Search results for: ethical issues in public health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 16678

Search results for: ethical issues in public health

16438 Factors Associated With Poor Glycaemic Control Among Patients With Type 2 Diabetes at Gatundu Level 5 Hospital. Kiambu County, Kenya: Key Lessons and Way Forward

Authors: Carolyne Ndungu, Wesley Too, Diana Kassaman

Abstract:

Diabetes is a global public health problem with an increasing morbidity and mortality rate across the globe. It is reported that 422 million people worldwide have diabetes with type 2 diabetes more common in people of African descent. Whilst prevalence of diabetes is four times more than it was in the last three decades, making it the world's ninth greatest cause of mortality, treatment of complications resulting from poor glycemic control is still high, contributing to poverty level in sub-Saharan. Poor treatment adherence has also been identified as a major contributing factor poor glycemic control among diabetic patients and still remains a significant challenge especially among patients living in rural Kenya. This study therefore seeks to identify gaps, barriers and challenges towards medication non-adherence among diabetic patients on follow-up at Kiambu County Referral Hospital, Kenya. Methods: A cross- sectional descriptive study was carried out at Gatundu Level five Hospital in Kiambu County. The study population consisted of adult patients with type two diabetes mellitus (T2DM) on follow up, at the Diabetes clinic between the month of June to July 2022. Systematic sampling of 200 participants was carried out. Ethical approvals from relevant authorities were done and ethical aspects of the study were also observed. Data analysis is ongoing using logistic regression analysis. Results, recommendations -contribution of this study will be highlighted within the next one month.

Keywords: adherence, diabetes, medication, Kenya

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16437 Factors Affecting Ethical Leadership and Employee Affective Organizational Commitment: An Empirical Study

Authors: Sharmin Shahid, Zaher Zain

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The purpose of this study is to explore and examines the theoretical frameworks of ethical leadership style and affective organizational commitment. Additionally, to investigate the extent to which employee orientation and ethical guidance either strengthen or weaken on the relationship between ethical leadership style and affective commitment. The study will also measure the mediating effects of leader’s integrity either influence to inspire and revival employee’s affective commitment or not. The methodology of the study comprised sample of 237 managers, departmental heads, top-level executives, and professors of several financial institutions, banks, and universities in Bangladesh who are directly related with decision making process of respective organization. A cross sectional research design will be used to examine the direct, moderating, and mediating analysis among the research key variables. Data were gathered based on personal administered questionnaire. The findings of the study will be significance because it will provide the real scenario of leadership style which leads to financial and strategic success of any organizations. In addition, the results will be interesting enough to find out either ethical leadership style have positive relationship with affective commitment or not. Employee-orientation and ethical guidance is a moderator to improve leadership style and affective commitment, whereas, leader’s integrity mediates the relationships between leadership style and affective organizational commitment to do the right thing in the right way for the betterment of entire organizational success. Research limitations of the study are the data collected by self administered questionnaire, a method with well-known shortcomings. Second, the study concentrated on financial institutions, banks top executives, and universities professors in Bangladesh. An important implication of the research is that the interesting findings will give some insight to the leadership style and helps management to focus on their management and leadership efficacy, as that could improve their affective organizational commitment. The findings will be original and unique value adding with the existing literature on leadership studies. The study is based on a comprehensive literature review. The results will be based on a sample of financial institutions, banks, and universities in Bangladesh. The research findings are useful to academics and corporate leaders of financial institutions, banks, and universities all over the world.

Keywords: affective organizational commitment, Bangladesh, ethical guidance, ethical leadership style

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16436 Systematic Review of Technology-Based Mental Health Solutions for Modelling in Low and Middle Income Countries

Authors: Mukondi Esther Nethavhakone

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In 2020 World Health Organization announced the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as Coronavirus disease 2019 (COVID-19) pandemic. To curb or contain the spread of the novel coronavirus (COVID 19), global governments implemented social distancing and lockdown regulations. Subsequently, it was no longer business as per usual, life as we knew it had changed, and so many aspects of people's lives were negatively affected, including financial and employment stability. Mainly, because companies/businesses had to put their operations on hold, some had to shut down completely, resulting in the loss of income for many people globally. Finances and employment insecurities are some of the issues that exacerbated many social issues that the world was already faced with, such as school drop-outs, teenage pregnancies, sexual assaults, gender-based violence, crime, child abuse, elderly abuse, to name a few. Expectedly the majority of the population's mental health state was threatened. This resulted in an increased number of people seeking mental healthcare services. The increasing need for mental healthcare services in Low and Middle-income countries proves to be a challenge because it is a well-known fact due to financial constraints and not well-established healthcare systems, mental healthcare provision is not as prioritised as the primary healthcare in these countries. It is against this backdrop that the researcher seeks to find viable, cost-effective, and accessible mental health solutions for low and middle-income countries amid the pressures of any pandemic. The researcher will undertake a systematic review of the technology-based mental health solutions that have been implemented/adopted by developed countries during COVID 19 lockdown and social distancing periods. This systematic review study aims to determine if low and middle-income countries can adopt the cost-effective version of digital mental health solutions for the healthcare system to adequately provide mental healthcare services during critical times such as pandemics (when there's an overwhelming diminish in mental health globally). The researcher will undertake a systematic review study through mixed methods. It will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The mixed-methods uses findings from both qualitative and quantitative studies in one review study. It will be beneficial to conduct this kind of study using mixed methods because it is a public health topic that involves social interventions and it is not purely based on medical interventions. Therefore, the meta-ethnographic (qualitative data) analysis will be crucial in understanding why and which digital methods work and for whom does it work, rather than only the meta-analysis (quantitative data) providing what digital mental health methods works. The data collection process will be extensive, involving the development of a database, table of summary of evidence/findings, and quality assessment process lastly, The researcher will ensure that ethical procedures are followed and adhered to, ensuring that sensitive data is protected and the study doesn't pose any harm to the participants.

