Search results for: health services accessibility

Authors: Yaa Asuaba Duopah, Lisa Moran, Khalifa Elmusharaf, Dervla Kelly

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Background: Research has identified a strong link between stress and drug use behaviours. Also, it has been established that the prolonged use of crack cocaine stimulates emotional, cognitive, neurological and social changes. This paper examines the psychological stressors associated with crack cocaine use and the coping mechanisms used to mitigate them. Methodology The study is qualitative and adopts a critical realist approach. The coping circumplex model is the theoretical model that underpins this study. Data was collected through 26 face-to-face in-depth semistructured interviews with people who use crack cocaine. Participants consisted of 15 males and 11 females between the ages of 24-57 years. Data were analysed using thematic analysis. Results Cravings, financial burdens, relationship breakdown and emotional /cognitive stimulation were revealed as psychological stressors associated with crack cocaine use. Maladaptive coping which includes self-harm, isolation, not speaking about/not dealing with emotions and using substances were adopted by persons who use crack cocaine. Positive coping such as seeking help and keeping busy were also adopted. Social and environmental factors such as stigma, easy accessibility of crack cocaine and flashbacks served as barriers to positive coping. Positive coping was linked to the availability and easy accessibility to social support and strong family bonds. Conclusion Persons who use crack cocaine do not cope well with its psychological stresses. The study findings linked social and family support to positive coping. There is a need for addiction and mental health services to liaise with family support services and social services to promote stronger family relationships and social systems using family-focused and social interventions.

Keywords: psychological stress, substance misuse disorder, coping, mental health

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Authors: Sadeeq Launi

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NGOs, the world over, have been recognized as part of the institutions that complement government activities in providing services to the people, particularly in respect of human development. This study examined the role played by the NGOs in human development in Bauchi State, Nigeria, between 2004 and 2013. The emphasis was on reproductive health and access to education role of the selected NGOs. All the research questions, objectives and hypotheses were stated in line with these variables. The theoretical framework that guided the study was the participatory development approach. Being a survey research, data were generated from both primary and secondary sources with questionnaires and interviews as the instruments for generating the primary data. The population of the study was made up of the staff of the selected NGOs, beneficiaries, health staff and school teachers in Bauchi State. The sample drawn from these categories were 90, 107 and 148 units respectively. Stratified random and simple random sampling techniques were adopted for NGOs staff, and Health staff and school teachers data were analyzed quantitatively and qualitatively and hypotheses were tested using Pearson Chi-square test through SPSS computer statistical package. The study revealed that despite the challenges facing NGOs operations in the study area, NGOs rendered services in the areas of health and education This research recommends among others that, both government and people should be more cooperative to NGOs to enable them provide more efficient and effective services. Governments at all levels should be more dedicated to increasing accessibility and affordability of basic education and reproductive health care facilities and services in Bauchi state through committing more resources to the Health and Education sectors, this would support and facilitate the complementary role of NGOs in providing teaching facilities, drugs, and other reproductive health services in the States. More enlightenment campaigns should be carried out by governments to sensitize the public, particularly women on the need to embrace immunization programmes for their children and antenatal care services being provided by both the government and NGOs.

Keywords: access to education, human development, NGOs, reproductive health

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Authors: Sohayla Khaled El Fakahany

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Cultural and structural limitations and conservative social norms have direct effects on the availability of sources of sexual and reproductive health and rights (SRHR) in the Arab Region. Nevertheless, SRHR advocates, healthcare providers, and organizations have created online spaces like websites, blogs, and social media platforms to increase people’s access and ability to share information, experiences, and services. While these efforts help increase the accessibility to information and services, they also create and reflect inequalities based on limited internet access. Furthermore, these emergent ways of sharing and raising awareness online cannot be seen as a substitute for the urgent need for public healthcare systems and services to address SRHR issues in Arab states. This research aims to analyze the impact of the increasing importance of the role of social media platforms and technologies in the dissemination of SRHR-related information online to the youth as well as the associated inequalities of access. It also seeks to assess the effects and inequalities of the dependence on online platforms, which should be complementary to public and private SRHR services. The theoretical framework adopts Asef Bayat’s concept of social non-movements to analyze how collective mobilization around SRHR issues is exercised in repressive and conservative settings in the Arab region. Using digital ethnography of four prominent digital platforms and a qualitative survey of people aged 18-30 years, the research draws attention to the urgent need for better access to knowledge and services around gender, bodily autonomy, and sexual and reproductive health in the Arab region.

Keywords: sexual and reproductive health and rights, social non-movements, digital platforms, Arab region

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Authors: Ashley Andrew

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Over the years, there have been drastic developments in technology that have altered the ways we interact with and utilize technology. Social media platforms have expanded, access to information is easily accessible on cellular devices, ways of banking have changed, and virtual meetings/work have become the norm. The COVID-19 pandemic also highlighted the importance of pivoting and adapting to the benefits that technology provides, including Accessibility (services are more available to people living in remote areas and/or with mobility concerns), Convenience (technology has allowed easier options for booking appointments and connecting with loved ones), Availability (People can attend services that best meet their availability/schedule). Although there have been large improvements in accessibility to services and resources with the evolution of technology, there are also some major concerns that are not being addressed when it comes to technology and intimate partner violence. This study explores how the growth in technology has changed the way people are being abused and harmed and the sad reality that regulations and laws have not caught up with the advances in technology. The study will also explore cyberstalking, social media triggers, and location-tracking devices and applications. By exploring how technology impacts intimate partner violence, clinicians will learn how to better assess and safety plan for these risk factors.

