Ministry Of Public Health Research Articles

Understanding government social media communication strategies and public engagement during the COVID-19 crisis in Lebanon

The COVID-19 pandemic has prompted governments to adopt various online communication strategies, including the use of social media platforms. Drawing on the crisis and emergency risk communication model, this study investigates the Facebook communication strategies employed by the Ministry of Public Health (MoPH) during the COVID-19 crisis in Lebanon and examines the public engagement with these efforts. A content analysis was conducted on 2,001 posts related to COVID-19 from January 2020 to June 2021. The posts were classified into categories and the frequency and median were used to measure government posting activity and engagement. The study analyzed additional post features such as hashtags, mentions, captions, and language to provide further context to the findings. Trend analysis was also conducted to examine how the metrics varied with key events. The results show that MoPH predominantly used photos (72.00%) and the majority of its posts were published during the initial phase of the outbreak (74.20%). The most prevalent categories of posts were uncertainty reduction (54.57%), self-efficacy (30.33%), and vaccines and immunization (16.89%). MoPH’s Facebook page witnessed a surge in followers during the post-COVID-19 period, increasing by over 300.00% from the pre-COVID-19 years. Posts content, media type, and crisis stage influenced the level of public engagement. The study reveals that Facebook is effective for strategic health crisis communication. Furthermore, it provides practical insights for public sector emergency managers responsible for online communication during outbreaks.

Proceedings of the 6th Asia Dengue Summit, June 2023.

The 6th Asia Dengue Summit (ADS) themed "Road Map to Zero Dengue Death" was held in Thailand from 15th-16th June 2023. The summit was hosted by Tropical Medicine Cluster, Chulalongkorn University, Bangkok, Thailand in conjunction with Queen Saovabha Memorial Institute, The Thai Red Cross Society; Faculty of Tropical Medicine, Mahidol University; and the Ministry of Public Health. The 6th ADS was convened by Asia Dengue Voice and Action (ADVA); Global Dengue and Aedes Transmitted Diseases Consortium (GDAC); Southeast Asian Ministers of Education Tropical Medicine and Public Health Network (SEAMEO TROPMED); Fondation Mérieux (FMx) and the International Society for Neglected Tropical Diseases (ISNTD). Dengue experts from academia and research, and representatives from the Ministries of Health, Regional and Global World Health Organization (WHO) and International Vaccine Institute (IVI) participated in the three-day summit. With more than 51 speakers and 451 delegates from over 24 countries, 10 symposiums, and 2 full days, the 6th ADS highlighted the growing threat of dengue and its antigenic evolution, flagged the urgent need to overcome vaccine hesitancy and misinformation crisis, and focused on dengue control policies, newer diagnostics, therapeutics and vaccines, travel-associated dengue, and strategies to improve community involvement.

Characterization and evaluation of the use of dangerous abbreviations in a hospital in Quito, Ecuador

Introduction. The dangerous abbreviations not allowed used in the record of the Clinical History, due to an erroneous interpretation, could trigger associated adverse events in health care. Methods. Cross-sectional descriptive study, 15 786 cases registered in the Medical Records of Hospital General del Sur de Quito of 42 clinical and surgical units were reviewed, the use of dangerous abbreviations was included, the acronyms allowed according to the regulations of the Ministry of Public Health of Ecuador were excluded. The information was consolidated in a database in Excel 2017 format and the compliance and frequencies of abbreviations used with the SPSS Version 22.0 program were analyzed. Results. 69,84% (n=11 026 services) complied with the proper use of allowed abbreviations, the clinical area with 74,9% and the surgical area with 62,62%. 6 199 dangerous abbreviations were found, the most frequent being “(…) FR, FC, LPM, RPM, TA, TAM, RX, GSRN, CD4, M2, CD8, ASC, ECG, AQX, NPO, VIH, BH, FUM, HTA, RHB, SAT, GSM, TAC, RHA, DH, RP, APP, AM, TTO, IDG (…)”. Conclusions. Percentages of higher compliance were determined in the clinical units, followed by the surgical ones. The abbreviations used in the records of the Clinical Histories are not included in Ministerial Agreement 00000115, Patient Safety Manual - User, of the Ministry of Public Health of Ecuador.

