Improve Health Services Research Articles

Assessing community awareness and participation in health facility governing committees in two districts of Tanzania: a cross-sectional study

BackgroundTanzania has been promoting community participation in health, either directly or through health facility governing committees (HFGCs), as part of its wider, ongoing health system reforms since the 1990s. Although some studies have assessed the functioning of the HFGCs, little is known about community knowledge and involvement in their activities.MethodsA cross-sectional survey assessing community awareness and participation in HFGCs was conducted between July and October 2022, involving two rural districts of Tanzania, which were selected based on their performance: Handeni, showing low performance and Mbarali, high performance. A total of 1,184 household heads living in the catchment areas of diverse facilities were involved. Frequencies and percentages were calculated overall and by district. The Chi-squared test was applied to assess statistically significant differences in knowledge, awareness, and participation between the districts.ResultsThe results revealed that 85.3% of the participants were unaware of the presence of the HFGCs and 91.7% did not know their roles. Additionally, 87% had neither heard nor seen any announcement about the selection of committee members. Only 14.5% considered that HFGCs were accountable to the community. While 96.7% of the respondents said they had never received any feedback from the HFGCs, only 8.1% reported that HFGCs were collecting views from the community. Regarding participation, 79.9% believed that the community had not been supporting their activities; however, 44.7% believed that the committees were important in improving health service delivery. Feedback and support were more common in Handeni.ConclusionThe level of community awareness of and participation in HFGCs was very low in both districts. The Ministry of Health and the President’s Office of Regional Administration and Local Government should implement an action plan to raise community awareness of the role of the HFGCs and their significance in promoting social accountability within the Tanzanian health system.

Methods for projecting health workforce planning in Ireland: a collaborative approach

Abstract Background Health workforce planning (HWFP) is the process of analysing, forecasting, and planning workforce supply and demand, assessing gaps, and determining target workforce to ensure that health systems are prepared for future demand. HWFP elicits recommendations that are ideally utilised by the health system to support medical workforce over a defined time. Methods The objective of this project is to inform intake for medical and surgical specialties in Ireland to reach the necessary consultant workforce by 2038. A literature search was conducted to help inform the methodology for this project. The most common approach was a needs-based model, and additional reviews discussed the integration of medical engagement into the modelling approach. Results This project will employ a collaborative approach, combining mathematical modelling and a combination of quantitative and qualitative inputs, including the following phases: 1. The research phase will estimate baseline supply and demand data across medical and surgical specialties in Ireland using statistical models; 2. The presentation phase will include input from clinical leads to allow for more accurate assumptions in the baseline of each model; 3. Review of projections will include feedback from the clinical leads to help clarify and improve the initial model; 4. Presentation of the revised projection will include further collaboration with clinical leads to finalise the model. Conclusions The robust methodology for this HWFP project will ideally inform medical and surgical specialities in Ireland through 2038. Specific and extensive predictions of health workforce supply and demand will enhance strategic preparation, which is a key priority for the Health Service Executive in Ireland. Key messages • A collaborative approach to HWFP is essential for health service preparation and improvement. • The project will be finalised by the end of 2024, and the methodology for conducting similar HWFP projects can be adapted by other EU states.

The HEROES (HEalth woRkfOrcE to meet health challengeS) Joint Action

Abstract Background The HEROES (HEalth woRkfOrcE to meet health challengeS) Joint Action aims to advance health workforce planning across the EU, addressing the pressing need for a resilient, sustainable, and accessible health service systems. Given the evident strain on health systems demonstrated during the COVID-19 pandemic, this initiative seeks to address the critical need for strategic HWF planning. Building on previous projects, HEROES will foster the capacity of EU states in workforce planning, preparing the health systems to meet future challenges. Methods The study adopts a collaborative framework involving 19 EU countries, segmented into clusters based on health system characteristics. A stepwise approach (‘AS IS,’ ‘TO BE,’ ‘TO DO’) characterizes the methodology, incorporating extensive data collection, stakeholder engagement, and scenario forecasting. Country-level information on HWF Data and Planning will be compared both across countries in clusters and across clusters. Results Initial findings indicate significant disparities in health workforce data quality, availability, and planning methodologies among the states. Identified methodologies also involve real-world data applications and predictive analytics to refine health workforce planning. Efforts are underway to define an Advanced Minimum Dataset (AMDS) to synchronize health workforce data and define planning tools across the clusters, as country-level AS IS reports have been finalized and cross-country comparisons are ongoing. Conclusions Collaborative, data-driven health workforce planning can significantly enhance health system resilience and responsiveness. Recommended public health actions include enhancing HWF data integration, forecasting capabilities, and stakeholder participation, with the aim of shaping national health policies and practices. The public health impact is profound, as it allows to improve health service delivery and workforce adaptability in response to dynamic health demands. Key messages • The HEROES Joint Action advances EU health workforce planning, with the aim of enhancing the resilience and responsiveness of health systems. • Strategic data-driven approaches in health workforce planning are pivotal for resilient, accessible and sustainable healthcare systems.