Keywords: abuse, intimate partner violence, safety planning, technology

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Authors: Jacques Wels

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Japan has one of the highest average retirement ages within the OCDE and is paving the way to raise the retirement age to 70. However, the Japanese labour market is facing two main issues that can have detrimental effects on health: non-standard employment forms are widespread among the ageing workforce, and poor working conditions can contribute to explain poor health in late career. To assess such a relationship, the study uses data from JSTAR. Using mediation analysis, it particularly looks at the association between job dissatisfaction, employment status, self-perceived health (SPH), and use of health care services. Results show that work quality and employment status are associated with SPH. Contract work has a particularly negative impact and therefore contributes to explain the use of health care services but is not significantly associated with lower job satisfaction levels. SPH is a good predictor of the use of health care services.

Keywords: self-reported health, occupational health, employment, older workers, mediation

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Authors: Joy Ghosh, Debasmita Biswas

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The road network of any area is the most important indicator of regional planning. For proper utilization of urban road networks, the structural parameters such as connectivity and accessibility should be analyzed and evaluated. This paper aims to explain the application of GIS on urban road network connectivity and accessibility analysis with a case study of Chandannagar City. This paper has been made to analyze the road network connectivity through various connectivity measurements like the total number of nodes and links, Cyclomatic Number, Alpha Index, Beta Index, Gamma index, Eta index, Pi index, Theta Index, and Aggregated Transport Score, Road Density based on existing road network in Chandannagar city in India. Accessibility is measured through the shortest Path Matrix, associate Number, and Shimbel Index. Various urban services, such as schools, banks, Hospitals, petrol pumps, ATMs, police stations, theatres, parks, etc., are considered for the accessibility analysis for each ward. This paper also highlights the relationship between urban land use/ land cover (LULC) and urban road network and population density using various spatial and statistical measurements. The datasets were collected through a field survey of 33 wards of the Chandannagar Municipal Corporation area, and the secondary data were collected through an open street map and satellite image of LANDSAT8 OLI & TIRS from USGS. Chandannagar was actually once a French colony, and at that time, various sort of planning was applied, but now Chandannagar city continues to grow haphazardly because that city is facing some problems; the knowledge gained from this paper helps to create a more efficient and accessible road network. Therefore, it would be suggested that some wards need to improve their connectivity and accessibility for the future growth and development of Chandannagar.

Keywords: accessibility, connectivity, transport, road network

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Authors: Suzanne L. Stewart, Sarah J. Ponton, Mikaela D. Gabriel, Roy Strebel, Xinyi Lu

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Indigenous Peoples have faced unique barriers to accessing and receiving culturally safe and appropriate mental health care while also facing daunting rates of mental health diagnoses and comorbidities. Indigenous researchers and clinicians have well established the connection of the current mental health issues in Indigenous communities as a direct result of colonization by way of intergenerational trauma throughout Canada’s colonial history. Such mental health barriers and challenges have become exacerbated during the COVID-19 pandemic. Throughout the pandemic, access to mental health, cultural, ceremonial, and community services were severely impacted and restricted; however, it is these same cultural activities and community resources that are key to supporting Indigenous mental health from a traditional and community-based perspective. This research employed a unique combination of a thorough, analytical scoping review of the existent mental health literature of Indigenous mental health in the COVID-19 pandemic, alongside narrative interviews employing an oral storytelling tradition methodology with key community informants that provide comprehensive cultural services to the Indigenous community of Toronto, as well as across Canada. These key informant interviews provided a wealth of insights into virtual transitions of Indigenous care and mental health support; intersections of historical underfunding and current financial navigation in technology infrastructure; accessibility and connection with Indigenous youth in remote locations; as well as maintaining community involvement and traditional practices in a current pandemic. Both the scoping review and narrative interviews were meticulously analyzed for overarching narrative themes to best explore the extent of the literature on Indigenous mental health and services during COVID-19; identify gaps in this literature; identify barriers and supports for the Indigenous community, and explore the intersection of community and cultural impacts to mental health. Themes of the scoping review included: Historical Context; Challenges in Culturally-Based Services; and Strengths in Culturally-Based Services. Meta themes across narrative interviews included: Virtual Transitions; Financial Support for Indigenous Services; Health Service Delivery & Wellbeing; and Culture & Community Connection. The results of this scoping review and narrative interviews provide wide application and contribution to the mental health literature, as well as recommendations for policy, service provision, autonomy in Indigenous health and wellbeing, and crucial insights into the present and enduring mental health needs of Indigenous Peoples throughout the COVID-19 pandemic.

