Search results for: Jordanian men and women’s health

Authors: Eyob Seife, Tesfalem Teshome, Bereket Seyoum, Behailu Getachew, Yohans Demis

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Developing countries continue to face preventable communicable diseases, such as vaccine-preventable diseases. The Expanded Programme on Immunization (EPI) was established by the World Health Organization in 1974 to control these diseases. Health data use is crucial in decision-making, but ensuring data quality remains challenging. The study aimed to assess the accuracy ratio, timeliness, and quality index of regular immunization programme data in the Birkod district of the Somali Region, Ethiopia. For poor data quality, technical, contextual, behavioral, and organizational factors are among contributors. The study used a quantitative cross-sectional design conducted in September 2022GC using WHO-recommended data quality self-assessment tools. The accuracy ratio and timeliness of reports on regular immunization programmes were assessed for two health centers and three health posts in the district for one fiscal year. Moreover, the quality index assessment was conducted at the district level and health facilities by trained assessors. The study found poor data quality in the accuracy ratio and timeliness of reports at all health units, which includes zeros. Overreporting was observed for most facilities, particularly at the health post level. Health centers showed a relatively better accuracy ratio than health posts. The quality index assessment revealed poor quality at all levels. The study recommends that responsible bodies at different levels improve data quality using various approaches, such as the capacitation of health professionals and strengthening the quality index components. The study highlighted the need for attention to data quality in general, specifically at the health post level, and improving the quality index at all levels, which is essential.

Keywords: Birkod District, data quality, quality index, regular immunization programme, Somali Region-Ethiopia

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Authors: Daniel Faraj, Arabella Raupach, Charlotte Hespe, Helen Wilcox, Kristie-Lee Anning

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Aim: International child sponsorship programs comprise a considerable proportion of global aid accessible to the general population. Team Philippines (TP), a healthcare and welfare initiative run in association with the University of Notre Dame Sydney since 2013, leads a holistic sponsorship program for thirty children from Calauan, Philippines. To date, empirical research has not been performed on the overall success and impact of the TP child sponsorship program. As such, this study aims to evaluate its effectiveness in improving pediatric outcomes. Methods: Study cohorts comprised thirty sponsored and twenty-nine age- and gender-matched non-sponsored children. Data were extracted from the TP Medical Director database and lifestyle questionnaires for July-November 2019. Outcome measures included anthropometry, markers of medical health, dental health, exercise, and diet. Statistical analyses were performed in SPSS. Results: Sponsorship resulted in fewer medical diagnoses and prescription medications, superior dental health, and improved diet. Further, sponsored children may show a clinically significant trend toward improved physical health. Sponsorship did not affect growth and development metrics or levels of physical activity. Conclusions: The TP child sponsorship program significantly impacts positive pediatric health outcomes in the Calauan community. The strength of the program lies in its holistic, sustainable, and community-based model, which is enabled by effective international child sponsorship. This study further supports the relationship between supporting early livelihood and improved health in the pediatric population.

Keywords: child health, public health, health status disparities, healthcare disparities, social determinants of health, morbidity, community health services, culturally competent care, medically underserved areas, population health management, Philippines

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Authors: Amaba, Marinela C., Espino, Gianne Ericka S. J. Valencia, Zeia Beatriz C.

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This study aims to determine the moderating role of attachment style on the relationship between psychological symptoms and well-being of mental health practitioners in rehabilitation centers that are accredited of the Department of Health in Pampanga. Using the data gathered from 46 mental health practitioners, multiple regression models were conducted to test the main and moderating effects of attachment styles. The findings show that all three psychological symptoms namely depression, anxiety, and stress have main effects on their general well-being on a negative direction. However, attachment style did not moderate the relationship between the psychological symptoms and general well-being. On one hand, results about the relationship of psychological symptoms and well-being are consistent to previous findings of other studies while on the other hand, results in moderation were contradicting.

Keywords: attachment style, psychological symptoms, well-being, mental health practitioners, rehabilitation centers

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Authors: Sally Kafelghazal

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Introduction: Arab Americans, who include immigrants, refugees, or U.S. born persons of Middle Eastern or North African descent, may experience significant difficulties during acculturation to Western society. Influential stressors include relocation, loss of social support, language barriers, and economic factors, all of which can impact mental health. There is limited research investigating the effects of acculturation on the mental health of the Arab American population. Objectives: The purpose of this study is to identify ways in which acculturation impacts the mental health of Arab Americans, specifically the development of depression and anxiety. Method: A literature search was conducted using PubMed and PsycArticles (ProQuest), utilizing the following search terms: “Arab Americans,” “Arabs,” “mental health,” “depression,” “anxiety,” “acculturation.” Thirty-nine articles were identified and of those, nine specifically investigated the relationship between acculturation and mental health in Arab Americans. Three of the nine focused exclusively on depression. Results: Several risk factors were identified that contribute to poor mental health associated with acculturation, which include immigrant or refugee status, facing discrimination, and religious ideology. Protective factors include greater levels of acculturation, being U.S. born, and greater heritage identity. Greater mental health disorders were identified in Arab Americans compared to normative samples, perhaps particularly depression; none of the articles specifically addressed anxiety. Conclusion: The current research findings support the potential association between the process of acculturation and greater levels of mental health disorders in Arab Americans. However, the diversity of the Arab American population makes it difficult to draw consistent conclusions. Further research needs to be conducted in order to assess which subgroups in the Arab American population are at highest risk for developing new or exacerbating existing mental health disorders in order to devise more effective interventions.

