a little bit less than that of general medical institutions. The proportion of male health technicians in community health centres and township hospitals both decreased, while the proportion of female technicians in both increased. From 2014 to 2020, the number of beds in PHIs also increased from 138.12 × 104 to 164.94 × 104. However, the proportion of beds in PHIs accounting for the total number of beds in medical institutions decreased. For the resulting capability, from 2014 to 2019, the proportion of diagnosis and treatment times in PHIs decreased from 57.41% to 51.96%, although it increased in 2020. The proportion of inpatients in PHIs decreased from 20.03% to 16.11%. From 2014 to 2020, the utilisation rate of hospital beds in PHIs decreased (from 55.6% to 34% for community health centres and 60.5% to 53.6% for township hospitals). The average daily bed days of doctors in township hospitals was higher than that of doctors in community health service centres. However, the average medical cost of outpatients and the per capita medical cost of inpatients in community health service centres were higher than in township hospitals. Conclusion: In recent years, although the service capability showed an increasing trend in PHIs, the growth rate was lower than the general health institutions. The utilisation rates of PHIs, including beds and physicians, were decreased. Among PHIs, the utilisation in township hospitals was higher than in community health centres with a relatively low price. Under the hierarchical medical system and normalisation period of the COVID-19 epidemic, it is important to improve the service capability to achieve its goal of increasing PHI utilisation and decreasing secondary and tertiary hospital utilisation.

REDACS: Regional emergency-driven adaptive cluster sampling for effective COVID-19 management

As COVID-19 is spreading, national agencies need to monitor and track several metrics. Since we do not have perfect testing programs on the hand, one needs to develop an advanced sampling strategies for prevalence study, control and management. Here we introduce REDACS: Regional emergency-driven adaptive cluster sampling for effective COVID-19 management and control and justify its usage for COVID-19. We show its advantages over classical massive individual testing sampling plans. We also point out how regional and spatial heterogeneity underlines proper sampling. Fundamental importance of adaptive control parameters from emergency health stations and medical frontline is outlined. Since the Northern hemisphere entered Autumn and Winter season (this paper was originally submitted in November 2020), practical illustration from spatial heterogeneity of Chile (Southern hemisphere, which already experienced COVID-19 winter outbreak peak) is underlying the importance of proper regional heterogeneity of sampling plan. We explain the regional heterogeneity by microbiological backgrounds and link it to behavior of Lyapunov exponents. We also discuss screening by antigen tests from the perspective of “on the fly” biomarker validation, i.e., during the screening.

Crisis (un)preparedness in the healthcare sector in the Czech Republic

This article deals with crisis (un)preparedness in health care in the Czech Republic. In the descriptive part we can find the current state of knowledge of crisis preparedness in the Czech Republic, including a description of individual institutions working in this field. Emphasis is also placed on the connection with the current legislation describing crisis preparedness in health care, i.e. the role of the Ministry of Health, health stations, ambulance services or hospitals. The descriptive part concludes that the currently set system has its loopholes. Therefore the article also suggests possible improvements in chapter 2. It focuses on conducting a thorough risk analysis, crisis planning and its prompt updating, and, last but not least, it also points out the method of verification of the set rules, i.e. exercises. The present article is a communication.

Exploring the Relationship between Job Satisfaction and Job Retention among Registered Nurses under the Nurse Deployment Program in Southern Philippines

Background: This study explores the relationship between job satisfaction and job retention among registered nurses working under the Nurse Deployment Program (NDP) in Southern Philippines. Methods: The study design employed in the study is Descriptive-correlational to measure the nurses' perceptions of organizational job satisfaction, and the link between job satisfaction and job retention using a survey questionnaire. A total of 139 registered nurses were selected using Random sampling method from the hospitals, rural health units, birthing places, and barangay health stations in municipalities of Lanao del Sur, Philippines. The data was analyzed through Frequency and Percentage Distribution and Spearman Rho Correlation using manual computation and SPSS. Nurse retention was calculated by dividing the average number of registered nurses during a period of 6 months by the job turnover rates on the units. Results: The findings revealed that the respondents were ‘satisfied’ on the overall indicators on the job satisfaction scale. With a Spearman Rho Correlation value of 0.003 and p-value of 0.016, the data suggested that there is a significant correlation between the respondents’ job satisfaction and job retention in the Nurse Deployment Project. Conclusion: This research illuminated the factors that may influence nurse retention, improve nurse job satisfaction, and promote healthy workplaces. It can serve as a standard or foundation for policymakers and implementers in identifying areas for improvement in boosting job satisfaction among nurses