Keywords: digital, mental health, covid, low and middle-income countries

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16435 Ethical Artificial Intelligence: An Exploratory Study of Guidelines

Authors: Ahmad Haidar

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The rapid adoption of Artificial Intelligence (AI) technology holds unforeseen risks like privacy violation, unemployment, and algorithmic bias, triggering research institutions, governments, and companies to develop principles of AI ethics. The extensive and diverse literature on AI lacks an analysis of the evolution of principles developed in recent years. There are two fundamental purposes of this paper. The first is to provide insights into how the principles of AI ethics have been changed recently, including concepts like risk management and public participation. In doing so, a NOISE (Needs, Opportunities, Improvements, Strengths, & Exceptions) analysis will be presented. Second, offering a framework for building Ethical AI linked to sustainability. This research adopts an explorative approach, more specifically, an inductive approach to address the theoretical gap. Consequently, this paper tracks the different efforts to have “trustworthy AI” and “ethical AI,” concluding a list of 12 documents released from 2017 to 2022. The analysis of this list unifies the different approaches toward trustworthy AI in two steps. First, splitting the principles into two categories, technical and net benefit, and second, testing the frequency of each principle, providing the different technical principles that may be useful for stakeholders considering the lifecycle of AI, or what is known as sustainable AI. Sustainable AI is the third wave of AI ethics and a movement to drive change throughout the entire lifecycle of AI products (i.e., idea generation, training, re-tuning, implementation, and governance) in the direction of greater ecological integrity and social fairness. In this vein, results suggest transparency, privacy, fairness, safety, autonomy, and accountability as recommended technical principles to include in the lifecycle of AI. Another contribution is to capture the different basis that aid the process of AI for sustainability (e.g., towards sustainable development goals). The results indicate data governance, do no harm, human well-being, and risk management as crucial AI for sustainability principles. This study’s last contribution clarifies how the principles evolved. To illustrate, in 2018, the Montreal declaration mentioned eight principles well-being, autonomy, privacy, solidarity, democratic participation, equity, and diversity. In 2021, notions emerged from the European Commission proposal, including public trust, public participation, scientific integrity, risk assessment, flexibility, benefit and cost, and interagency coordination. The study design will strengthen the validity of previous studies. Yet, we advance knowledge in trustworthy AI by considering recent documents, linking principles with sustainable AI and AI for sustainability, and shedding light on the evolution of guidelines over time.

Keywords: artificial intelligence, AI for sustainability, declarations, framework, regulations, risks, sustainable AI

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16434 Ethical Decision-Making in AI and Robotics Research: A Proposed Model

