Search results for: health justice and access
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 12116

Search results for: health justice and access

10076 Classification of Health Information Needs of Hypertensive Patients in the Online Health Community Based on Content Analysis

Authors: Aijing Luo, Zirui Xin, Yifeng Yuan

Abstract:

Background: With the rapid development of the online health community, more and more patients or families are seeking health information on the Internet. Objective: This study aimed to discuss how to fully reveal the health information needs expressed by hypertensive patients in their questions in the online environment. Methods: This study randomly selected 1,000 text records from the question data of hypertensive patients from 2008 to 2018 collected from the website www.haodf.com and constructed a classification system through literature research and content analysis. This paper identified the background characteristics and questioning the intention of each hypertensive patient based on the patient’s question and used co-occurrence network analysis to explore the features of the health information needs of hypertensive patients. Results: The classification system for health information needs of patients with hypertension is composed of 9 parts: 355 kinds of drugs, 395 kinds of symptoms and signs, 545 kinds of tests and examinations , 526 kinds of demographic data, 80 kinds of diseases, 37 kinds of risk factors, 43 kinds of emotions, 6 kinds of lifestyles, 49 kinds of questions. The characteristics of the explored online health information needs of the hypertensive patients include: i)more than 49% of patients describe the features such as drugs, symptoms and signs, tests and examinations, demographic data, diseases, etc. ii) these groups are most concerned about treatment (77.8%), followed by diagnosis (32.3%); iii) 65.8% of hypertensive patients will ask doctors online several questions at the same time. 28.3% of the patients are very concerned about how to adjust the medication, and they will ask other treatment-related questions at the same time, including drug side effects, whether to take drugs, how to treat a disease, etc.; secondly, 17.6% of the patients will consult the doctors online about the causes of the clinical findings, including the relationship between the clinical findings and a disease, the treatment of a disease, medication, and examinations. Conclusion: In the online environment, the health information needs expressed by Chinese hypertensive patients to doctors are personalized; that is, patients with different background features express their questioning intentions to doctors. The classification system constructed in this study can guide health information service providers in the construction of online health resources, to help solve the problem of information asymmetry in communication between doctors and patients.

Keywords: online health community, health information needs, hypertensive patients, doctor-patient communication

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10075 Work Ability Index (WAI) and Its Health-Related Detriments among Iranian Farmers Working in the Small Farm Enterprises

Authors: Akbar Rostamabadi, Adel Mazloumi, Abbas Rahimi Foroushani

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This study aimed to determine the Work Ability Index (WAI) and examine the influence of health dimensions and demographic variables on the work ability of Iranian farmers working in small farm enterprises. A cross-sectional study was conducted among 294 male farmers. The WAI and SF-36 questionnaires were used to determine work ability and health status. The effect of demographics variables on the work ability index was investigated with the independent samples t-test and one-way ANOVA. Also, multiple linear regression analysis was used to test the association between the mean WAI score and the SF-36 scales. The mean WAI score was 35.1 (SD=10.6). One-way ANOVA revealed a significant relationship between the mean WAI and age. Multiple linear regression analysis showed that work ability was more influenced by physical scales of the health dimensions, such as physical function, role-physical, and general health, whereas a lower association was found for mental scales such as mental health. The average WAI was at a moderate work ability level for the sample population of farmers in this study. Based on the WAI guidelines, improvement of work ability and identification of factors affecting it should be considered a priority in interventional programs. Given the influence of health dimensions on WAI, any intervention program for preservation and promotion work ability among the studied farmers should be based on balancing and optimizing the physical and psychosocial work environments, with a special focus on reducing physical work load.

Keywords: farmers, SF-36, Work Ability Index (WAI), Iran

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10074 Non-Timber Forest Products and Livelihood Linkages: A Case of Lamabagar, Nepal

Authors: Sandhya Rijal, Saroj Adhikari, Ramesh R. Pant

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Non-Timber Forest Products (NTFPs) have attracted substantial interest in the recent years with the increasing recognition that these can provide essential community needs for improved and diversified rural livelihood and support the objectives of biodiversity conservation. Nevertheless, various challenges are witnessed in their sustainable harvest and management. Assuming that sustainable management with community stewardship can offer one of the solutions to existing challenges, the study assesses the linkages between NTFPs and rural livelihood in Lamabagar village of Dolakha, Nepal. The major objective was to document the status of NTFPs and their contributions in households of Lamabagar. For status documentation, vegetation sampling was done using systematic random sampling technique. 30 plots of 10 m × 10 m were laid down in six parallel transect lines at horizontal distance of 160 m in two different community forests. A structured questionnaire survey was conducted in 76 households (excluding non-response rate) using stratified random sampling technique for contribution analysis. Likewise, key informant interview and focus group discussions were also conducted for data triangulations. 36 different NTFPs were recorded from the vegetation sample in two community forests of which 50% were used for medicinal purposes. The other uses include fodder, religious value, and edible fruits and vegetables. Species like Juniperus indica, Daphne bholua Aconitum spicatum, and Lyonia ovalifolia were frequently used for trade as a source of income, which was sold in local market. The protected species like Taxus wallichiana and Neopicrorhiza scrophulariiflora were also recorded in the area for which the trade is prohibited. The protection of these species urgently needs community stewardship. More than half of the surveyed households (55%) were depending on NTFPs for their daily uses, other than economic purpose whereas 45% of them sold those products in the market directly or in the form of local handmade products as a source of livelihood. NTFPs were the major source of primary health curing agents especially for the poor and unemployed people in the study area. Hence, the NTFPs contributed to livelihood under three different categories: subsistence, supplement income and emergency support, depending upon the economic status of the households. Although the status of forest improved after handover to the user group, the availability of valuable medicinal herbs like Rhododendron anthopogon, Swertia nervosa, Neopicrorhiza scrophulariiflora, and Aconitum spicatum were declining. Inadequacy of technology, lack of easy transport access, and absence of good market facility were the major limitations for external trade of NTFPs in the study site. It was observed that people were interested towards conservation only if they could get some returns: economic in terms of rural settlements. Thus, the study concludes that NTFPs could contribute rural livelihood and support conservation objectives only if local communities are provided with the easy access of technology, market and capital.

