Modern Health Care Services Research Articles

ANTIMICROBIAL ACTIVITY OF SOME MALAYSIAN MUSHROOMS ON ESCHERICHIA COLI AND STAPHYLOCOCCUS AUREUS

Background and Objective: Nowadays, the world is facing significant challenges in modern healthcare services because many antimicrobial agents have lost their effectiveness in treating infectious diseases primarily due to the development of microbial resistance. Mushroom species release various bioactive compounds and yet largely untapped resource of useful natural compounds. This study aimed to assess the primary screening for antimicrobial activity of selected Malaysian mushroom’s against Escherichia coli and Staphylococcus aureus.Methodology: The mycelia biomass extracts of the 8 collected Basidiomycetes mushrooms. Antibacterial activity was measured using Disc diffusion and Well diffusion methods against standard reference strains E. coli MTCC 740 and S. aureus MTCC 501. Results: The potential inhibition of Agaricus cupreobrunneus, which gave a reading of 4.6 cm for disc diffusion and 3.4 cm for well diffusion of inhibition against E. coli MTCC 740 and against S. aureus MTCC 501 that, gave a reading of 4 cm for disc diffusion and 3.1 cm for well diffusion approaches. The second highest bioactivity mushroom against E. coli MTCC 740 the highest inhibition was shown by extract of brown Agaricus bisporus which gave 3.5 cm and give 3.2 cm S. aureus MTCC 501 by disc diffusion. For well diffusion the zone of inhibition by same mushroom for E. coli MTCC 740 which gave reading 3.0 cm and gave 2.7 cm against S. aureus MTCC 501. Conclusions: The species studied showed potential inhibition of A.cupreobrunneus more than other mushrooms by disc diffusion method especially against E. coli more than S. aureus. Further studies are required to ascertain their toxicity against mammalian cells and potential side effects.

SMS-based family planning communication and its association with modern contraception and maternal healthcare use in selected low-middle-income countries

BackgroundThe objectives of this study were to 1) measure the percentage of women who received SMS-based family planning communication, and 2) its association with modern contraception and maternal healthcare services among mothers. In recent years, there has been a growing interest surrounding mobile phone-based health communication and service delivery methods especially in the areas of family planning and reproductive health. However, little is known regarding the role of SMS-based family planning communication on the utilisation of modern contraception and maternal healthcare services in low-resource settings.MethodsCross-sectional data on 94,675 mothers (15–49 years) were collected from the latest Demographic and Health Surveys in 14 low-and-middle-income countries. The outcome variables were self-reported use of modern contraception and basic maternal healthcare services (timely and adequate use of antenatal care, and of facility delivery services). Data were analysed using multivariate regression and random effect meta-analyses.ResultsThe coverage of SMS-based family planning communication for the pooled sample was 5.4% (95%CI = 3.71, 7.21), and was slightly higher in Africa (6.04, 95%CI = 3.38, 8.70) compared with Asia (5.23, 95%CI = 1.60, 8.86). Among the countries from sub-Saharan Africa, Malawi (11.92, 95%CI = 11.17, 12.70) had the highest percent of receiving SMS while Senegal (1.24, 95%CI = 1.00, 1.53) had the lowest. In the multivariate analysis, SMS communication shown significant association with the use of facility delivery only (2.22 (95%CI = 1.95, 2.83). The strength of the association was highest for Senegal (OR = 4.70, 95%CI = 1.14, 7.33) and lowest for Burundi (OR = 1.5; 95%CI = 1.01, 2.74). Meta analyses revealed moderate heterogeneity both in the prevalence and the association between SMS communication and the utilisation of facility delivery.ConclusionAlthough positively associated with using facility delivery services, receiving SMS on family planning does not appear to affect modern contraceptive use and other components of maternal healthcare services such as timely and adequate utilisation of antenatal care.