Pharmacological and Therapeutic Features of COVID - 19 Infection in Hodeidah, Yemen

Background: The symptoms and signs of coronavirus diseases 2019 (COVID-19) present at illness onset vary, but over the course of the disease, most persons with COVID-19 will experience the following: fever, cough, fatigue, anorexia, shortness of breath, hypoxia, sputum production, and myalgia. During the first year (2020), there was no effective cure for COVID-19 infection and the most common treatment for patients was supportive therapy. Ministry of Public Health and Population in Yemen presented national guideline that is extracted from other countries and World Health Organization (WHO). Objective: Therefore, in this research, we discuss the pharmacological and therapeutic approaches for management of COVID-19 during its early period of rampage, using availability of medicines in Yemeni local pharmaceutical marketing. On the other hand, the efficacy of therapeutic  was monitored. Methodology: 505 patients with COVID-19 from Hodeidah showed that respiratory infection illness can range from mild to critical. Mild to moderate was 386 case (78.93 %), severe cases was 73 cases (15.13 %) and critical cases was 28 cases (5.93 %). The major criteria for cases admission namely clinical examination, case definition, clinical investigation, radiological finding, hematological and biochemical finding and molecular biology assay namely real – time - polymerase chain reaction (RT- PCR). The pharmacological and therapeutic properties of supportive therapy of COVID-19 included" antipyretic agent, antiviral (oseltamivir) analgesic agent, glucocorticoid (dexamethasone), anticoagulant agent (enoxaparin), anti-cough (acetylcysteine), antibiotics broad spectrum to treat the secondary infection namely azithromycin, ceftriaxone, ceftazidime,  piperacillin and tazobactam, meropenam, and moxifloxacin. In addition, oxygen therapy is the major treatment that used in treatment of severe and critical cases. Also, vitamins (C and D) and mineral namely zinc were prescribed and proton pump inhibitor (PPI) (pantaprazol), anti-emetic (Ondansetron). Fluid therapy namely ringer lactate or normal saline were used in management of COVID -19. Results: The results showed that the age of the patients included in this study between 3- 92 years with 4.0 to 1.0 males: females.  49 patients were admitted in COVID-19 isolation department of Hodeidah, Yemen. 25/49 cases (54.34% ) were recovered with national guideline,  the average of  RR  pre - treatment was 30 ± 5 breath / minute and reduced to  23 ± 2 breath / minute post – treatment with significantly statistically different (p < 0.05). On the other hand, the clinical symptoms namely difficult in breathing, cough, fever, and headache reduced to absent absolutely (100 %). In addition, the results showed that the average of WBC pre - treatment was 20 ± 4 (×109/L) and reduced to 7 ± 2 (×109/L) post – treatment with significantly statistically different (p < 0.05). Also, lymphocytes decreased with COVID -19 infection to 2 % with average (10±5%) and improved post - treatment to 20 %.  In addition, neutrophil increased to 95 % with average (80±15%) and improved to 70 % post-treatment. the average of WBC pre - treatment was 20 ± 4 (×109/L) and reduced to 7 ± 2 (×109/L) post-treatment with significantly statistically different (p < 0.05). The outcome finding of management that 19 cases (3.88 %) of severe and 6 cases (1.22 %) of critical were recovered. On the other hand, 1 case of severe and 21 cases of critical COVID-19 were died. Conclusion: In spite of lack of specific antiviral drugs, the approach of pharmacology and therapeutics had good impact at level of mild to moderate cases, and severe cases while the critical cases needs to develop at level critical cases in intensive care unit (ICU) with mechanical ventilation (MV) procedure.

Daily Experience of Residents of the Masanga-Mbila District on Self-Medication at Home, in the Democratic Republic of Congo

Introduction: The delivery of medication is an act emanating from health professionals who have this task in their responsibilities and more particularly the pharmacist. The aim of this study is to understand the way in which the population of the Masanga-Mbila district experiences the phenomenon of self-medication on a daily basis. Methods: It is a descriptive study falling within qualitative research of the phenomenological type. She is carried out among the population of the Masanga district Mbila, commune of Mont- Ngafula, city of Kinshasa, in the Democratic Republic of Congo. This is an environment where observations have been made on this frequent practice of self-medication. The target population was made up of household managers within the population of the Masanga-Mbila district. The phenomenological survey method and the structured interview technique made it possible to collect information concerning the population's experience of self-medication. Results: After analysis thematic, we arrived at the results following: The Experience in the practice of self-medication was focused on three points: Self-medication is seen as a first resort before going to the hospital. Respondents put forward two reasons for their recourse to self-medication, the lack of financial means and the fact of having knowledge about medications and their use. In their experience, the respondents revealed in their receipt some consequences linked to the practice of self-medication, in particular rebellion and worsening of the illness. In the recommendations that they have formulated towards the community user, they wish that these latest can resort to self- medication only to relieve small sufferings and then always be to consult; and towards sellers of medicines, to avoid delivering medicines without a prescription medical. Conclusion: to contribute to the reduction of this practical, it falls under the Ministry of Public Health to strengthen pharmaceutical inspection and establish a system permanent control to ensure rational sale of products in our country; require pharmacies to only deliver medicines on medical prescription; s raise awareness among the population about the abuse of self-medication.