Keywords: contribution, medicinal, subsistence, sustainable harvest

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10073 A Sociological Study of Rural Women Attitudes toward Education, Health and Work outside Home in Beheira Governorate, Egypt

Authors: A. A. Betah

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This research was performed to evaluate the attitudes of rural women towards education, health and work outside the home. The study was based on a random sample of 147 rural women, Kafr-Rahmaniyah village was chosen for the study because its life expectancy at birth for females, education and percentage of females in the labor force, were the highest in the district. The study data were collected from rural female respondents, using a face-to-face questionnaire. In addition, the study estimated several factors like age, main occupation, family size, monthly household income, geographic cosmopolites, and degree of social participation for rural women respondents. Using Statistical Package for the Social Sciences (SPSS), data were analyzed by non-parametric statistical methods. The main finding in this study was a significant relationship between each of the previous variables and each of rural women’s attitudes toward education, health, and work outside home. The study concluded with some recommendations. The most important element is ensuring attention to rural women’s needs, requirements and rights via raising their health awareness, education and their contributions in their society.

Keywords: attitudes, education, health, rural women, work outside home

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10072 A Bayesian Approach for Health Workforce Planning in Portugal

Authors: Diana F. Lopes, Jorge Simoes, José Martins, Eduardo Castro

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Health professionals are the keystone of any health system, by delivering health services to the population. Given the time and cost involved in training new health professionals, the planning process of the health workforce is particularly important as it ensures a proper balance between the supply and demand of these professionals and it plays a central role on the Health 2020 policy. In the past 40 years, the planning of the health workforce in Portugal has been conducted in a reactive way lacking a prospective vision based on an integrated, comprehensive and valid analysis. This situation may compromise not only the productivity and the overall socio-economic development but the quality of the healthcare services delivered to patients. This is even more critical given the expected shortage of the health workforce in the future. Furthermore, Portugal is facing an aging context of some professional classes (physicians and nurses). In 2015, 54% of physicians in Portugal were over 50 years old, and 30% of all members were over 60 years old. This phenomenon associated to an increasing emigration of young health professionals and a change in the citizens’ illness profiles and expectations must be considered when planning resources in healthcare. The perspective of sudden retirement of large groups of professionals in a short time is also a major problem to address. Another challenge to embrace is the health workforce imbalances, in which Portugal has one of the lowest nurse to physician ratio, 1.5, below the European Region and the OECD averages (2.2 and 2.8, respectively). Within the scope of the HEALTH 2040 project – which aims to estimate the ‘Future needs of human health resources in Portugal till 2040’ – the present study intends to get a comprehensive dynamic approach of the problem, by (i) estimating the needs of physicians and nurses in Portugal, by specialties and by quinquenium till 2040; (ii) identifying the training needs of physicians and nurses, in medium and long term, till 2040, and (iii) estimating the number of students that must be admitted into medicine and nursing training systems, each year, considering the different categories of specialties. The development of such approach is significantly more critical in the context of limited budget resources and changing health care needs. In this context, this study presents the drivers of the healthcare needs’ evolution (such as the demographic and technological evolution, the future expectations of the users of the health systems) and it proposes a Bayesian methodology, combining the best available data with experts opinion, to model such evolution. Preliminary results considering different plausible scenarios are presented. The proposed methodology will be integrated in a user-friendly decision support system so it can be used by politicians, with the potential to measure the impact of health policies, both at the regional and the national level.

Keywords: bayesian estimation, health economics, health workforce planning, human health resources planning

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10071 Sexual Consent and Persons with Psychosocial Disabilities: Exploring Sexual Rights under Indian Laws

Authors: Sachin Sharma

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Sexual consent is integral to every sexual relationship. It is a process to facilitate sexual autonomy and bodily integrity. It assures complete sexual personhood and allows an individual to explore her sexual expressions independently. But the said proposition is not true for people with psychosocial disabilities. Generally, they are considered seraphic or mephistophelic and denied access to sexual autonomy. This result in institutionalizing the sexuality of disabled persons, where the eugenics-ableist narrative defines assessment and access to consent. This way, sexuality and disability are distanced apart. It is primarily due to the stigmatized socio-cultural constructs of sexuality that define sex within a “standard” and “charmed” circle. Such stigmatized expression influences the law, as it considers people with psychosocial disabilities incapable of sexual consent. The approach of legal institutions is very narrow towards interpreting their sexual rights. It echoes the modernist-ableism and strangulates the sexual choices. This way, it reflects the repressive model of sex and denies space to people with psychosocial disabilities. Moreover, judicial courts follow old and conservative methods while dealing with sexual issues. For instance, courts still practice the “standardized” norm of intelligence quotient (IQ) for determining the credibility of persons with psychosocial disabilities. Further, there is still doubt about assistive communicative techniques. This paper will try to question the normative structure of sexual consent and related laws while specifically addressing the issues of sex as desire and abuse. Considering the commitment to the United Nations Convention on the Rights of Persons with Disabilities (herein referred to as UNCRPD) and common law experience, the paper will draw a comparative study on the legal position of sexual rights in India. The paper will also analyze the role of UNCRPD in addressing sexual rights. The author will examine the position of sexual rights of people with psychosocial disabilities after the drafting of UNCRPD and specific state laws. The paper primarily follows the doctrinal method.

Keywords: sexual autonomy, institutionalized choices, overregulated laws, violation of individuality

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10070 Judicial Independence in Uzbekistan and the United States of America: Comparative-Legal Analysis

Authors: Botirjon Kosimov

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This work sheds light on the reforms towards the independence of the judiciary in Uzbekistan, as well as issues of further ensuring judicial independence in the country based on international values, particularly the legal practice of the United States. In every democratic state infringed human rights are reinstated and violated laws are protected by the help of justice based on the strict principle of judicial independence. The realization of this principle in Uzbekistan has been paid much attention since the proclamation of its independence. In the country, a series of reforms have been implemented in the field of the judiciary in order to actualize the principle of judicial independence. Uzbekistan has been reforming the judiciary considering both international and national values and practice of foreign countries. While forming a democratic state based on civil society, Uzbekistan shares practice with the most developed countries in the world. The United States of America can be a clear example which is worth learning how to establish and ensure an independent judiciary. It seems that although Uzbekistan has reformed the judiciary efficiently, it should further reform considering the legal practice of the United States.

