Search results for: health services in a developing nation

Authors: Patrick Downey

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The political problem besetting all nations, tribes, and families, as illuminated by Plato in the fifth book of his Republic, is the problem of our own private body with its own particular pleasures and pains. This problem we might label the “irrational love of one’s own.” The reasonable philosopher loves reality just because it is, but we love things only if we can convince ourselves that they are “ours” or an imaginative extension of “ours.” The resulting problem, that can only be medicated, but not cured, is that the “body private,” whether our own, our family, tribe, or nation, always lies underneath any level of “body politic” and threatens the bloodshed and disintegration of civil war. This is also the political problem the Bible deals with throughout, beginning with Adam and Eve’s fall from rationally shareable bodies (“the two were one flesh”) into unshareable bodies whose now shameful “privacy” must be hid behind a bloody rather than bloodless veil. The blood is the sign of always threatening civil war, whether murder between brothers, feuds within tribes, or later, war between nations. The scarlet thread of blood tying the entire Bible together, Old and New Testament, reminds us that however far our loves are pushed out beyond our private body to family, tribe or nation, they remain irrational because unshareable. Only by loving the creator God who first loved us, can we rationally love anything of our own, but it must be loved as gift rather than as a possession. Such a love renders all bodies and nations truly shareable, and achieving this shareability is the paradoxical plot of the Bible, wherein the Word becomes flesh in a particular body amidst a particular people and nation. Yet even with His own nation and His own Son, this Lord is not “partial” and demands justice towards widows, orphans, and sojourners, because the irrational love of only our own can become rational solely through the resurrection of this particular body, king of this particular nation and these particular people. His body, along with all other bodies, can thus now retain their particular wounds and history, while yet remaining shareable. Likewise, all nations will share in the nation of Israel, in the same way all distinct languages will share an understanding through the inner rational word that we see illustrated in Pentecost. Without the resurrection, however, this shareability of bodies and nations remains merely a useful fiction, as Plato saw, and the equally fictitious “rationality” of some sort of deductive universalism will not go away. Reading Scripture in terms of Plato’s “irrational love of one’s own” therefore raises questions for both a Protestant and Catholic understanding of nations, questions that neither can answer adequately without this philosophical and exegetical attention.

Keywords: body private, nations, shareability, body politic

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Authors: Alya Al Ghufli, Kelaithim Al Tunaiji, Sara Al Ali, Khalid Samara

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It is well known that health care systems encompass a variety of key knowledge sources that need to be integrated and shared amongst all types of users to attain higher-levels of motivation and productivity. The development of Health Integrated Systems (HIS) is often seen as a crucial step in strengthening the integration of knowledge to help serve the information needs of health care users. As an emergent economy, the United Arab Emirates (UAE) is regarded as a new arrival in the area of health information systems. As a new nation, there may be several challenges in terms of organisational climate and the sufficient skills and knowledge activities for effective use of HIS. In this regard, the lack of coordination, attitudes and practice of health-related systems can eventually result in unnecessary data and generally poor use of the system. This paper includes results from a qualitative preliminary study carried out from a case study investigation in a single large primary health care organisation in the United Arab Emirates (UAE) comprising various health care users. The study explored health care user’s perceptions about health integration and the impact it has on their practice. The main sources of information were semi-structured interviews and non-obtrusive observations. The authors conclude by presenting various recommendations for the development of HIS and knowledge activities and areas for further study.

Keywords: health integrated systems, knowledge sharing, knowledge activities, health information systems

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Authors: Marian Emmanuel Okon