Keywords: arab americans, arabs, mental health, anxiety, depression, acculturation

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Authors: Suchada Wongsawat

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The objectives of this quasi-experiment were: 1) to compare pretest and posttest scores of the experimental group who were given health education on the “Fruit Diets for Elderly Patients with Type 2 Diabetes Mellitus”; and 2) to compare the posttest scores between experimental group and controlled group. The samples of this study were elderly patients with type 2 Diabetes Mellitus at Tambon Kanai Health Promoting Hospital, Thailand. The samples were randomly assigned to experimental and controlled groups, with 30 patients in each group. Statistics used in the data analysis included frequency, percentage, average, standard deviation, paired t-test and independent t-test. The study revealed that the patients in the experimental group had significantly higher posttest scores than the pretest scores in the health education at the .05 statistical level. The posttest scores of the experimental group in the health education were significantly higher than the controlled group at the .05 statistical level.

Keywords: fruit, health education, elderly, diabetes

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Authors: Ayubova Nargiza Mirzabixulaevna, Kiryakov Dmitriy Andreyevich

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Relevance: According to experts from the World Health Organization, in 80% of cases, the causes of skin cancer are external factors: polluted air, radioactive substances, solar flares, and free radicals. In dermatology, one of the most common related to obligate diseases is actinic keratosis. Actinic keratosis (AC) is an area of abnormal proliferation and differentiation of keratinocytes, which carry the risk of progression into invasive squamous cell carcinoma of the skin. The purpose of the study is to study the prevalence of various forms of actinic keratosis among the population of Uzbekistan. Materials and methods of research: The study is based on the observation and clinical laboratory examination of 96 patients who were divided by gender and age. Women made up 45% and men made up 55%. The youngest patient was 43 years old, and the oldest was 92 years old. The control group consisted of 40 patients. The following clinical signs were evaluated: peeling, hyperkeratosis, erythema, pigmentation, atrophy. Results: Studies have shown that of all forms of actinic keratosis, erythematous (36%), hyperkeratotic (27%), pigmented (12%), cutaneous horn (7.0%), atrophic (7.0%), Actinic cheilitis (6%), lichenoid (5%) are common. Conclusion: Thus, the data we have obtained indicate that the main and pronounced clinical sign in the erythematous form is erythema and the hyperkeratic form is often found. With cutaneous horn, there is a sharp hyperkeratosis of the epidermis.

Keywords: actinic keratosis, patient, skin cancer, obligate diseases

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Authors: Melaku Tsehay

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The Consortium of Christian Relief and Development Associations (CCRDA), and the CORE Group Polio Partners (CGPP) Secretariat have been working with Global Alliance for Vac-cines and Immunization (GAVI) to improve the immunization data quality in Afar and Somali Regional States. The main aim of this study was to compare the quality of immunization data before and after the above interventions in health facilities in the pastoralist communities in Ethiopia. To this end, a comparative-cross-sectional study was conducted on 51 health facilities. The baseline data was collected in May 2019, while the end line data in August 2021. The WHO data quality self-assessment tool (DQS) was used to collect data. A significant improvment was seen in the accuracy of the pentavalent vaccine (PT)1 (p = 0.012) data at the health posts (HP), while PT3 (p = 0.010), and Measles (p = 0.020) at the health centers (HC). Besides, a highly sig-nificant improvment was observed in the accuracy of tetanus toxoid (TT)2 data at HP (p < 0.001). The level of over- or under-reporting was found to be < 8%, at the HP, and < 10% at the HC for PT3. The data completeness was also increased from 72.09% to 88.89% at the HC. Nearly 74% of the health facilities timely reported their respective immunization data, which is much better than the baseline (7.1%) (p < 0.001). These findings may provide some hints for the policies and pro-grams targetting on improving immunization data qaulity in the pastoralist communities.

Keywords: data quality, immunization, verification factor, pastoralist region

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Authors: Chenxu Fang, Qikai Guan

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Riverside public space in mountainous cities has unique scenic resources and humanistic connotations and is an important place indispensable to the activities of urban residents. In recent years, with the continuous development of society and the expansion of the city, the public space along the riverside has been affected to a certain extent. Based on this, this study is based on the concept of health and safety through the study of riverfront space in the local section of Jialing River in Chongqing City; according to the actual use function of riverfront public space, the riverfront public space in mountainous cities is categorized into leisure and recreational riverfront space, ecological conservation waterfront space, and composite function waterfront space. Starting from the health and safety elements affecting the environment in the riverfront public space, the health and safety influencing factors of the riverfront public space are categorized into three major categories, namely, material, non-material, and social, and through the field research and questionnaire collection, combined with the analysis of the Likert scale, the important levels of the health and safety influencing factors of different types of the riverfront public space of the mountainous cities are clarified. We summarize the factors affecting the health and safety of mountainous riverside spaces, map their importance levels to the design of different types of riverside spaces, and put forward three representative paths for the governance of the safety and health of mountainous riverside public space.