Determining staffing standards for primary care services using workload indicators of staffing needs in the Philippines

BackgroundHealth services cannot be delivered without an adequate, competent health workforce. Evidence suggests a direct relationship between density of health workforce and health outcomes. The Philippines is faced with health workforce challenges including shortages, inequitable distribution and inadequate skill mix which hinder health service delivery. Evidence-based workforce planning is, therefore, critical to achieve universal health care.MethodsThe Philippines adopted the World Health Organization’s workload indicators of staffing need methodology. Using a multistage sampling method, nine regions with poor health indicators in tuberculosis, family planning, and maternal child health were identified. Physicians, nurses, midwives, and medical technologists were prioritized in the study from 89 primary care health facilities (barangay health stations, rural health units, and city health offices). Data was collected using in-depth interviews, document reviews, observations, and field visits. The workload indicators of staffing need software were used for data analysis to determine staffing requirements and analyse workforce pressure.ResultsThe study showed varied results in terms of staffing requirements and workload pressure across cadres and facility types. Some health facilities exhibited staff shortages and high workload pressure. Out of the 40 rural health units and city health offices, only three had the required physicians needed and 22 facilities had a shortage of physicians working under high workload pressure. Other facilities had excess staff compared to the calculated requirements. Nurses at the rural health units showed high workload pressure. Ten rural health units had no medical technologists. Midwives at barangay health stations exhibited extremely low workload pressures.ConclusionThe study identifies the need for the Philippine Health System, both through the Department of Health and the local governments to efficiently optimize the available health workers by revising the services offered at the primary health care facilities. The results provide evidence for staffing requirements at various levels of care based on workloads, scope of practice and time taken to undertake specific tasks at the barangay health stations, rural health units and city health offices to be integrated into the human resources for health management systems.

Economic evaluation of population-based type 2 diabetes mellitus screening at different healthcare settings in Vietnam.

IntroductionFew economic evaluations have assessed the cost-effectiveness of screening type-2 diabetes mellitus (T2DM) in different healthcare settings. This study aims to evaluate the value for money of various T2DM screening strategies in Vietnam.MethodsA decision analytical model was constructed to compare costs and quality-adjusted life years (QALYs) of T2DM screening in different health care settings, including (1) screening at commune health station (CHS) and (2) screening at district health center (DHC), with no screening as the current practice. We further explored the costs and QALYs of different initial screening ages and different screening intervals. Cost and utility data were obtained by primary data collection in Vietnam. Incremental cost-effectiveness ratios were calculated from societal and payer perspectives, while uncertainty analysis was performed to explore parameter uncertainties.ResultsAnnual T2DM screening at either CHS or DHC was cost-effective in Vietnam, from both societal and payer perspectives. Annual screening at CHS was found as the best screening strategy in terms of value for money. From a societal perspective, annual screening at CHS from initial age of 40 years was associated with 0.40 QALYs gained while saving US$ 186.21. Meanwhile, one-off screening was not cost-effective when screening for people younger than 35 years old at both CHS and DHC.ConclusionsT2DM screening should be included in the Vietnamese health benefits package, and annual screening at either CHS or DHC is recommended.

Is “Culture” Needed in Aboriginal Elder Care Station? An Study from the Perspective of Service Providers

Many studies show that cultural perspective is an important factor in caring for elderly tribal adults. To understand the level of attention that the Cultural Health Station of Indigenous People attaches to culture during its operation, this study selected Taitung County as the region of study. A qualitative focus group research method and quantitative questionnaire, we try to understand “What are the demands of elderly tribal adults?” “Do services provided by the Tribal Cultural Health Station satisfy the demands of elderly tribal adults?” and “What are the gaps between the service demands and provided to elderly tribal adults?” The results showed that service providers believe that culture is markedly important to elderly tribal adults, that culture-based care designs offered by the Tribal Cultural Health Station is currently insufficient, and that to enhance the capacity of the multiethnic Tribal Cultural Health Station, the cognition and understanding of policy makers and enforcers must be elevated.