Global health

Abstract Global health emphasizes the importance of addressing health challenges that transcend national borders and require strong international collaboration and governance. This concept is grounded in collaborative transnational actions aimed at promoting health for all, reducing disparities, and protecting against threats. Strengthening health systems, public health infrastructure, improving health service delivery, and ensuring equal access to healthcare for all are key focus areas in global health. This plenary will address several major health challenges and critical issues, such as the rising burden of non-communicable diseases, re-emerging pandemics, environmental threats, and the suboptimal responses of national healthcare systems to manage these challenges. The need to focus on vulnerable and marginalized populations, particularly those affected by migration and ethnicity, will be highlighted. The discussion will also showcase the importance of including ethnic minority and Indigenous people’s perspectives in health policy and decision-making processes, as well as addressing the social determinants of health that disproportionately affect these communities. Central to the discussion on global health is the role of global health policy and diplomacy, focusing on how countries can collaborate to address health threats and challenges, shaping international strategies and frameworks. Innovation, including reverse innovation and the development of evidence-informed policies and effective public health strategies that can be implemented globally and is relevant also in resource-constrained contexts, is another critical aspect in addressing the intersection of health and development. Finally, strong public health leadership is needed to shape practices and policies, as well as fostering the next generation of global health leaders. The multifaceted nature of global health calls for a comprehensive approach to health—one that integrates policy, leadership, and equity into the core of public health strategies. The integration of health into all policies at the global level is vital for creating supportive environments, policies, services, and communications that promote better health for all. Moderators Iveta Nagyova President EUPHA Henrique Barros President ASPHER Speakers/Panellists Emma Rawson Te Patu President World Federation of Public Health Associations Charles Agyemang Professor of Global Migration, Ethnicity & Health, University of Amsterdam, Netherlands Agnès Buzyn Former Minister of Health and Social Affairs, France Moredreck Chibi Public Health Innovation Lead, WHO Regional Office for Europe

Utilizing Citizen Generated Data to enhance Women's Access to Sexual and Reproductive Health Services in Somalia: Insights, Barriers, and Pathways Forward

Purpose: This study was undertaken to capture citizen’s insights on practical steps that individuals, families, communities, and institutions could take to support the improvement of Sexual and Reproductive Health (SRH) services in Somalia. This includes raising awareness of issues affecting women's access to SRH, such as Gender-Based Violence (GBV) and Female Genital Mutilation (FGM). Methodology: This research employed a qualitative research design, utilizing semi-structured radio questions distributed through various channels such as radio promos, mini-dramas, interactive radio shows, and Short Messaging Service (SMS) on mobile phones. To enhance and validate the findings from the radio series, thirty Focus Group Discussions (FGD) involving 270 'hard-to-reach' participants were conducted across all Federal Member States (FMS) of Somalia, excluding Somaliland. Collaborating with 20 radio stations, a total of 4,268 participants from across Somalia were involved in this study. The qualitative data obtained was categorized into themes, and the subsequent information was analyzed using content analysis methodology for qualitative data, as well as descriptive statistics and inferential analysis through statistical package for social science (SPSS) version 25 and excel for quantitative data. The presentation of the data included the use of tables and figures. Findings: This study outlined key challenges in accessing quality SRH services for women in Somalia. Priorities included enhancing healthcare infrastructure and availability of SRH professionals, along with emphasizing health education on reproductive health and family planning. Food insecurity's impact, especially among displaced populations, was noted. GBV and FGM were highlighted, calling for comprehensive survivor care and male involvement in prevention. Collaboration between schools and the private sector was proposed for menstrual hygiene. Men's support for SRH access was deemed crucial. Addressing stigma around SRH access, GBV, and FGM was stressed, urging comprehensive awareness campaigns and improved healthcare provision for survivors. Unique Contribution to Theory, Practice and Policy: Addressing women's SRH in Somalia involves investing in healthcare infrastructure, expanding health education programs, ensuring access to nutritious food, and engaging men as allies in promoting women's SRH rights. Moreover, efforts to combat stigma, GBV, and FGM must be culturally sensitive and inclusive, involving religious and community leaders, and addressing underlying socio-economic factors contributing to these issues.

