Healthcare Services In Hospitals Research Articles

Healthcare utilization in general practice and hospitals preceding a diagnosis of systemic sclerosis: a nationwide registry study.

Irreversible tissue damage is frequently present at the time of diagnosis in systemic sclerosis (SSc), which calls for earlier diagnosis. This study estimated healthcare utilization three years before the diagnosis of SSc. We conducted a population-based cohort study using data from Danish national registries. Incident patients diagnosed with SSc between January 1, 2005, and December 31, 2018, were matched by age and gender with 10 references without SSc. The date of diagnosis was the index date. We estimated quarterly rates and adjusted incidence rate ratios (IRRs) with 95% confidence intervals (CI) of healthcare utilization in the three years preceding the diagnosis for patients with SSc and their references. A total of 1,650 SSc patients (1,255 women and 395 men) and 16 500 non-SSc references were included. The mean age was 58 years (interquartile range 48-68). Three years before diagnosis, patients with SSc had more contacts with general practice (IRRwomen= 1.43 [95% CI: 1.33; 1.53], IRRmen= 1.47 [95% CI: 1.26; 1.71]) and hospitals (IRRwomen= 1.86 [95% CI: 1.62; 2.14], IRRmen= 2.70 [95% CI: 2.04; 3.58]) compared with their references. In the last three months before diagnosis, patients with SSc had significantly more contacts with general practice (IRRwomen= 2.30 [95% CI: 2.16; 2.44], IRRmen= 2.98 [95% CI: 2.64; 3.35]) and hospitals (IRRwomen= 5.62 [95% CI: 5.08; 6.20], IRRmen= 9.53 [95% CI: 7.81; 11.63]). The higher use of healthcare services in general practice and hospitals in the three years before diagnosis suggests an opportunity to facilitate earlier diagnosis and treatment of SSc.

Towards integration of care in Portugal: Expansion of a new management model for the NHS

Abstract Introduction In 1999, the first Local Health Unit (LHU) was created in the Northern region of Portugal to improve management, share resources and integrate care. The LHU integrated a National Health Service (NHS) hospital and primary healthcare (PHC) services located within the same geographic area and became responsible for public health activities and the provision of care. Over the next few years, 7 LHUs were created, the last one in 2012. In 2024, the government expanded this model to the entire territory, creating 39 LHUs. This research analyses the objectives, characteristics and expected outcomes of the scale-up of LHUs. Methods This study utilised a mixed methods approach based on the 6 Ps - Problem, People (policy stakeholders), Process (policy development), Price tag (Resource allocation), Paper (policies, laws, regulations), Programmes (policy implementation); and the political, social and economic setting of the Policy Circle Framework. Findings A 2015 assessment revealed that LHUs did not differ from non-LHUs in terms of access, waiting times, clinical excellency, patient safety or patient centeredness. The degree of integration of care in LHUs seemed lower compared with non-LHUs. However, there was no systematic evaluation of the creation of the first LHU. Despite this, the government announced the intention to expand LHUs to the entire national territory, which culminated with the creation of 39 LHUs in 2024 to deliver integrated care, with an emphasis on the proximity and continuity of health services and promotion. Conclusions Despite the existing knowledge gap on the impacts of LHUs in health outcomes and management efficiency, LHUs can provide opportunities to advance integrated and patient-centred care and develop strategies for managing scarce resources, including the health workforce. Nevertheless, the integration of hospitals and PHC can threaten the centrality of primary health care both in terms of delivery of care and resource allocation.

Systematic Literature Review: Nurses' Work Hours and Workload Impact on Patient Safety Incidents

Patient safety is a key indicator in assessing the quality of healthcare services in hospitals, and nurses play a crucial role in maintaining that safety. However, long working hours and high workloads can affect nurses' performance, increasing the risk of fatigue, stress, and burnout, ultimately contributing to medical errors and decreased quality of care. This study aims to conduct a systematic literature review on the effect of nurses' working hours and workload on hospital patient safety incidents. Patient safety is a key indicator in assessing healthcare quality, and nurses play an essential role in maintaining patient safety during daily care. However, long working hours and high workloads can affect nurses' performance, increasing the risk of fatigue, stress, and burnout, ultimately contributing to medical errors and decreased quality of care. Through the analysis of various relevant studies, this review suggests that more flexible working hour arrangements and balanced workload management can reduce the risk of patient safety incidents and improve the quality of care provided. This study also recommends that hospital human resource management to create a healthier and safer working environment for nurses and patients.

