Private Health Institutions Research Articles

The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Peru

The tissue bank "Rosa Guerzoni Chambergo" (RGCTB) located at the Child's Health Institute was inaugurated in 1996, with the financial and technical support of the IAEA program on radiation and tissue banking. Since 1998, the biological bandage of fresh and lyophilised pigskin, amnion and bone tissue is processed routinely in this bank. In all cases, the tissue is sterilised with the use of Cobalt-60 radiation, process carried out at the Laboratories of Irradiation of the Peruvian Institute of Nuclear Energy (IPEN). The tissue bank in the Child's Health Institute helped to save lives in an accident occurred in Lima, when a New Year's fireworks celebration ran out of control in January 2002. Nearly 300 people died in the tragic blaze and hundreds more were seriously burned and injured. Eight Lima hospitals and clinics suddenly were faced with saving the lives of severely burned men, women and children. Fortunately, authorities were ready to respond to the emergency. More than 1,600 dressings were sterilised and supplied to Lima surgeons. The efforts helped save the lives of patients who otherwise might not have survived the Lima fire. Between 1998 and September 2007, 35,012 tissue grafts were produced and irradiated. Radiation sterilised tissues are used by 20 national medical institutions as well as 17 private health institutions. The tissue bank established in Peru with the support of the IAEA is now producing the following tissues: pigskin dressings, fresh and freeze-dried; bone allografts, chips, wedges and powdered, and amnion dressings air-dried. It is also now leading the elaboration of national standards, assignment being entrusted by ONDT (Organización Nacional de Donación y Transplantes; National Organisation on Donation and Transplant). This among other will permit the accreditation of the tissue bank. In this task is also participating IPEN.

Diagnóstico y tratamiento de las várices esófago gástricas en Chile: Realidad nacional

The better treatment modalities for bleeding esophageal varices have improved the prognosis of cirrhosis.To inquire about diagnostic and treatment modalities for esophageal bleeding in Chile.An enquiry about diagnosis and treatment of esophageal bleeding was designed and electronically sent to public and private health institutions that could admit patients and were located in cities with more than 100,000 inhabitants.The enquiry was answered by 31 of 35 public and 17 of 19 private health institutions that were consulted. Emergency endoscopy was available in 6 of 27 public and in the 16 private institutions that had an emergency room. Rubber band was available in 16 public (52%) and in all private institutions. Cyanoacrylate injections were done in 10 public (32%) and 11 (65%) private institutions. No public institution installed transjugular intrahepatic portosystemic shunts, but 8 had occasional access to this technique. This procedure was done in 7 (41%) private institutions and all had access to it. Surgical treatment was feasible in 20 public (65%) and all private institutions. Primary prophylaxis was done in 18 public (58%) and 14 private (82%) institutions. Secondary prophylaxis was carried out in 26 public (84%) and 16 private (94%) institutions.Public health institutions have poor access to adequate diagnostic and treatment methods for esophageal bleeding. The primary and secondary prophylaxis of esophageal varices must be improved in both types of institutions.

Management of bleeding esophageal varices in public and private institutions in Chile

The better treatment modalities for bleeding esophageal varices have improved the prognosis of cirrhosis. To inquire about diagnostic and treatment modalities for esophageal bleeding in Chile. An enquiry about diagnosis and treatment of esophageal bleeding was designed and electronically sent to public and private health institutions that could admit patients and were located in cities with more than 100,000 inhabitants. The enquiry was answered by 31 of 35 public and 17 of 19 private health institutions that were consulted. Emergency endoscopy was available in 6 of 27 public and in the 16 private institutions that had an emergency room. Rubber band was available in 16 public (52%) and in all private institutions. Cyanoacrylate injections were done in 10 public (32%) and 11 (65%) private institutions. No public institution installed transjugular intrahepatic portosystemic shunts, but 8 had occasional access to this technique. This procedure was done in 7 (41%) private institutions and all had access to it. Surgical treatment was feasible in 20 public (65%) and all private institutions. Primary prophylaxis was done in 18 public (58%) and 14 private (82%) institutions. Secondary prophylaxis was carried out in 26 public (84%) and 16 private (94%) institutions. Public health institutions have poor access to adequate diagnostic and treatment methods for esophageal bleeding. The primary and secondary prophylaxis of esophageal varices must be improved in both types of institutions.