Keywords: health and safety, mountain city, riverfront public space, spatial governance, Chongqing Jialing River

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Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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Authors: Helen J. Spray, Karina J. Linnell

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Local-global bias in adulthood is strongly dependent on environmental factors and a global bias is not the universal characteristic of adult perception it was once thought to be: whilst Western adults typically demonstrate a global bias, Namibian adults living in traditional villages possess a strong local bias. Furthermore, environmental effects on local-global bias have been shown to be highly gender-specific; whereas urbanisation promoted a global bias in urbanised Namibian women but not men, education promoted a global bias in urbanised Namibian men but not women. Adult populations, however, provide only a snapshot of the gene-environment interactions which shape perceptual bias. Yet, to date, there has been little work on the development of local-global bias across environmental settings. In the current study, local-global bias was assessed using a similarity-matching task with Navon figures in children aged between 4 and 15 years from across three populations: traditional Namibians, urban Namibians, and urban British. For the two Namibian groups, measures of urbanisation and education were obtained. Data were subjected to both between-group and within-group analyses. Between-group analyses compared developmental trajectories across population and gender. These analyses revealed a global bias from even as early as 4 in the British sample, and showed that the developmental onset of a global bias is not fixed. Urbanised Namibian children ultimately developed a global bias that was indistinguishable from British children; however, a global bias did not emerge until much later in development. For all populations, the greatest developmental effects were observed directly following the onset of formal education. No overall gender effects were observed; however, there was a significant gender by age interaction which was difficult to reconcile with existing biological-level accounts of gender differences in the development of local-global bias. Within-group analyses compared the effects of urbanisation and education on local-global bias for traditional and urban Namibian boys and girls separately. For both traditional and urban boys, education mediated all effects of age and urbanisation; however, this was not the case for girls. Traditional Namibian girls retained a local bias regardless of age, education, or urbanisation, and in urbanised girls, the development of a global bias was not attributable to any one factor specifically. These results are broadly consistent with aforementioned findings that education promoted a global bias in urbanised Namibian men but not women. The development of local-global bias does not follow a fixed trajectory but is subject to environmental control. Understanding how variability in the development of local-global bias might arise, particularly in the context of gender, may have far-reaching implications. For example, a number of educationally important cognitive functions (e.g., spatial ability) are known to show consistent gender differences in childhood and local-global bias may mediate some of these effects. With education becoming an increasingly prevalent force across much of the developing world it will be important to understand the processes that underpin its effects and their implications.

Keywords: cross-cultural, development, education, gender, local-global bias, perception, urbanisation, urbanization

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Authors: Francesca Favero, Despina Learmonth

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Carbohydrate addiction is said to be the sustained dependence on hyperpalatable foods rich in carbohydrates and sugar. This addiction manifests in increased consumption of carbohydrates through binging: a behaviour typically associated with eating disorders. There is a lack of consensus amongst relevant experts as to whether carbohydrates are physiologically or psychologically addictive. With an increased focus on carbohydrate addiction, an outpatient treatment programme, HELP, has been established in Cape Town, South Africa, to specifically address this issue. This research aimed to explore, pre-and post-intervention, the possible presence of, and subsequent shifts in, the maintaining mechanisms identified in the transdiagnostic model for eating disorders. However, the potential for the emergence of other perpetuating factors was not discounted and the nature of the analysis allowed for this possibility. Eight women between the ages of twenty-two and fifty, who had completed the outpatient treatment programme in the last six months, were interviewed. They were asked to speak retrospectively about their personal difficulties, eating and food, and their experience of the treatment. Thematic analysis was employed to identify themes arising from the data. Five themes congruent with the transdiagnostic model’s factors emerged: over-evaluation of weight and shape, core low self-esteem, interpersonal difficulties, clinical perfectionism and mood intolerance. A variety of sub-themes, elaborating upon the various ways in which the disordered eating was maintained, also emerged from the data. Shifts in these maintaining mechanisms were identified. Although not necessarily indicative of recovery, the results suggest that the outpatient HELP programme had a positive overall influence on the participants; and that the transdiagnostic model may be useful in understanding and guiding the treatment of clients who engage in this type of treatment programme.

Keywords: eating disorders, binge eating disorder, carbohydrate addiction, transdiagnostic model, maintaining mechanisms, thematic analysis, outpatient treatment

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Authors: Spencer Rutherford, Shadi Saleh

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War and conflict negatively impact all facets of a health system; services cease to function, resources become depleted, and any semblance of governance is lost. Following cessation of conflict, the rebuilding process includes a wide array of international and local actors. During this period, stakeholders must contend with various trade-offs, including balancing sustainable outcomes with immediate health needs, introducing health reform measures while also increasing local capacity, and reconciling external assistance with local legitimacy. Compounding these factors are additional challenges, including coordination amongst stakeholders, the re-occurrence of conflict, and ulterior motives from donors and governments, to name a few. Therefore, the present paper evaluated health system development in three post-conflict countries over a 12-year timeline. Specifically, health policies, health inputs (such infrastructure and human resources), and measures of governance, from the post-conflict periods of Afghanistan, Cambodia, and Mozambique, were assessed against health outputs and other measures. All post-conflict countries experienced similar challenges when rebuilding the health sector, including; division and competition between donors, NGOs, and local institutions; urban and rural health inequalities; and the re-occurrence of conflict. However, countries also employed unique and effective mechanisms for reconstructing their health systems, including; government engagement of the NGO and private sector; integration of competing factions into the same workforce; and collaborative planning for health policy. Based on these findings, best-practice development strategies were determined and compiled into a 12-year framework. Briefly, during the initial stage of the post-conflict period, primary stakeholders should work quickly to draft a national health strategy in collaboration with the government, and focus on managing and coordinating NGOs through performance-based partnership agreements. With this scaffolding in place, the development community can then prioritize the reconstruction of primary health care centers, increasing and retaining health workers, and horizontal integration of immunization services. The final stages should then concentrate on transferring ownership of the health system national institutions, implementing sustainable financing mechanisms, and phasing-out NGO services. Overall, these findings contribute post-conflict health system development by evaluating the process holistically and along a timeline and can be of further use by healthcare managers, policy-makers, and other health professionals.