Old-aged patients’ experiences with patient-centered primary health care in Serbia

Abstract Objective The population in Serbia is getting older, with the population aged 65+ increasing from 17.2% to 19.6% (2007-2017). As people age, their health needs become more complex and health services must be adopted to their needs. Patient-centeredness is regarded as the basis for modern healthcare services. Patients' satisfaction surveys are widely used to identify experiences of patients, including old ones. The aim of this study was to assess old-patient centeredness of primary healthcare (PHC) in Serbia according to patients' experiences with healthcare workers. Methods Between 2009 and 2015 cross-sectional studies were conducted in 169 Serbian PHC centers (160.948 patients), thereby using a questionnaire referring to socio-demographic characteristics, preventive care counseling, experiences with general practitioners (GPs) (knowledge of patients' health status, listening, giving clear explanations concerning illness and medicines), nurses (friendliness and provision of information), co-payment for healthcare and the overall satisfaction with PHC. Non-parametric tests (Chi-square and Kruskal-Wallis) were used for statistical analyses. Results A large portion of the respondents asserted to be satisfied or very satisfied with the obtained PHC services, the majority had positive experiences with GPs and nurses. About one third (32.7%) of patients were 60 years or older. Significant differences concerning the number of positive experiences in contact with GPs and nurses were found between age groups. In both domains patients 60 years or older, had more positive experiences and were overall more satisfied with PHC services than younger (p < 0.001). Conclusions The results show that old aged patients have positive experiences with GPs and nurses in Serbian PHC. Primary health care meets their needs and can be regarded as patient-centered. The main limitation of the study was the lack of a questionnaire specific for old aged, which could better explore their needs and experiences. Key messages Patient-centeredness is regarded as the basis for modern healthcare services and doctors and nurses have leading role in providing patient-centered healthcare. Old aged patients have specific healthcare needs and health systems have big challenge in obtaining adequate health care with good health outcomes.

Level of Antenatal Care Services Utilization and Associated Factors Among Mothers who have Given Birth in the Past Twelve Months in Gelemso Town, West Hararghe Zone, Oromia National Regional State, East Ethiopia

Background In Ethiopia, the levels of maternal and infant morbidity and mortality are among the highest in the world. This is attributed to, among other factors, none use of modern health care services by women. According to the 2011 Ethiopian Demographic Health Survey, more than seven in ten mothers did not receive antenatal care at all. Objectives The objective of this study was to determine level and identify factors influencing maternal antenatal care services utilization among mothers who gave birth in the last twelve months in Gelemso town west Hararghe Oromia, Ethiopia. Methods A community-based cross sectional study design was conducted on 347 study participants in Gelemso town west Hararghe Oromia Ethiopia from July 15, 2017 to August 15, 2017 G.C.A probability to proportional to size sampling technique was used to select the study population in two urban Kebeles. Data were collected using a pre tested structured questionairs. Descriptive results were presented using frequencies, and numerical summary measures. Bivariate analysis was carried out to assess the association between outcome variable and each in dependent variables. Odds ratio with 95% confidence level was estimated to identify factors associated with Antenatal Care (ANC) utilization using multivariable logistic regression. The statistical significance was declared at p- value < 0.05. Result The response rate this study was 98%. The prevalence of antenatal care service utilization was 64.6%. About 146 (42.1%) of the pregnant mother started antenatal care visit during the second trimester of pregnancy and a significant proportion 289(83.3%) had less than the recommended four visits. Educational status (AOR;15.19:CI 95%,6.006,38.417), husband attitude (AOR;1.995:CI 95%,1.016,3.916), marital status(AOR:4.587:CI 95%,1.888,11.146), planned pregnancy (AOR:4.938:CI 95%,2.514,9.702) were major factors associated with antenatal care service utilization. Conclusion Though more than half mother used antenatal care service in the study setting, two in ten of the mothers did not have the minimum number of visits recommended by World Health Organization. Promotion of information, education and communication in the community should be strengthened is to sustain antenatal care service utilization in the community.

