Poor Health Facilities Research Articles

Scientific risk performance analysis and development of disaster management framework: A case study of developing Asian countries

Disaster is a state of serious disruptions in the functionality of any society or county. Disasters pose serious economic or environmental impacts that surpass the capacity of the affected country or society to compete with the use of their assets. Recently, Pakistan significantly prone to health disasters due to COVID-19 among developing South Asian countries. The long-term impact of health disasters and other natural hazards put additional pressure mostly on the government's economic policy. It forces the government to follow a constructive approach like a disaster relief-based approach rather than a conventional mitigation management formation to reduce the impact of disaster risk. This study elaborates on the main issues associated with disaster preparedness as well as recovery of the economy and businesses of the country. For Scientific risk performance analysis, open-source data from the National Institute of Disaster Management (NDMA) has been utilized to study the current situation of COVID-19 in Pakistan. Results show Pakistan has been facing a highly vulnerable situation as more than three hundred and fifty thousand confirmed cases have been reported. Poor health and technical management facilities have been exposed against COVID-19 as Pakistan has a low heath budget because of its declining GDP growth rate in the world. This research will help in disaster preparedness and the development of a disaster risk management framework while designing strategies to deal with such pandemics in the future.

The Impact of Mining Exploration on Sangaredi Community’s Sustainable Development: Inhabitants Perspectives on Livelihood

Mining exploration has left many communities in deplorable conditions, ranging from low levels of livelihood sustenance to poor health facilities and poor road networks. This study examined the impact of mining exploration on sustainable development of a community in Guinea, West Africa. The paper reviews literature published on mining and exploration and its impact on community environments.’ However, this study employed descriptive quantitative and correlational methods, which facilitated the gathering, classification and presentation of data that led to analysis, description and conclusion of the study. In this study, 300 questionnaires were distributed to community inhabitants, which enhanced the compilation of first-hand information. Data was analysed using descriptive statistics. The results disclosed numerous problems, ranging from health to education and poor road networks. It was revealed that, exploration activities have damaged lands utilised for agricultural purposes, and deposits of toxic substances have damaged soil nutrients, which caused degradation of the land tenure system. Such problems have left lands to be unproductive. Because of the foregoing problems discovered as negative impact, it is fitting for government and mining corporations to pay considerable attention to Sangaredi community and address such problems. This study identified issues bothering Sangaredi and other communities where mining explorations are conducted. It descriptively explained issues of exploration and established the negative impact mining activities have caused in the community. However, such impact adversely affects the community at large. In addition, academics and mining consultants will use this information as a source for further investigation on the subject matter.

Techno Stress and Job Engagement among Employees : A Study on Textile Industry Sector

The digital technology is influencing all areas of life and is now considered as the essential facility of the development (Yakel, Conway, Hedstrom & Walate 2011.) The way of working life is redefined with the introduction of technology in to the Industrial system: This has led to a new concern for organizations and especially managers. This paper investigates the relationship between Organizations effectiveness and work stress (techno stress) among workers. Textile Industry plays a vital role in the economy as it contributes towards income, employment and gross domestic product. This research study investigates workers problems such as poor physical and mental health, poor and stressful working conditions and facilities pertaining to the productivity of laborer. For any technology platform to be successful, it must be accepted and adopted by the end users. So it is proposed to study the impact of digital technology in adopting and their contribution to the success of modern Industry and making the digital India initiative successful.

Epidemiological Assessment and Challenges of the COVID-19 Pandemic in Nigeria

The COVID-19 which belongs to the coronaviridae family has continued to spread in a geometric progression version. The disease that originated from Wuhan, Hubei, China has spread to all the continents of the World except Antarctica continent. As of the 5th of August, 2020 there are over 18 million reported cases of COVID-19 from 214 countries and territories of the world. More than 10 million people have recovered while approximately 696,147 people have died due to COVID-19. This review provides general information on the COVID-19 and gives deep insight into the course of the disease, interventions challenges and possible solutions in Nigeria “the giant of Africa”.
 Scientific databases including Science Direct, Pub Med, Elsevier, Scopus, and Nature were explored. Data has also been accessed from case reports, newspaper reports, internet data, World Health Organisation (WHO) reports, Centre of Disease Control (CDCs) and Nigerian Centre of Disease Control (NCDCs) reports. US National Library of Medicine, Clinicaltrials.gov, has been accessed to get information about ongoing clinical trials. The literature survey started in the first week of April, 2020 and was completed in the first week of August, 2020. The clinical symptoms of COVID-19 patients are generally categorized as critical, severe, moderate and mild or even asymptomatic in descending order in terms of severity. Predictions from experts in different parts of the World concerning the possible impact of the disease in Africa have been on the downside which is due to a lot of glaring factors including poor health facilities and services.