Keywords: dependent judges, independent judges, judicial independence, judicial reforms, judicial life tenure, obstacles to judicial independence

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10069 Cercarial Diversity in Freshwater Snails from Selected Freshwater Bodies and Its Implication for Veterinary and Public Health in Kaduna State, Nigeria

Authors: Fatima Muhammad Abdulkadir, D. B. Maikaje, Y. A. Umar

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A study conducted to determine cercariae diversity and prevalence of trematode infection in freshwater snails from six freshwater bodies selected by systematic random sampling in Kaduna State was carried from January 2013 to December 2013. Freshwater snails and cercariae harvested from the study sites were morphologically identified. A total of 23,823 freshwater snails were collected from the six freshwater bodies: Bagoma dam, Gimbawa dam, Kangimi dam, Kubacha dam, Manchok water intake and Saminaka water intake. The observed freshwater snail species were: Melanoides tuberculata, Biomphalaria pfeifferi, Bulinus globosus, Lymnaea natalensis, Physa sp., Cleopatra bulimoides, Bellamya unicolor and Lanistes varicus. The freshwater snails were exposed to artificial bright light from a 100 Watt electric bulb in the laboratory to induce cercarial shedding. Of the total freshwater snails collected, 10.55% released one or more types of cercariae. Seven morphological types of cercariae were shed by six freshwater snail species namely: Brevifurcate-apharyngeate distome, Amphistome, Gymnocephalus, Longifurcate-pharyngeate monostome, Longifurcate-pharyngeate distome, Echinostome and Xiphidio cercariae. Infection was monotype in most of the freshwater snails collected; however, Physa species presented a mixed infection with Gymnocephalus and Longifurcate-pharyngeate distome cercariae. B. globosus and B. pfeifferi were the most preferred intermediate hosts with the prevalence of 13.48% and 13.46%, respectively. The diversity and prevalence of cercariae varied among the six freshwater bodies with Manchok water intake having the highest infestation (14.3%) and the least recorded in Kangimi dam (3.9%). There was a correlation trend between the number of freshwater snails and trematode infection with Manchok exhibiting the highest and Bagoma none. The highest cercarial diversity was observed in B. pfeifferi and B. globosus with four morphotypes each, and the lowest was in M. tuberculata with one morphotype. The general distribution of freshwater snails and the trematode cercariae they shed suggests the risk of human and animals to trematodiasis in Manchok community. Public health education to raise awareness on individual and communal action that may control snail breeding sites, prevent transmission and provide access to treatment should be intensified.

Keywords: Cercariae, diversity, freshwater snails, prevalence, trematodiasis

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10068 Data Quality on Regular Childhood Immunization Programme at Degehabur District: Somali Region, Ethiopia

Authors: Eyob Seife

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Immunization is a life-saving intervention which prevents needless suffering through sickness, disability, and death. Emphasis on data quality and use will become even stronger with the development of the immunization agenda 2030 (IA2030). Quality of data is a key factor in generating reliable health information that enables monitoring progress, financial planning, vaccine forecasting capacities, and making decisions for continuous improvement of the national immunization program. However, ensuring data of sufficient quality and promoting an information-use culture at the point of the collection remains critical and challenging, especially in hard-to-reach and pastoralist areas where Degehabur district is selected based on a hypothesis of ‘there is no difference in reported and recounted immunization data consistency. Data quality is dependent on different factors where organizational, behavioral, technical, and contextual factors are the mentioned ones. A cross-sectional quantitative study was conducted on September 2022 in the Degehabur district. The study used the world health organization (WHO) recommended data quality self-assessment (DQS) tools. Immunization tally sheets, registers, and reporting documents were reviewed at 5 health facilities (2 health centers and 3 health posts) of primary health care units for one fiscal year (12 months) to determine the accuracy ratio. The data was collected by trained DQS assessors to explore the quality of monitoring systems at health posts, health centers, and the district health office. A quality index (QI) was assessed, and the accuracy ratio formulated were: the first and third doses of pentavalent vaccines, fully immunized (FI), and the first dose of measles-containing vaccines (MCV). In this study, facility-level results showed both over-reporting and under-reporting were observed at health posts when computing the accuracy ratio of the tally sheet to health post reports found at health centers for almost all antigens verified where pentavalent 1 was 88.3%, 60.4%, and 125.6% for Health posts A, B, and C respectively. For first-dose measles-containing vaccines (MCV), similarly, the accuracy ratio was found to be 126.6%, 42.6%, and 140.9% for Health posts A, B, and C, respectively. The accuracy ratio for fully immunized children also showed 0% for health posts A and B and 100% for health post-C. A relatively better accuracy ratio was seen at health centers where the first pentavalent dose was 97.4% and 103.3% for health centers A and B, while a first dose of measles-containing vaccines (MCV) was 89.2% and 100.9% for health centers A and B, respectively. A quality index (QI) of all facilities also showed results between the maximum of 33.33% and a minimum of 0%. Most of the verified immunization data accuracy ratios were found to be relatively better at the health center level. However, the quality of the monitoring system is poor at all levels, besides poor data accuracy at all health posts. So attention should be given to improving the capacity of staff and quality of monitoring system components, namely recording, reporting, archiving, data analysis, and using information for decision at all levels, especially in pastoralist areas where such kinds of study findings need to be improved beside to improving the data quality at root and health posts level.

Keywords: accuracy ratio, Degehabur District, regular childhood immunization program, quality of monitoring system, Somali Region-Ethiopia

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10067 The Eathquake Discourse as a Strategy of an Urban Renewal: A Case Study into the Karapınar Valley Regeneration Project in Eskişehir, Turkey

Authors: Cansu Civelek

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The flexible and uneven character of neoliberalism has provided adaptation of urban strategies into the constantly changing circumstances in order to renew and reproduce the neoliberal accumulation model. Instrumentalization of catastrophic events to this end has been one of those global urban strategies. Regarding Turkey, exploitation of natural disasters has been the latest tactic of the Justice and Development Party (JDP) government to achieve radical economic goals. ‘Unhealthy’ and ‘risky’ structures of squatter settlements have often been articulated while the regenerations, expropriations, and exclusions have been sugarcoated through the discourses of ‘reintegrating the shanty zones into the cities’, ‘supplying healthy housing’, and ‘win-win’ character of the projects. Being the first regeneration project of Eskişehir, the Karapınar Regeneration Project has been initiated in 2011 by the partnership of the Odunpazarı Municipality of the JDP and the Mass Housing Organization. Discourses around the forthcoming disasters, ‘risky structures’ of the squatters, and the importance of the ‘security of life and property’ have been utilized, even though the zone is situated on a geotechnically stable area. Yet, many of the locals are worried about the payments while some have already decided to move elsewhere at the outskirts of the city.