Leveraging Blockchain Technology for Public Health

This study delves into the metamorphic potential pertaining to blockchain technology public health, concentrating on its aptness towards addressing the critical challenges related to data security, privacy, and it enroute for improving health service outcomes. By incorporating decentralized structures and smart contracts, blockchain intensify data integrity, ensuring consistency and protective access control, which is principally effective for sensitive medical information. The study enlightens on the advantages of blockchain in entrusting patients as well as healthcare providers with control over public health related information, ensuring privacy and reinforcing regulatory compliance. It delves into the process of how blockchain can streamline healthcare processes, upgrading interoperability among healthcare systems, and create more systematic and affordable models for healthcare service delivery. Based on the case studies from different healthcare stakeholders, the paper provides factual and feasible insights for real-world implementations of blockchain in healthcare, exhibiting its potential to transfigure supply chain management, different insurance claims processing and managing electronic health records. Moreover, the study also recognizes the challenges, including technical constraints, ethical reviews, and the complication of integrating blockchain with existing healthcare framework. The study widens it discussion towards the legal and regulatory aspect, emphasizing the need for a comprehensive approach to adoption. Looking forward, the paper covers the emerging trends and offers guidance for healthcare stakeholders considering blockchain implementation, summarizing that blockchain could be a catalyst for remarkable improvements in public healthcare data administration and patient care.

Twinning Partnership Network: A Learning and Experience-Sharing Network Among Health Professionals in Rwanda to Improve Health Services.

We describe the development, implementation, and evaluation of a novel twinning approach: the Twinning Partnership Network (TPN). Twinning is a well-known approach to peer learning that has been used in a variety of settings to build organizational capacity. Although twinning takes many forms, the heart of the approach is that institutions with shared characteristics collaborate via sharing information and experiences to achieve a specific goal. We adapted a twinning partnership strategy developed by the World Health Organization to create a network of like-minded health institutions. The key innovation of the TPN is the network, which ensures that an institution always has a high-performing peer with whom to partner on a specific topic area of interest. We identified 10 hospitals and 30 districts in Rwanda to participate in the TPN. These districts and hospitals participated in a kickoff workshop in which they identified capacity gaps, clarified goals, and selected twinning partners. After the workshop, districts and hospitals participated in exchange visits, coaching visits, and virtual and in-person learning events. We found that districts and hospitals that selected specific areas and worked on them throughout the duration of the TPN with their peers improved their performance significantly when compared with those that selected and worked on other areas. Accreditation scores improved by 5.6% more in hospitals selecting accreditation than those that did not. Districts that selected improving community-based health insurance coverage improved by 4.8% more than districts that did not select this topic area. We hypothesize that these results are due to senior management's interest and motivation to improve in these specific areas, the motivation gained by learning from high-performing peers with similar resources, and context-specific knowledge sharing from peer hospitals and districts.

Improving pre-exposure prophylaxis service delivery to gay men and other men who have sex with men in South Africa: Generating novel insights with a nudgeathon

“Indlela - Behavioural Insights for Health” a behavioural science unit focused on improving health services in South Africa developed a pragmatic behavioural design framework called N-U-D-G-E. We used the nudgeathon approach to combine our technical expertise with stakeholder knowledge to apply this framework and rapidly co-create behavioural solutions designed to improve PrEP uptake and persistence amongst gay men and other men who have sex with men (MSM) in South Africa. Over two days we took 26 stakeholders divided into five teams through the framework and identified 602 solutions which were prioritized into two ideas per team and then pitched to an expert panel. This approach uncovered several high-potential, novel light-touch solutions to some of the challenges hindering PrEP delivery to gay men and other MSM in South Africa. This format is an effective way to engage stakeholders, including policy makers, in the process of both identifying behavioural barriers to optimal health decision making as well as creating novel solutions that can be tested.