Covid-19 in Nigeria: Exploring the Paradigm Shift and Issues’ Arising

Background: Corona viruses are a family of deadly viruses that cause respiratory illnesses; they were first reported in Wuhan city, China. Since its report in China, the virus has spread almost across the whole continents of the world leading to hundreds of thousands of deaths. Furthermore, upon declaration of Covid-19 as a public health emergency of international concern, the world has moved its frontiers to new way of life viz-a-viz paradigm shifts with a cascade of issues arising on a daily basis.Methods: The sources of the information presented was obtained through detailed review of literatures (search terms: Covid-19, Beta corona virus and paradigm shift and matter arising), anecdotal/case analysis, and surveys undertaking from the field. Also other key facts were obtained from relevant websites (such as Nigeria World health organization, Centre for Disease Control and prevention, Nigeria Center for Disease Control, Nigerian Federal Ministry of Health).Results: The likelihood of a worsened outbreak in Nigeria and other developing countries characterized by poor adherence to standard precautions, poor health care facility, deficiency of adequate laboratory facilities for prompt diagnosis and personal protective equipment (PPE) can raise the profile of this disease to worrisome levels. Regular training of health care workers, continue Covid-19 health awareness campaign, Health education of the communities, improved funding through budgetary allocation for surveillance, prompt case management including laboratory facilities, is not only extremely essential at this point in time but also expedient in the light of the threat of COVID-19.Conclusion: The dearth of molecular laboratories and poor health-care delivery system in Nigeria would continue to impede the effective prevention and control of evolving infectious diseases including Covid-19. There is an urgent need to address all the issues impeding on Covid-19 control in order to effectively control and prevent it.

Contextualising geographical vulnerability to COVID-19 in India

With over 697 000 confirmed cases and 19 700 deaths as of July 6, 2020, India accounts for around 6% of global COVID-19 infections and 3·5% of COVID-19-attributable mortality, and is ranked third worldwide in terms of the number of infections. Although the proportion of the total population infected is low compared with other countries—0·05% versus 0·87% in USA, 0·73% in Brazil, 0·46% in Russia, and 0·4% in Italy1—India has a high risk of community transmission because of crowded living conditions, congested cities, a large slum-dwelling population, poor health-care facilities, low educational attainment, and high levels of poverty.

Situation of COVID-19 Pandemic in South Asia

COVID-19 is spreading all over the world. Latest data shows cases of COVID-19 are increasing rapidly in developing countries. South Asia is also one of such regions where the cases are increasing rapidly. South Asia is less prepared to fight with COVID-19 pandemic due to poverty, poor health care facilities and lowest number of physicians per capita (less than 1). The COVID- death rates are interestingly low in South Asia when compared with other regions. But, as the numbers of cases are increasing rapidly and governments are not able to increase the health care facilities and health workers accordingly, this region is also one of the vulnerable region if the severe cases of COVID-19 increases. So, each country should focus to strengthen their health care system and proper mental health counseling to people to avoid the potential crisis that lies ahead.

Challenges in the setting of coronavirus 2019: A review of disease and experience from delta state university teaching hospital

Coronavirus disease 2019 (COVID-19) was first identified in December 2019 and declared a pandemic in March 2020 by the World Health Organization. Countries with advanced technology and huge financial base are finding it difficult to curtail the COVID-19 spread and its attendant morbidity and mortality. Spread of the disease to the African Sub-Region became fearful because poor health-care facilities and manpower needs due to the majorly dilapidated health-care infrastructure, considering the mortality tables from other more advanced nations. To adequately prepare the manpower and avoid strain on the workforce before the incidence of disease peaks, there was a massive re-training of health-care personnel and the workforce routine schedule re-designed. This paper reviews the disease and highlights the challenges in our setting toward combating the coronavirus 2019 disease.