Keywords: indigenous community services, indigenous mental health, indigenous scoping review, indigenous peoples and Covid-19

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Authors: Muyatdinova Aigul, Aitkaliyeva Madina

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The article deals with the evaluation of the quality of medical services on the basis of quality indicators. For this purpose allocated initially the features of the medical services market. The Features of the market directly affect on the evaluation process that takes a multi-level and multi-stakeholder nature. Unlike ordinary goods market assessment of medical services does not only market. Such an assessment is complemented by continuous internal and external evaluation, including experts and accrediting bodies. In the article highlighted the composition of indicators for a comprehensive evaluation

Keywords: health care market, quality of health services, indicators of care quality

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Authors: Jill Hanass-Hancock, Bradley Carpenter, Samantha Willan, Kristin Dunkle

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Access to quality health care for persons with disabilities is the litmus test in our strive toward universal health coverage. Persons with disabilities experience a variety of health disparities related to increased health risks, greater socioeconomic challenges, and persistent ableism in the provision of health care. In low- and middle-income countries, the support needed to address the diverse needs of persons with disabilities and close the gaps in inclusive and accessible health care can appear overwhelming to staff with little knowledge and tools available. An action-orientated disability inclusion toolkit for health facilities was developed through consensus-building consultations and field testing in South Africa. The co-creation of the toolkit followed a bottom-up approach with healthcare staff and persons with disabilities in two developmental cycles. In cycle one, a disability facility assessment tool was developed to increase awareness of disability accessibility and service delivery gaps in primary healthcare services in a simple and action-orientated way. In cycle two, an intervention menu was created, enabling staff to respond to identified gaps and improve accessibility and inclusion. Each cycle followed five distinct steps of development: a review of needs and existing tools, design of the draft tool, consensus discussion to adapt the tool, pilot-testing and adaptation of the tool, and identification of the next steps. The continued consultations, adaptations, and field-testing allowed the team to discuss and test several adaptations while co-creating a meaningful and feasible toolkit with healthcare staff and persons with disabilities. This approach led to a simplified tool design with ‘key elements’ needed to achieve universal health coverage: universal design of health facilities, reasonable accommodation, health care worker training, and care pathway linkages. The toolkit was adapted for paper or digital data entry, produces automated, instant facility reports, and has easy-to-use training guides and online modules. The cyclic approach enabled the team to respond to emerging needs. The pilot testing of the facility assessment tool revealed that healthcare workers took significant actions to change their facilities after an assessment. However, staff needed information on how to improve disability accessibility and inclusion, where to acquire accredited training, and how to improve disability data collection, referrals, and follow-up. Hence, intervention options were needed for each ‘key element’. In consultation with representatives from the health and disability sectors, tangible and feasible solutions/interventions were identified. This process included the development of immediate/low-cost and long-term solutions. The approach gained buy-in from both sectors, who called for including the toolkit in the standard quality assessments for South Africa’s health care services. Furthermore, the process identified tangible solutions for each ‘key element’ and highlighted where research and development are urgently needed. The cyclic and consultative approach enabled the development of a feasible facility assessment tool and a complementary intervention menu, moving facilities toward universal health coverage for and persons with disabilities in low- or better-resourced contexts while identifying gaps in the availability of interventions.

Keywords: public health, disability, accessibility, inclusive health care, universal health coverage

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Authors: Natalie Cutler, Lorna Moxham, Moira Stephens

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Safety is a priority in mental health services, and no more so than in the acute inpatient setting. Mental health service policies and accreditation frameworks commonly approach safety from a risk reduction or elimination perspective leading to service approaches that are arguably more focused on risk than on safety. An exploration what safety means for people who have experienced admission to an acute mental health inpatient unit is currently under way in Sydney, Australia. Using a phenomenographic research approach, this study is seeking to understand the meaning of safety from the perspective of people who use, rather than those who deliver mental health services. Preliminary findings suggest that the meanings of safety for users of mental health services vary from the meanings inherent in the policies and frameworks that inform how mental health services and mental health practice are delivered. This variance has implications for the physical and environmental design of acute mental health inpatient facilities, the policies and practices, and the education and training of mental health staff in particular nurses, who comprise the majority of the mental health workforce. These variances will be presented, along with their implications for the way quality and safety in mental health services are evaluated.

Keywords: acute inpatient, mental health, nursing, phenomenography, recovery, safety

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Authors: Rachel Tambyah, Katarzyna Olcoń, Julaine Allan, Pete Destry, Thomas Astell-Burt

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The rising social and financial burden of mental illness indicates an urgent need to explore interventions that can be used as well as or instead of traditional treatments. Although there is growing evidence of the positive mental health outcomes of spending time in nature, the implementation of nature-based interventions (NBIs) within mental health services remains minimal. Based on interviews with mental health clinicians in Australia, this study demonstrated that clinicians supported the use of NBIs and would promote them to their clients.