Keywords: Afghanistan, Cambodia, health system development, health system reconstruction, Mozambique, post-conflict, state-building

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Authors: M. Caporale

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French Curricula across the US have recently suffered low enrollment and have experienced difficulties with retention, thus resulting in fewer students minoring and majoring in French and enrolling in upper-level classes. Successful undergraduate programs offer French courses with a strong cultural and interdisciplinary or multidisciplinary component. The World Language Curriculum in liberal arts colleges in America needs to take into account the cultural aspects of the language and encourage students to think critically about the country or countries they are studying. Limiting the critical inquiry to language or literature narrowly defined provides and incomplete and stagnant picture of France and the Francophone world in today's global community. This essay discusses the creation and implementation of a hybrid interdisciplinary L1/L2 course titled "Topics in Francophone Cinema" (subtitle "Francophone Women on Screen and Behind the Camera"). Content-based interdisciplinary courses undoubtedly increase the profile of French and Francophone cultural Studies by introducing students of other disciplines to fundamental questions relating to the French and Francophone cultures (in this case, women's rights in the Francophone world). At the same time, this study determines that through targeted reading and writing assignments, sustained aural exposure to L2 through film,and student participation in a one-credit supplementary weekly practicum (creative film writing workshop), significant advances in L2 competence are achieved with students' oral and written production levels evolving from Advanced Low to Advanced-mid, as defined by the ACFL guidelines. Use of differentiated assessment methods for L1/L2 and student learning outcomes for both groups will also be addressed.

Keywords: interdisciplinary, Francophone cultural studies, language competency, content-based

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Authors: Farhat Nigar

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Social stress is stress which arises from one's relationships with others and from the social environment. When a person finds that they are not capable of coping with a situation, stress arises. Sanitation workers faces a lot of discrimination from the society which leads to stress and have severe impact on their mental health. Sanitation workers face lot of work pressure which sometimes leads to mental health problems, but there is lack of proper data of sanitation workers dealing with mental health problems which is a big obstacle before evolving policies for the welfare of sewage and septic tank workers which needs attention. The objective of the study is to find out the effect of social stress on the mental health of sanitation workers and to explore the scope of social work in coping with mental health problems of workers. This descriptive and analytical study was conducted on 100 sanitation workers of Aligarh city through convenience sampling. Data were collected from respondents by schedule and interview method. Most of the respondents said that they don’t enjoy equal status in society and at the workplace as well which leads to stress. Many of them said that social stress leads to poor performance in the workplace. Some of the workers feel depressed when their work is not appreciated and recognized in society. Majority of respondents has stress in financial and employment-related difficulties. Thus it can be said that social stress has several impacts on mental health which leads to poor performance, lack of confidence, and motivation which sometimes leads to depression. Social work can play a very important and challenging role in overcoming these difficulties by providing education, motivation and guiding them and by making them aware of their rights and duties.

Keywords: discrimination, health, stress, sanitation workers

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Authors: A. Onur Kutlu, H. Tolga Bolukbasi

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Since the 1990s, governments, international organizations and scholars have drawn increasing attention to the significance of women in the labour force. While advanced industrial countries in North Western Europe and North America have managed to increase female labour force participation (FLFP) in the early post world war two period, emerging economies of the 1970s have only been able to increase FLFP only a decade later. Among these areas, Southern Europe features a wave of remarkable bounce backs in FLFP. However, despite striking similarities between the features in Southern Europe and those in Turkey, Turkey has not been able to pull women into the labour force. Despite a host of institutional similarities, Turkey has failed to reach to the level of her Southern European neighbours. This paper addresses the puzzle why Turkey lag behind in FLFP in comparison to her Southern European neighbours. There are signs showing that FLFP is currently reaching a critical threshold at a time when structural factors may allow a trend. It is not known, however, the constellation of conditions which may bring rising FLFP in Turkey. In order to gain analytical leverage from similar transitions in countries that share similar labour market and welfare state regime characteristics, this paper identifies the conditions in Southern Europe that brought rising FLFP to be able to explore the prospects for Turkey. Second, this paper takes these variables in the fuzzy set Qualitative Comparative Analysis (fsQCA) as conditions which can potentially explain the outcome of rising FLFP in Portugal, Spain, Italy, Greece and Turkey. The purpose here is to identify any causal pathway there may exist that lead to rising FLFP in Southern Europe. In order to do so, this study analyses two time periods in all cases, which represent different periods for different countries. The first period is identified on the basis of low FLFP and the second period on the basis of the transition to significantly higher FLFP. Third, the conditions are treated following the standard procedures in fsQCA, which provide equifinal: two distinct paths to higher levels of FLFP in Southern Europe, each of which may potentially increase FLFP in Turkey. Based on this analysis, this paper proposes that there exist two distinct paths leading to higher levels of FLFP in Southern Europe. Among these paths, salience of left parties emerges as a sufficient condition. In cases where this condition was not present, a second path combining enlarging service sector employment, increased tertiary education among women and increased childcare enrolment rates led to increasing FLFP.