Uncovering patient dissatisfaction with Healthcare Services at a tertiary hospital in Uganda: Patient perspective in a descriptive cross-sectional study

Introduction: Patient satisfaction is a widely recognized standard for assessing the effectiveness of healthcare services in hospitals. This study aimed to discover factors associated with patient dissatisfaction with healthcare services offered at Masaka Regional Referral Hospital, Masaka District-Uganda. Methods: A descriptive cross-sectional study that employed quantitative data collection methods was conducted between February and March 2024. Using Systematic random sampling, 384 study participants were included. Data was collected using an interviewer-administered questionnaire analyzed and presented using Microsoft Excel 2019 Version. Results: Most respondents 120 (31.25%) were aged between 31-40 years, 56.77% were females, 67.71 were married or cohabiting with the majority of respondents in low-income class and, 194(50.53%) having a monthly income of less than 100,000Ug. Shs. As (53.13%) were unemployed, 221 (57.55%) were rural residents, and the majority 248(65%) traveled long distances of greater than 10 kilometers to reach the Hospital. The majority of respondents 298(77.61%) disagreed that there was an adequate seating area, the majority of respondents 304(79.17%) waited for long hours before getting services and 204(53.12%) disagreed upon being given adequate time and information regarding their health and 174(45.31%) reported that HCWs were rude to them. Conclusions: Majority of respondents were dissatisfied with the services they had received at the hospital as most of them 208(54.17%) rated the services provided as poor. Therefore, there should be Implementation of targeted Interventions to address socio-demographic disparities, Enhance Patient-Centered Care and Communication Practices, optimization of health institutional practices to improve service delivery, and further research studies are recommended to better understand the gaps in patient satisfaction with healthcare services in Uganda.

Patient safety culture can improve the quality of nursing care

Patient safety is an indispensable and vital component of healthcare systems, constituting a fundamental pillar of quality within healthcare organizations [1]. Currently, the focus on ensuring patient safety is a crucial aspect of delivering healthcare services in hospitals, as any deficiencies in this area may result in unfavorable outcomes. Indeed, the entitlement to be protected from harm while undergoing medical treatment is a fundamental human right. Ensuring patient safety is a critical measure of hospital management, and neglecting it may result in a rise in patient mortality [2]. Nursing errors and mistakes not only result in harm to patients but also give rise to various issues. These include ineffective and incomplete treatment, prolonged hospital stays, escalated expenses, erosion of patient confidence in the healthcare system, and the potential for legal complications for nurses [3].

Impact of a health system vertical integration program on patient expenditures and healthcare utilization: Evidence from county hospitals in East China

In 2009, China launched a vertical integration pilot program to promote collaboration between tertiary and county hospitals to reduce rural-urban disparities and strengthen capacity building in healthcare services delivery in county healthcare facilities. Through the program, tertiary hospitals implemented a workforce mobility program to temporarily assign selected physicians and healthcare staff to paired county hospitals. This study uses hospital-level data from 2009 to 2015 to investigate the program's impact on medical expenditures and healthcare utilization among patients visiting the paired county hospitals. A difference-in-differences method with hospital and year-fixed effects is used to address the unobservable heterogeneity of hospitals and the potential impact of national healthcare reform. We find that the average outpatient expenditure experienced a 4.0% decline after the county hospitals received paired assistance from tertiary hospitals. The decline is mainly driven by a reduced proportion of diagnostic testing expenditures. However, there is no evidence that the program affected inpatient expenditures. In addition, county hospitals had 5.1% more outpatient visits after receiving paired assistance, while the average length of stay remains stable. These results are robust when we control the effect of the Zero-Markup drug policy and conduct permutation tests of sample assignment. We conclude that the paired assistance program has successfully improved hospital healthcare services delivery and controlled patient expenditures. Vertical integration has improved healthcare system performance in East China from 2009 to 2015.