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Introduction: The Niger Delta region of Nigeria has a vast reserve of oil and gas, which has globally positioned the nation as the sixth largest exporter of crude oil. Production rapidly rose following oil discovery. In most oil producing nations of the world, the wealth generated from oil production and export has propelled economic advancement, enabling the development of industries and other relevant infrastructures. Therefore, it can be assumed that majority of the oil resource such as Nigeria’s, has the potential to improve the health of the population via job creation and derived revenues. However, the health benefits of this economic development might be offset by the environmental consequences of oil exploitation and production. Objective: This research aims to evaluate the balance between the health benefits of oil-led economic development and harmful environmental consequences of crude oil exploitation in Nigeria. Study Design: A pathway has been designed to guide data search and this study. The model created will assess the relationship between oil-led economic development and population health development via job creation, improvement of education, development of infrastructure and other forms of development as well as through harmful environmental consequences from oil activities. Data/Emerging Findings: Diverse potentially suitable datasets which are at different geographical scales have been identified, obtained or applied for and the dataset from the World Bank has been the most thoroughly explored. This large dataset contains information that would enable the longitudinal assessment of both the health benefits and harms from oil exploitation in Nigeria as well as identify the disparities that exist between the communities, states and regions. However, these data do not extend far back enough in time to capture the start of crude oil production. Thus, it is possible that the maximum economic benefits and health harms could be missed. To deal with this shortcoming, the potential for a comparative study with countries like United Kingdom, Morocco and Cote D’ivoire has also been taken into consideration, so as to evaluate the differences between these countries as well as identify the areas of improvement in Nigeria’s environmental and health policies. Notwithstanding, these data have shown some differences in each country’s economic, environmental and health state over time as well as a corresponding summary statistics. Conclusion: In theory, the beneficial effects of oil exploitation to the health of the population may be substantial as large swaths of the ‘wider determinants’ of population heath are influenced by the wealth of a nation. However, if uncontrolled, the consequences from environmental pollution and degradation may outweigh these benefits. Thus, there is a need to address this, in order to improve environmental and population health in Nigeria.

Keywords: environmental pollution, health benefits, oil-led economic development, petroleum exploitation

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Authors: Shilan Rahmani Azr, Siavash Emtiyaz

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Recent development in computing and communicative technologies leads to much easier mobile accessibility to the information. Users can access to the information in different places using various deceives in which the care variety of abilities. Meanwhile, the format and details of electronic documents are changing each day. In these cases, a mismatch is created between content and client’s abilities. Recently the service-oriented content adaption has been developed which the adapting tasks are dedicated to some extended services. In this method, the main problem is to choose the best appropriate service among accessible and distributed services. In this paper, a method for determining the optimal path to the best services, based on the quality control parameters and user preferences, is proposed using max heap tree. The efficiency of this method in contrast to the other previous methods of the content adaptation is related to the determining the optimal path of the best services which are measured. The results show the advantages and progresses of this method in compare of the others.

Keywords: service-oriented content adaption, QoS, max heap tree, web services

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Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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Authors: Dyego Ramos Henrique, Viviane Pimentel, Katia Souto, Ana Valéria Mendonça, Andrea Gallassi

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Socioeconomic inequalities in Brazil have accentuated the aggravations of poverty among the most vulnerable populations, among which are the quilombola communities. The objective was to reflect on a situation of food and nutritional security in two Brazilian quilombola communities. The data were collected by means of reports of experience through the production of talk wheels in two quilombola communities (Itamatatiua and Mesquita), located in the cities of Alcântara and Cidade Ocidental. Access to health services and health promotion actions were still incipient in the quilombola communities visited. The perceptions of the participants of the quilombolas revealed that there are still repressed demands that have rendered the fulfillment of the principles of equity, universality and integrality, both for access to health and for access and availability of food. They recognize in governmental instances a socioeconomic-cultural valorization and nutritional qualities intrinsic to the foods produced by them. Although they have been used as communities of quilombolas live and their level of access to services and programs, dealing with quilombola communities does not mean dealing with 'isolated groups or a strictly homogeneous population.' It demands a great need of attention in relation to the access and availability of food, besides overcoming barriers that made it an unfeasible valuation of social, economic and cultural precepts, intrinsic to the thought about food and nutritional security in Brazilian quilombos.

Keywords: access to services, food and nutrition security, health promotion, quilombo population

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Authors: Debra L. Stanley, Gabriela Wasileski

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Offenders face many challenges as they transition from being incarcerated to the community, ranging from housing and employment needs to long standing problems with addictions and mental health issues. A lack of appropriate behavioral health services in the more remote parts of the United States has led to a significant illegal substance abuse problem, housing instability, and unaddressed mental health and trauma issues. High rates of poverty and unemployment exacerbate the growing behavioral health issues, drug overdoses, co-occurring disorders, and crime that are so prevalent across rural communities. This study examines the challenges of rural jail reentry faced by offenders in a treatment capacity. The client-centered evidence-based program is uniquely designed to provide continuity of care that focuses on issues which affect rural communities. Prior to release from jail, individuals go through comprehensive assessment screenings to measure mental health and substance use disorder as well as trauma and prior crime victimization histories; the assessments help to target client-specific services. The quasi-experimental research design tracks clients throughout their recovery and reintegration into the community. Individuals in a rural program often do not have the benefit of easy access or peer mentoring that is so often found in urban recovery programs. Therefore, much of the support is provided through telehealth and e-services. The goal of this study is to explore the nature of rural reentry programs and measures of recidivism, drug overdoses, and other behavioral health needs and successful reentry to include stable housing and employment.