Incidence of Vibrio parahaemolyticus Coryphaena Hippurus (dorado fish) and Thunnus alalunga (albacore fish) sold in high-demand markets in Guayaquil City

Foodborne diseases affect around 600 million people in the world. In Ecuador, the Ministry of Public Health (MSP) reported 12,203 cases of food poisoning caused mainly by Salmonella species, hepatitis virus or other pathogenic microorganisms in 2019. However, there are no reports of diseases caused by Vibrio species in Ecuador. The present study assessed the presence of V. parahaemolyticus, mesophilic aerobics, total coliforms and E. coli. Samples of Coryphaena hippurus (dorado fish) and Thunnus alalunga (albacore fish) in 3 different markets in the city of Guayaquil, Ecuador. As a result, Vibrio parahaemolyticus was not found in any of the 60 samples analyzed. In contrast, the E. coli levels met the requirements established in the INEN 183 - 2013 Standard norm. All samples from Market 1 were within the acceptance range regarding mesophilic aerobic levels. However, high mesophilic aerobic levels were obtained in 60% of the albacore samples and 50% of the dorado samples from this market. In the same way, 40% of the albacore and 100% of Dorado samples from market 3 were high in mesophilic microorganisms. However, the mesophilic aerobic analyses revealed safer levels in samples from market 1 than in markets 2 and 3, according to the NTE INEN. 183:2013. Keywords: Foodborne diseases1, fish2, Albacore3, E coli4, mesophilic aerobics5, Dorado6.

Incidence of Vibrio parahaemolyticus Coryphaena hippurus (dorado fish) and Thunnus alalunga (albacore fish) sold in high-demand markets in Guayaquil City

Foodborne diseases affect around 600 million people in the world. In Ecuador, the Ministry of Public Health (MSP) reported 12,203 cases of food poisoning caused mainly by Salmonella species, hepatitis virus or other pathogenic microorganisms in 2019. However, there are no reports of diseases caused by Vibrio species in Ecuador. The present study assessed the presence of V. parahaemolyticus, mesophilic aerobics, total coliforms and E. coli. Samples of Coryphaena hippurus (dorado fish) and Thunnus alalunga (albacore fish) in 3 different markets in the city of Guayaquil, Ecuador. As a result, Vibrio parahaemolyticus was not found in any of the 60 samples analyzed. In contrast, the E. coli levels met the requirements established in the INEN 183 - 2013 Standard norm. All samples from Market 1 were within the acceptance range regarding mesophilic aerobic levels. However, high mesophilic aerobic levels were obtained in 60% of the albacore samples and 50% of the dorado samples from this market. In the same way, 40% of the albacore and 100% of Dorado samples from market 3 were high in mesophilic microorganisms. However, the mesophilic aerobic analyses revealed safer levels in samples from market 1 than in markets 2 and 3, according to the NTE INEN. 183:2013. Keywords: Foodborne diseases1 , fish2 , Albacore3 , E coli4 , mesophilic aerobics5 , Dorado6

Power dynamics and participation within humanitarian coordination groups: A case study of the MHPSS Taskforce in Lebanon.

The humanitarian sector has often been criticised for its hierarchical power dynamics. Such dynamics often centre the priorities of 'international' actors, thereby marginalising the knowledge and expertise of those closest to the setting and play out in various fora, including coordination mechanisms. While guidance emphasises the importance of supporting local systems and government structures rather than creating parallel humanitarian structures, this approach is not consistently applied, creating challenges. We used a case study approach to explore how power relations influence the practice of the Mental Health and Psychosocial Support Taskforce in Lebanon, a nationally-led coordination mechanism chaired by the Ministry of Public Health with UN agencies as co-chairs. We conducted 34 semi-structured interviews with Taskforce members and other stakeholders coordinating with the Taskforce, including local non-governmental organisations (NGOs), international NGOs, United Nations agencies and government ministries. Interview transcripts were collaboratively analysed using Dedoose. We conducted feedback workshops with participants and integrated their feedback into analysis. We found that UN agencies and international NGOs are perceived as holding more decision-making power due to their access to funding and credibility-both shaped by the humanitarian system. Our findings also suggest that power dynamics arising mainly from differences in seniority, relations between 'local' and 'expat' staff, and language used in meetings may affect, to varying degrees, decision-making power and members' voices. We also show how the agenda/focus of meetings, meeting format, language, and existing relationships with Taskforce leaders can influence levels of participation and decision-making in Taskforce meetings, ranging from lack of participation through being informed or consulted about decisions to decisions made in partnership. Our findings have broader implications for coordinating service delivery within the humanitarian sector, emphasising the need to reflect upon power imbalances critically and continually and to ensure a shared understanding of decision-making processes.

Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar.