Room of horrors – ein low-fidelity Simulationstraining für patientensicherheitsrelevante Gefährdungspotentiale im Klinikalltag

IntroductionEven in well-developed healthcare systems, raising awareness for undesirable dangers and risks of modern healthcare services among the clinical staff is a continuous and methodical challenge. The concept of the so-called “Room of Horrors” is both an innovative and a low-fidelity simulation approach for team-based training of patient safety-relevant hazards. The purpose of this evaluation study is to report on practicability and acceptance of such a low-threshold simulation training. MethodA fictitious patient room including a patient manikin (lying in bed) was set up in the hospital to simulate the Room of Horrors. Additional artifacts such as a side table, medication and the medical record completed the simulation, in which 12 typical errors or latent risks related to patient safety were hidden. After a short briefing, individuals or groups (2–5 participants) should enter the room and try to find as many errors as possible. The error detection rate was evaluated immediately followed by a debriefing. The participants were then asked to answer a short structured questionnaire to provide content-related feedback about the patient safety simulation. ResultsWithin three days, the Room of Horrors was visited by a total of 89 participants (27 teams and 6 individuals). Average error detection rate was 8.54 out of 12 hidden errors (71%), whereby the teams showed a slightly better result. All the surveyed participants found the simulation to be educational and beneficial. The importance of team discussion was particularly emphasized by a majority of participants. 91% of the participants found the wrong patient identification wristband and in spite of a documented lactose intolerance a yogurt on the side table. 88% of the participants recognized the bell which was out of the patients reach. Few participants found the missing indication of a permanent catheter (24%) and a doubled prescription of paracetamol (42%). DiscussionA comparison of several international studies about so-called Rooms of Horrors shows that the present study has a relatively high average detection rate (71%), although a significant percentage of the participants are not engaged in medical or nursing services. Not surprisingly, the average detection of errors of the teams were higher than individuals. This strengthens the theory that a discursive discussion and exchange of dialogue among the clinical staff in a patient's room increases patient safety or at least strengthens situational awareness for clinical risks. The consistently positive feedback coincides with the evaluation results of other clinics and thus demonstrates the acceptance of simulation-based on-site training. The organizational and financial effort to execute the simulation training remained very low (apart from the resulting costs incurred due to the participants missing from their regular hospital duties). Hence, the evaluation study proves practicability and acceptance of this simulation method. ConclusionThe study provides no information about the extent to which the simulation actually influences the behavior and situational awareness of the participants. At least the awareness of the participants for real risks, hazards and errors of modern patient care was raised temporarily. The Room of Horrors can be easily adapted to different learning goals and settings. It is a flexible and practical learning arrangement. In comparison to the organizational and financial efforts involved, the implementation can be recommended without exception.

Effects of community-based health insurance on modern family planning utilization in Ethiopia

Background: Community-based health insurance (CBHI) has been established in a number of developing countries to expand access to modern health care service. However, few studies have focused on health care utilization of CBHI members in Ethiopia. Accordingly, the aim of this study was to assess the effect of CBHI on modern family planning (FP) utilization as part of its routine outcome monitoring activities. Methods: The USAID Transform: Primary Health Care project, conducted a continuous monitoring follow up visit using a multistage sampling technique in its four major targeted regions. A total of 3433 households were selected and 3313 women of reproductive age (15-49 years) were interviewed. The questionnaire captured the CBHI status of each household and FP use data from randomly selected women. Microsoft Access database was used to enter the data, which was then transferred to SPSS Version 20 for further analysis. Results: 49% of women (aged 15-49 years) were found to be enrolled in CBHI scheme. Half of the women (50.2%) use any family planning method, of which 49% of them used modern family planning method in project-supported areas. Over half of women (57%) who are exposed to CBHI schemes utilized family planning method which is statistically significant Conclusions: Modern FP utilization among insured women was higher compared with uninsured women. While FP methods are provided for free, CBHI enrollment improves FP use among women of child-bearing age. Women who have access to CBHI may frequently visit health facilities seeking services for themselves and their families, during which they may be introduced to FP services. This in turn may improve their awareness and attitude towards FP. The results will increase awareness for program implementer's of the benefits of CBHI schemes in FP programming, particularly in rural settings, and provide an opportunity to increase lifelong returns in Ethiopia.