New therapeutic landscapes in Africa: Parental categories and practices in seeking infant health in the Republic of Guinea

In considering African health care practice, it is usual to draw strong distinctions between biomedical and traditional practices, and between public and private health institutions. Whilst distinctions between traditional and biomedical, and between public and private medicine make sense from the vantage point of health professionals, we question how far these distinctions are pertinent in shaping health-seeking behaviour given experience of them. This paper argues that other distinctions are becoming far more important to African therapeutic landscapes to the ways that people evaluate the salience of different health providers to their problems. We draw on ethnographic research and illustrative evidence from 1550 ‘infant health biographies’ from rural and urban areas in the Republic of Guinea, where 93% of health expenditure takes place outside the state sector. We outline the distinctions that inform parents' health-seeking practices here. These include distinctions between women's and children's health providers (at state health centres), and those that men frequent (private pharmacies); between familiar ailments with known therapies (whether self-treatment, biomedical or herbal), and unfamiliar ones requiring expert diagnostics (whether from Islamic healers, diviners or doctors); between illnesses treatable by injection, and those aggravated by injection; between types of payment; and between high quality/strong medicines, and poor quality/weak ones. As people engage with emergent therapeutic landscapes, relations of knowledge and expertise, and forms of social solidarity, are emerging with significant implications for potential pathways of health system development, how these are conceptualised, and the forms of citizenship and partnership they might involve.

Cost Issues in Pacemaker Surgery in Nigeria

Permanent pacemakers are being implanted worldwide for prolongation and improvement of lives of patients who have conduction defects. Even though the average cost of pacing has reduced significantly over the years, procurement of the all important treatment modality remains a major financial drain especially in a poor country like Nigeria. We conducted this study to determine the cost implication of pacemaker surgery in Nigeria and to identify the factors that affect it. We also sought to determine the source(s) of funds for pacemaker procurement in Nigeria. Out of the 62 patients who qualified for pacemaker insertion, only 41 of them could meet the financial needs. Despite the fact that 51(82.3%) of the needy patients belong to social classes I& II only 8 implantations were self sponsored. We recorded major cost difference between the private and public health institution and we suggested ways of making pacemaker procurement cheaper and affordable to the needy population of patients. NQJHM Vol. 14 (2) 2004: pp. 140-142

Eliminating Human African Trypanosomiasis: Where Do We Stand and What Comes Next?

While the number of new detected cases of HAT is falling, say the authors, sleeping sickness could suffer the punishment of success, receiving lower priority by public and private health institutions.

Medical Informatics in Clinical Practice: An Overview.

Health and patients care is data intensive and involves a wide spectrum of information and often may involve input from other clinical departments and ancillary of clinical support department. For efficient care patients data should be integrated and accessible throughout clinics and hospital. Clinical departmental computer systems can enhance the collection,. Distribution and interpretation of patients data. Providing a high-quality service to patients involves having the right information at the right place and at the right time. Computer technology and networking have revolutionized access and transmission of medical knowledge. Medical informatics involves the use of computer system-analytic tools to support patients of public health care and this forms the basis of hospital information systems. Although the subject of medical informatics has been popularized over two decades in many countries including South African, it remains a largely unexplored subject in the Nigerian medical community. Knowledge and practice and application of computer technology in both private and public Nigeria educational and health institutions are largely rudimentary of non-existent. Yet, health information systems hold tremendous benefits for improving the quality of care including effective utilization of scare human resources. This review article is providing and overview on medical informatics and to stimulate interest in computer support in health care in our locality. NQJHM Vol. 13 (3-4) 2003: pp. 16-19