BASIC SOLUTIONS TO DEVELOP HUMAN RESOURCES FOR RESPONDING COVID–19 IN HO CHI MINH CITY HEALTH DEPARTMENT, VIETNAM

The COVID-19 pandemic has been raging and spreading worldwide, causing unprecedented negative impacts on the world economy and Vietnam. Facing the complicated development of the epidemic, it is required that we have solutions to limit the risks of negative impacts of the epidemic on the economy, ensure social security, thereby creating a foundation for maintaining stable and sustainable economic growth in the coming years. The development of human resource in health sectors in general and health stations of wards, communes and towns in Ho Chi Minh City is considered one of the urgent solutions to meet the long-term requirements effectively responding to the COVID-19 epidemic. 
 
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Differences in Accessibility of Public Health Facilities in Hierarchical Municipalities and the Spatial Pattern Characteristics of Their Services in Doumen District, China

This study used the two-step floating catchment area method and potential model to calculate facility accessibility and potential service scope of public health infrastructure distribution, and to evaluate its spatial equity. We applied the Gini coefficient to measure the spatial equilibrium at each level of public health infrastructure in Doumen District, Guangdong, China, from different perspectives. The following results were obtained: (1) Significant spatial differences were observed in the accessibility of public health facilities among different levels; the higher the health facility level, the greater the difference in spatial accessibility. Spatial differences in the accessibility of public health infrastructure at the primary level and higher were distributed in a block-like pattern, while spatial differences in the accessibility of rural health stations were distributed in a circular pattern. Administrative villages tended to have the highest and lowest accessibility of tertiary and secondary hospitals, but not of primary hospitals and rural health stations. The frequencies for administrative villages with the highest and lowest accessibility were 32.8% and 49.6% of the total number of villages in the district, respectively, for tertiary hospitals; 39.2% and 48.8% for secondary hospitals; 19.2% and 24.8% for primary hospitals; 16.8% and 21.6% for rural health stations. (2) The potential service scope was spatially dissociative for tertiary hospitals, and differed more significantly in terms of space for secondary hospitals; the potential service scope of the two overlapped. The potential service scope of primary hospitals was relatively balanced, with strong spatial continuity, while that of rural health service centers was spatially fragmented. The service scope of rural health service centers was mostly consistent with their respective village-level administrative divisions. (3) The higher the level of public health infrastructure, the less balanced its spatial layout. Conversely, the lower the level of public health infrastructure, the more balanced its spatial layout.

Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being. A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations. The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only. The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals. Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

Risk factors for malaria in high incidence areas of Viet Nam: a case\u2013control study

BackgroundA key step to advancing the goal of malaria elimination in Viet Nam by 2030 is focusing limited resources for treatment and prevention to groups most at risk for malaria transmission.MethodsTo better understand risk factors for malaria transmission in central Viet Nam, a survey of 1000 malaria positive cases and 1000 malaria negative controls was conducted. Cases and controls were matched for age and gender and self-presented at commune health stations (CHS) in Binh Phuoc, Dak Nong and Dak Lak Provinces. Diagnoses were confirmed with microscopy, rapid diagnostic test and PCR. Participants were interviewed about 50 potential risk factors for malaria, which included information about occupation, forest visitation, travel, healthcare-seeking behaviour and prior use of anti-malaria interventions. Participants were enrolled by trained government health workers and the samples were analysed in Vietnamese government laboratories. Data were analysed by univariable, block-wise and multivariable logistic regression.ResultsAmong cases, 61.8% had Plasmodium falciparum, 35.2% Plasmodium vivax and 3% mixed species infections. Median (IQR) age was 27 (21–36) years and 91.2% were male. Twenty-five risk factors were associated with being a case and eleven with being a control. Multivariable analysis found that malaria cases correlated with forest workers, recent forest visitation, longer duration of illness, having a recorded fever, number of malaria infections in the past year, having had prior malaria treatment and having previously visited a clinic.ConclusionsThis study demonstrates the benefits of increased statistical power from matched controls in malaria surveillance studies, which allows identification of additional independent risk factors. It also illustrates an example of research partnership between academia and government to collect high quality data relevant to planning malaria elimination activities. Modifiable risk factors and implications of the findings for malaria elimination strategy are presented.