Authors: Sylvie Michel, Emmanuelle Gagnou, Joanne Hamet

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Researchers in the fields of AI and Robotics frequently encounter ethical dilemmas throughout their research endeavors. Various ethical challenges have been pinpointed in the existing literature, including biases and discriminatory outcomes, diffusion of responsibility, and a deficit in transparency within AI operations. This research aims to pinpoint these ethical quandaries faced by researchers and shed light on the mechanisms behind ethical decision-making in the research process. By synthesizing insights from existing literature and acknowledging prevalent shortcomings, such as overlooking the heterogeneous nature of decision-making, non-accumulative results, and a lack of consensus on numerous factors due to limited empirical research, the objective is to conceptualize and validate a model. This model will incorporate influences from individual perspectives and situational contexts, considering potential moderating factors in the ethical decision-making process. Qualitative analyses were conducted based on direct observation of an AI/Robotics research team focusing on collaborative robotics for several months. Subsequently, semi-structured interviews with 16 team members were conducted. The entire process took place during the first semester of 2023. Observations were analyzed using an analysis grid, and the interviews underwent thematic analysis using Nvivo software. An initial finding involves identifying the ethical challenges that AI/robotics researchers confront, underlining a disparity between practical applications and theoretical considerations regarding ethical dilemmas in the realm of AI. Notably, researchers in AI prioritize the publication and recognition of their work, sparking the genesis of these ethical inquiries. Furthermore, this article illustrated that researchers tend to embrace a consequentialist ethical framework concerning safety (for humans engaging with robots/AI), worker autonomy in relation to robots, and the societal implications of labor (can robots displace jobs?). A second significant contribution entails proposing a model for ethical decision-making within the AI/Robotics research sphere. The model proposed adopts a process-oriented approach, delineating various research stages (topic proposal, hypothesis formulation, experimentation, conclusion, and valorization). Across these stages and the ethical queries, they entail, a comprehensive four-point comprehension of ethical decision-making is presented: recognition of the moral quandary; moral judgment, signifying the decision-maker's aptitude to discern the morally righteous course of action; moral intention, reflecting the ability to prioritize moral values above others; and moral behavior, denoting the application of moral intention to the situation. Variables such as political inclinations ((anti)-capitalism, environmentalism, veganism) seem to wield significant influence. Moreover, age emerges as a noteworthy moderating factor. AI and robotics researchers are continually confronted with ethical dilemmas during their research endeavors, necessitating thoughtful decision-making. The contribution involves introducing a contextually tailored model, derived from meticulous observations and insightful interviews, enabling the identification of factors that shape ethical decision-making at different stages of the research process.

Keywords: ethical decision making, artificial intelligence, robotics, research

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16433 The Algorithmic Dilemma: Virtue Development in the Midst of Role Conflict and Role Ambiguity in Platform Work

Authors: Thumesha Jayatilake

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As platform work continues to proliferate, algorithmic management, which takes care of its operational role, poses complex challenges, including job satisfaction, worker involvement, ethical decision-making, and worker well-being. This conceptual paper scrutinizes how algorithmic management influences virtue development among platform workers, with an emphasis on the effects of role conflict and role ambiguity. Using an interdisciplinary approach, the research elucidates the complex relationship between algorithmic management systems and the ethical dimensions of work. The study also incorporates the interplay of human interaction and short-term task orientation, thus broadening the understanding of the impacts of algorithmic management on virtue development. The findings have significant implications for policymakers, academics, and industry practitioners, illuminating the ethical complexities presented by the use of algorithms in modern employment settings.

Keywords: algorithmic management, ethics, platform work, virtue

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16432 Chest Pain as a Predictor for Heart Issues in Geriatrics

Authors: Leila Kargar, Homa Abri, Golsa Safai

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The occurrence of chest pain among geriatrics could be considered as a predictor of heart issues. There is a need for attention to this pain among this population. This review paper has tried to collect the recent data with attention to the chest pain among geriatrics. This review paper has focused on specific keywords, including chest pain, heart issues, and geriatrics, among published papers from 2015 till 2020. To collect data for this purpose, Scopus, Web of Sciences, and PubMed were used. After inserting related papers to the Endnote, an independent researcher checked the abstract, and papers with unclear methods or non-English language were excluded. Finally, 7-papers were included in this review paper. The findings of those papers showed that chest pain could be a predictor for heart issues, and also, there is a direct relationship between chest pain and heart issues among geriatrics. So, early detection and an accurate decision could be helpful to prevent heart issues in this population.

Keywords: pain, heart issue, geriatrics, health

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16431 Transit Network Design Problem Issues and Challenges

Authors: Mahmoud Owais

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Public Transit (P.T) is very important means to reduce traffic congestion, to improve urban environmental conditions and consequently affects people social lives. Planning, designing and management of P.T are the key issues for offering a competitive mode that can compete with the private transportation. These transportation planning, designing and management issues are addressed in the Transit Network Design Problem (TNDP). It deals with a complete hierarchy of decision making process. It includes strategic, tactical and operational decisions. The main body of TNDP is two stages, namely; route design stage and frequency setting. The TNDP is extensively studied in the last five decades; however the research gate is still widely open due to its many practical and modeling challenges. In this paper, a comprehensive background is given to illustrate the issues and challenges related to the TNDP to help in directing the incoming researches towards the untouched areas of the problem.

Keywords: frequency setting, network design, transit planning, urban planning

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16430 Expanding the World: Public and Global Health Experiences for Undergraduate Nursing Students

Authors: Kristen Erekson, Sarah Spendlove Caswell

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Nurse educators have the challenge of training future nurses that will provide compassionate care to an increasingly diverse population of patients in a culturally sensitive way. One approach to this challenge is an immersive public and global health experience as part of the nursing program curriculum. Undergraduate nursing students at our institution are required to participate in a Public and Global Health course. They participate in a didactic preparatory course followed by a 3-to-4-week program in one of the following locations: The Czech Republic, Ecuador, Finland/Poland, Ghana, India, Spain, Taiwan, Tonga, an Honor Flight to Washington D.C. with Veterans, or in local (Utah) communities working with marginalized populations (including incarcerated individuals, refugees, etc.). The students are required to complete 84 clinical hours and 84 culture hours (which involve exposure to local history, art, architecture, customs, etc.). As Faculty, we feel strongly that these public and global health experiences help cultivate cultural awareness in our students and prepare nurses who are better prepared to serve a diverse population of patients throughout their careers. This presentation will highlight our experiences and provide ideas for other nurse educators who have an interest in developing similar programs in their schools but do not know where to start. Suggestions about how to start building relationships that can lead to these opportunities, along with logistics for continuing the programs, will be highlighted.