Keywords: jail reentry, rehabilitation, behavioral health, drug abuse, recidivism

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Authors: Archil Undilashvili, Ketevan Stvilia, Dustin Gilbreath, Giorgi Dzneladze, Gordon Charchward

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Introduction: In recent years, diverse types of wheelchairs, both local production and imported, have been made available on the Georgian market for wheelchair users. Some types of wheelchairs are sold together with a service package, while the others, including the State Program, Supported locally-produced ones, don’t provide adjustment and maintenance service packages to users. Within the USAID Physical Rehabilitation Project in Georgia, a study was conducted to assess the impact of the wheelchair service provision in line with the WHO guidelines on the health and overall satisfaction of wheelchair users in Georgia. Methodology: A cross-sectional survey was conducted in May 2021. A structured questionnaire was used for telephone interviews that, along with socio-demographic characteristics, included questions for assessment of accessibility, availability, timeliness, cost and quality of wheelchair services received. Out of 1060 individuals listed in the census of wheelchair users, 752 were available for interview, with an actual response rate of 73.4%. 552 wheelchair users (31%) or their caregivers (69%) agreed to participate in the survey. In addition to using descriptive statistics, the study used multivariate matching of wheelchair users who received wheelchair services and who did not (control group). In addition, to evaluate satisfaction with service provision, respondents were asked to assess services. Findings: The majority (67%) of wheelchair users included in the survey were male. The average age of participants was 43. The three most frequently named reasons for using a wheelchair were cerebral palsy (29%), followed by stroke (18%), and amputation (12%). Users have had their current chair for four years on average. Overall, 60% of respondents reported that they were assessed before providing a wheelchair, but only half of them reported that their preferences and needs were considered. Only 13% of respondents had services in line with WHO guidelines and only 22% of wheelchair users had training when they received their current chair. 16% of participants said they had follow-up services, and 41% received adjustment services after receiving the chair. A slight majority (56%) of participants were satisfied with the quality of service provision and the service provision overall. Similarly, 55% were satisfied with the accessibility of service provision. A slightly larger majority (61%) were satisfied with the timeliness of service provision. The matching analysis suggests that users that received services in line with WHO guidelines were more satisfied with their chairs (the difference 17 point/0-100 scale) and they were four percentage points less likely to have health problems attributed to the chair. The regression analysis provides a similar finding of a 21 point increase in satisfaction attributable to services. Conclusion: The provision of wheelchair services in line with WHO guidelines and with follow-up services is likely to have a positive impact on the daily lives of wheelchair users in Georgia. Wheelchair services should be institutionalized as a standard component of wheelchair provision in Georgia.

Keywords: physical rehabilitation, wheelchair users, persons with disabilities, wheelchair production

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Authors: Deinzel R. Uezono, Vivien Fe F. Fadrilan-Camacho, Bianca Margarita L. Medina, Antonio Domingo R. Reario, Trisha M. Salcedo, Luke Wesley P. Borromeo

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The environment of health care workers is considered one of the most hazardous settings due to the nature of their work. In developing countries especially, the Philippines, this continues to be overlooked in terms of programs and services on occupational health and safety (OHS). One possible reason for this is the existing information gap on OHS which limits data comparability and impairs effective monitoring and assessment of interventions. To address this gap, there is a need to determine the current conditions of Filipino health care workers in their workplace. This descriptive cross-sectional study assessed the occupational health and safety conditions of health care workers in barangay health centers in a selected city in Metro Manila, Philippines by: (1) determining the hazards present in the workplace; (2) determining the most common self-reported medical problems; and (3) describing the elements of an OHS system based on the six building blocks of health system. Assessment was done through walkthrough survey, self-administered questionnaire, and key informant interview. Data analysis was done using Epi Info 7 and NVivo 11. Results revealed different health hazards present in the workplace particularly biological hazards (exposure to sick patients and infectious specimens), physical hazards (inadequate space and/or lighting), chemical hazards (toxic reagents and flammable chemicals), and ergonomic hazards (activities requiring repetitive motion and awkward posture). Additionally, safety hazards (improper capping of syringe and lack of fire safety provisions) were also observed. Meanwhile, the most commonly self-reported chronic diseases among health care workers (N=336) were hypertension (20.24%, n=68) and diabetes (12.50%, n=42). Top commonly self-reported symptoms were colds (66.07%, n=222), coughs (63.10%, n=212), headache (55.65%, n=187), and muscle pain (50.60%, n=170) while other diseases were influenza (16.96%, n=57) and UTI (15.48%, n=52). In terms of the elements of the OHS system, a general policy on occupational health and safety was found to be lacking and in effect, an absence of health and safety committee overseeing the implementing and monitoring of the policy. No separate budget specific for OHS programs and services was also found to be a limitation. As a result, no OHS personnel and trainings/seminar were identified. No established information system for OHS was in place. In conclusion, health and safety hazards were observed to be present across the barangay health centers visited in a selected city in Metro Manila. Medical conditions identified as most commonly self-reported were hypertension and diabetes for chronic diseases; colds, coughs, headache, and muscle pain for medical symptoms; and influenza and UTI for other diseases. As for the elements of the occupational health and safety system, there was a lack in the general components of the six building blocks of the health system.