Health Services Utilization Among Older Adults in Vietnam: Evidence From the National Household Living Standard Survey 2016.

This study-using multinomial logistic regressions-analyzed a national sample of 2977 older adults to examine factors associated with their health services utilization in four types of health providers-namely, commune health stations (CHSs), private clinics, private hospitals, and public hospitals in Vietnam. Older Vietnamese favored using public hospitals for their health consultancies, even for regular health checkups. For nonsevere illness, the relative risk ratio of choosing private clinics was three times (95% CI: 2.2-4.1) that of CHSs. Possession of public health insurance was a key enabling factor that influenced the older adults' choice of CHSs over private clinics. Older adults of ethnic minority and living in rural areas were more likely to use CHSs than other health facilities. This study suggests a substantial quality improvement of services at CHSs, an innovative reform toward a diversified structure of private and public clinics to address diverse needs and to strengthen primary care for older adults.

THE PRACTICE OF HEALTH COMMUNICATION AND EDUCATION ABOUT DIABETES AMONG VILLAGE HEALTH WORKERS IN VU THU DISTRICT, THAI BINH PROVINCE IN 2020

Objective: Describe the practice of health communication and education about diabetes among village health workers in Vu Thu district, Thai Binh province in 2020. Subjects: Village Health Worker and Head of Commune Health Station in the communes of Vu Thu district, Thai Binh province. Method: the epidemiological method described through the cross-sectional investigation, combine quantitative research and qualitative research. Results: 69.5% of village health workers had carried out communication and health education for villagers about diabetes in the past year; Over 80% of village health workers had a plan and over 60% cooperate in communicating and educating about diabetes about diabetes; 15/15 opinion of the head of the station said that the communication and education about diabetes in the commune was small, not continuous, mainly indirect communication; 13/15 comments that the biggest difficulty in health communication and education was that the village health workers were still limited in knowledge and skills.

Community support model on breastfeeding and complementary feeding practices in remote areas in Vietnam: implementation, cost, and effectiveness

BackgroundPoor access to healthcare facilities and consequently nutrition counseling services hinders the uptake of recommended infant and young child feeding (IYCF) practices. To address these barriers and improve IYCF practices, Alive & Thrive (A&T) initiated community support groups in remote villages across nine provinces in Vietnam.ObjectiveThis study examines the effectiveness of the support group model and related project costs for reaching underserved areas to improve IYCF practices.MethodsTo evaluate the model’s implementation and project costs, we reviewed implementation guidelines, expenditure and coverage reports, monitoring data, and budgets for the nine provinces. To evaluate the model’s effectiveness, we used a 3-stage sampling method to conduct a cross-sectional survey from April to May 2014 in three provinces entailing interviewing mothers of children aged 0–23 months in communes with (intervention; n = 551) and without support groups (comparison; n = 559).FindingsCoverage: From November 2011 to November 2014, in partnership with the government, A&T supported training for 1513 facilitators and the establishing 801 IYCF support groups in 267 villages across nine provinces. During this period, facilitators provided ~ 166,000 meeting/support contacts with ~ 33,000 pregnant women and mothers with children aged 0–23 months in intervention villages. Costs: The average project costs for supporting the meetings, compensating village collaborators, and providing supportive supervision through staff in commune health stations were USD 5 per client and USD 1 per contact. After adding expenditures for training, supportive supervision, and additional administrative costs at central and provincial levels, the average project cost was USD 15 per client and USD 3 per contact. Effectiveness: Survey participants in intervention and comparison communes had similar maternal, child, and household characteristics. Multiple logistic regression models showed that living in intervention communes was associated with higher odds of early initiation of breastfeeding (OR: 1.7; 95% CI: 1.1, 2.7), exclusive breastfeeding from 0 to 5 months (OR: 12.5; 95% CI: 6.7, 23.4), no bottle feeding (OR: 2.69; 95% CI: 1.82, 3.99), and minimum acceptable diet (OR: 1.51; 95% CI: 0.98, 2.33) compared to those living in comparison communes.ConclusionThe IYCF support group model was effective in reaching populations residing in remote areas and likely contributed to improved IYCF practices. The study suggests that the model could be scaled up to promote equity in breastfeeding support.