Cloudlet Based Medical Data Sharing with Privacy Protection

This modern society expects sophisticated modern health care services to enhance the healthy living conditions. The world’s ageing population and prevalence of chronic diseases has lead to high demand for medical data monitoring. The modern technology is supporting in all the way to realize the sophisticated health services. Specialized doctors are generally very rare and they may be geographically far away from needy patient. Without the support of technology, they cannot provide health services from remote places. In most of the cases, patients are immovable to doctor’s place due to their critical health conditions. But, the technology is a coming to help in such situations in a great way. The modern technology is helping in providing health services remotely with same quality as a local doctor can provide. The key concept behind this technology is collecting health data with highest possible accuracy and sharing it with remotely present health specialists. The wearable devices can collect body data most accurately and can send data to cloud for sharing it with remotely present health specialists. But, we know, sharing medical information is very critical and challenging issue because medical information contains patient’s important and highly confidential information. On the other hand, medical ethics says that doctors cannot share patient’s health records with others without the consent of patient. Such data will be shared between only authentic persons in cloud. The chain of processing mainly includes data collection, data storage, and data sharing. In this work a protected cloudlet based medical data sharing is proposed. In this paper, three major issues pertaining to medical data sharing are addressed. Firstly, a method for secured medical data sharing using cloudlet is proposed. During data collection, Number Theory Research Unit (NTRU) method used to encrypt user’s body data collected by wearable devices, then transmitted to nearby cloudlet. Secondly, a new trust model to help users to select trustable partners for sharing stored data in the cloudlet is presented. This model is to help similar patients to communicate with each other. Thirdly, a novel collaborative intrusion detection system (IDS) method based on cloudlet mesh is proposed, which can effectively prevent the remote healthcare big data cloud from attacks. Finally, an analysis of security to the information is presented and the results are quite encouraging.

Health Care Seeking Behaviour Among the Tangsa Women of Tinsukia District of Assam: A Micro Study.

The tribal people are more tradition bound and have poorer health indicators and limited access to healthcare services. However, with changing time and continuous effort of the government, they are now in a transitional phase between traditional and modern healthcare practices. This article attempts to explore context, reasons, and options behind the health-seeking behavior of the Tangsa (Hill Tribe) women of Margherita sub-division of Tinsukia district, Assam, along with their access to the public healthcare services. Using both simple random and purposive sampling method, primary data were collected in the field from the married women, adolescent girls, and mothers who have girl child of 0–9 years of age from two Tangsa villages, namely Kharangkong and Hassak. Data were collected using standard field methods, for example, observation, survey schedule, interview, semi-structured and open- ended questionnaires, case study, and participatory tools such as focused group discussion (FGD). The findings indicate that Tangsa women generally prefer traditional healing practices to cure many of the common diseases. But a portion of women ranging from 42 to 74 percent received the benefits from different government health schemes related to reproductive health. Institutional delivery is gradually increasing, but iron and folic acid (IFA) intake by pregnant women and adolescent girls is still very poor. The public health department should make more effort to increase the level of awareness and knowledge among the tribal women about the benefits that can be availed from various schemes and modern healthcare services.