Keywords: nature, nature-based interventions, mental health, mental health services, mental health clinicians

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Authors: Mona Nikidehaghani, Freda Hui

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In Australia, one-third of mental health carers provide 40 hours or more of unpaid care per week. These hidden workers contribute significantly to the Australian mental health workforce by providing unpaid services both direct and indirect to people in their care. However, carers are often neglected in the healthcare system because Government services focus on those with a mental health condition rather than those supporting them. The aim of this study is to evaluate the perceptions of mental health carers on the effectiveness of community services designed for carers and how these services could be improved. We collaborated with One Door Mental Health, a community organisation that supports mental health carers. Through semi-structured interviews with 27 mental health carers residing in the Illawarra region (NSW), we documented their daily challenges and evaluated outcomes of the current programs for carers. Our findings demonstrate that services such as education programs enable capacity building and improve the social life and mental health of carers. Drawing on the perceptions of mental health carers, this study maps pathways for making meaningful changes in the lives of carers and proposes an outcome framework to evaluate the impact of a community organisation on the lives of their clients. The framework prepared by this project would be replicable, allowing other community organisations to measure the outcomes and improve their services.

Keywords: capacity building, community development, community service, mental health carers

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Authors: Ha Hai Duong, Amnon Levy Livermore, Kankesu Jayanthakumaran, Oleg Yerokhin

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The issues of economic development, the environment and human health have been investigated since 1990s. Previous researchers have found different empirical evidences of the relationship between income and environmental pollution, health as determinant of economic growth, and the effects of income and environmental pollution on health in various regions of the world. This paper concentrates on integrative relationship analysis of GDP, carbon dioxide emissions, and health services and population health in context of Vietnam. We applied the dynamic generalized method of moments (GMM) estimation on datasets of Vietnam’s sixty-three provinces for the years 2000-2010. Our results show the significant positive effect of GDP on emissions and the dependence of population health on emissions and health services. We find the significant relationship between population health and GDP. Additionally, health services are significantly affected by population health and GDP. Finally, the population size too is other important determinant of both emissions and GDP.

Keywords: economic development, emissions, environmental pollution, health

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Authors: M. Jaculine Mary

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Today electronic resources are considered as an integral part of information sources to impart efficient services to the people aspiring to acquire knowledge in different fields. E-resources are those resources which include documents in e-format that can be accessed via the Internet in a digital library environment. The present study focuses on accessibility and use of e-resources by faculty and research scholars of academic libraries of Coimbatore, TamilNadu, India. The main objectives are to identify their purpose of using e-resources, know the users’ Information and Communication Technology (ICT) skills, identify satisfaction level of availability of e-resources, use of different e-resources, overall user satisfaction of using e-resources, impact of e-resources on their research and problems faced by them in the access of e-resources. The research methodology adopted to collect data for this study includes analysis of survey reports carried out by distributing questionnaires to the users. The findings of the research are based on the study of responses received from questionnaires distributed to a sample population of 200 users. Among the 200 respondents, 55 percent of research students and 45 percent of faculty members were users of e-resources. It was found that a majority of the users agreed that relevant, updated information at a fast pace had influenced them to use e-resources. Most of the respondents were of the view that more numbers of computers in the library would facilitate quick learning. Academic libraries have to take steps to arrange various training and orientation programmes for research students and faculty members to use the availability of e-resources. This study helps the librarian in planning and development of e-resources to provide modern services to their users of libraries. The study recommends that measures should be taken to increase the accessibility level of e-resource services among the information seekers for increasing the best usage of available electronic resources in the academic libraries.

Keywords: academic libraries, accessibility, electronic resources, satisfaction level, survey

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Authors: Rozo D. Juan Felipe, Ramírez L. Leonardo Juan, Puerta A. Gabriel Alberto

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The telemedicine services require correct computing resource management to guarantee productivity and efficiency for medical and non-medical staff. The aim of this study was to examine web management strategies to ensure the availability of resources and services in telemedicine so as to provide medical information management with an accessible strategy. In addition, to evaluate the quality-of-service parameters, the followings were measured: delays, throughput, jitter, latency, available bandwidth, percent of access and denial of services based of web management performance map with profiles permissions and database management. Through 24 different test scenarios, the results show 100% in availability of medical information, in relation to access of medical staff to web services, and quality of service (QoS) of 99% because of network delay and performance of computer network. The findings of this study suggest that the proposed strategy of web management is an ideal solution to guarantee the availability, reliability, and accessibility of medical information. Finally, this strategy offers seven user profile used at telemedicine center of Bogota-Colombia keeping QoS parameters suitable to telemedicine services.

Keywords: availability, medical information, QoS, strategy, telemedicine

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Authors: Silvija Šiljeg, Ivan Marić, Ante Šiljeg

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The accessibility of urban green spaces (UGS) is an integral element in the quality of life. Due to rapid urbanization, UGS studies have become a key element in urban planning. The potential benefits of space for its inhabitants are frequently analysed. A functional transport network system and the optimal spatial distribution of urban green surfaces are the prerequisites for maintaining the environmental equilibrium of the urban landscape. An accessibility analysis was conducted as part of the Urban Green Belts Project (UGB). The development of a GIS database for Zadar was the first step in generating the UGS accessibility indicator. Data were collected using the supervised classification method of multispectral LANDSAT images and manual vectorization of digital orthophoto images (DOF). An analysis of UGS accessibility according to the ANGst standard was conducted in the first phase of research. The accessibility indicator was generated on the basis of seven objective measurements, which included average UGS surface per capita and accessibility according to six functional levels of green surfaces. The generated indicator was compared with subjective measurements obtained by conducting a survey (718 respondents) within statistical units. The collected data reflected individual assessments and subjective evaluations of UGS accessibility. This study highlighted the importance of using objective and subjective measures in the process of understanding the accessibility of urban green surfaces. It may be concluded that when evaluating UGS accessibility, residents emphasize the immediate residential environment, ignoring higher UGS functional levels. It was also concluded that large areas of UGS within a city do not necessarily generate similar satisfaction with accessibility. The heterogeneity of output results may serve as guidelines for the further development of a functional UGS city network.