Keywords: female labour force participation, fsQCA, Southern Europe, Turkey

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Authors: Ransford Kwaku Afeadie

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Purpose – The health challenges that characterises most of the migrants’ urban slums raise a lot of concern for their well-being. Health-seeking behaviour becomes an important step towards maintaining a healthy life. The importance of contextual issues is necessary to help meet specific community health needs and programmes. Therefore, this study aims to bridge the knowledge gap by investigating health-seeking behaviour disparity among rural-urban labour migrant slum dwellers before and after migration to the urban slums of Madina in the Greater Accra Region, Ghana. Design/methodology/approach – The author used explanatory sequential approach of research investigation. Questionnaire and interview guides were used to collect data from the respondents; however, in the absence of an existing reliable sampling frame, the various communities were selected by the use of cluster sampling proportional to size. At the second stage, a simple random sampling was used to select the various household heads. A total of 241 questionnaires were retrieved from the respondents representing a response rate of 100%. The author used the purposive sampling technique to conduct eight in-depth interviews and six key informants’ interviews. Findings – The author found various discrepancies in many of the activities that could fulfill substantial health-seeking behaviour in the slum as compared to migrant’s places of origin. The reason for coming to the slum amidst many settlements needs and low education background are the factors that accounted for this. This study, therefore, contradicts the proposition held by the health belief model. It is, therefore, important to note that contextual issues are key, in this case, rural-urban migrant slums present a different dynamic that must be taken into account when designing health programmes for such settings. Originality/value – Many, if not all the, studies on health-seeking behaviour have focused on urban slums without taking into account urban migrants’ slums. Such a failure to take into account the variations of the health needs of migrants’ urban slum settings can eventually lead to a mismatch of health programmes meant to address their challenges. Therefore, this study brings to the fore such variations that must be taken into account when designing health programmes. The study also indicates that even with the same people, there were disparities in terms of health-seeking behaviour in the slum and at places of origin.

Keywords: health-seeking behaviour, rural–urban migration, urban slums, health belief model

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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India is battling with the issues of accessibility, affordability and availability of quality health to the masses. Indian medical heritage which dated back to 3000 BC unveils the rich knowledge pool which has undergone a perceptible change over years, such as eradication of many communicable diseases, increasing individual awareness of quality health and import driven medical device market etc. Despite a slew of initiatives the holistic slogan of ‘health for all’ remains elusive and a concern for the nation. The 21st-century projects a myriad of challenges like cultural diversity, large population, demographic dividend and geographical segmentation leading to varied needs of people as per their regional conditions of climate, disease prevalence, nutrition and sanitation. But these challenges are also opportunities for the development of indigenous, low cost and accessible technologies to tackle them. This requires reinforcing the potential of indigenous technologies in coordination with prevailing health issues in various regions of country. This paper emphasis on the strategy for exploring the indigenous technologies with entrusted up-scaling to meet the diverse needs of the people. This review proposes to adopt technology transfer as a strategy to establish a vibrant ecosystem for identifying and up-scaling the indigenous medical technologies with diligent hand-holding for public health.

Keywords: health, indigenous, medical technology, technology transfer

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Authors: Vephkhvia Grigalashvili

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The defense of Georgia is every citizen’s duty. The present article reviews the principles and standards of gender policy in the Georgian national defense sector. In addition, it looks at mechanisms for ensuring gender equality, going through the relevant Georgian legislation. Furthermore, this work aims to conduct a comparative analysis of defense models of Georgia, Finland, and the Baltic States in order to identify core institutional challenges. The study produced the following findings:(a) The national defense planning is based on the Total Defense approach, which implies a wide involvement of the country`s population in state defense. (b) This political act does not specify gender equality aspects of the Total Defense strategy; (c) According to the Constitution of Georgia, irrespective of gender factors, every citizen of Georgia is legally obliged to participate in state security activities. However, the state has an authority (power of choice) to decide which gender group (male or/and female citizen) must fulfill above mentioned their constitutional commitment. For instance, completion of compulsory military and reserve military services is a male citizen’s duty, whereas professional military service is equally accessible to both genders. The study concludes that effective implementation of the Total Defense concept largely depends on how Georgia uses its capabilities and human resources. Based on the statistical fact that more than 50% of the country’s population are women, Georgia has to elaborate on relevant institutional mechanisms for implementation of gender equality in the national defense organization. In this regard, it would be advisable: (i) to give the legal opportunity to women to serve in compulsory military service, and (ii) to develop labor reserve service as a part of the anti-crisis management system of Georgia.

Keywords: gender in defense organisation, gender mechanisms, gender in defense policy, gender policy

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Authors: Panas Gerasimos, Kotidou Varvara, Halkiopoulos Constantinos, Gkintoni Evgenia

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As a result of growing technology and briefing by the internet, users resort to the internet and subsequently to the opinion of an expert. In many cases, they take control of their health in their hand and make a decision without the contribution of a doctor. According to that, this essay intends to analyze the confidence of searching health issues on the internet. For the fulfillment of this study, there has been a survey among doctors in order to find out the reasons a patient uses the internet about their health problems and the consequences that health information could lead by searching on the internet, as well. Specifically, the results regarding the research of the users demonstrate: a) the majority of users make use of the internet about health issues once or twice a month, b) individuals that possess chronic disease make health search on the internet more frequently, c) the most important topics that the majority of users usually search are pathological, dietary issues and the search of issues that are associated with doctors and hospitals. However, it observed that topic search varies depending on the users’ age, d) the most common sources of information concern the direct contact with doctors, as there is a huge preference from the majority of users over the use of the electronic form for their briefing and e) it has been observed that there is large lack of knowledge about e-health services. From the doctor's point of view, the following conclusions occur: a) almost all doctors use the internet as their main source of information, b) the internet has great influence over doctors’ relationship with the patients, c) in many cases a patient first makes a visit to the internet and then to the doctor, d) the internet significantly has a psychological impact on patients in order to for them to reach a decision, e) the most important reason users choose the internet instead of the health professional is economic, f) the negative consequence that emerges is inaccurate information, g) and the positive consequences are about the possibility of online contact with the doctor and contributes to the easy comprehension of the doctor, as well. Generally, it’s observed from both sides that the use of the internet in health issues is intense, which declares that the new means the doctors have at their disposal, produce the conditions for radical changes in the way of providing services and in the doctor-patient relationship.