Keywords: neoliberal urbanism, urban regeneration, illegal settlements, discourses

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10066 The Impact of FDI on Economic Growth in Algeria

Authors: Mohammed Yagoub

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The new orientation to the market economy sponsored by the Algeria government in the early Nineties of the last century, and its desire to develop investment mechanisms and the promotion of development recently, the access into a partnership with the European Union, and the forthcoming accession to the World Trade Organization, foreign direct investment makes one of the most important means of opening up to foreign markets and bring technology and interact with globalization, this article we will discuss the impact of FDI on economic growth in the Algerian.

Keywords: economic, development, markets, FDI, displacement, globalization

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10065 The Application of Local Wisdom in Health Care of Early Childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province

Authors: Supalak Fakkhum, Wannita Pochanakul

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This research is qualitative research that aims to study the application of local wisdom in health care of early childhood at Ban Nam Chieo Community, Laem Ngop, Trat Province. The target is one folk medicine healer and 45 parents who have children or grandchildren aged between 0-5 years. The folk medicine healer was interviewed and observed during early childhood health care practice. Parents were interviewed. The results showed that local wisdom in health care of early childhood are as follows: 1. Local wisdom about early childhood diseases: It is believed that the disease was determined while the child was still in the womb, in the third month of pregnancy. When a child is born, they will have La, La-ong and Saang diseases, which are URI (upper respiratory infection) and DI (diarrhea) diseases. Supernatural aspect is also considered. 2. The treatment is chosen to match the symptoms of the disease. Caring for early childhood includes psychological therapy by rituals and spells. 3. For local wisdom concerning prevention and health promotion, parents normally bring their child to folk medicine healers for “throat paint” as an act of protection and health promotion. Folk healers often prescribe food according to belief and local wisdom.

Keywords: local wisdom, early childhood, folk medicine, healer

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10064 Analysis of Cycling Accessibility on Chengdu Tianfu Greenway Based on Improved Two-Step Floating Catchment Area Method: A Case Study of Jincheng Greenway

Authors: Qin Zhu

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Under the background of accelerating the construction of Beautiful and Livable Park City in Chengdu, the Tianfu greenway system, as an important support system for the construction of parks in the whole region, its accessibility is one of the key indicators to measure the effectiveness of the greenway construction. In recent years, cycling has become an important transportation mode for residents to go to the greenways because of its low-carbon, healthy and convenient characteristics, and the study of greenway accessibility under cycling mode can provide reference suggestions for the optimization and improvement of greenways. Taking Jincheng Greenway in Chengdu City as an example, the Baidu Map Application Programming Interface (API) and questionnaire survey was used to improve the two-step floating catchment area (2SFCA) method from the three dimensions of search threshold, supply side and demand side, to calculate the cycling accessibility of the greenway and to explore the spatial matching relationship with the population density, the number of entrances and the comprehensive attractiveness. The results show that: 1) the distribution of greenway accessibility in Jincheng shows a pattern of "high in the south and low in the north, high in the west and low in the east", 2) the spatial match between greenway accessibility and population density of the residential area is imbalanced, and there is a significant positive correlation between accessibility and the number of selectable greenway access points in residential areas, as well as the overall attractiveness of greenways, with a high degree of match. On this basis, it is proposed to give priority to the mismatch area to alleviate the contradiction between supply and demand, optimize the greenway access points to improve the traffic connection, enhance the comprehensive quality of the greenway and strengthen the service capacity, to further improve the cycling accessibility of the Jincheng Greenway and improve the spatial allocation of greenway resources.

Keywords: accessibility, Baidu maps API, cycling, greenway, 2SFCA

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10063 Sustainable Community Participation in Australia

Authors: Virginia Dickson-Swift, Amanda Kenny, Jane Farmer, Sarah Larkins, Karen Carlisle, Helen Hickson

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In this presentation, we will focus on the methods of Remote Services Futures (RSF), an evidence-based method of community participation that was developed in Scotland. Using oral health as the focus, we will discuss the ways that RSF can be used to achieve sustainable engagement with stakeholders from various parts of the community. We will describe our findings of using RSF methods to engage with rural communities, including the steps involved and what happened when we asked people about the oral health services that they thought were needed in their community. We found that most community members started by thinking that a public dental clinic was required in every community, which is not a sustainable health service delivery option. Through a series of facilitated workshops, communities were able to discuss and prioritise their needs and develop a costed plan for their community which will ensure sustainable service delivery into the future. Our study highlights the complexities of decision making in rural communities. It is important to ensure that when communities participate in health care planning that the outcomes are practical, feasible and sustainable.

Keywords: community participation, sustainable health planning, Remote Services Futures, rural communities

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10062 Exploring Women's Needs Referring to Health Care Centers for Doing Pap Smear Test

Authors: Arezoo Fallahi, Fateme Aslibigi, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background and Aims: Cancer of the cervix, one of cancer-related death, is the second most common cancer in women worldwide. It develops over time but it is one of the most preventable types of cancer and there is the available proper screening program for its preventing. Since Pap smear test is vital to prevent and control of disease but women do not accomplish it regularly. Therefore, this study was aimed to explore women's needs referring to health care centers for doing Pap smear test. Material and methods: In this study, an inductive qualitative method with content analysis approach was used. This survey was done in varamin city (is located capital of Iran) in year 2014. Through the purposive sampling 15 women's view of point referring to health care centers of for doing Pap smear test was surveyed. Inclusion criteria were: 20-50 years old married women, having experience Pap smear test and attendance to participate in the Study. Recorded semi- structured interviews were typed and analyzed through of content analysis method. To obtain trustworthiness and rigor of the data, the criteria of credibility, dependability, confirmability and transferability was used. Results: During the data analysis, four main categories of “role of health care team”, “role of organizations”, “social support” and “policies and administration system” were developed. The participants emphasized on making motivational rules and coordination among organizations to do behaviors related to women health. Conclusion: The findings of study showed that doing Pap smear test are attributed to appropriate and intimate interactions with health professionals, family support, encouraging legislation and policies and coordination and notification of organizations. Therefore, designers and stockholders of policies and health system should more consider to growth and involve other organizations toward women's health.