Health Facilities in Kokrajhar District of Assam, India

Health can be considered as the state of being free from illness or injury. A health facility is a facility where quality health care access is provided. The number and quality of health facilities in a country or region is common measures of that area’s prosperity and quality of life. Therefore, health infrastructure is one of socio economic indicators of an area. As per the guideline of the WHO, the Doctor Population ratio should be 1:1000 but in case of India it is very pathetic as the ratio stands at 1:1456 (Economic survey 2019-20) and the state of Assam is more pathetic i.e 1:1800. A health status of a region is dependent on the health care availability provided in the region. The district Kokrajhar is situated in the westernmost part of Assam and is lacking far behind in health care facilities as compared to other districts of the state. Most of the families belong to the Below Poverty Line (BPL) category and their PCI is also one of the lowest. The reason for poor health care facilities in the district is mainly because of Doctors unwillingness to join the government services and their reluctance to serve in the rural areas. The main objective of this paper is to highlight the health facilities and health status of the district in comparison to the state and the country. The study is based on the secondary data sources and both descriptive and analytic methods have been used for the study. Statistical techniques are also used to represent the data. The study reveals that the causes of low status of health facilities in the region is due to lack of accessibility, poverty, insufficient medical equipment and insufficient workforce and cultural norms and due to all this, people of the district is facing many problems. The diseases like Typhoid, Jaundice, Eye problem, Malaria, Tuberculosis, Pneumonia etc are commonly seen in the district. . This study will aid the governments, NGOs, planners, administrators and above all the society as the research work highlights some of the hidden truths pertaining to health care facilities in the district.

Nigeria, a high burden state of obstetric fistula: a contextual analysis of key drivers.

Obstetric fistula (OF) remain a source of public health concern and one of the most devastating maternal morbidities afflicting about two million women, mostly in developing countries. It is still prevalent in Nigeria due to the existence of socio-cultural beliefs/practices, socio-economic state and poor health facilities. The country's estimated annual 40,000 pregnancy-related deaths account for about 14% of the global maternal mortality, placing it among the top 10 most dangerous countries in the world for a woman to give birth. However, maternal morbidities including OF account for 20 to 30 times the number of maternal mortalities. This review substantiates why OF is yet to be eliminated in Nigeria as one of the countries with the largest burden of obstetric fistula. There is need for coordinated response to prevent and eliminate this morbidity via political commitment, implementation of evidence-based policy and execution of prevention programs.

Thyroidectomy under local anaesthesia in a poor resource health facility in Northeastern Nigeria

Background: The provision of quality health care is one of the priorities of every government. The quality of such care is however, limited by the human and technical resources available. The varying types of thyroidectomy for Goitres are often done under general anaesthesia, unless, there is a contraindication such as, cardiopulmonary instability. Recently, there is increasing evidence that thyroidectomy could be done under local anaesthesia with or without anxiolytics or opioid analgesia augmentation. This study reports on our experience of performing thyroidectomy under infiltrative local anaesthesia.

“We do what we can do to save a woman” health workers’ perceptions of health facility readiness for management of postpartum haemorrhage