Keywords: cognitive models, health marketing, e-health, psychological factors, digital marketing, e-health services

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Authors: Ellen Lagast, Melissa Ceuterick, Mark Leys

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Although adolescence is a stressful period with an increased risk for mental illnesses such as anxiety and depression, little in-depth knowledge is available on the determinants of the use of psychotropic drugs (BZD/SSRIs) and the effects. A qualitative research with adolescents in Flanders was performed. Based on indepth interviews, the interviewees indicate feelings of ambiguity towards their medication use because on the one hand the medication helps to manage their mental vulnerability and disrupted lives, but on the other hand they experience a loss of control of their self and their environment. Undesired side-effects and stigma led to a negative pharmaceutical self. The interviewed youngsters also express dissatisfaction about the prescription behavior with regard to psychotropic drugs of their general practitioner (GP). They wished to have received more information about alternative non-pharmaceutical treatment options. Notwithstanding these comments, the majority of the interviewees maintained trust in their GP to act in their best interest. This paper will relate the prescription behavior in primary care to the organization of mental health care to better understand the “phamaceuticalization” and medicalization of mental health problems in Belgium. Belgium implemented fundamental mental health care reforms to collaborate, to integrate care and to optimize continuity of care. Children and adolescents still are confronted with long waiting lists to access (non-medicalized) mental health services. This access to mental health care partly explains general practitioners’ prescription behavior of psychotropics. Moreover, multidisciplinary practices have not pervaded primary health care yet. Medicalization and pharmaceuticalization of mental health vulnerabilities of youth are both a structural and cultural problem.

Keywords: adolescents, antidepressants, benzodiazepines, mental health system, psychotropic drugs

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Authors: Qirat Naz

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The aim of this research study is to explore the perspectives of migrants and interpreters from diverse backgrounds on language barriers, their English language proficiency and access to health care facilities. A qualitative research methodology was used including in-depth interviews and focus group discussions. Data was collected from 20 migrants who have difficulty conversing in the English language and 12 interpreters including family members and friends who provide translation services as part of accessing health care. The findings seek to address three key research questions: how language is a barrier for non-national language speakers to access the health care facilities, what is the impact of various socio-cultural and linguistic backgrounds on health compliance, and what is the role of interpreters in providing access to, usage of, and satisfaction with health-care facilities. The most crucial component of providing care was found to be effective communication between patient and health care professionals. Language barrier was the major concern for healthcare professionals in providing and for migrants in accessing sufficient, suitable, and productive health care facilities. Language and sociocultural background play a significant role in health compliance as this research reported; respondents believe that patients who interact with the doctors who have same sociocultural and linguistic background benefit from receiving better medical care than those who do not. Language limitations and the socio-cultural gap make it difficult for patients and medical staff to communicate clearly with one another, which has a negative effect on quality of care and patient satisfaction. The use of qualified interpreters was found to be beneficial but there were also drawbacks such as accessibility and availability of them in a timely manner for patient needs. The findings of this research can help health care workers and policy makers working to improve health care delivery system and to create appropriate strategies to overcome this challenge.

Keywords: migration, migrants, language barrier, healthcare access

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Authors: F. Slaven, M. Uys, Y. Erasmus

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The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.

Keywords: mental health, public health facilities, South Africa, training

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Authors: Amaraporn Puraya, Roongtiva Boonpracom, Somsak Thojampa, Sirikanok Klankhajhon, Kittisak Kumpeera

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The objective of this qualitative research was to study the elderly health care process by community participation. Data were collected by quality research methods, including secondary data study, observation, in-depth interviews, and focus group discussions and analyzed by content analysis, reflection and review of information. The research results pointed out that the important elderly health care process by community participation consisted of 2 parts, namely the community participation development process in elderly health care and the outcomes from the participation development process. The community participation development process consisted of 4 steps as follows: 1) Building the leadership team, an important social capital of the community, which started from searching for both formal and informal leaders by giving the opportunity for public participation and creating clear agreements defining roles, duties and responsibilities; 2) investigating the problems and the needs of the community, 3) designing the elderly health care activities under the concept of self-care potential development of the elderly through participation in community forums and meetings to exchange knowledge with common goals, plans and operation and 4) the development process of sustainable health care agreement at the local level, starting from opening communication channels to create awareness and participation in various activities at both individual and group levels as well as pushing activities/projects into the community development plan consistent with the local administration policy. The outcomes from the participation development process were as follows. 1) There was the integration of the elderly for doing the elderly health care activities/projects in the community managed by the elderly themselves. 2) The service system was changed from the passive to the proactive one, focusing on health promotion rather than treating diseases or illnesses. 3) The registered nurses / the public health officers can provide care for the elderly with chronic illnesses through the implementation of activities/projects of elderly health care so that the elderly can access the services more. 4) The local government organization became the main mechanism in driving the elderly health care process by community participation.