Keywords: qualitative approach, pap smear test, women, health care centers

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10061 Benefits of Shaping a Balance on Environmental and Economic Sustainability for Population Health

Authors: Edna Negron-Martinez

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Our time's global challenges and trends —like those associated with climate change, demographics displacements, growing health inequalities, and increasing burden of diseases— have complex connections to the determinants of health. Information on the burden of disease causes and prevention is fundamental for public health actions, like preparedness and responses for disasters, and recovery resources after the event. For instance, there is an increasing consensus about key findings of the effects and connections of the global burden of disease, as it generates substantial healthcare costs, consumes essential resources and prevents the attainment of optimal health and well-being. The goal of this research endeavor is to promote a comprehensive understanding of the connections between social, environmental, and economic influences on health. These connections are illustrated by pulling from clearly the core curriculum of multidisciplinary areas —as urban design, energy, housing, and economy— as well as in the health system itself. A systematic review of primary and secondary data included a variety of issues as global health, natural disasters, and critical pollution impacts on people's health and the ecosystems. Environmental health is challenged by the unsustainable consumption patterns and the resulting contaminants that abound in many cities and urban settings around the world. Poverty, inadequate housing, and poor health are usually linked. The house is a primary environmental health context for any individual and especially for more vulnerable groups; such as children, older adults and those who are sick. Nevertheless, very few countries show strong decoupling of environmental degradation from economic growth, as indicated by a recent 2017 Report of the World Bank. Worth noting, the environmental fraction of the global burden of disease in a 2016 World Health Organization (WHO) report estimated that 12.6 million global deaths, accounting for 23% (95% CI: 13-34%) of all deaths were attributable to the environment. Among the environmental contaminants include heavy metals, noise pollution, light pollution, and urban sprawl. Those key findings make a call to the significance to urgently adopt in a global scale the United Nations post-2015 Sustainable Development Goals (SDGs). The SDGs address the social, environmental, and economic factors that influence health and health inequalities, advising how these sectors, in turn, benefit from a healthy population. Consequently, more actions are necessary from an inter-sectoral and systemic paradigm to enforce an integrated sustainability policy implementation aimed at the environmental, social, and economic determinants of health.

Keywords: building capacity for workforce development, ecological and environmental health effects of pollution, public health education, sustainability

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10060 Developing a Systemic Approach for Understanding the Factors Influencing Participation in Recreational Angling

Authors: Daniel Phillip Svozil, Eileen Petrie, Kristy Robson, Lee Baumgartner, Max Finlayson

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Recreational angling is recognized for its potential to improve health and wellbeing which has translated into policy initiatives to increase participation in the sport. However, these benefits have been examined mostly among voluntary participants. Thus, there is an assumption that recreational angling is perceived equally and that these benefits may be evident even to non-anglers. This paper reviews the published benefits to health and wellbeing of recreational angling and proposes an approach to systemically analyze interactions among the perceptions, socio-economic barriers, and knowledge of these benefits among people at different levels of participation (including non-participants). The outcomes of this study will assist in identifying the feasibility of recreational angling for improving health and wellbeing outcomes among participants (i.e., fishing may not be for everyone) and designing interventions that address the perceptions and socio-economic barriers among individuals that may benefit from participation in recreational angling.

Keywords: angling, health, wellbeing, connecting with nature

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10059 Implementing Bioremediation Technologies to Degrade Chemical Warfare Agents and Explosives from War Affected Regions in Sri Lanka

Authors: Elackiya Sithamparanathan

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Chemical agents used during the Sri Lankan civil war continue to threaten human and environmental health as affected areas are re-settled. Bioremediation is a cost-effective and eco-friendly approach to degrading chemical agents, and has greater public acceptance than chemical degradation. Baseline data on contaminant distribution, environmental parameters, and indigenous microbes are required before bioremediation can commence. The culture and isolate of suitable microbes and enzymes should be followed by laboratory trials, before field application and long-term monitoring of contaminant concentration, soil parameters, microbial ecology, and public health to monitor environmental and public health. As local people are not aware of the persistence of warfare chemicals and do not understand the potential impacts on human health, community awareness programs are required. Active community participation, and collaboration with international and local agencies, would contribute to the success of bioremediation and the effective removal of chemical agents in war affected areas of Sri Lanka.

Keywords: bioremediation, environmental protection, human health, war affected regions in Sri Lanka

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10058 Multi-Criterial Analysis: Potential Regions and Height of Wind Turbines, Rio de Janeiro, Brazil

Authors: Claudio L. M. Souza, Milton Erthal, Aldo Shimoya, Elias R. Goncalves, Igor C. Rangel, Allysson R. T. Tavares, Elias G. Figueira

Abstract:

The process of choosing a region for the implementation of wind farms involves factors such as the wind regime, economic viability, land value, topography, and accessibility. This work presents results obtained by multi-criteria decision analysis, and it establishes a hierarchy, regarding the installation of wind farms, among geopolicy regions in the state of ‘Rio de Janeiro’, Brazil: ‘Regiao Norte-RN’, ‘Regiao dos Lagos-RL’ and ‘Regiao Serrana-RS’. The wind regime map indicates only these three possible regions with an average annual wind speed of above of 6.0 m/s. The method applied was the Analytical Hierarchy Process-AHP, designed to prioritize and rank the three regions based on four criteria as follows: 1) potential of the site and average wind speeds of above 6.0 ms-¹, 2) average land value, 3) distribution and interconnection to electric network with the highest number of electricity stations, and 4) accessibility with proximity and quality of highways and flat topography. The values of energy generation were calculated for wind turbines 50, 75, and 100 meters high, considering the production of site (GWh/Km²) and annual production (GWh). The weight of each criterion was attributed by six engineers and by analysis of Road Map, the Map of the Electric System, the Map of Wind Regime and the Annual Land Value Report. The results indicated that in 'RS', the demand was estimated at 2,000 GWh, so a wind farm can operate efficiently in 50 m turbines. This region is mainly mountainous with difficult access and lower land value. With respect to ‘RL’, the wind turbines have to be installed at a height of 75 m high to reach a demand of 6,300 GWh. This region is very flat, with easy access, and low land value. Finally, the ‘NR’ was evaluated as very flat and with expensive lands. In this case, wind turbines with 100 m can reach an annual production of 19,000 GWh. In this Region, the coast area was classified as of greater logistic, productivity and economic potential.