Enhancing Health Services through Telemedicine: Addressing the Gaps in LBW Monitoring and Training at Puskesmas Gedangan, Sidoarjo Regency

Puskesmas in Sidoarjo Regency do not yet have facilities for monitoring LBW in real time via android either by health workers at the health centre or the patient's family. Puskesmas Gedangan serves communities spread across several villages with a coverage area spread across several villages. This is an obstacle for families to get access to monitor the patient's progress, because the patient is in the NICU or ICU room. Another thing is that there is no training for users in the use of telemedicine-based Baby Incubator equipment. The role of users and families of patients is very important to keep the equipment in good condition. However, operating trainings based on new technology for users have never been conducted. Efforts to solve the above problems are to carry out counselling and assistance in the use of baby incubator equipment to users including nurses, midwives and other non-health worker users, so as to increase the knowledge of officers or users which in turn will have an impact on increasing the productivity of officers or users and improving the quality of service at the health centre. The purpose of this Community Service is to increase the role and participation of Poltekkes Kemenkes Surabaya in improving the degree of public health in the Puskesmas Gedangan area, Sidoarjo Regency. The results of community service through the application of telemedicine-based Baby Incubator at Puskesmas Gedangan are increased knowledge and skills regarding telemedicine-based baby incubator equipment. This will improve health services, especially for babies who need intensive care. The implementation of this technology provides significant benefits, including increased accessibility of health services, speed of response to patient health conditions, family involvement in care, and efficient use of resources. Assistance to Puskesmas personnel and patient families in the form of training, monitoring and evaluation of the use of appropriate technology in the form of Telemedicine-based baby incubator utilization.

POSTPARTUM DEPRESSION AND PERSONALITY

Introduction – Postpartum depression is a psychological problem that occurs in women after giving birth. A study says that about 10-20% of women experience depression. The cause of postpartum depression is not known with certainty. Some studies say psychological factors are one of the causes, therefore researchers use Big Five Personality (conscientiousness, neuroticism, agreeableness, openness to experience, and extraversion) neuroticism, extraversion, conscientiousness, agreeableness, openness to experience) to help explain the description of personality types in postpartum mothers. This can help health workers in improving health services to mothers. This paper aims to find the relationship of personality with the degree of depression postpartum Methods – study, the source of data obtained from the electronic database used in this review literature uses 4 databases, namely Pubmed, Frontiers, ScienceDirect, and Elsevier which have been published from 2019-2022. Results – The results of this study neuroticism, extraversion, and conscientiousness have a significant association with the occurrence of postpartum depression. Discuss – Neuroticism personality type is also associated with anxiety in women after giving birth, therefore health workers need to learn personality types and conduct routine checks on postpartum mothers to minimize the occurrence of postpartum depression. Conclusion – In the Big Five Personalities personality types neuroticism, extraversion, and conscientiousness can be used as dominant indicators of the occurrence of postpartum depression, while for personality types agreeableness and openness to experience are currently still under further research development. Keywords: personality, depression, postpartum.

Therapeutic Communication Relationship With The Level of Anxiety of Primigravida Mother in Facing Childbirth At TK IV Hospital Cijantung Kesdam Jaya in 2023

One factor that affects the safety of labor is anxiety during the labor process. Anxiety and fear can cause severe pain and can also result in decreased uterine contractions, resulting in longer labor. The purpose of this study is to determine the relationship between therapeutic communication and the anxiety level of primigravida mothers in facing labor. This research type is descriptive-analytic. This study population is all primigravida laboring mothers in TK IV Cijantung Kesdam Jaya Hospital in 2023, as many as 30 people. Samples of this study were all primigravida pregnant women before childbirth at TK IV Cijantung Kesdam Jaya Hospital in January–February 2023, with as many as 30 respondents. The technique of sampling in this study was purposive sampling. Analyze the data with Chi Square. The statistical test results obtained P value = 0.000 means P value α (0.05). The results indicate that there is a relationship between therapeutic communication and the level of anxiety of primigravida mothers in the face of childbirth. It is expected that TK IV Cijantung Kesdam Jaya Hospital will improve health services for mothers in labor by managing the application of therapeutic communication by midwives in providing care to mothers in labor.