ABSTRACT Background: In many low-resource settings, in-service training is a common strategy to improve the performance of health workers and ultimately reduce the persistent burden of maternal mortality and morbidities. An evaluation of the Helping Mothers Survive Bleeding After Birth (HMS BAB) training as a single-component intervention in Tanzania found some positive albeit limited effect on clinical management and reduction of postpartum haemorrhage (PPH). Aim: In order to better understand these findings, and particularly the contribution of contextual factors on the observed effects, we explored health workers’ perceptions of their health facilities’ readiness to provide PPH care. Methods: We conducted 7 focus group discussions (FGDs) and 12 in-depth interviews (IDIs) in purposively selected intervention districts in the HMS BAB trial. FGDs and IDIs were audio-recorded, transcribed and translated verbatim. Thematic analysis, using both inductive and deductive approaches, was applied with the help of MAXQDA software. Results: Health workers perceive that their facilities have a low readiness to provide PPH care, leading to stressful situations and suboptimal clinical management. They describe inconsistencies in essential supplies, fluctuating availability of blood for transfusion, and ineffective referral system. In addition, there are challenges in collaboration, communication and leadership support, which is perceived to prevent effective management of cases within the facility as well as in referral situations. Health workers strive to provide life-saving care to women with PPH despite the perceived challenges. In some health facilities, health workers perceive supportive clinical leadership as motivating in providing good care. Conclusion: The potential positive effects of single-component interventions such as HMS BAB training on clinical outcome may be constraint by poor health facility readiness, including communication, leadership and referral processes that need to be addressed.

Intrigues and Challenges Associated with COVID-19 Pandemic in Nigeria

Coronavirus disease 2019 (COVID-19) pandemic has emerged as a global health crisis, with 3,855,788 infected persons and 256,862 deaths worldwide as of May 9, 2020. In Nigeria, the first case of the pandemic was reported by the Nigerian Centre for Disease Control on February 27, 2020. Between the dates when the index case was reported and May 9, 2020, the nation has recorded a total of 4151 confirmed COVID-19 cases from 25,951 samples screened and 745 (18%) cases discharged with 128 deaths indicating a case fatality rate of 3.1%. Thirty-four (34) States and the Federal Capital Territory have recorded coronavirus disease. The most affected States in Nigeria is Lagos (epicentre of COVID-19) with 1764 cases, followed by 576 cases in Kano states and only one COVID-19 case in Anambra State 42 days since the last report of index case. Demographically, a total of 2828 male subjects have been infected representing 68% and 1323 female subjects representing 32%. The age group 31 - 40 years is mostly affected accounting for 24%. The number of people with travel history is 210 (5%), 947 (23%) contacts, 2618 (63%) without epidemiological link and 376 (9%) with an incomplete information. Nigeria is currently witnessing community transmission of COVID-19. Some observed issues aiding community transmission of COVID-19 in Nigeria are: the distrust of some Nigeria citizens towards government on COVID-19 management, poverty, religious beliefs, ignorance on face mask sharing, low level of informed populace, misconceptions, stigmatization of infected individuals, poor health facilities, inadequate testing Centre, shortage of health workers, poor treatment among others. Effective people’s health preventive behaviour and community-based health policy and strategies to mitigate these challenges are therein suggested.

Evidence-Based Practice and Associated Factors Among Health Care Providers Working in Public Hospitals in Northwest Ethiopia During 2017

Background: Despite the fact that evidence-based practice (EBP) is believed to be associated with improved health, safety, and cost outcomes, most medical practice in low- and middle-income countries such as Ethiopia is not evidence-based. Understanding the extent of and barriers to EBP in Ethiopia is important for learning how to best to improve quality of care. Few studies have assessed EBP in Ethiopia.Objective: This study aimed to assess reported level of EBP and associated factors among health care providers working in public hospitals in northwest Ethiopia.Methods: A cross-sectional study was conducted with 415 randomly selected nurses, midwives, and physicians using stratified sampling (97.6% response rate). Data were collected using a structured, self-administered questionnaire that was developed by reviewing the literature and adapting the Melnyk and Fineout-Overholt EBP Implementation Scale. After validating scales, bivariate and multivariate linear regression models were used to identify factors associated with EBP implementation.Results: The mean EBP implementation score was 10.3 points out of a possible 32 points and 60% of respondents scored below average. Most (60.2%) respondents reported poor confidence in their ability to judge the quality of research and half (50.1%) said that they were unable to find resources for implementing EBP. The most frequently mentioned barriers to EBP were lack of training (81.2%), poor health facility infrastructure (79.3%), and lack of formal EBP/patient education units in facilities (78.0%). The factors found to be significantly and independently associated with EBP implementation were years of work experience (β = –0.10; P < 0.05); having been trained as a bachelor's degree-level nurse (β = 3.45; P < 0.001) or a bachelor's degree-level midwife (β = 2.96; P < 0.001), a general practitioner (β = 7.86; P < 0.001), or a specialist physician (β = 15.04; P < 0.001) rather than a diploma-level nurse; working in a pediatrics ward (β = –1.74; P < 0.05); and reporting as barriers either a lack of clarity on the importance of EBP (β = –0.93; P < 0.05) or a lack of orientation sessions on new health priorities (β = –0.91; P < 0.05).Conclusions: Health professionals had low levels of EBP implementation and poor EBP skills. These problems were particularly acute for providers with lower levels of training. A large number of respondents reported structural and institutional barriers to EBP. These results suggest that clear leadership and ongoing, cross-disciplinary, skill-building approaches are needed to increase EBP implementation in Ethiopia. (Curr Ther Res Clin Exp. 2020; 81:XXX–XXX)