Keywords: AHP, renewable energy, wind energy

Procedia PDF Downloads 151
10057 University Students’ Perceptions of the Influence of Cannabis Use on Mental Health

Authors: Konesh Navsaria, Itumeleng Ramodumo

Abstract:

The study explored university students’ perceptions of cannabis use on academic life at a higher education institution (HEI) in Nelson Mandela Bay, South Africa. Cannabis is described as the most commonly-used drug by youth, especially those who are in tertiary institutions. The use of cannabis has both negative and positive effects; this is evident in different areas of human functioning. Cannabis usage has been debated upon in courts regarding its legalization and decriminalization, and on the 18th of September 2018, the South African High Court decriminalized cannabis for personal use. Cannabis use has increased in academic settings, and this has raised concerns about how it affects the mental health of students. A qualitative approach was used for the study with an explorative, descriptive design. Purposive sampling was used to select 15 participants for the study. Data were collected using focused-group interviews, following ethical clearance from the HEI. The collected data were analyzed and interpreted using thematic analysis, and cognitive behavioural theory was used as the theoretical framework. The research findings indicated both positive and negative influences of cannabis use on mental health. Most participants who expressed positive effects have used cannabis before, whereas most participants with negative perspectives of cannabis use on mental health are non-cannabis users. The findings revealed that participants perceived that the quantity of cannabis smoked determined whether there was a positive or negative effect on mental health; that is, large doses of cannabis were perceived as having negative effects. The research findings also revealed that the legalization of cannabis is very likely to increase its use and also highlighted precautionary measures users take to avoid the substance’s negative effects on mental health.

Keywords: cannabis use, mental health, university students, legalization

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10056 Khon Kaen University Family Health Assessment Tool Training Program on Primary Care Unit Nurses’ Skills

Authors: Suwarno, D. Jongudomkarn

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Family Health Assessment (FHA) is a key process to identify the family health needs, family health problems, and family health history. Assessing the family health is not only from the assessment tool but also from health care provider especially Nurse. Nurses’ have duties to assess the family as holistic view and they have to increase their capacities (knowledge, skills and experiences) in FHA. Thus, the continuing nursing education-training program on using the KKU FHA Tool was aimed to enhance the participant nurses’ capacities in (FHA) based on such tool. The aim of this study was to evaluate the KKU FHA Tool training program on PCU nurses’ capacity before and after training program in Primary Care Unit Bantul, Yogyakarta. The Quasi-Experiment with one group pre-, post-test design as a research design with convenient sampling technique and one group pre- post test formula for Nurses who work in Six PCU Bantul, Yogyakarta as much as fourteen respondents. The research processes were used training program with module, video and handbook KKU FHA Tool, KKU FHA tool form and capacities questionnaires. It was analyzed by descriptive data, Kolmogorov-Smirnov and Paired Sample t-test. The overall comparing analysis of paired sample t-test revealed that the mean values of pre-test were 3.35 with SD 0.417, post-test was 3.86 with SD 0.154 and post-test in later two weeks was 4.00 with SD 0.243. It was found that the p value of among the pre-test, the intermediate post-test and the post–test in later two weeks were 0.000. The p value of the intermediate post-test and post-test in later two weeks was 0.053. KKU FHA Tool training program in PCU Bantul Yogyakarta was enhanced the participant nurses’ capacities significantly. In conclusion, we are recommending KKU FHA Tool forms have to develop and implement with qualitative research as complementary data in PCU Bantul Yogyakarta by Focus Group Discussion.

Keywords: family health assessment, KKU FHA tool, training program, nurses capacities

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10055 Ethnography of the Social and Cultural Perspectives of Childhood Neuro-Developmental Disorders: Implications for Health Seeking

Authors: Denis Nono, Catherine Abbo, Thomas Wenzel

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Introduction: The study explored socio-cultural perspectives of childhood disorders and its implications for health seeking. Emphasis was on exploring local understanding and perceptions and how these ideas affect health seeking. Study aim: To explore the socio-cultural perspectives of neuro-developmental disorders and its implications on health seeking behaviour. Methods: The methods used in this study included key informant interviews conducted with health professionals. Parents of the children aged (6-15 years) with neuro-developmental disorders were recruited from the hospital to participate in focus group discussion, participant observation and individual in-depth interviews. Results: The study found out that stigma extended from children to parents and caregivers who were also shunned by community members. Participants described their children as “a gift from God” others described them as “a test from God”. The communities perceive the disorders as a spiritual infliction and always insisted that the children be taken for Acholi cultural and traditional rituals to cleanse children and they believed that mental illness has spiritual linkages. Conclusion: This study gives unique insights into the perceptions of neuro-developmental disorders and health seeking behavior in Gulu District and neighboring communities. The results showed that communities linked disorders to spiritual affliction, misunderstandings between families, bewitching, and other supernatural forces. Some of the participants highly recommended biomedical approaches to prevention, management and control of the disorders.

Keywords: ethnography, health seeking, neuro-developmental disorders, socio-cultural

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10054 Yoga as a Tool for Public Health

Authors: Divya Kanchibhotla

Abstract:

Of all the major health threats to emerge, none has challenged the very foundation of public health so profoundly as the rise of non-communicable diseases (NCD). Encouraging a holistic health approach encompasses the community’s well-being. Competent public health grounded with holistic health approach can lay a better foundation in the modern world. Yoga has been increasingly explored as an adjunct therapy to major disorders. This study explores the efficacy of Yoga as a tool for public health. A survey was administered to 5500 adults, and 300 teens were selected from 25 states of India. The study explored the differences in health, happiness, and sustainable living between Yoga-practitioners and Non-yoga practitioners. The study also explored the practice and habits of yoga practitioners (frequency, place, reasons to practice) and Health, Happiness, and Sustainable Living. The subjects were grouped based on age, education, experience in yoga (years of practice), and occupational background. The study population comprised of 54% males and 46% females. Majority of the respondents (59%) were from 18 to 30 years age group. The study indicated that 96.4% of the total respondents have heard of Yoga. However, only 46.8% of the total study population practice yoga (YP) and the rest 53.2% were non-practitioners (NP). From a perspective of how Yoga and health, 72.7% yoga practitioners asserted a peaceful and happy life, 71.9% yoga practitioners felt satisfaction in life, and 70.2 % yoga practitioners had satisfactory health. 61.9% of yoga practitioners report being vegetarian, not eating junk food, and not drinking alcohol than 38.1% Non-Practitioners population. 47% of yoga practitioners found themselves to be more sensitive to the environment compared to only 40% of non-practitioners. India has been witnessing an unprecedented rise in the NCDs, accounting for 61% deaths. The importance of yoga as an adjunct therapy for various disorders and diseases is gaining momentum across the globe. There are various studies on yoga that have indicated benefits of yoga as a unique holistic approach towards lifestyle and a consistent, complementary solution that could be adopted for long-term viability for a well being. The comprehensive study is the first of its kind that takes a holistic look at the prevalence of Yoga for public health in India. Our study is unique and stands out as it is detailed in its outlook with extensive coverage of almost the whole country (surveying 25 out of 29 states) and contemplates on the benefits to an individual at the grass-root level – physical, mental and social outlook. The insights from the study will enable the health care systems and grassroots organizations to make the holistic practice of Yoga accessible to spread sustainable living for a healthy community.