Strategic Human Resource Management in Healthcare: Elevating Patient Care and Organizational Excellence through Effective HRM Practices

Human Resources (HR) are a key factor in the operations and service quality of hospitals. This study aims to analyze the role of HR in enhancing the efficiency and effectiveness of healthcare services in hospitals. The research method used includes a literature review and field surveys of medical and non-medical staff at several hospitals. The results show that effective HR management significantly contributes to increased patient satisfaction, reduced medical errors, and operational efficiency. Additionally, regular training and career development are proven to be effective in improving employee competence and motivation. This study recommends HR management strategies focused on skill enhancement, the use of information technology, and the development of a positive work culture to achieve higher service standards.

Android-Based Drug Information Application Using Augmented Reality Technology

The use of Augmented Reality technology in the pharmaceutical sector, particularly in pharmacies, has introduced significant innovations in providing drug information to consumers. AR applications can help healthcare workers and patients better understand drug use through three-dimensional visualization superimposed on the real environment. Observations at Sultan Abdul Aziz Syah Peureulak Hospital indicate that 70% of patients still experience confusion regarding the drug information provided by pharmacy staff. This difficulty is caused by the complexity of the information, lack of personal interaction, or low health literacy. To address this problem, the Android-based Mediscan application was developed using AR technology. This application utilizes Unity and Vuforia Engine software to present drug information visually in card form via the smart device screen. Users can point the camera at a particular drug and receive complete information regarding general indications, dosage, drug class, contraindications, and side effects. This research aims to develop the Mediscan application, calculate the level of patient understanding, measure consumer satisfaction, and evaluate the impact of using AR in presenting drug information. The System Development Life Cycle methodology with the Waterfall model was used in this research. The results show that AR technology can be implemented in Android-based applications to present drug information visually and interactively. The majority of patients feel more informed and gain a better understanding of the medication they are taking. AR technology in the Mediscan application improves user experience, supports the education and training of medical personnel and patients, and enhances the quality of healthcare services in hospitals. This application also makes it easier for medical personnel and pharmacists to convey drug information more effectively and efficiently.

The Relationship Between Job Satisfaction and Performance of Inpatient Nurses at Malahayati Islamic Hospital Medan

Nurse performance can significantly impact the quality of healthcare services in hospitals, meaning that low nurse performance can affect patient trust, satisfaction, and ultimately, the quality of life and well-being of the community. One factor influencing nurse performance in hospitals is job satisfaction. Job satisfaction reflects employees' feelings towards their jobs. Thus, this study aims to describe the relationship between job satisfaction and nurse performance. The research uses a cross-sectional study design with a sample size of 77 inpatient nurses at Malahayati Islamic Hospital in Medan, employing total sampling techniques. The research instruments include the Job Satisfaction Survey developed by Spector (1994) and the Individual Work Performance Questionnaire (IWPQ) developed by Koopmans et al. (2014). Data analysis was conducted using univariate and bivariate analysis with the chi-square test. The results showed that the majority of nurses' job satisfaction fell into the optimal category (71.4%) and the majority of nurse performance was categorized as good (63.6%). There is a significant relationship between job satisfaction and the performance of inpatient nurses at Malahayati Islamic Hospital in Medan, with a p-value of 0.000 (P value <0.05).