Despite widespread adoption of community health (CH) systems, there are evidence gaps to support global best practice in remote settings where access to health care is limited and community health workers (CHWs) may be the only available providers. The nongovernmental health organization Pivot partnered with the Ministry of Public Health (MoPH) to pilot a new enhanced community health (ECH) model in rural Madagascar, where one CHW provided care at a stationary CH site while additional CHWs provided care via proactive household visits. The program included professionalization of the CHW workforce (i.e., targeted recruitment, extended training, financial compensation) and twice monthly supervision of CHWs. For the first eighteen months of implementation (October 2019-March 2021), we compared utilization and proxy measures of quality of care in the intervention commune (local administrative unit) and five comparison communes with strengthened community health programs under a different model. This allowed for a quasi-experimental study design of the impact of ECH on health outcomes using routinely collected programmatic data. Despite the substantial support provided to other CHWs, the results show statistically significant improvements in nearly every indicator. Sick child visits increased by more than 269.0% in the intervention following ECH implementation. Average per capita monthly under-five visits were 0.25 in the intervention commune and 0.19 in the comparison communes (p<0.01). In the intervention commune, 40.3% of visits were completed at the household via proactive care. CHWs completed all steps of the iCCM protocol in 85.4% of observed visits in the intervention commune (vs 57.7% in the comparison communes, p-value<0.01). This evaluation demonstrates that ECH can improve care access and the quality of service delivery in a rural health district. Further research is needed to assess the generalizability of results and the feasibility of national scale-up as the MoPH continues to define the national community health program.

A comparative analysis of non-pharmaceutical interventions for preventing the respiratory syncytial virus in 30 European countries.

Respiratory syncytial virus (RSV) is a leading cause of childhood respiratory infections. Non-pharmaceutical interventions (NPIs) can help to reduce RSV transmission and our aim was to provide an overview of recommended NPIs across Europe during the 2022-2023 epidemic season. The webpages of national European public health agencies and ministries were reviewed and the information they provided on RSV prevention was compared with the December 2022 guidelines from the European Centre for Disease Prevention and Control. We examined 30 countries, leading to 21 issued recommendations for RSV prevention through institutional channels, including six that were specific for the 2022-2023 season. The top five recommendations were: hand and respiratory hygiene (95%), avoiding crowded spaces (67%), staying at home when ill (62%), cleaning household items (57%) and limiting contact with sick people (57%). They also included: face masks (33%), ventilating indoor spaces (29%), properly disposing of contaminated material (13%) and keeping siblings home from preschool if there was a newborn infant in the family (10%). There was significant heterogeneity in the NPIs recommended by different countries during RSV epidemics. Ongoing evaluation is essential to optimise the effectiveness of NPIs and adapt to changing RSV patterns.

Profiles of Community Care Sites and provider Community Health Workers: A Case study at Gombe Matadi, Kenge and Kisantu Rural Health Zones in the Democratic Republic of Congo

BACKGROUND: In sub-Saharan Africa, the DRC is ones of countries with high infant and child mortality. To solve this problem, the Ministry of Public Health has set up a new program: ICCM at the level of Community Care Sites managed by non-health professionals who are provider CHWs to serve Health Areas with difficult access. Since its implementation, there have not yet been many studies that concretely describe the functionality of CCS. To contribute to the extension of CCC in other Rural Health Zones, we conducted a study in 3 RHZ by choosing the Realistic Evaluation Approach to analyze the functionality of CCS in the DRC.&#x0D; &#x0D; METHODS: This is a cross-sectional study which is essentially a case study. Data were collected at the CCS level in these 3 RHZ chosen after multistage random sampling by mixed method (qualitative, quantitative). We used the following techniques: documentary review, direct observation at the CCS level, an in-depth interview with registered nurses and members of the health Zone management team and a survey using quantitative questionnaire with provider CHWs. The conceptual model that we developed is inspired by realist evaluation with an emphasis on Mechanisms. The relationship between the dependent variable (CCS functionality) and the independent variables was proven using Odds Ratio and Multiple Logistic Regression.&#x0D; &#x0D; RESULTS: CCS functionality and provider CHW profile were measured through the standards enacted for CCS implantation. At the significance level (p=0.05) has been in place for 3 years or more increases by 7 times chance that it is functional (OR = 6.7; p = 0.000). Has household been located less than 5 km from CCS increases by 4 times chance that the CCS is functional (OR = 7.04; p = 0.034). Has provider CHW is regularly trained and supervised increases by 10 times chance that the CCS is functional (OR = 10.01; p = 0.031). If provider CHW participate in Community cell animation meetings (OR = 4.34; p = 0.009) and CCS Management is done by CCS Management team increase by 4 times chance that this CCS is functional (OR = 3.6; p = 0.002). Finally, if there is an initiative for funding CCS increases by 8 times CCS functionality (OR = 8.69; p = 0.009).&#x0D; &#x0D; CONCLUSION: CCS are functional in the 3 RHZs. Their organization, establishment and operation are directly linked to the provision of services to populations living mainly in health areas with difficult access, the availability of inputs of three ICCM-C diseases management, namely uncomplicated malaria, diarrhoea and pneumonia as well as building provider community health workers capacity to ensure their management. This study shows an effective contribution of provider CHWs on CCS functionality in health areas with difficult access.