Prescribing patter of clinicians in private health institutions in Edo and Delta states of Nigeria

Prescribing patter of clinicians in private health institutions in Edo and Delta states of Nigeria

HIV/ AIDS information flow and access: experiences from Babati district, Tanzania

This paper is based on an empirical study of the flow and access to HIV/AIDS information in the Babati District of Manyara region in Tanzania. The study integrated both qualitative and quantitative research designs. A sample of 131 respondents comprising of 50 male and 81 female was conveniently selected from three villages in Dareda ward. Primary data was collected using face to face interviews, focus group discussion, dissemination workshop, and in depth interviews with key informants. Findings revealed that the provision of HIV/AIDS information in the study area is undertaken by multiple agencies including: the district council, village governments, private and public health institutions, civil society organizations, schools, faith based organizations and other community-based organizations. The data showed that access to HIV/AIDS information is through radio; television and video show programmes, newspapers, oral presentations in schools and clinics, and various types of meetings. Other delivery methods include posters, songs, dances, and dramas. The findings revealed that, while information on HIV/AIDS prevention was available, limited information was available on care and support of people living with HIV/AIDS (PLWHA). Furthermore, access to current and up to date information on all aspects of HIV/AIDS was found to be problematic. Generally, HIV/AIDS information system and structure at local level was found to be inadequate. Major challenges that limit access to and flow of HIV/AIDS information include low levels of education, language barriers, lack of information and library services, limited access to radio, television programmes, and newspapers. Family structures were also found to inhibit the free flow of HIV/AIDS information between parents and children. University of Dar es Salaam Library Journal Vol. 8 (1&2) 2006: pp. 49-59

Clinicians’ practices related to management of filarial adenolymphangitis and lymphoedema in Orissa, India

The Global Programme to Eliminate Lymphatic Filariasis (GPELF), which includes alleviation of disability and suffering of patients, is implemented primarily in India by primary health care system. The present study assesses the current practices related to lymphoedema care among clinicians of primary healthcare system in three filarial endemic districts of Orissa, India. The results are based on the data obtained through in-depth interviews with 50 clinicians from primary health centres (PHCs) and private clinics located in 22 PHCs sampled from three districts. All clinicians are aware of common as well as atypical manifestations of LF and offered treatment to them. The most commonly dealt complaints are lymphoedema of chronic LF and acute lymphangitis. All the clinicians reported that they prescribed diethylcarbamazine (DEC) for the treatment of patients with acute episodes, and only 50% of them prescribed antibiotics along with DEC. However, there is no uniform pattern either in the dosage of DEC or in the use of antibiotics. In this study, all the clinicians are aware that repeated acute episodes leads to lymphoedema. Majority of clinicians (94%) prescribed DEC to prevent this progression. For reduction of oedema, they offered a variety of treatments and more than half of the clinicians prescribed DEC. The study districts have been covered by the mass drug administration (MDA) of DEC under the GPELF. In order for the GPELF as a whole to prove successful and sustainable, those persons who are already suffering from LF need to be cared for and their suffering is to be relieved. Current practices of clinicians, both at government and private health institutions should be improved. With the revised knowledge that bacterial infections play a key role in the progression of disease, the attitude of clinicians towards the treatment of LF has to be changed.