Qualitative study investigating the health needs of school-aged children and adolescents in Dubai

BackgroundChildren’s health has been linked with morbidities such as cardiovascular events, type 2 diabetes and obesity in adulthood. Further efforts are needed to understand the current and emerging challenges due...

The Mental Health Clinical Liaison Programme for Schools: developing a new approach in Child and Adolescent Mental Healthcare in Spain

Mental health issues among children and adolescents have increased, especially after the COVID-19 pandemic. Despite awareness, less than half get needed care, leading to long-term consequences. The World Health Organization calls for integrated, preventive community interventions. In this paper, we present The Mental Health Clinical Liaison Programme for Schools in the Community of Madrid, Spain, which features school-based activities delivered by multidisciplinary mental health teams, offering early detection, intervention, and prevention strategies for children and adolescents. We describe the activities implemented, present the evidence supporting them, provide preliminary data, and discuss the scope and challenges of the programme. In 2023–2024, the programme intervened in 53 primary and secondary schools, helping identify in 876 cases, evaluating 356, and referring 122 to other services. It supported interventions for 179 patients already in mental healthcare and 34 reintegrations after psychiatric hospitalization. Anti-stigma workshops have been conducted, involving approximately 1620 students. Ongoing research aims to evaluate the effectiveness and cost-effectiveness of these interventions to ensure continuous improvement in mental health services for young people.

Digital Intervention to Improve Health Services for Young People in Zimbabwe: Process Evaluation of 'Zvatinoda!' (What We Want) Using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) Framework.

Youth in Southern Africa face a high burden of HIV and sexually transmitted infections, yet they exhibit low uptake of health care services. The Zvatinoda! intervention, co-designed with youth, aims to increase the demand for and utilization of health services among 18-24-year-olds in Chitungwiza, Zimbabwe. The intervention utilized mobile phone-based discussion groups, complemented by "ask the expert" sessions. Peer facilitators, supported by an "Auntie," led youth in anonymous online chats on health topics prioritized by the participants. Feedback on youth needs was compiled and shared with health care providers. The intervention was tested in a 12-week feasibility study involving 4 groups of 7 youth each, totaling 28 participants (n=14, 50%, female participants), to evaluate feasibility and acceptability. Mixed methods process evaluation data included pre- and postintervention questionnaires (n=28), in-depth interviews with participants (n=15) and peer facilitators (n=4), content from discussion group chats and expert guest sessions (n=24), facilitators' debrief meetings (n=12), and a log of technical challenges. Descriptive quantitative analysis and thematic qualitative analysis were conducted. The RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework was adapted to analyze and present findings on (1) reach, (2) potential efficacy, (3) adoption, (4) implementation, and (5) maintenance. Mobile delivery facilitated engagement with diverse groups, even during COVID-19 lockdowns (reach). Health knowledge scores improved from pre- to postintervention across 9 measures. Preintervention scores varied from 14% (4/28) for contraception to 86% (24/28) for HIV knowledge. After the intervention, all knowledge scores reached 100% (28/28). Improvements were observed across 10 sexual and reproductive health (SRH) self-efficacy measures. The most notable changes were in the ability to start a conversation about SRH with older adults in the family, which increased from 50% (14/28) preintervention to 86% (24/28) postintervention. Similarly, the ability to use SRH services even if a partner does not agree rose from 57% (16/28) preintervention to 89% (25/28) postintervention. Self-reported attendance at a health center in the past 3 months improved from 32% (9/28) preintervention to 86% (24/28) postintervention (potential efficacy). Chat participation varied, largely due to network challenges and school/work commitments. The key factors facilitating peer learning were interaction with other youth, the support of an older, knowledgeable "Auntie," and the anonymity of the platform. As a result of COVID-19 restrictions, regular feedback to providers was not feasible. Instead, youth conveyed their needs to stakeholders through summaries of key themes from chat groups and a music video presented at a final in-person workshop (adoption and implementation). Participation in discussions decreased over time. To maintain engagement, introducing an in-person element was suggested (maintenance). The Zvatinoda! intervention proved both acceptable and feasible, showing promise for enhancing young people's knowledge and health-seeking behavior. Potential improvements include introducing in-person discussions once the virtual group has established rapport and enhancing feedback and dialog with service providers.