Keywords: global health nursing, nursing education, clinical education, public health nursing

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16429 Business Ethics in Islam: Making Islamic Banking Attractive for the Customers Round the Globe

Authors: Fahad Ahmed Qureshi

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Is it essential for a Muslim businessperson and employees of Islamic financial institutions not only in Islamic Banks to perform his/her actions ethically in a universally, competing habitat? The answer is an emphatic NO! in Islam, ethics conduct all departments of life. The orders for eternal success or falah in Islam are the same for all Muslims–whether in managing their business activities or in carrying out their routine affairs. Without designating any circumstantial ambience, Allah specify people who achieve success as those who are “inviting to all that is good (Khayr), enjoining what is right (Ma'ruf) and forbidding what is wrong (Munkar).” Within a business context, however, what sole axioms of regimen should a company follow? What is a Muslim businessperson’s encumbrance to internal and external stakeholders? Although an organization’s top executives may display sterling ethical behavior, how can middle- and lower-level managers be enthusiastic to perform in a correspondingly ethical manner? What are some protocols that would clinch persistent ethical behavior in a Muslim business?

Keywords: business, ethics, finance, Islam

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16428 Effectiveness of Public Health Laws and Study of Social Aspects: With Special Reference to India

Authors: Arun Karoriya, Mrinal Agrawal

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Health is one of the basic requirements of human being. And today India is facing a major degradation of health at every age group. As society evolves and flourishes, there are different types of rules, norms, standards which are required to control the conduct of the human being for its well-being and growth. Right to health is one of those aspects that can be counted, discovered and examined under the purview of constitutional provisions of India. The condition of health is at downfall despite the fact that there are several policies framed by the government. There is an urgent call for rigid public health laws to ensure safe and disease free society. The effectiveness of health law has to be examined by keeping in mind that it is hampering growth and economy and society establishment. Health in any society is a main social aspect as it plays a major role for economic development. The multidimensional approach to determine it is by discussing i) rational selection and use of medicines ii) sustainable adequate financing iii) affordable prices iv)reliable health and supply systems.

Keywords: degradation, flourish, multidimensional, policies

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16427 The Potential of Public Open Space to Promote Sustainable Transportation and Reduce Dependence on Cars

Authors: Farnoosh Faal

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The excessive reliance on private cars has led to a range of problems, such as traffic congestion, air pollution, and carbon emissions, which have significant impacts on public health and the environment. Public open spaces have the potential to promote sustainable transportation and reduce dependence on cars by providing alternative mobility options, including walking, cycling, and public transit. This paper examines the existing research on the relationship between public open spaces and sustainable transportation. It discusses the key design principles and planning strategies that can enhance the accessibility and safety of public open spaces, particularly for pedestrians and cyclists. The paper also explores the role of public open spaces in promoting active mobility and reducing car use in urban and suburban contexts. Finally, the paper highlights the policy and institutional barriers that hinder the integration of public open spaces with sustainable transportation systems and suggests some potential solutions to overcome these barriers. Overall, the paper argues that public open spaces have immense potential to facilitate sustainable transportation and reduce car dependence, and therefore, it is important to prioritize the development and maintenance of public open spaces as a key component of sustainable urban and regional planning.

Keywords: public open space, sustainable transportation, active mobility, car dependence, urban and regional planning, traffic congestion

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16426 Friendly Public Spaces in Iran

Authors: Bibi Somayeh Aliakbari, Niknaz Kachooei, Fatemeh Amiri Najafabadi

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According to the results of contemporary urbanism, social living moved into buildings and the quality of urban space has been declining. But still, there are life in open public space and it is one of reason attendance and activities of people in open public spaces.The purpose of this research is finding reason creation friendly public space in urban spaces and also use these in new urban spaces.The research methodology consisted of a qualitative model based on observation and graphical analysis. In this paper case study is public space historical, moderns in urban scales and local scales in Iran.This paper shows that Existence of friendly public space in cities cause is attendance and activities of people in open public spaces that it is reason the revitalization of public open spaces in cities.