Keywords: non-communicable disease (NCD), sustainable development goal (SDG 3), public health, healthy living

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10053 Trends and Inequalities in Distance to and Use of Nearest Natural Space in the Context of the 20-Minute Neighbourhood: A 4-Wave National Repeat Crosssectional Study, 2013 to 2019

Authors: Jonathan R. Olsen, Natalie Nicholls, Jenna Panter, Hannah Burnett, Michael Tornow, Richard Mitchell

Abstract:

The 20-minute neighborhood is a policy priority for governments worldwide and a key feature of this policy is providing access to natural space within 800 meters of home. The study aims were to (1) examine the association between distance to nearest natural space and frequent use over time and (2) examine whether frequent use and changes in use were patterned by income and housing tenure over time. Bi-annual Scottish Household Survey data were obtained for 2013 to 2019 (n:42128 aged 16+). Adults were asked the walking distance to their nearest natural space, the frequency of visits to this space and their housing tenure, as well as age, sex and income. We examined the association between distance from home of nearest natural space, housing tenure, and the likelihood of frequent natural space use (visited once a week or more). Two-way interaction terms were further applied to explore variation in the association between tenure and frequent natural space use over time. We found that 87% of respondents lived within 10 minute walk of a natural space, meeting the policy specification for a 20-minute neighbourhood. Greater proximity to natural space was associated with increased use; individuals living a 6 to 10 minute walk and over 10 minute walk were respectively 53% and 78% less likely to report frequent natural space use than those living within a 5 minute walk. Housing tenure was an important predictor of frequent natural space use; private renters and homeowners were more likely to report frequent natural space use than social renters. Our findings provide evidence that proximity to natural space is a strong predictor of frequent use. Our study provides important evidence that time-based access measures alone do not consider deep-rooted socioeconomic variation in use of Natural space. Policy makers should ensure a nuanced lens is applied to operationalising and monitoring the 20-minute neighbourhood to safeguard against exacerbating existing inequalities.

Keywords: natural space, housing, inequalities, 20-minute neighbourhood, urban design

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10052 The Causes and Potential Solutions for Foodborne Illness, Food Security, and Food Safety: In the Case of the East Harerghe Region of Oromia, Ethiopia

Authors: Tuji Jemal Ahmed, Abdi Mohammed, Geremew Geidare Kailo

Abstract:

Food security, foodborne illness, and food safety are critical issues that affect the East Harerghe region of Oromia, Ethiopia. Despite the region's potential for agriculture, food insecurity remains a significant problem, with many households experiencing chronic hunger and malnutrition. The region also experiences high rates of foodborne illnesses, including cholera, typhoid, and diarrhea, which are caused by poor hygiene and sanitation practices. Additionally, food safety is a significant challenge, particularly in rural areas, where there is a lack of infrastructure, inadequate food storage facilities, and limited access to information about food safety. There are several factors that contribute to the current situation in the East Harerghe region; firstly, the region is susceptible to natural disasters, for instance, drought, which affects crop yields and livestock production. Secondly, the region also experiences poor infrastructure, which affects the storage and transportation of food, particularly in rural areas. Thirdly, there is a lack of awareness and knowledge on good hygiene and sanitation practices, specifically during food handling, processing, and storage. Fourthly, unitability due to conflict and other forms of land degradation exacerbates food insecurity and malnutrition. Finally, limited access to financial resources and markets commonly affects smallholder farmers by their ability to produce and sell food. To address the current situation in that area, several potential solutions can be implemented; investment in infrastructure is necessary, especially in rural areas, to improve the storage and transportation of food. Education and awareness programs on good hygiene and sanitation practices should target local communities, smallholder farmers, and food vendors. Financial resources and markets should be made more accessible to smallholder farmers, particularly through the provision of credit and improved access to markets. Addressing the underlying causes of conflict and promoting peaceful coexistence can help to reduce displacement and loss of livelihoods. Finally, the enforcement of food safety regulations and the implementation of standards for food processing and storage facilities are necessary to ensure food safety. In conclusion, addressing the challenges of food security, foodborne illness, and food safety in the East Harerghe region requires a coordinated effort from various stakeholders, including the government, non-governmental organizations, and local communities. By implementing the solutions outlined above, the region can improve its food security, prevent foodborne illnesses, and keep food safe for its population. Eventually, building the resilience of communities to shocks such as droughts, floods, and conflict is necessary to ensure long-term food security in the region.

Keywords: foodborne illness, food handling, food safety, food security

Procedia PDF Downloads 100
10051 The Play Street: A Community Treat for Psychosocial Replete

Authors: Benjamin Cramer, Josephine Chau, Helen Little, Erica Randle

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Play Streets provide a safe and open space for children to play and adults to socialize by closing residential streets to through traffic. While research on Play Streets has typically focused on physical activity outcomes in children, there is limited research on the psychosocial health externalities for the wider community. Charles Sturt, a local government area in Adelaide, South Australia, has been hosting Play Streets for several years. The current study is a mixed-methods evaluation of the Charles Sturt Play Streets, concerned with the perceived psychological and social impacts that Play Streets impact on the community. A combination of semi-structured interviews of Play Street organizers and participants will be conducted and analyzed using inductive thematic analysis. Pre-existing survey data will also be analyzed quantitatively and qualitatively to triangulate the findings of the qualitative interviews. The implications of this research are far-reaching, from informing local councils of any additional health benefits of Play Streets, expanding the growing literature on Play Streets beyond childhood physical activity, informing the development of city infrastructure, and advancing the Sustainability Development Goals of Good Health and Wellbeing, Reduced Inequalities, and Sustainable Cities and Communities.