Current situation of stress, anxiety, and depression of the health care workers working at the Health Care Center of Soc Son district, Hanoi, Vietnam, 2019

A cross-sectional study using DASS21 was performed in June 2019 on staff working at the commune health stations (CHSs), regional general clinics and district general clinics in Soc Son district, Hanoi to assess the mental disorders of the health care workers are working here. Among the 355 health care workers (HCWs) who participated, women accounted for 75.5%. People aged under 30 accounting for 33.5% of HCWs. Physicians, nurses take up 54.4%, and HCWs in the Soc Son district have worked in the health sector for more than ten years, accounting for 45.1%. The study shows that the rates of stress, anxiety, and depression were 13.8%, 25.4% and 16.6%, respectively. 31% of HCWs have at least one mental disorder, 8.2% of study subjects have all three manifestations of mental disorders, 8.4% of study subjects have two symptoms and 14.4% of the study subjects had only one manifestation. The rates of stress, anxiety, and depression were initially screened from the research results. The development of research directions for defnitive diagnosis and support for improving health care workers’ mental health should be integrated.

A Validation Study of the Rainbow Model of Integrated Care-Measurement Tool for Patients in China.

Introduction:The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care (RMIC), which provides a comprehensive theoretical framework for integrated care. The aim of this paper is to modify the original patient version of the RMIC-MT for the Chinese primary care context and validate its psychometric properties.Methods:The translation and adaptation processes were performed in four steps, forward and back-translation, experts review and pre-testing. We conducted a cross-sectional study with 386 patients with diabetes attending one of 20 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method was used to assess the construct validity. Confirmation factor analysis was used to evaluate model fit of the modified version. Cronbach’s alpha was used to ascertain the internal consistency reliability.Results:During the translation and adaptation process, all 24 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Five factors (person-centeredness, clinical integration, professional integration, team-based coordination, organizational integration) with 15 items were determined by exploratory factor analysis, accounting for 53.51% of the total variance. Good internal consistency was achieved with each item correlated the highest on an assigned subscale and Cronbach’s alpha score of 0.890. Moderately positive associations (r≥ 0.4, p<0.01) between the score of the scale and these correlations indicate good construct validity.Conclusions:The results showed initial satisfactory psychometric properties for the validation of the Chinese RMIC-MT patient version. Its application in China will promote the development of people-centered integrated primary care. However, future studies with diverse samples crossing regions would be needed to test its psychometric properties for the various Chinese primary care contexts.

Screening of major endocrine disorders among stations of oil products distributions in Basrah city, Iraq

Background: Gasoline poses a threat to the public health, in general, and gasoline station workers, in particular. Cardiometabolic syndrome is a very common health problem among gasoline station workers throughout the world. In spite of its significance, few health assessments studies (if any) are available exploring the health risk effects of gasoline in relation to occupational exposure in Iraq. Trying to fill this gap, the present study aimed to evaluate health risk effects of gasoline on gasoline station workers in Iraq. Methods: The study population (N=134) was composed of randomly selected male gasoline pump workers (N=83) in Basrah, Iraq. Unexposed healthy individuals (N=51) without any systemic or mental illness were used as a control group. Body mass index (BMI), blood pressure, and blood glucose level were measured in both groups. Results: The results indicated that the BMI, blood pressure, and blood glucose levels were significantly higher among gasoline station workers in comparison to those in the control group. Conclusion: Based on the results, it can be claimed that exposure to gasoline could increase the potential risk of many disorders such as metabolic syndrome, high blood pressure, and elevated blood glucose level. It is highly recommended to consider preventive measures that protect gasoline station workers from such health threats. In addition, learning about the importance of wearing gloves, special coats, and face mask is believed to considerably reduce the risk of getting involved with such health problems.

Relationship of knowledge about and attitudes towards violence with recognition of violence against women among health staff in pre-hospital emergency medical services