Keywords: public space, public open space, friendly public space, Iran

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16425 PrEP and Risk: Challenges for an Emerging Sanitary Pact

Authors: Roberto Rubem Silva-Brandao, Aurea Maria Zollner Ianni

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This article discusses the use and the incorporation of Pre-exposure Prophylaxis for HIV (PrEP) within a risk society context. Considering contemporary social theoreticians, we discuss implications of biotechnological uses for health enhancement. Firstly, we explore examples of biological manipulation and its consequences of use on given ecological dynamics, particularly taking into account other Sexually Transmitted Infections. In addition, we discuss how HIV resistance cases occurred with people on PrEP and its possible consequences on population-based interventions. Moreover, we present recent studies that analyze biological modifications on bodies of those who are on consistent use of PrEP, and how these body modifications are addressed on common practices of Public Health. Secondly, we present our theoretical references, which are intended to the analysis that situates our contemporary society in the reflexive stage of modernization. We discuss limits of biological use by individuals and how this can fabric feelings of freedom and autonomy within the individualization process and health. Finally, we argue that biotechnological uses on health, specifically on Public Health, tackling the risk aspects of its application, shows that another sanitary pact is needed.

Keywords: PrEP, public health, social sciences, risk society

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16424 The Increase of Adolescent Obesity Rates after the COVID-19 Pandemic and Possible Obesity Prevention Programs for Implementation

Authors: Tatiana Pratt, Benyamin Hanasabzadeh, Panayiota Courelli

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The COVID-19 pandemic is one of the largest global public health issues of this current century. COVID-19 puts people diagnosed with obesity at higher risk of not only contracting the virus but also being hospitalized and dying, making this a vital time to implement obesity prevention programs. However, COVID-19 is predicted to rapidly increase the obesity rate in the United States due to the mandatory sedentary lifestyle the pandemic demands; this is especially harmful to adolescent-aged children because it creates lifelong unhealthy habits and behaviors. Adolescent obesity prevention programs have been rigorously implemented throughout the last century to help diminish the ever-increasing adolescent obesity rate. Since the pandemic kept adolescents inside and away from in-person school, many programs have now become ineffective due to their in-person participation. Examples of in-person participation programs include school lunch programs, OSNAP and New Moves. Therefore, online programs or remote intervention measures are now more essential. This leads to programs such as Time2bHealthy, HEALTH[e]TEEN, and SWITCH should be looked at with more vitality. Adolescents have intertwined their lives with technology and screen usage. Therefore, online and remote prevention programs will continue to play a large role in the post-pandemic era. This literature review will be reviewing past and current adolescent obesity prevention programs and their effectiveness with the new remote, sedentary lifestyle adolescents. Furthermore, it will suggest new ways to more productively decrease adolescent obesity rates by analyzing the harmful factors that COVID-19 introduced into their lifestyles.

Keywords: adolescent, obesity, overweight, COVID-19, preventative care, public health, public policy, obesity prevention programs, online programs

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16423 Literary Imagination and Leadership: Lessons From the Classroom

Authors: Naor Cohen

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In recent years, business schools made teaching ethical leadership a higher priority. Greater attention to moral and ethical concepts and reasoning processes may prove beneficial to future business leaders. But with a shift in focus, there is a need for a shift in pedagogy. This paper explores an imaginative literature-based pedagogy in the teaching of ethical leadership. An imaginative literature-based pedagogy uses works of fiction to help students build moral analysis and moral judgment capabilities through a rigorous assessment of the moral soundness of actions, motivations, rationales, and consequences portrayed in works of fiction. Business students enrolled in 4 leadership senior-level courses were assigned the White Tiger: A Novel by Aravind Adiga as their main course reading. Students' engagement was measured as a three-factor construct exploring cognitive engagement, behavioural engagement and emotional engagement. In addition, students' final papers were analyzed using thematic content analysis. This paper will present the results of this analysis and argue that incorporating fiction into the leadership curriculum allows students to explore the dire consequences of avoiding countervailing interests, engaging in dishonesty and engaging in moral puffery-based leadership.

Keywords: ethical leadership, empathetic imagination, business education, pedagogy, fiction

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16422 Knowledge and Utilization of Partograph among Obstetric Care Givers in Public Health Institutions of Addis Ababa, Ethiopia

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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16421 Health as an Agenda in Indian Politics: A Study of Election Manifestos in 16th General Elections

Authors: Kiran Bala

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Health, education and employment opportunities available for a common citizen reflect the development status of a country. Health of an individual affects the growth of a country in every aspect. According to a study by WHO, India is estimated to lose more than $237 billion of its GDP over the period 2006-15 on account of premature death and morbidity from Non-communicable diseases alone. Each year 37 million people fall below poverty line due to high expenditure on health services they have to incur. Falling sick puts a double burden on them in terms of loss of income and expenditure on health care which pushes them further into debt and poverty. Adding to the gravity of situation, public spending on health in India has itself declined after liberalization from 1.3% of GDP in 1990 to 0.9% in 1999. The Approach Paper of the Government of India to the Twelfth Five Year Plan indicated that health expenditure alone as a per cent of GDP was about 1.4 per cent (B.E.) in 2011-12. It also mentioned that if one included expenditure on rural water supply and sanitation, the figure would be about 1.8 per cent. Given the abysmally low level of priority accorded to health in Indian economic policy, it becomes rather important to study the representation of health in the Indian public sphere. To this end, this study examines the prioritization of health in the public policy agenda of the national/regional political parties as evidenced in their election manifestos at a time when the nation is poised to go for the General Elections. The paper also focuses attention on the prioritization of health in the public perception as evidenced in their reasons for their preferences for a particular party or individual contestant. To arrive at the reasons for the priority level accorded by the political actors and the citizens, the study uses Focus groups of health policy makers, media persons, medical practitioners and voters. Collected data will be analysed in the theoretical framework of spiral of silence and agenda setting theory.