Exploring the Trend of Technology Use and Innovation in Health Care Service in Hospitals through a Bibliometric Analysis

Background: Information technology innovation is needed in various fields, including health. In the health sector, technological innovations can be applied to patient care, hospital management and research. Technological innovation can be applied to various hospital activities, from patient data collection to cleaning staff activities. Various innovations are needed to simplify health service activities to make services more effective and efficient. The purpose of the study was to explore the trend of technology use and innovation in health care services in hospitals by analyzing network visualization, overlay visualization, and density visualization on the topic through bibliometric analysis. Main body: In this research, bibliometric analysis was used. Records were identified through a database search at https://app.dimensions.ai/. The data obtained was then selected further by the PRISMA flow diagram. Papers were limited to publication years 2020-2023. The publication type is the article only, on the other hand, book chapters, thesis and proceeding publications are excluded. Data were analyzed using VOSviewer, and then reviewed by co-occurrence and co-authors. From the network visualization, it was identified that there were 199 items divided into 8 clusters with 9,504 links with a total link strength of 54,785. After identifying the clusters, the trends of technology use and innovation in health care services in hospitals were artificial intelligence, digital health technology, electronic health records, health information technology, smart health, telemedicine, virtual care, communication technology, electronic medical records and health care delivery. From the overlay visualization, it was indicated that the newest topics that were widely researched related to this theme were digital health service, digital transformation, digital health technology, digital tools, and telehealth service. From density visualization, it was indicated that topics that were rarely researched related to trends of technology use and innovation in healthcare services in hospitals were communication technology, healthcare organizations, and digital solutions. Conclusion: Technological developments have had a major impact on improving the quality of services in hospitals. Health professionals need to develop and improve their competencies so that they can continue to keep up with current technological developments and innovations.

Patterns of health service use for children with mental disorders in an Australian state population cohort.

The rate of mental health services provided to children and young people is increasing worldwide, including in Australia. The aim of this study was to describe patterns of hospital and ambulatory mental health service use among a large population cohort of adolescents followed from birth, with consideration of variation by age, sex and diagnosis. Characteristics of services provided for children with mental disorder diagnoses between birth and age 17.5 years were ascertained for a population cohort of 85,642 children (52.0% male) born between 2002 and 2005, from 'Admitted Patients', 'Emergency Department' and 'Mental Health Ambulatory' records provided by the New South Wales and Australian Capital Territory Health Departments. A total of 11,205 (~13.1%) children received at least one hospital or ambulatory health occasion of service for a mental health condition in the observation period. More than two-fifths of children with mental disorders had diagnoses spanning multiple categories of disorder over time. Ambulatory services were the most heavily used and the most common point of first contact. The rate of mental health service contact increased with age across all services, and for most categories of mental disorder. Girls were more likely to receive services for mental disorders than boys, but boys generally had an earlier age of first service contact. Finally, 3.1% of children presenting to mental health services experienced involuntary psychiatric inpatient admission. The extent of hospital and ambulatory-based mental healthcare service among children emphasises the need for primary prevention and early intervention.

Examining the Applicability of Surgical Coaching Rules for Resident Autonomy in Non-teaching Hospitals.

This retrospective study aims to analyze the impact of standardized rules for teaching in university hospitals on surgical resident autonomy and patient safety, as measured by patient outcomes, and also examines the learning curves for residents and their impact on patient outcomes in a non-teaching hospital. The data for the study was collected retrospectively from medical records of 2000 adult patients who went through surgical procedures fromJanuary 2020 to December 2022. Participants were categorized into two groups based on the supervision level provided by attending surgeons and residents. Appropriate statistical methods were used to analyze the data. It was observed that operative times of cases handled by both attending and resident surgeons were less than those handled by residents alone. On the other hand, the former group had a significantly higher burden of comorbidities and higher rate of perioperative complications than the latter. These results have important implications for the training of medical residents and the overall delivery of healthcare services in university hospitals. The findings will also help towards better understanding of the effectiveness of these rules and their potential for improving the quality of care provided by residents in these settings.