Occurrence of different <i>Plasmodium</i> species in malaria patients in Owerri, Nigeria

An investigation into the species of Plasmodium parasites in malaria endemic area of Owerri was carried out between January and March 2005. Five hundred blood samples from two public and one private health institutions were examined using the conventional microscopic examination of Giemsa and Leishman stained smears. Results showed that the prevalence rate of malaria parasite in the area was 62.0%. Only two species namely Plasmodium falciparum and P. vivax were identified with the former predominating (99.2%). International Journal of Natural and Applied Sciences Vol. 2 (4) 2006: pp. 409-411

Skilled Health Professionals’ Migration and its Impact on Health Delivery in Zimbabwe

The paper investigates the magnitude of migration of health professionals from Zimbabwe, the causes of such movements and the associated impacts on health care delivery. International migration of health professionals has led to staff shortages and the situation is worse in public compared to private health institutions. The quality of care given to patients has also declined. The research calls for the adoption of an integrated approach in solving the problems of the health professions.

Epidemiology of medical complaints in Mexico: identifying a general profile

To determine the problems that were the sources of the complaints most frequently received at the National Commission of Medical Arbitration (CONAMED) in Mexico, as well as the diagnoses most frequently related, the institutions involved, and the populations affected. From all complaints received from 1 January 1998 to 31 December 2000, we chose a random sample of 639 complaints and carried out our study using a cross-sectional design. CONAMED receives complaints from Mexico City and the surrounding areas. Patients attending public and private health institutions from the three levels of medical attention who submitted a complaint to the CONAMED in Mexico. Assessment of health care quality (good practice or malpractice). Type of malpractice (negligence, lack of skill, or deceit). Main motives of complaint. We analyzed 639 complaints; 57.6% were submitted by women, average age 41.0 years. Surgical treatment was the main cause of complaint. Most frequent diagnoses were diseases of the digestive system. Evaluation of medical practice revealed 36.5% of malpractice. Lack of skill accounted for 67.4% of those cases. Malpractice was identified in a third of the complaints, and lack of skill was the main reason for malpractice. Surgical patients were the most frequently affected. The other two-thirds of the complaints were related to lack of communication between patients and physicians. These results suggest potential points of intervention to decrease the risk and the conflict.

Health in interwar Palestine: ethnic realities and international views.

This paper analyses the developments of the separate Jewish and Arab health systems and health realities. It is found that the activities of charitable institutions, the attitude of the British mandate government and different traditions of medical policy all played a part in the emergence of two separate health worlds. The influx of foreign funding for private health institutions, in particular, played a prominent part in establishing different service levels of healthcare for Jewish, Arab Christian and Arab Moslem communities. Thus, the medical sphere both reflected and interacted with wider political events.

Bio medical waste management in Jammu city

Ironically waste was not a problem for the society when man was primitive and uncivilized. The proliferation of modern concept of consumerism supplemented with culture of disposables has aggravated the waste problem. These biomedical wastes along with the municipal wastes commonly exceed the carrying capacity of biosphere to reabsorb and recycle. The present paper deals with the status of Bio medical waste management in Jammu city. 42 government and private health institutions have been identified which generate about 3917 kg/day @ 1.52 Kg/bed/day contributing 26% to the municipal solid waste. The paper seeks to demonstrate the waste collection, segregation, treatment and disposal of the wastes in the otherwise unplanned city of temples.

Rape survivors and the right to emergency medical treatment to prevent HIV infection.

The South African Constitution provides that No one may be refused emergency medical treatment. The question arises whether rape survivors qualify for emergency medical treatment in terms of the Constitution and if so who is responsible for providing such treatment. The decision by the South African Cabinet to implement antiretroviral treatment for rape survivors seems to indicate that the government recognises that this duty lies with the state. We therefore examine the meaning of emergency medical treatment; the duties of police officers medical practitioners state health institutions and private health institutions; and the role of non-governmental organisations with regard to rape survivors. (authors)

Factores asociados a síntomas depresivos y síntomas somáticos en mujeres climatéricas de la ciudad de Temuco