Keywords: health, election manifestos, public perception, policies

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16420 Comparing Quality of Care in Family Planning Services in Primary Public and Private Health Care Facilities in Ethiopia

Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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16419 Cost Effectiveness of Transcatheter Aortic Valve Replacement vs Surgical Aortic Valve Replacement in a Low-Middle Income Country

Authors: Vasuki Rayapati, Bhanu Duggal

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Trans catheter aortic valve replacement (TAVR) is the recommended treatment over surgical aortic valve replacement (SAVR) for high-risk groups, patients >75 years of age with severe symptomatic Aortic stenosis (AS). In high income countries TAVR is more cost effective because of – i) Reduction in total length of stay including less number of days in ICU ii) Non-procedural costs like cost of general anaesthesia are higher for SAVR. In India, there are two kinds of hospitals – Public and Private. Most patients visit public sector hospitals than private sector hospitals. In a LMIC like India, especially in the Public health sector cost of TAVR is prohibitive. In a small study from three (public) hospitals in India, it was envisaged that cost of TAVR should decrease at least by 2/3 to be a cost effective option in Public health sector for severe AS.

Keywords: cost effectiveness, TAVR vs SAVR, LMIC, HTA

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16418 Humanity in Public Policy: The Polemic of Death Penalty Policy in Indonesia

Authors: Alvian R. E. Purnomo, K. Noni Srijati, Hernawan Adi

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Government regulation is a result of agreement on the struggle of ideas, interests, and ideologies among elites in state institution. The polemic about death penalty policy in Indonesia is still becoming an interesting discussion and also a complex issue. There are pros/ cons of whether the policy is humane or not. Indonesia becomes the concern of the world’s community because the policy of death penalty applied is considered not reflecting the values of Indonesian culture including tolerance, mutual cooperation, and love. This paper examines them using literature study on how public policy theories respond to humanity issues and how Indonesian government should take steps to the issue of the death penalty that has become polemic until now.

Keywords: government regulation, public policy, death penalty policy, humanity

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16417 Perception of Risks of the Telecommunication Towers in Malaysia: A Qualitative Inquiry

Authors: Y. Kamarulzaman, A. Madun, F. D. Yusop, N. Abdullah, N. K. Hoong

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In 2011, the Malaysian Government has initiated a nationwide project called 1BestariNet which will adopt the using of technology in teaching and learning, resulting in the construction of telecommunication towers inside the public schools’ premise. Using qualitative approach, this study investigated public perception of risks associated with the project, particularly the telecommunication towers. Data collection involved observation and in-depth interviews with 22 individuals consist of a segment of public that was anxious about the risks of radio frequency electromagnetic field (RFEMF) which include two employees of telecommunication companies (telcos) and five employees of Government agencies. Observation of the location of the towers at 10 public schools, a public forum, and media reports provide valuable information in our analysis. The study finds that the main concern is related to the health risks. This study also shows that it is not easy for the Government to manage public perception mainly because it involves public trust. We find that risk perception is related with public trust, as well as the perceived benefits and level of knowledge. Efficient communication and continuous engagement with the local communities help to build and maintain public trust, reduce public fear and anxiety, hence mitigating the risk perception among the public.

Keywords: risk perception, risk communication, trust, telecommunication tower, radio frequency electromagnetic field (RFEMF)

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16416 WhatsApp as a Public Health Management Tool in India

Authors: Drishti Sharma, Mona Duggal

Abstract:

Background: WhatsApp can serve as a cost-effective, scalable, convenient, and popular medium for public health management related communication in the developing world where the existing system of communication is top-down and slow. The product supports sending and receiving a variety of media: text, photos, videos, documents, and location, as well as voice/video calls. With growing number of users of smartphones and improving access and penetration of internet, the scope of information technology remains immense in resolving the hurdles faced by traditional public health system. Poor infrastructure, gap in digital literacy, faulty documentation, strict organizational hierarchy and slow movement of information across desks and offices- all these, make WhatsApp an efficient prospect to complement the existing system for communication, feedback and leadership for public health system in India. Objective: This study investigates the benefits, challenges and limitations associated with WhatsApp usage as a public health management tool. Methods: The study was conducted within the Chandigarh Union Territory. We used a qualitative approach and conducted individual semi-structured interviews and group interviews (n = 10). Participants included medical officers (n 20), Program managers (n = 4), academicians (n=2) and administrators (n=2). Thematic and content qualitative analyses were conducted. Message log of the WhatsApp group of one of the health program was assessed. Results: Medical Officers said that WhatsApp helped them remain in touch with the program officer. They could easily give feedback and highlight those challenges which needed immediate intervention from the program managers, hence they felt supported. Also, the application helped them share pictures of their activities (meetings and field activities) with the group which they thought inspired others and gave themselves immense satisfaction. Also, it helped build stronger relationships and better coordination among themselves, the same being important in team events. For program managers, it had become a portal for coordinating large scale campaigns. Its reach and the fact that the feedback is real-time make WhatsApp ideal for district level events. Though the easy informal connectivity made them answerable to their staff but it also provided them with flexibility in operations. It turned out to be an important portal for sharing outcome and goals related feedback (both positive and negative) to the team. To be sure, using WhatsApp for the purpose of public health program presents considerable challenges, including technological barriers, organizational challenges, gender issues, confidentiality concerns and unplanned aftereffects. Nevertheless, its advantages in a low-cost setting make it an efficient alternative. Conclusion: WhatsApp has become an integral part of our lives. Use of this app for public health program management within closed groups looks promising and useful. At the same time, addressing the challenges involved would make its usage safer.

Keywords: communication, mobile technology, public health management, WhatsApp

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16415 Completion of the Modified World Health Organization (WHO) Partograph during Labour in Public Health Institutions of Addis Ababa, Ethiopia

Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

Abstract:

Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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16414 Industry 4.0 Adoption, Control Mechanism and Sustainable Performance of Healthcare Supply Chains under Disruptive Impact

Authors: Edward Nartey

Abstract:

Although the boundaries of sustainable performance and growth in the field of service supply chains (SCs) have been broadened by scholars in recent years, research on the impact and promises of Industry 4.0 Destructive Technologies (IDTs) on sustainability performance under disruptive events is still scarce. To mitigate disruptions in the SC and improve efficiency by identifying areas for cost savings, organizations have resorted to investments in digitalization, automation, and control mechanisms in recent years. However, little is known about the sustainability implications for IDT adoption and controls in service SCs, especially during disruptive events. To investigate this paradox, survey data were sought from 223 public health managers across Ghana and analyzed via covariance-based structural equations modelling. The results showed that both formal and informal control have a positive and significant relationship with IDT adoption. In addition, formal control has a significant and positive relationship with environmental and economic sustainability but an insignificant relationship with social sustainability. Furthermore, informal control positively impacts economic performance but has an insignificant relationship with social and environmental sustainability. While the findings highlight the prevalence of the IDTs being initiated by Ghanaian public health institutions (PHIs), this study concludes that the installed control systems in these organizations are inadequate for promoting sustainable SC behaviors under destructive events. Thus, in crisis situations, PHIs need to redesign their control systems to facilitate IDT integration towards sustainability issues in SCs.

Keywords: industry 4.0 destructive technologies, formal control, informal control, sustainable supply chain performance, public health organizations

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16413 A Review on the Perception of Beşiktaş Public Square

Authors: Neslinur Hizli, Berrak Kirbaş Akyürek

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Beşiktaş, one of the historical coastal district of İstanbul, is on the very edge of the radical transformation because of an approaching ‘Beşiktaş Public Square Project’. At this juncture, due its location, presence on the coast, population density and distance to the other centers of the city, the decisions to be taken are critical to whole Istanbul that will be majorly affected from this transformation. As the new project aims to pedestrianize the area by placing the vehicular traffic under the ground, Beşiktaş and its square will change from top to bottom. Among those considerations, through the advantages and disadvantages the perception of the existing conditions of the Beşiktaş play significant role. The motive of this paper is the lack of determination and clarity on the cognition of the Square. After brief analysis on the historical transformation of the area, prominent studies on the criteria of public square are revised. Through cognitive mapping methodology, characteristics of the Square and the public space in general find a place to discuss from individual views. This study aims to discuss and review Beşiktaş Public Square from perspective, mind and behavior of the users. Cognitive map study with thirty subjects (30) is evaluated and categorized upon the five elements that Kevin Lynch defined as the images of the city. The results obtained digitized and represented with tables and graphs. Findings of the research underline the crucial issues on the approaching change in Beşiktaş. Thus, this study may help to develop comprehensive ideas and new suggestions on the Square.