Effects of community-based health insurance on modern family planning utilization in Ethiopia

Background: Community-based health insurance (CBHI) has been established in a number of developing countries to expand access to modern health care service. However, few studies have focused on health care utilization of CBHI members in Ethiopia. Accordingly, the aim of this study was to assess the effect of CBHI on modern family planning (FP) utilization as part of its routine outcome monitoring activities. Methods: The USAID Transform: Primary Health Care project, conducted a continuous monitoring follow up visit using a multistage sampling technique in its four major targeted regions. A total of 3433 households were selected and 3313 women of reproductive age (15-49 years) were interviewed. The questionnaire captured the CBHI status of each household and FP use data from randomly selected women. Microsoft Access database was used to enter the data, which was then transferred to SPSS Version 20 for further analysis. Results: In total 50.8% of married women (aged 15-49 years) were found to be enrolled in CBHI. Current modern FP use is 47.5% among married women in project-supported areas. Modern FP use is 50.9% among married women who are exposed to CBHI schemes, versus 44.1% among women who are not exposed to CBHI which is statistically significant. Conclusions: Modern FP utilization among insured women was higher compared with uninsured women. While FP methods are provided for free, CBHI enrolment improves FP use among women of child-bearing age. Women who have access to CBHI may frequently visit health facilities seeking services for themselves and their families, during which they may be introduced to FP services. This in turn may improve their awareness and attitude towards FP. The results will increase awareness for program implementers of the benefits of CBHI schemes in FP programming, particularly in rural settings, and provide an opportunity to increase lifelong returns in Ethiopia.

Operating Rooms Scheduling for Elective Surgeries in a Hospital Affected by War-Related Incidents.

Hospital scheduling presents huge challenges for the healthcare industry. Various studies have been conducted in many different countries with focus on both elective and non-elective surgeries. There are important variables and factors that need to be taken into considerations. Different methods and approaches have also been used to examine hospital scheduling. Notwithstanding the continuous changes in modern healthcare services and, in particular, hospital operations, consistent reviews and further studies are still required. The importance of hospital scheduling, particularly, has become more critical as the trade-off between limited resources and overwhelming demand is becoming more evident. This situation is even more pressing in a volatile country where shootings and bombings in public areas happened. Hospital scheduling for elective surgeries in volatile country such as Iraq is therefore often interrupted by non-elective surgeries due to war-related incidents. Hence, this paper intends to address this issue by proposing a hospital scheduling model with focus on neuro-surgery department. The aim of the model is to maximize utilization of operating room while concurrently minimizing idle time of surgery. The study focused on neurosurgery department in Al-Shahid Ghazi Al-Hariri hospital in Baghdad, Iraq. In doing so, a Mixed-integer linear programming (MILP) model is formulated where interruptions of non-elective surgery are incorporated into the main elective surgery based model. Computational experiment is then carried out to test the model. The result indicates that the model is feasible and can be solved in reasonable times. Nonetheless, its feasibility is further tested as the problems size and the computation times is getting bigger and longer. Application of heuristic methods is the way forward to ensure better practicality of the proposed model. In the end, the potential benefit of this study and the proposed model is discussed.

Wearable Sensor Devices for Prevention and Rehabilitation in Healthcare: Swimming Exercise With Real-Time Therapist Feedback

Wearable sensor devices are playing an increasingly important role in providing pervasive and personalized healthcare. Important elements of modern healthcare services are physical rehabilitation and injury prevention. Wearable sensor devices attached to the patient can offer valuable supplemental information to healthcare professionals during treatment or therapy. In physical rehabilitation, wearable inertial sensor devices help therapists to monitor and evaluate parameters and key performance indicators of the rehabilitation activities. Therapy efficiency can be increased by using real-time feedback systems. Three different feedback system architectures are defined and studied: 1) therapist; 2) user; and 3) cloud system. A case study involving rehabilitation therapy based on swimming exercises was performed. Field test results show that the developed sensor device and real-time therapist feedback application provide sufficiently accurate and precise data for the efficient evaluation of swimming parameters, such as stroke time and stroke rotation angle symmetry. Rehabilitation therapists should be able to operate the system without the constant presence of trained and experienced technical personnel (engineers). The wide adoption of wearable sensor device-based applications will lead to cloud systems where big data analytics will offer additional benefits to healthcare, well-being, and quality of life.