Enhancing the notification system for surveillance of infectious diseases in Qatar during the FIFA World Cup 2022: project overview

BackgroundIn 2022, the Surveillance Department of the Ministry of Public Health in Qatar adopted an integrated project called the Notification Enhancement Project (NEP) to enhance the infectious disease notification system. Efficient surveillance and notification promote early alerts and allow immediate interference in reducing morbidity and mortality from outbreaks. The project was designed to improve the knowledge, attitudes, practices, and notification processes of healthcare workers in Qatar by increasing their reporting rates.MethodsThe strategy for comprehensively enhancing notifications was based on the observation and evaluation of the current notification system, the implementation of interventions, and post-evaluation follow-up. To implement the project, we relied on three aspects: effective methods used in previous relevant studies through a literature review, feedback received from healthcare workers, and suggestions from public health surveillance experts from the Ministry of Public Health, Qatar. A preassessment was conducted through an online survey by the Ministry of Public Health. The effectiveness of the different interventions was assessed by analyzing the data of notified patients reported through the Disease Surveillance and Reporting Electronic System. Pre- and postintervention assessments were performed by comparing the percentage of patients notified by healthcare providers with that of patients confirmed by healthcare providers in the laboratory to compare the notification rates over three time periods between January and December 2022.ResultsThere was significant improvement in the infectious disease notification process. A comparison before and after the implementation of the interventions revealed an increase in the communicable disease notification rate among healthcare workers. Pre- and postintervention data were compared. Infectious disease notification activities by healthcare workers increased from 2.5% between January and May 2022 to 41.4% between November and December 2022.ConclusionThis study highlights the efficiency of different interventions in correcting the underreporting of infectious diseases. Our findings suggest that implementing the Notification Enhancement Project significantly improves notification rates. We recommend continuing interventions through constant education and training, maintaining solid communication with HCWs through regular reminder emails and feedback, periodic assessment of the electronic notification system, and engagement of healthcare workers and other stakeholders to sustain and expand progress achieved through continuous evaluation.

Les fractures de l’extrémité supérieure du fémur : Estimation du coût médical direct de la prise en charge hospitalière

Proximal femur fractures are one of the most common injuries in older adults representing a serious health condition in developed as well as developing countries. This study aimed to assess the hospitalization costs of the proximal femur fracture. We conducted a prospective descriptive study spread over six months about patients hospitalized and operated on for proximal femur fractures. In order to estimate the cost we referred to the nomenclature of professional acts and the prices set by the Ministry of Public Health and the Ministry of Finance. The study included 100 patients, 55 females and 45 males with an average age of 76 years. The average hospital length of stay was 5 days. The preoperative stay was at a mean of three days. The average total hospitalization cost for these fractures was 2877 Tunisian Dinars depending on the type of fracture and surgical treatment. The main components of the costs were hospital stay costs and human resources costs 40%, cost of the implant 25.9%, cost of consumables 12%, operating cost 10%, cost of additional examinations 9% and cost of medications 2%. Proximal femur fractures represent an important cause of health resource consumption. To reduce the cost of hospital care, we recommend limiting the length of hospital stay as much as possible, investing in total hip and hemi-arthroplasties and adapting economical behavior taking into account the cost of consumables.

Prevalence and determinants of COVID-19 vaccine acceptance among vulnerable populations in Thailand: An application of the health belief model