Keywords: urban green spaces (UGS), accessibility indicator, subjective and objective measurements, Zadar

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Authors: Bakhrouri Sarah

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The city of Algiers constitutes the first commercial pole of the country; 56.3% of its economic entities come from the commercial sector. Shopping centers are the new form of commerce that has emerged in the city since the 2000s. They are considered to be commercial and leisure poles and major generators of travel. However, shopping centers in the capital Algiers are poorly served by public transport, and their choice of location is mainly conditioned by the availability of land; accessibility by public transport does not appear to be an important criterion in the choice of their location. As a result, travel to and from these commercial centers is mainly by car, which breaks with the sustainability objectives of national transportation policy. Our study attempts to examine the impact of public transport accessibility of shopping centers on consumers' travel behaviour. The main objective of this research is to determine the link between the accessibility of these facilities, the use of private cars, and public transport modes. To this end, we analyze the choice of travel mode of consumers and the different factors that determine it by focusing on the influence of accessibility. The results showed a considerable influence of the accessibility on the travel behavior of the consumer in Algiers, so it is recommended to improve the accessibility of shopping centers by public transport in order to contribute to a modal shift.

Keywords: accessibility, shopping centers trips, public transportation, Algiers

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Authors: Bengi Demirci

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Out-of-pocket payments have become one of the common models adopted by health care reforms all over the world, and they have serious implications for not only the financial set-up of the health care systems in question but also for the people involved in terms of their access to the health care services provided. On the one hand, out-of-pocket payments are used in raising resources for the finance of the health care system and in decreasing non-essential health care expenses by having a deterrent role on the patients. On the other hand, out-of-pocket payment model causes regressive distribution effect by putting more burdens on the lower income groups and making them refrain from using health care services. Being a relatively incipient country having adopted the out-of-pocket payment model within the context of its Health Transformation Program which has been ongoing since the early 2000s, Turkey provides a good case for re-evaluating the pros and cons of this model in order not to sacrifice equality in access to health care for raising revenue for health care finance and vice versa. Therefore this study aims at analyzing the impact of out-of-pocket payments on the health finance system itself and on the patients’ access to healthcare services in Turkey where out-of-pocket payment model has been in use for a while. In so doing, data showing the revenue obtained from out-of-pocket payments and their share in health care finance are analyzed. In addition to this, data showing the change in the amount of expenditure made by patients on health care services after the adoption of out-of-pocket payments and the change in the use of various health care services in the meanwhile are examined. It is important for the incipient countries like Turkey to be careful in striking the right balance between the objective of cost efficiency and that of equality in accessing health care services while adopting the out-of-pocket payment model.

Keywords: health care access, health care finance, health reform, out-of-pocket payments

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Authors: Mercy Marimirofa, Farai Machinga, Alfred Zvoushe, Tsitsidzaishe Musvosvi

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The Government of Zimbabwe embarked on integrating family planning with Sexually Transmitted Infection (STI) and Human Immunodeficiency Virus (HIV) services in May 2020 with support from the World Health Organization (WHO). There was high HIV prevalence, incidence rates and STI infections among women attending FP clinics. Spilhaus is a specialized center of excellence clinic which offers a range of sexual reproductive health services. HIV services were limited to testing only, and clients were referred to other facilities for further management. Integration of services requires that all the services be available at one point so that clients will access them during their visit to the facility. Objectives: The study was conducted to assess the impact the one-stop-shop model has made in accessing integrated Family Planning services and sexual reproductive health services compared to the supermarket approach. It also assessed the relationship family planning services have with other sexual reproductive health services. Methods: A secondary data analysis was conducted at Spilhaus clinic in Harare using family planning registers and HIV services registers comparing years 2019 and 2021. A 2 sample t-test was used to determine the difference in clients accessing the services under the two models. A Spearman’s rank correlation was used to determine if accessing family planning services has a relationship with other sexual reproductive health services. Results: In 2019, 7,548 clients visited the Spilhaus clinic compared to 8,265 during the period January to December 2021. The median age for all clients accessing services was 32 years. An increase of 69% in the number of services accessed was recorded from 2019 to 2021. More services were accessed in 2021. There was no difference in the number of clients accessing family planning services cervical cancer, and HIV services. A difference was found in the number of clients who were offered STI screening services. There was also a relationship between accessing family planning services and STI screening services (ρ = 0.729, p-value=0.006). Conclusion: Programming towards SRH services was a great achievement, the use of an integrated approach proved to be cost-effective as it minimised the required resources for separate programs. Clients accessed important health needs at once. The integration of these services provided an opportunity to offer comprehensive information which addressed an individual’s sexual reproductive health needs.