Human Rights and Mental Health: A Review of Current Awareness and Emerging Developments

Human rights are universal fundamental protections worth of all individuals, including those with mental health conditions. However, these rights are often observed violated in mental health care settings, where individuals may face forced treatment, isolation, and degrading conditions. Despite global advocacy efforts, to ensuring that these rights are respected, continues to be a challenge for healthcare professionals and the general public. This review examines the current awareness of human rights among mental health professionals and the public, identifies the knowledge gaps, and highlights the recent developments in policy and practice aimed at improving human rights in mental health care. A comprehensive search of academic databases identified relevant studies published between 2019 and 2024. Findings suggest a promising level of public knowledge about human rights, yet negative attitudes and stigma persist. While improvements in mental health services have been observed among healthcare professionals; resource limitations and a lack of social support remain challenging. A gap between knowledge and practice is evident, necessitating further education and training to ensure a deeper understanding of human rights complexities in mental healthcare. Overall, this review underscores the importance of continued efforts to raise awareness and advocate for the human rights of individuals with mental health conditions. By implementing educational and sensitization programs, a supportive environment can be created that empowers them to seek help without fear of discrimination.

Integration of IPC/WASH critical conditions into quality of care and quality improvement tools and processes: Bangladesh case study

Unsafe patient care in hospitals, especially in low- and middle-income countries, is often caused by poor infection prevention and control (IPC) practices; insufficient support for water, sanitation, and hygiene (WASH); and inadequate waste management. We looked at the intersection of IPC, WASH, and the global initiative of improving health care quality, specifically around maternal and newborn care in Bangladesh health facilities. We identified 8 primary quality improvement and IPC/WASH policy and guideline documents in Bangladesh and analyzed their incorporation of 30 subconditions under 5 critical conditions: water; sanitation; hygiene; waste management/cleaning; and IPC supplies, guidelines, training, surveillance, and monitoring. To determine how Bangladesh health care workers implemented the policies, we interviewed 33 informants from 16 public and private facilities and the national level. Bangladesh’s 8 primary guidance documents covered 55% of the 30 subconditions. Interviews showed that Bangladesh health facility staff generally rely on eight tools related to quality improvement (five); IPC (two); and supportive supervision (one) plus a robust supervision mechanism. The stakeholders identified a lack of human resources and environmental hygiene infrastructure and supplies as the main gaps in providing IPC/WASH services. We concluded that the Bangladesh government had produced substantial guidance on using quality improvement methods to improve health services. Our recommendations can help identify strategies to better integrate IPC/WASH in resources including standardizing guidelines and tools within one toolkit. Strategizing with stakeholders working on initiatives such as universal health coverage and patient safety to integrate IPC/WASH into quality improvement documents is a mutually reinforcing approach.

Mental Health Crisis and Policing Demand

ObjectivesPolice are frequently called to assist in situations where mental ill health, rather than crime, is the primary concern. There is an urgent need to reduce this demand on police by improving appropriate health service delivery. This research examines police interactions in which an individual is identified as being vulnerable due to a mental health concern. We aim to determine the demographic, health, and social factors that are associated with being identified by police as vulnerable due to a mental health concern and assess patterns of health system service use preceding police contact to identify potential points for intervention. MethodsA dataset of police records for individuals identified as vulnerable due to a mental health concern is linked to health and social administrative data including: information on mental ill health, alcohol and drug related problems, disabilities and long-term illnesses, Accident and Emergency calls, hospital visits, and demographic characteristics. We describe a cohort of individuals identified by police as vulnerable due to a mental health concern and assess their traits and patterns of healthcare service use compared to the general population. ResultsThe results allow us to better understand who comes into contact with the police while experiencing mental health difficulties and point to the risk factors indicating where to concentrate resources for improved health service delivery. Conclusions/ImplicationsThis research will improve partnership working between the police and healthcare services, reduce unnecessary police demand, and improve outcomes for people suffering from mental health crisis.