Keywords: play streets, mental health, social health, community health

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10050 Iran’s Sexual and Reproductive Rights Roll-Back: An Overview of Iran’s New Population Policies

Authors: Raha Bahreini

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This paper discusses the roll-back of women’s sexual and reproductive rights in the Islamic Republic of Iran, which has come in the wake of a striking shift in the country’s official population policies. Since the late 1980s, Iran has won worldwide praise for its sexual and reproductive health and services, which have contributed to a steady decline in the country’s fertility rate–from 7.0 births per women in 1980 to 5.5 in 1988, 2.8 in 1996 and 1.85 in 2014. This is owed to a significant increase in the voluntary use of modern contraception in both rural and urban areas. In 1976, only 37 per cent of women were using at least one method of contraception; by 2014 this figure had reportedly risen to a high of nearly 79 per cent for married girls and women living in urban areas and 73.78 per cent for those living in rural areas. Such progress may soon be halted. In July 2012, Iran’s Supreme Leader Ayatollah Sayed Ali Khamenei denounced Iran’s family planning policies as an imitation of Western lifestyle. He exhorted the authorities to increase Iran’s population to 150 to 200 million (from around 78.5 million), including by cutting subsidies for contraceptive methods and dismantling the state’s Family and Population Planning Programme. Shortly thereafter, Iran’s Minister of Health and Medical Education announced the scrapping of the budget for the state-funded Family and Population Planning Programme. Iran’s Parliament subsequently introduced two bills; the Comprehensive Population and Exaltation of Family Bill (Bill 315), and the Bill to Increase Fertility Rates and Prevent Population Decline (Bill 446). Bill 446 outlaws voluntary tubectomies, which are believed to be the second most common method of modern contraception in Iran, and blocks access to information about contraception, denying women the opportunity to make informed decisions about the number and spacing of their children. Coupled with the elimination of state funding for Iran’s Family and Population Programme, the move would undoubtedly result in greater numbers of unwanted pregnancies, forcing more women to seek illegal and unsafe abortions. Bill 315 proposes various discriminatory measures in the areas of employment, divorce, and protection from domestic violence in order to promote a culture wherein wifedom and child-bearing is seen as women’s primary duty. The Bill, for example, instructs private and public entities to prioritize, in sequence, men with children, married men without children and married women with children when hiring for certain jobs. It also bans the recruitment of single individuals as family law lawyers, public and private school teachers and members of the academic boards of universities and higher education institutes. The paper discusses the consequences of these initiatives which would, if continued, set the human rights of women and girls in Iran back by decades, leaving them with a future shaped by increased inequality, discrimination, poor health, limited choices and restricted freedoms, in breach of Iran’s international human rights obligations.

Keywords: family planning and reproductive health, gender equality and empowerment of women, human rights, population growth

Procedia PDF Downloads 307
10049 Effects of Physical Activity Used as Treatment in Community Mental Health Services

Authors: John Olav Bjornestad, Bjorn Tore Johansen

Abstract:

The number of people suffering from mental illnesses is increasing, and such illness is currently one of the major causes of disability and poor health. The reason for this is most likely a lack of physical activity. The purpose of this study was to discover if physical activity was an effective mode of treatment for psychiatric patients at an out-patient treatment facility. The study included an exploration of whether or not patients having physical activity included as an integral part of their treatment (to a greater degree than do patients who are physically inactive) would achieve 1) an improvement in their physical condition 2) a reduction in symptomatic pressure and 3) an increase in their health-related quality of life. The intervention period lasted a total of 12 weeks. The training group completed a minimum of 2 training sessions per week with an intensity of 60-75% of maximum heart rate. The participants’ health-related quality of life (SF-36), symptomatic pressure (SCL-90-R) and physical condition (UKK-walking test) were measured before and after intervention. Twenty participants were pre-tested, and out of this initial group, nine patients completed the intervention program and participated thereafter in post-testing. The results showed that participants on average improved their physical condition, reduced their symptomatic pressure and increased their health-related quality of life over the course of the intervention period. The training group experienced significant changes in their symptomatic pressure (the anxiety dimension) and health-related quality of life (the mental health dimension) from the pre-testing stage to the post-testing one. Furthermore, there was a significant connection between symptomatic pressure and health-related quality of life. The patients who were admitted to the psychiatric out-patient clinic were in a physical condition that was significantly poorer than that of persons of the same age in the remainder of the population. Experiences from the study and the relatively large defection from it demonstrate that there is a great need for close follow-up of psychiatric patients’ physical activity levels when physical activity and lifestyle changes are included as part of their treatment program.

Keywords: health-related quality, mental health, physical activity, physical condition

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10048 Unlocking the Health Benefits of Goat Meat

Authors: K. Makangali, G. Tokysheva, A. Shoman

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Goat meat and goat meat products have garnered increasing attention within the realm of nutrition and health due to their potential to provide a myriad of benefits. This scientific article presents a comprehensive review of the health advantages associated with goat meat consumption and the products derived from it. The paper explores the nutritional content of goat meat, highlighting its favorable composition in terms of protein, essential minerals, and amino acids. It delves into the intricate balance of macronutrients, with lower fat and cholesterol levels compared to other meats, making goat meat a desirable choice for individuals seeking healthier dietary options.

Keywords: goat meat, amino acid, nutrition, meat products, meat

Procedia PDF Downloads 79
10047 Strengthening Functional Community-Provider Linkages: Lessons from the Challenge Initiative for Healthy Cities Program in Indore, India

Authors: Sabyasachi Behera, Shiv Kumar, Pramod Gautam, Anisur Rahman, Pawan Pathak, Rahul Bhadouria

Abstract:

Background: The increasing proportion of population especially urban poor and vulnerable groups or groups with specific needs, with health indicators worse than their rural counterparts in India face various issues related with availability and quality of health care. The reasons are myriad, starting from information and awareness of the community, especially, in a scenario wherein the needs and challenges of floating and migrant urban populations remain poorly understood. Weak linkages between health care facilities and slum dwellers and vulnerable populations hinder the improvement of health services for urban poor. Method: To address this issue, TCIHC program is helping health department of Indore city of Madhya Pradesh to establish a referral mechanism with a dual approach: at both community and facility level. The former is based on the premise of ‘building social capital’, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services at appropriate levels of care (Minus 2: Accredited Social Health Activist and Community Health Groups; Minus 1: Urban Health Nutrition Days; Zero: Urban Primary Health Center; Plus 1: secondary facility with BEmONC services; Plus 2: secondary facilities with CEmONC services; Plus 3: tertiary level facility) for the urban poor. The latter focuses on encouraging the provision of all services at various levels of service delivery points and stakeholders to function in a coordinated manner to ensure better health service availability and coverage in underserved slum areas. Results: This initiative has enhanced the utilization of community based, primary and secondary level services through defined referral pathways that are clearly known to a community dweller. Conclusion: An ideal referral mechanism should begin with referral at the community level wherein services of a frontline health care provider are accessed by them at their door-step, causing no delay in both understanding and decision on the health issues faced by them.

Keywords: levels of care, linkages, referral mechanism, service delivery

Procedia PDF Downloads 143