BackgroundDomestic violence, specifically, violence against women, is prevalent in all segments of society regardless of social class, ethnicity, culture or country. In other words, domestic violence is a global concern. AimThe study aims to investigate the relationship between the attitude and knowledge of the health staff in pre-hospital emergency medical services about violence against women and their recognition of such form of violence. MethodsThis descriptive study was conducted on 1023 paramedics and emergency medicine technicians who work in the pre-hospital emergency health setting and are members of the Paramedic and Pre-hospital Emergency Medicine Association. The Attitudes towards Violence against Women Scale (ATVAWS) and Health Staff's Recognition of Signs of Violence against Women Scale (HPRSVAWS) were used for data collection. ResultsThe mean scores for the ATVAWS and HPRSVAWS were 46.68 ± 6.92 and 20.31 ± 3.23, respectively. Of the participants, 48.5% had been subjected to violence, 43.93% had been subjected to violence perpetrated by their mothers, 41.53% had been exposed to physical violence and 4.2% remain exposed to domestic violence. Participants who had been exposed and those who remain exposed to domestic violence produced high scores in ATVAWS, which indicates an improvement in the traditional approach (less opposing view) to violence. High scores in the ATVAWS for (a) those who were exposed to violence in their workplaces, (b) who had never attended to actual or suspected cases of violence against women in their professional life, (c) who had attended to seven or more cases of violence against women, (d) who were less competent in physically examining actual or suspected cases of violence and (e) who had not been trained on violence against women, which indicates an increase in the traditional approach to violence. ConclusionThe study found that health staff in emergency health stations better recognised the signs of violence against women as their attitudes towards violence were less similar to the traditional approach. That is, they mostly held non-violent views. The characteristics, attitudes, perceptions and values of health professionals were considered important factors in addressing violence.

Maintaining Mutual Benefits between Investor and Local Community: Mechanisms to Reopen Lega Dambi Gold Mining, Ethiopia

Mining, specifically, large-scale gold mining has become one of the primary economic activities that play a pivotal role in the socio-economic development of one country. But there is no consensus among scholars whether gold mining companies maintain mutual benefits with local communities. The main objective of this research is to scrutinize the mechanism to be employed in reopening Lega Dambi large-scale gold mining by maintaining mutual benefits between the company and the local community. The researcher employed a qualitative method and a case study research design. Focus group discussions and semi-structured interviews were used to collect data from the local community, elders, religious leaders, Abbaa Gadaas, Guji Zone, and Odo Shakiso Woreda investment office, land management office, social and labor affair, mineral, and energy office administrators, and Odo Shakiso Woreda health station and Adola hospital. Secondary sources and regulatory frameworks such as FDRE Constitution and Mining Operations Proclamation No. 678/2010 were used to triangulate with primary data. The finding shows that Lega Dambi's large-scale gold mining company failed to maintain mutual benefits between itself and the local community. Basic tenets such as national and regional corporate social responsibility, community development agreement, impact and benefit agreements, social and labor plan, and social license were not implemented properly to balance the mutual benefit between the company and the local community. The researcher concluded that Lega Dambi large-scale gold mining company disregarded the role of the local community during commencement time albeit it had a strong relationship with the central government. Consequently, the company was terminated because of a bad relationship it had with the local community. It is recommended that national and regional corporate social responsibility that shows the company’s specific joint administration of the central and Oromia region governments should be designed and implemented fully. It is also recommended that discussions should be held with local communities and arrived at a consensus concerning the reopening of the company.

A Review of the Condition of OPD Patients in Arba’een On-foot Pilgrimage in 2019

Background: The annual religious ritual of Arba’een is the global largest mass gathering of pilgrims from different countries participating in a mass movement on an 80-km pathway to visit the Shrine of Imam Hussein, the grandson of Prophet Muhammad. The provision of health care for such a mass movement has always been an important vital issue for the health care system. Objectives: The current study investigated the common illnesses in addition to the quantity of health care services offered by temporary clinics and health stations located on the way to the shrine to such a mass gathering of on-feet pilgrims in Iraq in Arba’een 2019. Methods: This cross-sectional study was conducted at temporary clinics and health stations where pilgrims in need of nursing, midwifery, and pharmaceutical care were provided with services by general and expert physicians on the way from Najaf to Karbala in Iraq during a week in October 2019. Results: Imam Reza Temporary Clinic offered services to a total of 26,875 patients, including 9,934 females (36.96%) and 16,941 males (63.04%), on all days of the week. The most common chief complaint reported by the patients were musculoskeletal problems (n=11,945; 21.99%), foot blisters (n=11,372; 20.94%), and skin lesions (n=10,662; 19.62%). Conclusions: The present study highlighted the need for providing more organized services, especially in emergency health care, and necessity of paying further and closer attention to the significance of the health history of those pilgrims attending such religious mass gatherings in previous years.