2027. What Are the Views Among Pakistani Physicians Toward Antimicrobial Resistance and Hospital Antimicrobial Stewardship Programs? A Multi-Site Qualitative Study

BackgroundAntimicrobial resistance (AMR) is a major public health issue that the world is facing in the 21st century and implementation of antimicrobial stewardship program (ASP) is one of the recognized approaches to combat AMR. Little is known on the views among Pakistani physicians regarding AMR and the benefits of hospital ASP implementation. This study was aimed to investigate the perception and attitude of physicians about AMR and ASP.MethodsQualitative face-to-face and telephonic interviews were conducted by using purposive sampling method with 22 physicians working in seven tertiary care public hospitals of Punjab, Pakistan. All interviews were audio-recorded and transcribed verbatim. Qualitative software was used, and a thematic analysis conducted.ResultsThree major themes were identified: (1) the growing concern of AMR in Pakistan, (2) the role(s) of healthcare professionals in antibiotic prescribing and infection control, and (3) managing antibiotic resistance in hospitals. Poor healthcare facilities, insufficient trained medical staff, and inadequate resources were the key barriers in the implementation of ASP in Pakistan.ConclusionPhysicians of public sector tertiary care teaching hospitals have shown poor familiarity toward hospital ASPs but the concept of hospital ASPs in Pakistan can be established by using the distinct themes that originated during this study. Overall, the attitude of physicians was positive toward its enforcement in all types of hospital settings including teaching hospitals.Disclosures All authors: No reported disclosures.

Automatic detection of Plasmodium parasites from microscopic blood images.

Malaria is caused by Plasmodium parasite. It is transmitted by female Anopheles bite. Thick and thin blood smears of the patient are manually examined by an expert pathologist with the help of a microscope to diagnose the disease. Such expert pathologists may not be available in many parts of the world due to poor health facilities. Moreover, manual inspection requires full concentration of the pathologist and it is a tedious and time consuming way to detect the malaria. Therefore, development of automated systems is momentous for a quick and reliable detection of malaria. It can reduce the false negative rate and it can help in detecting the disease at early stages where it can be cured effectively. In this paper, we present a computer aided design to automatically detect malarial parasite from microscopic blood images. The proposed method uses bilateral filtering to remove the noise and enhance the image quality. Adaptive thresholding and morphological image processing algorithms are used to detect the malaria parasites inside individual cell. To measure the efficiency of the proposed algorithm, we have tested our method on a NIH Malaria dataset and also compared the results with existing similar methods. Our method achieved the detection accuracy of more than 91% outperforming the competing methods. The results show that the proposed algorithm is reliable and can be of great assistance to the pathologists and hematologists for accurate malaria parasite detection.

Bihar's annual AES outbreaks continue to mystify

Sweltering heat, litchi toxins, malnutrition, and poor healthcare facilities blamed for the recurring child-killing epidemic. Sweltering heat, litchi toxins, malnutrition, and poor healthcare facilities blamed for the recurring child-killing epidemic.