Kajian terhadap Putusan Hakim Nomor 1747/Pid.B/2023/Pn. Sby Ditinjau dari Undang Undang No 17 Tahun 2023 Tentang Kesehatan

ABSTRACT. Access to healthcare services is a fundamental right guaranteed by the 1945 Constitution. Hospitals play a crucial role in providing healthcare services, improving and maintaining the health of every individual. The Indonesian state fully regulates health services under Law Number 17 of 2020. Despite the regulations, there have been instances of individuals providing healthcare services under fake identities, leading to various forms of crime in the health sector. This research aims to examine the legal implications for hospitals that employ individuals with fake identities to provide health services. Additionally, it intends to determine the criminal liability of individuals who provide health services with fake identities, according to Law Number 17 of 2023. The research method employed is a normative juridical approach with descriptive analysis. The data was collected through literature studies using secondary data, while the data analysis used qualitative juridical methods. The results of this research indicate that hospitals have a responsibility to compensate for losses incurred due to the negligence of their medical personnel, both administratively, civilly, and criminally. On the other hand, individuals who provide healthcare services in hospitals with fake identities will face criminal charges under the law.

Role of electromedical personnel in ensuring the availability of electromedical device in hospitals

Objective: To examine the validity and reliability of a questionnaire used to assess the role of electromedical personnel in ensuring the availability of electromedical equipment for healthcare services in Indonesian hospitals, both during normal times and the COVID-19 pandemic. Methodology: This study involved the participation of 70 electromedical personnel from government hospitals in Surabaya and Yogyakarta, which are central and referral hospitals for COVID-19 patients. The questionnaire consisted of 16 questions that represented various skills required by electromedical personnel, including maintenance, repair, testing, monitoring, calibration, inspection, safety, fitness for use testing, assembly, installation planning, and review of electromedical devices. To evaluate the validity and reliability of the questionnaire, statistical measures such as Pearson product-moment correlation and Cronbach's alpha coefficient were utilized. The Smart PLS 3.0 program was employed to conduct these tests. Results: The reliability test demonstrated that all valid questions in the questionnaire were reliable, as indicated by a Cronbach's alpha coefficient of 0.936. Among the authorities assessed, the highest coefficient values for the role of conducting inspection of device performance (0.813) and the role of conducting safety inspections (0.821). Conclusion: The questionnaire is a valid and reliable research instrument for measuring the role of electromedical personnel in ensuring the availability of electromedical equipment in hospitals.

Investigating the complex relationships between nurses' work factors, Sharia-based nursing care, and patient satisfaction in an Islamic hospital: A PLS-SEM approach.

Healthcare services in Islamic hospitals are becoming increasingly important due to the growing global Muslim population and the demand for spiritually sensitive healthcare. Understanding the factors contributing to patient satisfaction in this context is paramount. This research aimed to investigate the relationships between nurses' work factors, Sharia-based nursing care, and patient satisfaction in an Islamic hospital in Indonesia. This study employed a cross-sectional design involving 260 respondents, comprising 130 patients and 130 nurses in inpatient rooms. Data collection took place in August 2022 at an Islamic Hospital in Indonesia using validated questionnaires. SmartPLS 3.2.8 was used to generate Partial Least Square Structural Equation Modeling (PLS-SEM) to assess and analyze relationships between research variables. Nurses' work factors had a significant impact on Sharia-based nursing care (β = 0.813, t = 18.582, p <0.001). Furthermore, Sharia-based nursing care had a significant influence on patient satisfaction (β = 0.509, t = 3.941, p <0.001), while nurses' work factors had a moderately significant effect on patient satisfaction (β = 0.396, t = 3.079, p = 0.002). The interaction between work factors and Sharia-based nursing care had an influence on patient satisfaction (β = 0.366, t = 3.666, p <0.001), explaining 74.4% of the variance observed in patient satisfaction.Conclusion: This study offers valuable insights into the significance of improving nurses' work factors, including elements such as performance, feedback, correction, and job design, along with the integration of Sharia-based principles in nursing care. The study suggests that nursing administrators, healthcare policymakers, and academic institutions should prioritize the creation of supportive work environments and culturally sensitive care practices for nurses to enhance patient satisfaction.