ANALYSIS OF SERVICE QUALITY ON PATIENT SATISFACTION IN INPATIENT INSTALLATIONS OF REGIONAL HOSPITAL 2024

Good service is not only measured by luxurious facilities, complete technology and physical appearance, employee attitudes and behavior must also show high professionalism and commitment. Quality of health services refers to the level of perfection of health services that makes every patient feel satisfied. This study aims to determine factors related to service quality and patient satisfaction at the Inpatient Installation of Ogan Ilir District Hospital in 2024. Quantitative research design with a cross-sectional approach. The population in this study was 854 inpatients at the Ogan Ilir District Hospital. The sample in the research consisted of 90 respondents. The sampling technique uses purposive sampling, using the Slovin formula. This research was carried out on March 13 - April 17 2024. Data was collected using a questionnaire. Bivariate data analysis using the chi-square test and multivariate using logistic regression. The research results show that there is a relationship between responsiveness (p value 0.005) and tangibles (p value 0.001). There is no relationship between reliability (p value 0.86), assurance (p value 0.76) and empathy (p value 0.96). The most dominant factor in patient satisfaction in the Inpatient Installation of Ogan Ilir District Hospital in 2024 is tangibles (p value 0.00), (OR 0.183). The conclusion is that there is a relationship between responsiveness and tangible. Suggestions from the research results can provide input about the quality of service on patient satisfaction in the Inpatient Installation of the Ogan Ilir Regency Regional Hospital in 2024 and contribute to improving health services

Progress and scenario-based projections of health service availability and coverage towards UHC in the post-conflict and post-pandemic Iraq: a Bayesian hierarchical regression approach

BackgroundTwo decades have passed since the beginning of the Iraq War in 2003. Iraq has long suffered from conflicts and instability, where the people have limited access to healthcare. The...

Nurse-led proactive mobile application in symptom management for children with medical complexity: Study protocol for a randomized controlled trial.

To investigate the effect of a nurse support using a proactive mobile app to enhance parental self-efficacy in symptom management for children with medical complexity. A single-blinded, randomized controlled trial with a two-armed repeated measures design. Eligible parents and the children will be recruited from the special schools and non-government offices. They will be randomly assigned either to the intervention or control groups. Subjects in the study group will receive nurse parental support using a symptom management mobile app for 3 months. The control group will receive the usual care that is available in the community. Data will be collected pre-intervention (T1), immediately after the intervention (T2), and three-month after intervention (T3). The primary outcome is parental self-efficacy. The secondary outcomes include child's symptom burden and their health service utilization. Primary outcome will be compared across two groups in T2 and T3 using with control for the pre-test value of parental self-efficacy. Generalized estimating equation (GEE) will be used to address secondary objectives from T1 to T3 with appropriate link function. As a result of the successful implementation of this nurse-led symptom management, parental self-efficacy will be enhanced. Both the symptoms reported by the children and their health service utilization will be reduced. Findings of this study will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and the children in local communities. The evidence produced in this study will enlarge the knowledge base that supports evidence-based paediatric home nursing service with the use of health technology in symptom management. This evidence will also contribute to the development of other symptom management programs for other paediatric patient groups. NCT05765643 (ClinicalTrials.gov identifier). Parents of children with medical complexity contributed in mobile application development by giving comments on the usability of mobile application. Improve health service delivery: Home nursing service may not be sustainable in a long run in Hong Kong, as the health care system has been facing a serious nursing workforce shortage in recent years. Besides, these services are affected or even suspended during the community outbreak of infectious disease, like recent coronavirus disease pandemic. Nurse parental support in symptom management for the CMC using a proactive mobile health application will help in service delivery improvements because it maximizes the availability and accessibility of paediatric health service to parents and their CMC in local communities. Improve physical and psychological health of parents and their CMC: The success of program implementation will help to increase parental self-efficacy in symptom management for their CMC, as a result of decrease of children's symptom burden. Improve knowledge base: The evidence produced in this study will (1) enlarge the knowledge base that supports evidence-based paediatric community nursing service related to symptom management for the CMC. This evidence will contribute to the development of other symptom management programs for other paediatric patient groups.