Providers and women\u2019s perspectives on person-centered maternity care: a mixed methods study in Kenya

BackgroundGlobally, there has been increasing attention to women’s experiences of care and calls for a person-centered care approach. At the heart of this approach is the patient-provider relationship. It is necessary to examine the extent to which providers and women agree on the care that is provided and received. Studies have found that incongruence between women’s and providers’ perceptions may negatively impact women’s compliance, satisfaction, and future use of health facilities. However, there are no studies that examine patient and provider perspectives on person-centered care.MethodsTo fill this gap in the literature, we use cross-sectional data of 531 women and 33 providers in seven government health facilities in Kenya to assess concordance and discordance in person-centered care measures. Additionally, we analyze 41 in-depth interviews with providers from three of these facilities to examine why differences in reporting may occur. Descriptive statistical methods were used to measure the magnitude of differences between reports of women and reports of providers. Thematic analyses were conducted for provider surveys.ResultsOur findings suggest high discordance between women and providers’ perspectives in regard to person-centered care experiences. On average, women reported lower levels of person-centered care compared to providers, including low respectful and dignified care, communication and autonomy, and supportive care. Providers were more likely to report higher rates of poor health facility environment such as having sufficient staff. We summarize the overarching reasons for the divergence in women and provider reports as: 1) different understanding or interpretation of person-centered care behaviors, and 2) different expectations, norms or values of provider behaviors. Providers rationalized abuse towards women, did not allow a companion of choice, and blamed women for poor patient-provider communication. Women lacked assurance in privacy and confidentiality, and faced challenges related to the health facility environment. Providers attributed poor person-centered care to both individual and facility/systemic factors.ConclusionsImplications of this study suggests that providers should be trained on person-centered care approaches and women should be counseled on understanding patient rights and how to communicate with health professionals.

Clinicoepidemiological study of post burn contractures at a tertiary care centre in western India

Background: Burn injuries are one of the commonest form of trauma globally with long term consequences in the form of contractures. The management takes a troll of time, money and stress, despite that the agony remains with the patient only. We intended to study the clinicoepidemiopathological aspects of post burn contractures for a better understanding and management purpose.Methods: This study was conducted from October 2014 to February 2017 in a tertiary care hospital in western India and includes 51 patients.Results: In this study, we observed that the mean age of patients was 21.7 years and females formed 51% of the patient pool. Most of the patients came from a rural background with a mean distance of 77.72 kilometres from the treating hospital. Flame burns contributed to 78% of the cases, with hand (35.7%) being the most commonly involved area, 52.9% patients did not receive splinting or physiotherapy at the initial treatment of burns. Most cases were treated by split skin grafting (64.2%) and the most common complication seen in our study was infection, noted in 15.7% of cases whereas recurrence was seen in only one patient.Conclusions: We observed that young adults were the predominant group of patients with a slight female preponderance. Factors like increased distance from the treating hospital, rural background of patients, poor healthcare facilities with poor rehabilitative facilities and irregular follow up of patients contributed to increased incidence of post burn contractures. We also noted that majority cases can be treated by contracture release with split skin grafting without major complications.

Perspective of Pakistani Physicians towards Hospital Antimicrobial Stewardship Programs: A Multisite Exploratory Qualitative Study.

Background: Antimicrobial resistance (AMR) is a global threat and the antimicrobial stewardship program (ASP) is a globally used tool to combat AMR. There is little information on the views among Pakistani physicians regarding AMR and the benefits of hospital antimicrobial stewardship implementation. This study was designed to explore the physicians’ views about ASP. Methods: Qualitative face-to-face and telephonic interviews were conducted by using purposive sampling method with 22 physicians working in seven tertiary care public hospitals of Punjab, Pakistan. All interviews were audio recorded and transcribed verbatim. Qualitative software was used, and a thematic analysis was conducted. Results: Three broad themes were identified: (1) the growing concern of antimicrobial resistance in Pakistan, (2) the role(s) of healthcare professionals in antibiotic prescribing, and (3) managing antibiotic resistance in hospitals. Inadequate resources, poor healthcare facilities, and insufficiently trained medical staff were the major hurdles in ASP implementation in Pakistan. Conclusions: Our study found a poor familiarity of hospital ASP among physicians working in public sector tertiary care teaching hospitals, and a number of distinct themes emerged during this study that could be helpful in establishing the concept of hospital ASP in Pakistan. Overall, physicians showed a positive attitude towards the enforcement of ASP in all healthcare settings, including teaching hospitals.