Keywords: elderly health care process, community participation, elderly, Thailand

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Authors: Billy Zou

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Statement of the Problem: The burden of mental illness and problem behaviors in adolescence has risen worldwide. While less than 50% of teens have access to traditional mental health care, more than 73% have smartphones. Internet-based interventions offer advantages such as cost-effectiveness, availability, and flexibility. Methodology & Theoretical Orientation: A literature review was done using a PubMed search with the words mental health app yielding 2113 results. 103 articles that met inclusion criteria were reviewed, and findings were then described and synthesized. Findings: 1. Computer-based CBT was found to be effective for OCD, depression, social phobia, and panic disorder. 2. Web-based psychoeducation reduced problem behavior and improved parental well-being. 3. There is limited evidence for mobile-phone-based apps, but preliminary results suggest computer-based interventions are transferrable to mobile apps. 4. Adherence to app-based treatment was correlated with impressions about the user interface Conclusion & Significance: There is evidence for the effectiveness of computer-based programs in filling the significant gaps that currently exist in mental health delivery in the United States and internationally. There is also potential and theoretical validity for mobile-based apps to do the same, though more data is needed.

Keywords: children's mental health, mental health app, child and adolecent psychiatry, digital therapy

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Authors: A. Irudaya Veni Mary, M. Victor Louis Anthuvan, P. Christie, A. Indira

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In India, social enterprises are working to create social value in various fields including education; health; women and child development; environment protection and community development. Although social enterprises have brought about tremendous changes in the lives of beneficiaries, the importance of their works is not understood thoroughly. One of the ways to prove themselves is to measure the impact, which in recent times has received much attention. This paper focuses on the study of social value created by the social enterprises in the field of community development. It also aims to put forth a research tool for measuring the social value created by the social enterprises in the field of community development. A close-ended interview schedule was prepared to measure the social value creation and it was administered among 60 beneficiaries of two social enterprises who work in the field of community development. The study results show that the social enterprises have brought four types of impact in the life of their beneficiaries; economic impact, social impact, political impact and cultural impact. This study is limited to the social enterprises those who work towards community development. This empirical finding will enable the reader to understand various types of social value created by the social enterprises working in the field of community development. This study will also serve as guide for social enterprises in community development activities to measure their impact and thereby improve their operation towards the betterment of the society. This paper is derived from an empirical research carried out to describe the different types of social value created by the social enterprises in India.

Keywords: social enterprise, social entrepreneurs, social impact, social value, tool for social impact measurement

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Authors: Areej Makeineldein Mustafa

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The study evaluates the management processes and healthcare provider compliance with the National Institute for Health and Care Excellence recommendations for constipation management. We aimed to evaluate the adherence to National Institute for Health and Care Excellence guidelines in the management of constipation during the period from February to June 2023. We collected data from a random sample ( 51 patients) over 4 months with inclusion criteria for patients above 60 who were just admitted to the care of the elderly department during this period. Patient age, sex, medical records for constipation, acute or chronic constipation, or opioid-induced constipation, and treatment options were used to identify constipation and the type of treatment given. Our findings indicate that there is a gap between practice and National Institute for Health and Care Excellence guideline steps; only 3 patient was given medications according to National Institute for Health and Care Excellence guidelines in order of combination or steps of escalation. Addressing these gaps could potentially lead to enhanced patient outcomes and an overall improvement in the quality of care provided to individuals suffering from constipation.

Keywords: constipation, elderly, management, patient

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Authors: Gikunda Aloise, Mjema Saida, Barasa Herbert, Wanyungu John, Kimani Maureen

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Background: Community Health Workforce (CHW) is health care providers at the community level (Level 1) and serves as a bridge between the community and the formal healthcare system. This human resource has enormous potential to extend healthcare services and ensures that the vulnerable, marginalized, and hard-to-reach populations have access to quality healthcare services at the community and primary health facility levels. However, these cadres are neither recognized, remunerated, nor in most instances, registered in a master list. Management and supervision of CHWs is not easy if their individual demographics, training capacity and incentives is not well documented through a centralized registry. Description: In February 2022, Amref supported the Kenya Ministry of Health in developing a community health workforce database called Community Health Workers Master List Registry (CHWML), which is hosted in Kenya Health Information System (KHIS) tracker. CHW registration exercise was through a sensitization meeting conducted by the County Community Health Focal Person for the Sub-County Community Health Focal Person and Community Health Assistants who uploaded information on individual demographics, training undertaken and incentives received by CHVs. Care was taken to ensure compliance with Kenyan laws on the availability and use of personal data as prescribed by the Data Protection Act, 2019 (DPA). Results and lessons learnt: By June 2022, 80,825 CHWs had been registered in the system; 78,174 (96%) CHVs and 2,636 (4%) CHAs. 25,235 (31%) are male, 55,505 (68%) are female & 85 (1%) are transgender. 39,979. (49%) had secondary education and 2500 (3%) had no formal education. Only 27 641 (34%) received a monthly stipend. 68,436 CHVs (85%) had undergone basic training. However, there is a need to validate the data to align with the current situation in the counties. Conclusions/Next steps: The use of CHWML will unlock opportunities for building more resilient and sustainable health systems and inform financial planning, resource allocation, capacity development, and quality service delivery. The MOH will update the CHWML guidelines in adherence to the data protection act which will inform standard procedures for maintaining, updating the registry and integrate Community Health Workforce registry with the HRH system.