Keywords: Beşiktaş public square, cognitive map, perception, public space

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16412 Good Practices for Model Structure Development and Managing Structural Uncertainty in Decision Making

Authors: Hossein Afzali

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Increasingly, decision analytic models are used to inform decisions about whether or not to publicly fund new health technologies. It is well noted that the accuracy of model predictions is strongly influenced by the appropriateness of model structuring. However, there is relatively inadequate methodological guidance surrounding this issue in guidelines developed by national funding bodies such as the Australian Pharmaceutical Benefits Advisory Committee (PBAC) and The National Institute for Health and Care Excellence (NICE) in the UK. This presentation aims to discuss issues around model structuring within decision making with a focus on (1) the need for a transparent and evidence-based model structuring process to inform the most appropriate set of structural aspects as the base case analysis; (2) the need to characterise structural uncertainty (If there exist alternative plausible structural assumptions (or judgements), there is a need to appropriately characterise the related structural uncertainty). The presentation will provide an opportunity to share ideas and experiences on how the guidelines developed by national funding bodies address the above issues and identify areas for further improvements. First, a review and analysis of the literature and guidelines developed by PBAC and NICE will be provided. Then, it will be discussed how the issues around model structuring (including structural uncertainty) are not handled and justified in a systematic way within the decision-making process, its potential impact on the quality of public funding decisions, and how it should be presented in submissions to national funding bodies. This presentation represents a contribution to the good modelling practice within the decision-making process. Although the presentation focuses on the PBAC and NICE guidelines, the discussion can be applied more widely to many other national funding bodies that use economic evaluation to inform funding decisions but do not transparently address model structuring issues e.g. the Medical Services Advisory Committee (MSAC) in Australia or the Canadian Agency for Drugs and Technologies in Health.

Keywords: decision-making process, economic evaluation, good modelling practice, structural uncertainty

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16411 Emotions in Health Tweets: Analysis of American Government Official Accounts

Authors: García López

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The Government Departments of Health have the task of informing and educating citizens about public health issues. For this, they use channels like Twitter, key in the search for health information and the propagation of content. The tweets, important in the virality of the content, may contain emotions that influence the contagion and exchange of knowledge. The goal of this study is to perform an analysis of the emotional projection of health information shared on Twitter by official American accounts: the disease control account CDCgov, National Institutes of Health, NIH, the government agency HHSGov, and the professional organization PublicHealth. For this, we used Tone Analyzer, an International Business Machines Corporation (IBM) tool specialized in emotion detection in text, corresponding to the categorical model of emotion representation. For 15 days, all tweets from these accounts were analyzed with the emotional analysis tool in text. The results showed that their tweets contain an important emotional load, a determining factor in the success of their communications. This exposes that official accounts also use subjective language and contain emotions. The predominance of emotion joy over sadness and the strong presence of emotions in their tweets stimulate the virality of content, a key in the work of informing that government health departments have.

Keywords: emotions in tweets, emotion detection in the text, health information on Twitter, American health official accounts, emotions on Twitter, emotions and content

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16410 Non-Cooperative Game Theory Approach for Ensuring Community Satisfaction on Public-Private Partnership Projects

Authors: Jason Salim, Zhouyang Lu

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Private sector involvement in Public Private Partnership (PPP) projects may raise public suspicion, as PPP is often mistaken as merely a partnership between private and government agencies without consideration for greater “public” (community). This public marginalization is crucial to be dealt with because undermining opinion of majority may cause problems such as protests and/ or low demand. Game theory approach applied in this paper shows that probability of public acceptance towards a project is affected by overall public’s perception on Private sectors’ possible profit accumulation from the project. On the contrary, goodwill of the government and private coalition alone is not enough to minimize the probability of public opposition towards a PPP project. Additionally, the threat of loss or damage raised from public opposition does not affect the profit-maximization behavior of Private sectors.

Keywords: community satisfaction, game theory, non-cooperative, PPP, public policy

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16409 Imputing the Minimum Social Value of Public Healthcare: A General Equilibrium Model of Israel

Authors: Erez Yerushalmi, Sani Ziv

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The rising demand for healthcare services, without a corresponding rise in public supply, led to a debate on whether to increase private healthcare provision - especially in hospital services and second-tier healthcare. Proponents for increasing private healthcare highlight gains in efficiency, while opponents its risk to social welfare. None, however, provide a measure of the social value and its impact on the economy in terms of a monetary value. In this paper, we impute a minimum social value of public healthcare that corresponds to indifference between gains in efficiency, with losses to social welfare. Our approach resembles contingent valuation methods that introduce a hypothetical market for non-commodities, but is different from them because we use numerical simulation techniques to exploit certain market failure conditions. In this paper, we develop a general equilibrium model that distinguishes between public-private healthcare services and public-private financing. Furthermore, the social value is modelled as a by product of healthcare services. The model is then calibrated to our unique health focused Social Accounting Matrix of Israel, and simulates the introduction of a hypothetical health-labour market - given that it is heavily regulated in the baseline (i.e., the true situation in Israel today). For baseline parameters, we estimate the minimum social value at around 18% public healthcare financing. The intuition is that the gain in economic welfare from improved efficiency, is offset by the loss in social welfare due to a reduction in available social value. We furthermore simulate a deregulated healthcare scenario that internalizes the imputed value of social value and searches for the optimal weight of public and private healthcare provision.

Keywords: contingent valuation method (CVM), general equilibrium model, hypothetical market, private-public healthcare, social value of public healthcare

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