Conflicting demands on a modern healthcare service: Can Rawlsian justice provide a guiding philosophy for the NHS and other socialized health services?

We explore whether a Rawlsian approach might provide a guiding philosophy for the development of a healthcare system, in particular with regard to resolving tensions between different groups within it. We argue that an approach developed from some of Rawls’ principles – using his ‘veil of ignorance’ and both the ‘difference’ and ‘just savings’ principles which it generates – provides a compelling basis for policy making around certain areas of conflict. We ask what policies might be made if those making them did not know if one was patient, doctor, nurse or manager – in this generation or the next.We first offer a brief summary of Rawls’ approach and how we intend to extrapolate from it. We examine how this adapted Rawlsian framework could be applied to specific examples of conflict within healthcare; we demonstrate how this framework can be used to develop a healthcare service which is both sustainable (in its training and treatment of staff, and in encouraging research and innovation) and open (to protect the powers and opportunities of those using the health service). We conclude that while Rawls’ approach has previously been rejected as a means to address specific healthcare decisions, an adapted veil of ignorance can be a useful tool for the consideration of how a just health service should be constructed and sustained. Turning the theoretical into the practical (and combining Rawls’ thought experiment with Scanlonian contractarianism), managers, doctors, patients, carers and nurses could come together and debate conflicting issues behind a hypothetical veil.

Antiplasmodial Anthraquinones from Medicinal Plants: The Chemistry and Possible Mode of Actions

Malaria killed nearly half a million people in 2015, and 70% of this victims were young children. Malarial chemotherapy makes use of several drugs, each with its own pharmacological limitations, and with parasite resistance being the most challenging. People of low income nations often rely on traditional medicine as a treatment due to limited access to modern healthcare services. Despite uncertainties present in the outcome of traditional medicine, ethnomedicine approach has yielded important lead candidates. The investigation of medicinal plants utilized in the malaria endemic region yielded many antiplasmodial compounds with anthraquinone moiety. This paper describes natural anthraquinones extracted from medicinal plants utilized in traditional medicine for the treatment of malaria. In addition, the insight on structure-activity relationship and their mode of actions are also elaborated.

Patients’ experiential knowledge and expertise in health care: A hybrid concept analysis

Although the concept of experiential expertise is relatively new in modern health care services, policy, and research, it has profound implications for improving participation in healthcare. The absence of theoretical and conceptual clarity has led to poor understanding and miscommunication among researchers, health practitioners, and policy makers. The aim of this article is to present a concept analysis of experiential expertise and to explain its defining characteristics, applicability, and significance. A combination of Rodger’s evolutionary method combined with Schwartz-Barcott and Kim’s hybrid model was selected as a method for the analysis of the experiential expertise concept. This method combines theoretical (24 definitions) with empirical data analysis (17 interviews). Antecedents, attributes, and consequences are determined. A comprehensive definition is provided, and the interrelatedness between experiential expertise and related concepts was mapped. Experiential expertise is a complex process exceeding the boundaries of individual experiences. Its availability cannot be taken for granted. Using experiential expertise in health care can facilitate patient empowerment leading to improved quality of life and health care. The present study offers clarity by proposing a conceptual model that can assist researchers, policy makers, and health care professionals in facilitating implementations in practice.

Evaluation of the Physical Development of Children of Secondary School Age: аn Analysis of the Results of a Cross-Sectional Study