Keywords: intergration, one stop shop, family planning, reproductive health

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Authors: Sumitra Sharma, Christina Parker, Kathleen Finlayson, Clint Douglas, Niall Higgins

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Background: Telehealth services have potential to increase accessibility, utilization, and effectiveness of healthcare services. As the telehealth services are yet to integrate within regular hospital services in Nepal, the use of the telehealth services among adults with diabetes is scarce. Prior to implementation of telehealth services for adults with diabetes, it is necessary to examine influencing factors of telehealth services. Objective: This study aimed to investigate factors influencing telehealth services for diabetes care in Nepal. Methods: This study used a mixed-method study design which included a cross-sectional survey among adults with diabetes and semi-structured interviews among key healthcare professionals of Nepal. The study was conducted in a medical out-patient department of a tertiary hospital of Nepal. The survey adapted a previously validated questionnaire, while semi-structured questions for interviews were developed from literature review and experts consultation. All interviews were audio-recorded, and inductive content analysis was used to code transcripts and develop themes. For a survey, a descriptive analysis, chi-square test, and Mann Whitney U test were used to analyze the data. Results: One hundred adults with diabetes were participated in a survey, and seven healthcare professionals were recruited for interviews. In a survey, just over half of the participants (53%) were male, and others were female. Almost all participants (98%) owned a mobile phone, and 67% of them had a computer with internet access at home. Majority of participants had experience in using Facebook messenger (95%), followed by Viber (60%) and Zoom (26%). Almost all of the participants (96%) were willing to use telehealth services. There were significant associations between female sex and participants living 10 km away from the hospital with their willingness to use telehealth services. There was a significant association between participants' self-perception of good health status with their willingness to use video-conference calls and phone calls to use telehealth services. Seven themes were developed from interview data which are related to predisposing, reinforcing, and enabling factors influencing telehealth services for diabetes care in Nepal. Conclusion: In summary, several factors were found to influence the use of telehealth services for diabetes care in Nepal. For effective implementation of a sustainable telehealth services for adults with diabetes in Nepal, these factors need to be considered.

Keywords: contributing factors, diabetes mellitus, developing countries, telemedicine, telecare

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Authors: Lilla Anjani, Ervina Ahyudanari

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Tourism is one of the contributors to regional economic income. Banyuwangi has made rapid developments related to the tourism sector, especially since 2010. There are 25 tourist visit locations that can become tourist destinations. Banyuwangi has tourism transportation to support the ease of reaching tourist places. This transportation operates with six routes, namely the final destination of Ijen Crater, Glenmore, Bajangan, Bangsring, Red Island, and Pine Forest. Despite having tourism transportation, tourists tend to choose to use a private car or rent a car because there is no access to tourist places using public transportation. Tourism transportation is also one form of sustainable tourism development in the future, such as the Sustainable Development Goals. The Banyuwangi government has a special program for tourism development that is supported by all sectors in Banyuwangi. To support the development of tourism in Banyuwangi, it is necessary to analyze existing tourism transportation as well as suggestions regarding new routes to reach all tourism locations in Banyuwangi Regency. The analysis reviewed in this study is an analysis of accessibility, distance, and time to the tourism location. There are 30 tourism destination points from 39 ODTW references from the transportation service, and the tourism office of Banyuwangi Regency Banyuwangi tourism objects can be divided into six zones based on travel time and distance. The highest accessibility value for Zone A is 51.96, and the lowest is 11.989. The highest accessibility value for Zone B is 33.4269, and the lowest is 21.737. The highest accessibility value for Zone C is 33,407, and the lowest is 14,848. The highest accessibility value for Zone D is 58,967, and the lowest is 14,742. The highest accessibility value for Zone E is 56,401, and the lowest is 14.1. The highest accessibility value for Zone F is 176.14, and the lowest is 44.1. There are two tourist transportation routes with six sessions every day. The resulting new route is in the form of grouping based on locations that can be reached in one particular area.

Keywords: accessibility, tourism clustering, Banyuwangi tourism, sustainable development goals

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Authors: Calvin Odhiambo

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Depression among young adults is a common health problem and a growing public health concern. Of the young adult population, college students are particularly vulnerable to depression as they find themselves grappling with the stress and anxiety of college life while at the same navigating the demands of separation and independence from familial ties. To deal with the resultant mental health challenges affecting this population, most colleges offer counseling services to their student population. What is not known, however, is the extent to which students are aware of or even utilize such mental health services. Our study set out to assess the level of student awareness and utilization of counseling services and programs at a southeastern public university in the United States. Data were collected through self-administered questionnaires given to a convenience sample of 508 undergraduate students voluntarily recruited from 38 classes representing five colleges. Data analysis was done using the Statistical Package of Social Sciences (SPSS) version 25. Results showed that even though a majority of students were aware of the mental health services offered by the university, an overwhelming majority of these students did not utilize any of these services or participate in any mental health programs offered by the university. Significant gender and racial differences were observed. Reasons for the lack of awareness and utilization of mental health services are explored. Recommendations are made on how to increase student awareness and utilization of mental health services, and the implications of the findings are discussed. The findings of this study help to fill an academic lacuna on this issue and provides an important basis for developing policies to help mitigate the growing problem of depression and attendant mental health problems among undergraduate students.