Keywords: community health registry, community health volunteers (CHVs), community health workers masters list (CHWML), data protection act

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Authors: Ivy Chumo, Sheillah Simiyu, Hellen Gitau, Isaac Kisiangani, Caroline Kabaria Kanyiva Muindi, Blessing Mberu

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The global sanitation workforce bridges the gap between sanitation infrastructure and the provision of sanitation services through essential public service work. Manual pit emptiers often perform the work at the cost of their dignity, safety, and health as their work requires repeated heavy physical activities such as lifting, carrying, pulling, and pushing. This exposes them to occupational and environmental health hazards and risking illness, injury, and death. The study will extend the studies by presenting occupational health risks and suggestions for improvement in informal settlements of Nairobi, Kenya. This is a qualitative study conducted among sanitation stakeholders in Korogocho, Mukuru and Kibera informal settlements in Nairobi. Data were captured using digital voice recorders, transcribed and thematically analysed. The discussion notes were further supported by observational notes made during the interviews. These formed the basis for a robust picture of occupational health of manual pit emptiers; a lack or inappropriate use of protective clothing, and prolonged duration of working hours were described to contribute to the occupational health hazard. To continue working, manual pit emptiers had devised coping strategies which include working in groups, improvised protective clothing, sharing the available protective clothing, working at night and consuming alcohol drinks while at work. Many of these strategies are detrimental to their health. Occupational health hazards among pit emptiers are key for effective working and is as a result of a lack of collaboration amongst stakeholders linked to health, safety and lack of PPE of pit emptiers. Collaborations amongst sanitation stakeholders is paramount for health, safety, and in ensuring the provision and use of personal protective devices.

Keywords: sanitation, occupational health, manual emptiers, informal settlements

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Authors: Tareq Aljaber

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The number of mobile health apps is growing at a fast frequency as it's nearly doubled in a year between 2015 and 2016. Though, there is a lack of an effective evaluation framework to verify the usability and reliability of mobile phone health education applications which would help saving time and effort for the numerous user groups. This abstract describing a framework for evaluating mobile applications in specifically mobile health education applications, along with a guidance select tool to assist different users to select the most suitable mobile health education apps. The effective framework outcome is intended to meet the requirements and needs of the different stakeholder groups additionally to enhancing the development of mobile health education applications with software engineering approaches, by producing new and more effective techniques to evaluate such software. This abstract highlights the significance and consequences of mobile health education apps, before focusing the light on the required to create an effective evaluation framework for these apps. An explanation of the effective evaluation framework is going to be delivered in the abstract, beside with some specific evaluation metrics: an efficient hybrid of selected heuristic evaluation (HE) and usability evaluation (UE) metrics to enable the determination of the usefulness and usability of health education mobile apps. Moreover, an explanation of the qualitative and quantitative outcomes for the effective evaluation framework was accomplished using Epocrates mobile phone app in addition to some other mobile phone apps. This proposed framework-An Evaluation Framework for Mobile Health Education Apps-consists of a hybrid of 5 metrics designated from a larger set in usability evaluation and heuristic evaluation, illuminated grounded on 15 unstructured interviews from software developers (SD), health professionals (HP) and patients (P). These five metrics corresponding to explicit facets of usability recognised through a requirements analysis of typical stakeholders of mobile health apps. These five hybrid selected metrics were scattered across 24 specific questionnaire questions, which are available on request from first author. This questionnaire has been sent to 81 participants distributed in three sets of stakeholders from software developers (SD), health professionals (HP) and patients/general users (P/GU) on the purpose of ranking three sets of mobile health education applications. Finally, the outcomes from the questionnaire data helped us to approach our aims which are finding the profile for different stakeholders, finding the profile for different mobile health educations application packages, ranking different mobile health education application and guide us to build the select guidance too which is apart from the Evaluation Framework for Mobile Health Education Apps.

Keywords: evaluation framework, heuristic evaluation, usability evaluation, metrics

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Authors: Mehwish Sarfaraz Ahmad

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Background: There is a prevailing perception in Pakistan that private hospitals offer better services than government hospitals. Unfortunately, Pakistan faces challenges in providing efficient healthcare due to limited resources and management capabilities, resulting in demotivation among healthcare workers. Aim: The purpose of this study was to conduct a comprehensive assessment of the occupational health and well-being of healthcare workers in both public and private sector tertiary care hospitals in Lahore, Pakistan, to compare the well-being of healthcare professionals in these two sectors and investigate the influence of workplace culture and experiences on their overall health. Methods: A cross-sectional study was conducted using a validated International Questionnaire, and data from 440 participants was collected using a stratified random sampling technique from a diverse group of healthcare professionals from the public and private tertiary care hospitals in Lahore, Pakistan. The researcher conducted a comparative analysis using appropriate statistical tests, such as Anova, t-tests, chi-square tests, and regression analysis, to explore potential relationships between various factors. Results: The majority of respondents (70.2%) reported their health as "Good" or "Very good, a small percentage (8.2%) rated their health as "Poor," while 24.1% considered their health as "Fair". 39.6% reported being satisfied with their workplace culture, while a majority of 60.4% indicated being unsatisfied with their workplace culture. Results showed that workplace culture has a positive correlation with the overall health and well-being of healthcare professionals. The study found significant differences in health ratings, prevalence of chronic health conditions, workplace culture, and safety perceptions between healthcare professionals in public and private sector tertiary care hospitals. Conclusion: The study's findings emphasize the significance of promoting a positive workplace culture, ensuring workplace safety, and addressing chronic health conditions among healthcare workers.

Keywords: occupational health and well-being, workplace culture, frequency of fatigue, availabity of benefits

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