Background.Physical development is one of the leading criteria for assessing the health status of children. The body mass index (BMI) is a reliable sign of physical development disorders. The possibility of diagnosing childhood obesity, a significant problem of modern healthcare service, is of particular value. Our aim was to assess the prevalence of obesity, overweight, and underweight in students aged 11 and 15 years attending educational institutions in the regions of the Russian Federation.Methods.The data is based on a prospective assessment of the screening of children. A total of 2,540 children were examined, the study included data of 2,023 schoolchildren of both sexes aged 11 and 15 years. The BMI calculation was assessed using SDS tables and centile scales (WHO, 2007).Results.When assessing the body mass index in 11-year-old boys in the regions of Russia according to SDS, obesity was determined in 18.6% of cases, overweight — in 15.4% of cases, and underweight — in 5.4% of cases. In 15-year-old boys, obesity was detected in 10% of cases, overweight — in 11.5% of cases, and underweight — in 8.5% of cases. In girls aged 11 and 15 years, obesity was detected in 9.2% and 3.6% of cases, overweight — in 14.3% and 10.5% of cases, underweight — in 10.5% and 8.9% of cases, respectively.Conclusion.In the Russian Federation, cases of underweight or overweight were detected, but these indicators do not exceed the number of children with normal parameters. A high proportion of obese boys is detected mainly due to 11-year-olds. More cases of obesity were registered in girls aged comparing with 15-year-old girls.

Demand for health care service and associated factors among patients in the community of Tsegedie District, Northern Ethiopia

BackgroundDemand-side barriers are as important as supply factors in deterring patients from obtaining treatment. Developing countries including Ethiopia have been focusing on promoting health care utilization as an important policy to improve health outcomes and to meet international obligations to make health services broadly accessible. However, many policy and research initiatives focused on improving physical access rather than focusing on the pattern of health care service utilization related to demand side. Understanding of determinants of demand for health care services would enable to introduce and implement appropriate incentive schemes to encourage better utilization of health care services in the community of Tsegedie district, Northern Ethiopia.MethodsA community based cross sectional study design was conducted from March1–30/2016 in Northern Ethiopia. Systematic random sampling technique was used to select 423 participants from 2189 patients of the one-month census. A pretested and standardized semi-structured interviewer administered questionnaire was used to collect the data. The data were entered using Epi-info version 7 and analysed by STATA version 11. Multinomial logistic regression model was used to identify the determinants of demand for health care service.ResultsA total of 423 (with a response rate of 98.3%) study participants were included in the study. The finding indicates that 72.5% (95%CI = 61.6, 81.1) of the participants demanded modern health care services. The multinomial logistic regression econometric model revealed that perceived severity of illness (β = 1.27; 95% CI = 0.74, 1.82), being educated household head (β = 0.079; 95% CI = 0.96, 1.74), quality of treatment (β = 0.99; 95% CI = 0.47, 1.5), distance to health facility β = 1.96; 95%CI = 0.11, 0.27), cost of treatment (β = − 1.99; 95% CI = 0.85, 3,13) were significantly and statistically associated with demand for health care service.ConclusionThis study revealed that in Tsegedie district, majorities (72.5%) of the patients demanded modern health care service. Distance to health care facility, user-fees, educational status of household, quality of service, and severity of illness were found to be significantly associated with demand for health care service.Out of pocket, payments should be changed by prepayment schemes like community-based insurance than to depend on user fees and appropriate health information dissemination activities should strengthen to create awareness about modern care.

Prevalence of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus among blood donors of Mekelle blood bank, Northern Ethiopia: A three-year retrospective study.

Blood transfusion services are a vital and integral part of modern healthcare services. However, the risk of transfusion transmittable infections (TTI) has been a major handicap. Therefore, this study was aimed at determining the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) among blood donors. A retrospective study was conducted to collect data about the blood donors who consecutively donated blood from October 2011 to 2014. A three-year retrospective study was conducted in Mekelle Blood Bank. A data abstraction format was used to collect the sociodemographic and clinical data, and the prevalence of HBV, HCV, and HIV was determined. Data were analyzed using STATA version 10 analytical software. P value less than 0.05 was considered significant in all the analyses. A total of 10 728 blood donors, median (interquartile range) of age 30 (23-45) years and 3750 (34.9%) males were enrolled in this study. Of the participants 407(3.79%), 143(1.33%), and 111(1.03%) blood donors were positive for HBV, HCV, and HIV, respectively. HBV-HIV coinfections were found 10 (1.93%) blood donors, followed by HBV-HCV and HIV-HCV. A significant association between sex and marital status with HBV and HIV infection was found. However, significant association of HCV was observed among sex ( X 2 = 33.18, P < 0.001) and occupational ( X 2 = 84.33, P < 0.001). A significant percentage of HBV, HCV, and HIV among blood donors was observed. To select a donor and collect safe blood risk factors exposing blood donor should be studied, and community-based prevalence studies onTTI are also required.