Depression is an important mental health problem. The Chilean Ministry of Health has considered depression in women as one of the health priorities for the country. To assess the prevalence of depressive and somatic symptoms and their risk factors in climacteric women. A special questionnaire was applied to 171 women (45 to 55 years of age), coming from a community organization (PRODEMU) and a private health institution (ISAPRE Banmedica). Risk factors for depression were determined using multiple logistic regression. The prevalence of depressive symptoms was 43%. Women with primary education had an odds ratio for depression of 2.49, compared with women with high school or university education. Other risk factor for depression was the lack of a renumerated job (Odds ratio 1.9). The risk factors for somatic symptoms were the presence of depressive symptoms (OR 3.2), lack of secondary or university education (OR 2.4), low income (OR 1.9) and having a current partner (OR 3.6). There is a high prevalence of depressive symptoms in the studied population of climacteric women. Lack of education and of a renumerated job are important risk factors for the presence of such symptoms. Women with a low level of education and with depressive symptoms have also a high risk of presenting somatic symptoms.

Place de la chirurgie ambulatoire en France. Comparaisons internationales

Ambulatory surgery in France was under constraining rules since 1992. In 1998, there were 7 600 ambulatory stations which allowed 2 700 000 ambulatory procedures in a year. French Association for Ambulatory Surgery and International Association for Ambulatory Surgery adopted a limited list of 18 reference procedures to launch a survey on the prevalence of ambulatory surgery. The prevalence rate of ambulatory procedures among this list raised from 35.2% in 1997 to 39.3% in 1999. This rate was the same in public and private health institutions. Ambulatory practice was increasing more than the inpatient procedures. Inter-country comparisons pointed out France as the tenth country for ambulatory prevalence among 13 members of Organization for Economic Cooperation and Development. This underlined the fact that there was probably a growth potential for ambulatory surgery in France.

The health system in Nepal—An introduction

We present here a study on the health system in Nepal. Approximately two-thirds of the health problems in Nepal are infectious diseases. Epidemics occur frequently with a high rate of morbidity and mortality and there are occasional outbreaks of infectious diseases of unknown etiology. In addition, the rapid rate of HIV infection in the Indian sub-continent is likely to add a new dimension of opportunistic infections. Until now, the Health System introduced as the General Health Plan in 1956 has been expanded by focusing on primary health care, and a comprehensive network-like Health System has been developed; the most basic unit is a Sub-Health Post or Health Post in each Village Development Committee area. However, the expansion of the Health System has not been matched by an expansion in the domestive resources, workers and supplies, and the available resources are not efficiently distributed. In addition, insufficient resources available for preventive and promotive medicine and the occurrence of non-infectious diseases such as cancer and cardiovascular diseases has been increasing. The Government recently introduced a Health Policy encouraging the private sector to invest in the production of health workers and in providing quality health services. As a result, several private health institutions have been founded and are expected to contribute to the development of the human resources required by Nepal.

Caesarean section delivery in Kerala, India: evidence from a National Family Health Survey

Ensuring safe pregnancy and motherhood occupies a pivotal role and has been considered as one of the key issues in the framework of reproductive and child health programmes. Evidence from research studies indicate that there is a growing tendency for caesarean section deliveries especially during complications confronted at the time of pregnancy and delivery. The present study focuses on the demographic, antenatal care, spatial and socio-economic variables associated with caesarean section delivery in Kerala, India. The data from the National Family Health Survey has been utilised for this purpose. The results from logistic regression models indicate that maternal age, birth order, current age, births in health institutions and spatial differences were significantly associated with caesarean section deliveries in Kerala. The older cohorts of mothers were found at higher risk to have caesarean section when compared to their younger counterparts. When controlled for demographic variables, the odds for caesarean section was about 1.7 times more likely to occur in private health institutions. The inclusion of spatial and socio-economic variables has neither influenced the demographic and antenatal care variables nor showed any significant association with caesarean section delivery in the state. The present study calls for that a detailed investigation on behavioural aspects of both the physician and the patient with regard to type of delivery in the state. Information related to pregnancy and health related aspects needs to be monitored more accurately, both in the public and private hospitals, to understand the determinants associated with caesarean section.