A PLS-SEM Analysis of Factors Determining Medical Personnel Performance in a Tertiary Referral Hospital

Background: Health workers’ performance is essential to the effective delivery of hospital healthcare services, which can determine the quality of care and patient safety. Employees’ job performance becomes more crucial for tertiary hospitals where advanced and subspecialty care is provided to treat high-risk and critical emergency patients. Objectives: This study was conducted to develop a conceptual framework for understanding the factors that affect medical personnel's performance at the hospital, with perception as the intervening variable. Methods: This cross-sectional study used an online self-administered survey tool, in which 119 responses were collected from health workers who provide Comprehensive Emergency Obstetric and Newborn Care (CEmONC) in a tertiary hospital in Padang, Indonesia. A partial least squares structural equation model (PLS-SEM) was constructed to analyze the factors determining medical personnel performance. Results: The study showed that personal perceptions significantly correlate with health workers’ job performance, with attitudes and motivations found to have a powerful effect on the forming of perceptions. In addition, their performance is also significantly influenced by the aspects of quality, quantity, timeliness, effectiveness, teamwork, and commitment. However, the study does not support the relationship between knowledge, expectations, or actual performance with the medical employee’s job performance. Conclusion: This result suggests the hospital management team in the tertiary hospital considers these factors to improve healthcare services quality and promote a supportive work environment to improve the medical personnel’s performance.

Facilitators and barriers to communication in rehabilitation services across healthcare levels: a qualitative case study in a Norwegian context

BackgroundPeople with problems in functioning following severe injury or illness often need multiple and combined interventions in their rehabilitation processes. In these processes, communication and collaboration between the involved healthcare professionals are essential. Despite efforts in research and policy, communication across hospital and primary healthcare services and within the primary healthcare settings remains challenging. In one region of Norway, a new intermunicipal rehabilitation team has been established to supplement the traditional services and context-bound research is needed to gain insight into the complexity of the new communication structures that are developing. The aim of this study was to explore facilitators and barriers to communication to inform further improvement of the services.MethodsA qualitative case study design was used to explore the exchange of patient information in the rehabilitation processes of four patients. Data collection included participant observations in communication situations and an exploration of the electronic patient records of these four patients. Reflexive thematic analysis was used to analyse the empirical data.ResultsThe complex rehabilitation processes explored involved a large number of actors across healthcare organisational levels. Lacking a common culture for rehabilitation, poor access to written information and unclear responsibility for sharing information across organisational boundaries seemed to represent barriers to interprofessional communication. Joint meetings, the use of common rehabilitation tools and language and establishing informal communication channels served to facilitate communication.ConclusionThe intermunicipal team collaborating across different organisational levels added complexity to communication structures, but also facilitated interprofessional communication by promoting formal and informal ways of exchanging information. However, the intricate organisational divisions of healthcare provision in the Norwegian context represent boundaries which can be difficult to overcome. Therefore, cross-organisational coordination services should be developed.

The Observation of Patient Satisfaction with Healthcare Services in Chinese Public Hospitals Through Patients Experiences in Jiangsu

Background: The objective of this study was to assess patients' overall satisfaction with and experiences with various aspects of healthcare in Chinese public hospitals. In addition, it aimed to find out the extent to which patients' experiences in public hospitals in urban and rural locations might be accountable for general satisfaction. Methods: The data were derived from questionnaires designed to serve the patient's satisfaction within hospitals regarding several aspects in ten primary and tertiary level public/private hospitals across Jiangsu (China). In 2019, a survey encompassing 1185 Patients, physicians, and paramedical staff members was conducted in ten public hospitals located in Jiangsu, China. Donabedian's model classified patient experience questions into six categories under the heading’s "structure" and "process," with overall satisfaction serving as the "outcome" category. To compare patient experiences and overall satisfaction in urban and rural settings, chi-square tests were employed. Results: For assessing the government healthcare system's staff, health insurance plans, and healthcare delivery units. The health status of the target populations was compared with that of the responders by looking at the demographic distribution, life expectancy, service delivery with and without favoritism, and health behaviors. Surveys from decision-makers, implementers, and the general public who experience policy revealed that a much higher proportion of respondents reported improvements and favorable changes in the majority of areas. The survey's findings indicate that patients are often more satisfied with urban hospitals as compared to rural hospitals. In Jiangsu, medical personnel are given nearly identical resources and facilities, albeit in transformed forms according to their jurisdiction. The process is how the policies are initiated, negotiated, formulated, communicated, implemented, and evaluated. Policy development is dominated by political factors impacting all aspects of policy, i.e., context, process, and content. Conclusions: Jiangsu has updated and implemented its health policy according to the demand of the day, which has noted the experiences of its workers, compassionate attitudes, and service delivery despite the workload. The province has put in place several insurance schemes, but there is an issue of dissatisfaction in rural health centers as compared to urban hospital patients that can be resolved by bringing awareness in the rural society; Jiangsu is also home to the best version of the Electronic Medical Record system. Furthermore, the satisfaction of urban hospital patients is comparatively high due to the excellent behavior of healthcare workers, the proper referral system, insurance availability, the duration of healthcare services, the out-of-pocket treatment cost, the resources availability at PHC centers, and the development of the healthcare system were also noted with noteworthy numbers.