BackgroundAssessing the acceptance of vaccinations among vulnerable populations is essential to ensure proper coronavirus disease 2019 (COVID-19) control. This study used the Health Belief Model to examine the intention to vaccinate against COVID-19 among vulnerable populations in Thailand. MethodsThis analytical cross-sectional study was conducted in Thailand between October and November 2021. Using multistage random sampling, 945 individuals from vulnerable populations (i.e., older adults, pregnant women, market or street vendors, and individuals with chronic diseases) were selected and invited to complete a self-reported questionnaire. The questionnaire assessed participants’ socioeconomic characteristics, COVID-19 preventive measures, knowledge, preventative health beliefs, and vaccine intention. A generalized linear mixed model was used to identify factors associated with the intention to receive the vaccine. ResultsThe prevalence of intent to accept the COVID-19 vaccine was 75.03% (95% confidence interval [CI]: 72.16–77.68). The Health Belief Model factors associated with vaccine acceptance were cue to action (adjusted odds ratio [AOR] = 3.13; 95% CI: 2.07–4.71), perceived benefits (AOR = 2.04; 95% CI: 1.38–3.01), and perceived severity (AOR = 1.77; 95% CI: 1.18–2.65). Significant other covariates were wearing a face mask in the previous month (AOR = 2.62; 95% CI: 1.59–4.31), being 1–2 m away from other people (AOR = 1.58; 95% CI: 1.11–2.24), trust in government (AOR = 1.44; 95% CI: 1.03–2.02). Additionally, women were more likely to accept the COVID-19 vaccine compared to men (AOR = 1.43; 95% CI: 1.02–2.01). ConclusionsApproximately one quarter of vulnerable individuals do not intend to be vaccinated. Health Belief Models can explain vaccine acceptance, and aid the Ministry of Public Health in planning future efforts to increase vaccine uptake. Healthcare professionals' advice, village health volunteers’ information, and partnership collaborations are critical. Facilitating mobile community units, launching educational campaigns, maintaining a distance of 1–2 m from others, and wearing masks may increase COVID-19 vaccine acceptability. This research can help prepare for future pandemics.

Spatial associations between chronic kidney disease and socio-economic factors in Thailand.

Chronic kidney disease (CKD) is a persistent, progressive condition characterized by gradual decline of kidney functions leading to a range of health issues. This research used recent data from the Ministry of Public Health in Thailand and applied spatial regression and local indicators of spatial association (LISA) to examine the spatial associations with night-time light, Internet access and the local number of health personnel per population. Univariate Moran's I scatter plot for CKD in Thailand's provinces revealed a significant positive spatial autocorrelation with a value of 0.393. High-High (HH) CKD clusters were found to be predominantly located in the North, with Low-Low (LL) ones in the South. The LISA analysis identified one HH and one LL with regard to Internet access, 15 HH and five LL clusters related to night-time light and eight HH and five LL clusters associated with the number of health personnel in the area. Spatial regression unveiled significant and meaningful connections between various factors and CKD in Thailand. Night-time light displayed a positive association with CKD in both the spatial error model (SEM) and the spatial lag model (SLM), with coefficients of 3.356 and 2.999, respectively. Conversely, Internet access exhibited corresponding negative CKD associations with a SEM coefficient of - 0.035 and a SLM one of -0.039. Similarly, the health staff/population ratio also demonstrated negative associations with SEM and SLM, with coefficients of -0.033 and -0.068, respectively. SEM emerged as the most suitable spatial regression model with 54.8% according to R2. Also, the Akaike information criterion (AIC) test indicated a better performance for this model, resulting in 697.148 and 698.198 for SEM and SLM, respectively. These findings emphasize the complex interconnection between factors contributing to the prevalence of CKD in Thailand and suggest that socioeconomic and health service factors are significant contributing factors. Addressing this issue will necessitate concentrated efforts to enhance access to health services, especially in urban areas experiencing rapid economic growth.

Health and safety in hair salons during the Covid-19 situation: A cross-sectional study in a semi-urban district in Thailand

ObjectiveSince the COVID-19 crisis in Thailand, the need for salons to have impeccable hygiene and client-hairdresser monitoring heightened. Due to scarce research on the COVID-19 preventive measures taken by hairdressing salons in semi-urban locations in Thailand during the pandemic, this study aimed to evaluate the standard of hair salons in preventing COVID-19 disease transmission in a semi-urban district in the northeastern region of Thailand. MethodsUsing the purposive sampling method, data were collected from 22 Hair Salons. Data collection tools were a self-completed questionnaire designed into different sections to obtain information on demographics, work conditions and environmental health standard compliance according to guidelines set by the Thai Ministry of Public Health during the COVID-19 pandemic. Descriptive analyses were done, such as mean, standard deviation, and frequency. ResultsThe mean age of our respondents was 41.82 (±8.18) years, more than half were females (63.6 %). Most of the criteria assessing beauty salon standards according to Department of Health guidelines were passed, with all of the salons passing the lighting evaluation and mostly passing the heat and electric shock protection system evaluation, but the implementation of guidelines for preventive measures during the COVID-19 epidemic, according to Department of Health guidelines, suggested non-compliance by most hair Salons. ConclusionBeauty salons should implement and strictly adhere to guidelines according to Department of Health standards. Training or education sessions regarding the prevention of infectious disease transmission should be conducted, as hairdressers should be motivated to comply with health and environmental health standards for both salon staff and clients' confidence. Further research should also be done on the behaviours associated with health risks in beauty salons at the national or border-nation level.