Keywords: depression, counseling services, undergraduate college students, utilization of mental health services, perceptions and awareness

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Authors: Abdulwahab Alalyani, Mahbub Rashid

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Urban Open Space (UOS) a central role to promotes community health, including daily activities, but these resources may not available, accessible enough, and or equitably be distributed. This paper measures and compares spatial equity of the availability and accessibility UOS among low, middle, and high-income neighborhoods in Riyadh city. The measurement mothdulgy for the UOSavailability was by calculating the total of UOS with respect to the population total (m2/inhabitant) and the accessibility indicted by using walking distance of a 0.25 mi (0.4 km) buffering streets network.All UOS were mapped and measured using geographical information systems. To evaluate the significant differences in UOS availability and accessibility across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences.The findings are as follows; finding, UOSavailability was lower than global standers. Riyadh has only 1.13 m2 per capita of UOS, and the coverage accessible area by walking distance to UOS was lower than 50%. The final finding, spatial equity of the availability and accessibility, were significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of UOS should be focused on increasing Urban park availability and should be given priority to those low-income and unhealthy communities.

Keywords: distribution urban open space, urban open space accessibility, spatial equity, riyadh city

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Authors: Yen-Jong Chen, Jei-An Su

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Public use facilities provide the basic infrastructure supporting the needs of urban sustainable development. These facilities include roads (streets), parking areas, green spaces, public schools, and city parks. However, how to acquire land with the proper location and size still remains uncertain in a capitalist economy where land is largely privately owned, such as in cities in Taiwan. The issue concerning the proper acquisition of reserved land for local public facilities (RLPF) policies has been continuously debated by the Taiwanese government for more than 30 years. Lately, the government has been re-evaluating projects connected with existing RLPF policies from the viewpoints of the needs of local residents, including the living environments of older adults. This challenging task includes addressing the requests of official bureau administrators, citizens whose property rights and current use status are affected, and other stakeholders, along with the means of development. To simplify the decision to acquire or release public land, we selected only public facilities that are needed for living in the local community, including parks, green spaces, plaza squares, and land for kindergartens, schools, and local stadiums. This study categorized these spaces as the community’s “leisure public facilities” (LPF). By constructing an accessibility index of the services of such multi-function facilities, we computed and produced a GIS map of spatial buffer zones for each LPF. Through these procedures, the service needs provided by each LPF were clearly identified. We then used spatial buffer zone envelope mapping to evaluate these service areas. The results obtained can help decide which RLPF should be acquired or released so that community services can be maximized under a limited budget.

Keywords: urban public facilities, community demand, accessibility, spatial buffer zone, Taiwan

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Authors: Ivan N. Gallegos, Merle Dawn Comidoy, Mira Sol Cabal, Paul Martin Acol, Arnie Polistico

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Barangay Health Workers (BHWs) are the lead health advocates who provide basic health care services at the grass-roots level. Hence, adequate skills and training are needed to deliver these services effectively. The study aimed at identifying the communication needs of Barangay health workers situated at the dumpsite of Davao City, Philippines, gravitating towards designing a communication plan tailor-fitted to their needs. It employed a qualitative research design, particularly an in-depth interview of the health workers. Several communication problems were identified, including the lack of participation of BHWs in the Barangay development plan, the lack of a continuous skills enhancement program, ineffective communication strategies resulting in insufficient knowledge of proper personal hygiene, and the inactive participation of community members in health services. Based on these communication problems, the following activities and training were suggested: capacitating BHWs on writing proposals and plans; basic communication skills training; educational seminars for parents; and a sanitation campaign.

Keywords: communication planning, health care services, Barangay health workers, communication strategies

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Authors: Marilena Ianculescu, Adriana Alexandru

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Internet of Health Things (IoHT) has already proved to be a persuasive means to support a proper assessment of the living conditions by collecting a huge variety of data. For a customized health management of a senior patient, IoHT provides the capacity to build a dynamic solution for sustaining the shift inside the patient-physician relationship by allowing a real-time and continuous remote monitoring of the health status, well-being, safety and activities of the senior, especially in a non-clinical environment. Thus, is created a win-win solution in which both the patient and the physician enhance their involvement and shared decision-making, with significant outcomes. Health monitoring systems in smart environments are becoming a viable alternative to traditional healthcare solutions. The ongoing “Non-invasive monitoring and health assessment of the elderly in a smart environment (RO-SmartAgeing)” project aims to demonstrate that the existence of complete and accurate information is critical for assessing the health condition of the seniors, improving wellbeing and quality of life in relation to health. The researches performed inside the project aim to highlight how the management of IoHT devices connected to the RO-SmartAgeing platform in a secure way by using a role-based access control system, can allow the physicians to provide health services at a high level of efficiency and accessibility, which were previously only available in hospitals. The project aims to identify deficient aspects in the provision of health services tailored to a senior patient’s specificity and to offer a more comprehensive perspective of proactive and preventive medical acts.