ACHIEVEMENT OF NATIONAL INDICATORS OF HOSPITAL QUALITY IN INDONESIA

Background: The National Quality Indicator Measurement (INM) of hospitals is mandatory to be conducted as a basis for planning, monitoring, evaluation, and decision-making for the improvement of healthcare services in hospitals, following Minister of Health Regulation Number 30 of 2022. Objective: This study aims to determine the overview of the achievement of hospitals in Indonesia in reporting and meeting the National Quality Indicators (INM). Method: The method used in this study is descriptive with secondary data analysis. Quality indicator data was obtained from the achievement data of national quality indicators reported in the mutu fasyankes.kemenkes.go.id/simar/ application. Results: All provinces have implemented the reporting of INM measurements, and the number of hospitals reporting INM in the first quarter of 2023 has increased compared to the reporting of hospital INM in the fourth quarter of 2022. There are still 18 provinces with INM reporting compliance below 50%. There is no difference in reporting compliance between government/TNI/POLRI-owned hospitals, state-owned enterprises, and private hospitals. The average achievement of INM targets in 2023 has improved compared to 2022. Compliance with the use of Personal Protective Equipment (PPE) is an indicator of low achievement. Conclusion and Suggestions: Compliance in reporting INM by hospitals has increased after the implementation of the obligation to measure and report INM according to Minister of Health Regulation Number 30 of 2022. However, the achievement of the compliance indicator for the use of PPE is still low. It is necessary to strengthen healthcare workers' adherence to the use of PPE.

Mothers’ Accessibility to ANC, and PNC Services: A Case Study in Baidoa, Southwest State of Somalia

Although there are several accessible healthcare services in hospitals and other designated healthcare facilities, there are studies that reveal mothers’ little or lack of utilization of the services to the full potential of the facilities. For instance, antenatal care (ANC) and postnatal care (PNC) services are offered in many health facilities in the district of Baidoa in order to improve the healthcare of the mother and her baby, but mothers’ use of the services is assumed to be low, particularly after the first visit or two visits. Considering that assumption, this study attempts to explore how mothers access their ANC and PNC services; whether they complete the required visits, and reasons related to the completion or incompletion of the recommended visits. The study focuses on mothers registered for their ANC and PNC services at Darussalam Mother Child Health (MCH) Center in Baidoa, Southwest state of Somalia. A close-ended survey questionnaire was used to collect data from 50 mothers accessing ANC and PNC services at Darussalam MCH in Baidoa city. Where further explanation was needed, an open-ended question was asked for the participants to express their opinion and personal experiences. The results reveal that 64% of surveyed mothers were attending ANC services while 36% were visiting the health facility to receive PNC services. More than 56% were unemployed, 30% self-employed, and 14% were employed by the administration of the government of the Southwest State. Unlike other studies that demonstrate mothers’ low attendance and missing of scheduled appointments for their ANC and PNC visits, the current study reveals that a majority of 82% were visiting the MCH on schedule, expressing various reasons leading to their promptness. Despite most of the available literature supporting low-income mothers in underdeveloped countries’ low accessibility to health services such as ANC and PNC, this study provides a gleam of hope in that many women are attending their ANC and PNC appointments in order to realize the benefits of the services for themselves and their baby.