Utilisation of and factors associated with non-COVID-19 healthcare services in public facilities amongst cross-border migrants in Thailand, 2019–2022

BackgroundIt is believed that the COVID-19 pandemic might disrupt routine healthcare services. A vulnerable group such as cross-border migrants is of critical concern if the pandemic affects their service utilisation. In this study, we aim to explore the impact of COVID-19 and other related factors on non-COVID-19 service amongst cross-border migrants in Thailand.MethodsWe conducted an ecological time-series cross-sectional analysis using secondary data from 2019 to 2022, focusing on insured and non-insured migrants in a unit of a provincial monthly quarter. We obtained data on registered migrants from the Ministry of Labour and inpatient visits from the Ministry of Public Health (MOPH). Our analysis involved descriptive statistics and a random-effects negative binomial regression, considering variables such as COVID-19 cases, number of hospital beds, registered regions, and COVID-19 waves. We assessed inpatient utilisation number and rate as our primary outcomes.ResultsThe admission numbers for insured and non-insured migrants in all regions increased 1.3–2.1 times after 2019 despite a decrease in the numbers of registered migrants. The utilisation of services for selected communicable and non-communicable diseases and obstetric conditions remained consistent throughout 2019–2022. The admission numbers and rates were not associated with an increase in COVID-19 incidence cases but significantly enlarged as time passed by compared to the pre-COVID-19 period (44.5–77.0% for insured migrants and 15.0–26.4% for non-insured migrants). Greater Bangkok saw the lowest admission rate amongst insured migrants, reflected by the incidence rate ratio of 5.7–27.5 relative to other regions.ConclusionThe admission numbers and rates for non-COVID-19 healthcare services remained stable regardless of COVID-19 incidence. The later pandemic waves (Delta and Omicron variants) were related to an increase in admission numbers and rates, possibly due to disruptions in outpatient care, leading to more severe cases seeking hospitalisation. Lower admission rates in Greater Bangkok may be linked to the fragmentation of the primary care network in major cities and the disintegration of service utilisation data between private facilities and the MOPH. Future research should explore migrant healthcare-seeking behaviour at an individual level, using both quantitative and qualitative methods for deeper insights.

Esophageal cancer: a twenty-four-year experience at a tertiary care center with an evaluation of the prognostic significance of the neutrophil-lymphocyte ratio

BackgroundA high neutrophil-lymphocyte ratio (NLR) may be associated with worse survival in esophageal cancer (EC). Our aims were to describe the demographic and clinical data of EC in a tertiary referral center in Lebanon and to determine the prognostic value of NLR.MethodsA retrospective cohort study based on chart review of patients diagnosed with EC was conducted at the American University of Beirut Medical Center (AUBMC). The demographic characteristics, clinical presentation and outcomes were described and compared between squamous cell carcinomas (ESCC) and adenocarcinomas (EAC). Data about esophageal cancer incidence were obtained from the National Cancer Registry, the Ministry of Public Health and GLOBOCAN 2020. Cox regression analysis was performed to determine whether the NLR is an independent predictor of survival, using variables based on clinical knowledge and previously established data.Results110 patients were diagnosed with EC, which was the least common among other gastrointestinal malignancies. Our follow up rates reached 86.4%. The median survival was 9 months (IQR 3–25.5.) and was comparable between ESCC (median of 7 months, IQR 2–25) and EAC (median of 9 months, IQR 3–26.3), p = 0.803. Advanced stage was associated with a worse prognosis (p = 0.037). The mean NLR(±SD) was 5.20 ± 6.8, with no significant difference between EAC and ESCC (4.5 ± 3.4 vs. 5.9 ± 9.2, p = 0.420) or between early or advanced stages (5.4 ± 8.1 vs. 4.7 ± 6.8, p = 0.732). The area under the curve for the NLR was 0.560 (95% CI: 0.374–0.746, p = 0.488). After adjusting for age, gender, TNM staging and grading, cox regression analysis showed that an increased NLR was a significant predictor of mortality, with an adjusted hazard ratio of 1.095 (p = 0.011).ConclusionEC is quite uncommon in Lebanon despite a high prevalence of smoking and obesity. Advanced stage and high NLR were associated with a negative prognostic value.

Street-level quasi-bureaucracy and professional discretion: how transformational leadership and public service motivation influence village health volunteers' professional discretion