Regulation of Blood and Blood products in India, USA and EU

Blood and blood products are precious commodity which gives life to another person. Though we have immense discoveries and invention in science and technology, yet we cannot make blood hence, human blood has no substitute. The availability of safe blood and blood products is essential for diverse modern healthcare services including some surgeries, treatments for cancer, chronic medical conditions, trauma care, organ transplantation, and childbirths that ultimately improve life for millions of patients who are need of transfusion annually. We do not have yet well-defined and stringent regulatory framework for blood products regulation. Frailty may arise from the inability of governments to enforce laws, regulations, and policies and personnel who may not aware or cannot follow quality assurance and/ or good manufacturing practices. While the health sector in developed nation has made outstanding accomplishments in the past few decades. The study sheds on the overview of blood transfusion system in India and other developed nations. There were a mix of methodologies, including literature review (government documents), interviews with key officials in Indian Red Cross Society and analysis of data was used. Results of analysis showed that there are several areas that need to be addressed as it potentially affect the timely availability of safe blood products, which calls for strengthening the planning and monitoring of blood transfusion services.

Social Exclusion and Survival Strategies among Slum Dwellers in Ibadan, Nigeria

Social exclusion remains the most visible expressions of slum settlements. This study investigates the expression of social exclusion and survival strategies among slum dwellers in Ibadan, Nigeria. A merger of Burgess’ concentric zone model and conflict theory formed the theoretical orientation for this study. Data were gathered through triangulation of quantitative and qualitative methods. In all, semi-structured questionnaire was administered to 400 respondents and 10 in-depth interviews were conducted among residents in Bere slum. Among others, lack of access to formal employment (98.0%), modern health care facilities (91.0%), consultation of government officials to know needs (92.2%), adequate shelter (100%), were the most mentioned challenges. Major survival strategies adopted were hawking, child labour, prostitution, stealing and gambling. Also, due to a lack of modern health care services in the area, self-medication (61.0%), traditional method of treatment (27.5%), and faith healing (11.5%) were most mentioned strategies adopted to cope with health challenges in the area. This paper therefore concludes that social inclusion of slum inhabitants in all government welfare services and decision making process should be advocated, as a means of reducing the rates of poverty and crime in Ibadan.

THE IMPACT OF JAMKESMAS ON HEALTHCARE UTILIZATION IN EASTERN REGIONS OF INDONESIA: A PROPENSITY SCORE MATCHING METHOD

Underutilization of health care for the poor is one critical problem in Indonesia. Out of pocket share is dominant on overall health financing. Therefore, it is plausible that low demand of modern healthcare services mainly relates to financial aspect. In 2008, the government of Indonesia has introduced health insurance schemes for the poor to help them overcome the problem of medical costs barrier called Jamkesmas (Social Health Insurance). This paper examines the impact evaluation of Jamkesmas to health care utilization in Eastern Indonesia. Data are drawn from Indonesia Family Life Survey East (IFLS-East) that held in 2012. This data only covers the eastern regions of In­donesia that widely known has relatively lower performance in development and infrastructure. Moreover, this study employs Propensity Score Matching (PSM) approach to analyse the data. The results show that average treatment effect for treated group are positive for outpatient utilization. In addition, availability of the healthcare facility variables, travelling time and distance to district capital are factors that determine Jamkemas coverage in Eastern Indonesia.