Keywords: health management, internet of health things, remote monitoring, senior patient

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Authors: Sisira Edirippulige, Anthony C. Smith, Sumudu Wickramasinghe, Nigel R. Armfield

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Background: E-Health is steadily integrating into modern health services, making significant changes in the way health services are traditionally delivered. To work in this new environment, healthcare workers are required to have new knowledge, skills, and competencies specific to e-Health. The aim of this study was to understand the self-reported perceptions of graduates regarding the influence of an e-Health postgraduate program on their professional careers. Methods: All graduates from 2005 to 2015 were surveyed using an online questionnaire that consisted of a mixture of closed and open-ended questions. Results: The number of participants in the study was 32. Response rate was 62%. Graduates thought that the postgraduate e-Health program had an influence on their professional practice. The majority of the participants mentioned that they had worked in the e-Health field since their graduation. Their professional roles mainly involved implementation of e-Health in health service settings and the use of e-Health in clinical practice. Conclusions: While e-Health may be steadily integrating into modern health services, e-Health specific job opportunities are still relatively limited. E-Health workforce development must be given priority.

Keywords: e-health, postgraduate education, clinical practice, curriculum

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Authors: Shengdan Yang

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The outbreak of the COVID-19 pandemic in early 2020 has made public health issues to be re-examined. The value of green space configuration is an important measure of community health quality. By combining quantitative and qualitative methods, the structure and function of community green space can be better evaluated. This study selects Wuhan Kunhou Community as the site and proposes to analyze the daily health service function of the community's green infrastructure. Through GIS-based spatial analysis, case study, and field investigation, this study evaluates the accessibility of green infrastructure and discusses the ideal green space form based on health indicators. The findings show that Kunhou Community lacks access to green infrastructure and public space for daily activities. The research findings provide a bridge between public health indicators and community space planning and propose design suggestions for green infrastructure planning.

Keywords: accessibility, community health, GIS, green infrastructure

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Authors: Dipendra Kumar Yadav, Rajani Ghimire, Saroj Yadav

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Background: The concern about adolescent on reproductive health has grown due to unprecedented increasing rates of early pregnancies and sexually transmitted Infections and they do not have adequate awareness and knowledge about it. Access to these services as well as information about them is, therefore, crucial for adolescents to utilize and benefit from sexual and reproductive health services. The objective of the study was to assess the reproductive health knowledge, attitude and health services utilization among adolescents in rural and urban areas of Kaski district. Materials and Methods: A community-based descriptive cross-sectional study was conducted among adolescents (10-19 years of age) in rural and urban areas of Kaski district, Nepal. The period of data collection was October to November, 2014. Altogether 419 participants were taken for the study. Results: The mean age of the respondents was 15.86 and standard deviation was ±2.305. More than half (58.7 %) of the respondents were females and 41.3 % were males. Out of 419, majority (78.8%) of the respondents were known about family planning, among them only 70 % of respondents were aware about family planning methods. Fifty-one percentages of the respondents were aware about the sexually transmitted diseases. Before giving a birth there is need to consult with partner with this fact 68.7 % of the respondents were agree, 23.6 % of them were neutral and very few (7.6%) of them were disagree. Nearly twenty six percentage of the respondents were faced the reproductive health problems within one month. Out of 107 respondents, 57.9 % did not utilize reproductive health services because of different reasons. Conclusions: The overall level of knowledge towards reproductive health among adolescents was found low. However, levels of attitude towards different reproductive health components were found favorable. Only 42.1% of the respondents were utilized reproductive health services among those who was faced the reproductive health problems within one month which was low coverage of reproductive health services utilization.

Keywords: reproductive health knowledge, reproductive health attitudes, adolescent, service utilization

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Authors: Renee Monchalin

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Métis peoples, while comprising over a third of the total Indigenous population in Canada, experience major gaps in health services that accommodate their cultural identities. This is problematic given Métis peoples experience severe disparities in health determinants and outcomes compared to the non-Indigenous Canadian population. At the same time, Métis are unlikely to engage in health services that do not value their cultural identities, often utilizing mainstream options. Given these contexts, this research aims to fill the culturally-safe health care gap for Métis peoples in Canada. It does this by engaging 56 urban Métis women who participated in a longitudinal cohort study, Our Health Counts (OHC) Toronto. Traditionally, Métis women were central to the health and well-being of their communities. However, due to decades of colonial legislation and forced land displacement, female narratives have been silenced, and Métis identities have been fractured. This has resulted in having direct implications on Métis people’s current health and access to health services. Solutions to filling the Métis health service gap may lie in the all too often unacknowledged or missing voices of Métis women. Through a conversational method, this research will explore urban Métis women’s perspectives on identity and their experiences with health services in Toronto. The goal of this research is to learn from urban Métis women on steps towards filling the health service gap. This research is currently in the data collection stage. Preliminary findings from the conversations will be disseminated. Policy recommendations for health service providers will be provided to better accommodate Métis people.

Keywords: indigenous health, Metis health, urban, health service access, identity

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