PurposeVillage health volunteers are community health volunteers in Thailand that have helped the government deliver public health services for many years, particularly during the coronavirus disease 2019 (COVID-19) pandemic. Though labeled as “volunteers,” the village health volunteers are recruited, trained and supervised in a manner similar to how a government agency recruits, trains and supervises its street-level bureaucrats (SLBs). This study examines the two factors that affect how these street-level quasi-bureaucrats use their professional discretion: transformational leadership and public service motivation (PSM). Transformational leadership means a leadership style that develops, shares and sustains a vision to elevate SLBs to higher levels of performance, while PSM is defined as an SLB’s predisposition to make a difference by working in the public sector with a sense of calling. This study attempts to analyze the mediating role of psychological empowerment in the relationship between transformational leadership, PSM and professional discretion.Design/methodology/approachThe paper uses a three-wave survey-based quantitative method to avoid common method biases. This method provides evidence gathered from 105 subdistrict health promotion hospitals and 798 village health volunteers (VHVs) in five provinces in Thailand.FindingsPSM and transformational leadership influence the village health volunteers' use of professional discretion indirectly through the psychological empowerment mechanisms that make them feel positive toward their village health volunteer role and responsibility. The authors' findings suggest that the hospital directors' transformational leadership induces the village health volunteers' use of professional discretion by making them feel competent to do their work and feel fulfilled and valuable about their work. Similarly, the village health volunteers' PSM leads them to use professional discretion by making them feel fulfilled and valuable and by convincing them of the social and community impact of their work.Research limitations/implicationsWhile existing research focuses on VHVs' role in alleviating capacity constraints on the health care system, this study revealed an equally important role played by hospital directors. These directors' transformational leadership was instrumental in enhancing VHVs' psychological empowerment – particularly their perceptions of the meaning of their work and their competence – that ultimately enabled them to use professional discretion in their work. This study also highlighted the importance of VHVs' PSM, which leads to their use of professional discretion via the meaning and impact dimensions of psychological empowerment. Based on this study, PSM should also be incorporated into the community health volunteers' recruitment criteria. Also, public health agencies should consider including transformational leadership in the hospital directors' training programs and their promotion criteria.Practical implicationsAs VHVs' high-PSM level was found to enhance their professional discretion, the process of recruiting ordinary citizens to serve as community health volunteers should incorporate assessment of the candidates' PSM. Also, the Ministry of Public Health should design and assign tasks that citizen volunteers, particularly VHVs, consider meaningful and at which they feel competent.Social implicationsAside from technical training, directors of the subdistrict health promotion hospitals should regularly receive soft skill training (i.e. leadership training) and transformational leadership characteristics should be included in the government criteria for promotion.Originality/valueWhile past research has examined the impact of other leadership styles on psychological empowerment, this study took a further step by examining the mediating effects of psychological empowerment on the relationship between transformational leadership and professional discretion among VHVs. The authors analyzed the mechanism linking PSM to the VHVs' professional discretion. In addition, by examining the relative importance of different dimensions of psychological empowerment, this study offers a nuanced understanding of the psychological processes by which transformational leadership and PSM shape the SLBs' use of professional discretion in their work.

Assessing the acceptability of implementing a Screening, Brief Intervention and Referral to Treatment for alcohol use among transgender women in Bangkok, Thailand: A mixed-method pre-implementation study using the Consolidated Framework for Implementation Research.

Health inequities related to alcohol use exist for transgender individuals. While the Thailand Ministry of Public Health recently published a clinical guideline to implement a Screening, Brief Intervention and Referral to Treatment (SBIRT) in primary care, there has been no study regarding transgender women's (TGW) alcohol use and the acceptability of implementing SBIRT in a Thai context, a gap this study aimed to fill. A mixed-method approach was used. In the first phase, TGW service users and health-care providers (HCPs) completed a survey on the acceptability of prospective implementation of SBIRT. TGW service users completed the Alcohol Use Disorder Identification Test-Consumption (AUDIT-C). In the second phase, TGW service users, HCPs, clinic administrators and national-level alcohol, HIV and transgender health policymakers participated in in-depth qualitative interviews. The Tangerine Clinic, a transgender-led sexual health clinic in Bangkok, Thailand. In the first phase, TGW service users (n = 100) and HCP (n = 8) were surveyed. In the second phase, 22 stakeholders (n = 10 TGW service users; n = 8 HCP; n = 1 clinic administrator; n = 3 policymakers) were interviewed. Simple proportions were calculated for each survey item. Differences in acceptability by various demographic factors were calculated using univariate analysis. The qualitative data were coded using thematic analysis and a deductive approach. The results were mapped to the Consolidated Framework for Implementation Research domains and constructs. The quantitative and qualitative results were triangulated to expand understanding. Fifty per cent of the TGW participants exhibited problematic drinking levels (AUDIT-C ≥ 4). Implementing SBIRT was highly acceptable, as more than 95% of participants reported agreeing or completely agreeing to receive SBIRT for alcohol use. Barriers, such as complexity, time constraint and lack of knowledge and skills, were anticipated. Adaptability, such as tailoring the content of brief intervention to suit TGW health needs and SBIRT to fit with existing clinic procedures, might facilitate successful implementation. Screening, Brief Intervention and Referral to Treatment (SBIRT) for alcohol use has the potential to be successfully implemented in transgender-led sexual health clinic settings, with some adaptations to overcome anticipated barriers.