Keywords: health hazards, occupational health and safety, occupational health and safety system, safety hazards

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Authors: Mohammad Zakir, Saamia Shams

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Background: Provision of quality family planning services remarkably contribute towards increased uptake of modern contraceptive methods and have important implications on reducing fertility rates. The quality of care in family planning has beneficial impact on reproductive health of women, yet little empirical evidence is present to show the relationship between the impact of adequate training of Community Mid Wives (CMW) and quality family planning services. Aim: This study aimed to enhance the knowledge and counseling skills of CMWs in improving the access to quality client-centered family planning services in Pakistan. Methodology: A quasi-experimental longitudinal study using Initial Quality Assurance Scores-Training-Post Training Quality Assurance Scores design with a non- equivalent control group was adopted to compare a set of experimental CMWs that received four days training package including Family Planning Methods, Counselling, Communication skills and Practical training on IUCD insertion with a set of comparison CMWs that did not receive any intervention. A sample size of 100 CMW from Suraj Social Franchise (SSF) private providers was recruited from both urban and rural Pakistan. Results: Significant improvement in the family planning knowledge and counseling skills (p< 0.001) of the CMWs was evident in the experimental group as compared to comparison group with p > 0.05. Non- significant association between pre-test level family planning knowledge and counseling skills was observed in both the groups (p>0.05). Conclusion: The findings demonstrate that adequate training is an important determinant of quality of family planning services received by clients. Provider level training increases the likelihood of contraceptives uptake and decreases the likelihood of both unintended and unwanted pregnancies. Enhancing quality of family planning services may significantly help reduce the fertility and improve the reproductive health indicators of women in Pakistan.

Keywords: community mid wives, family planning services, quality of care, training

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Authors: Tero Huhtala, Minna Pikkarainen, Saila Saraniemi

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Information technology has long been used as an enabler of exchange for goods and services. Services are evolving from generic to personalized, and the reverse use of customer data has been discussed in both academia and industry for the past few years. This article presents the results of an empirical case study in the area of preventive health care services. The primary data were gathered in workshops, in which future personal data-based services were conceptualized by analyzing future scenarios from a business perspective. The aim of this study is to understand business model transformation in emerging personal data ecosystems. The work was done as a case study in the context of occupational healthcare. The results have implications to theory and practice, indicating that adopting personal data management principles requires transformation of the business model, which, if successfully managed, may provide access to more resources, potential to offer better value, and additional customer channels. These advantages correlate with the broadening of the business ecosystem. Expanding the scope of this study to include more actors would improve the validity of the research. The results draw from existing literature and are based on findings from a case study and the economic properties of the healthcare industry in Finland.

Keywords: ecosystem, business model, personal data, preventive healthcare

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Authors: Abdullah I. Alkraiji, Thomas W. Jackson, Ian Murray

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The proliferation of health data standards today is somewhat overlapping and conflicting, resulting in market confusion and leading to increasing proprietary interests. The government role and support in standardization for health data are thought to be crucial in order to establish credible standards for the next decade, to maximize interoperability across the health sector, and to decrease the risks associated with the implementation of non-standard systems. The normative literature missed out the exploration of the different steps required to be undertaken by the government towards the development of national health data standards. Based on the lessons learned from a qualitative study investigating the different issues to the adoption of health data standards in the major tertiary hospitals in Saudi Arabia and the opinions and feedback from different experts in the areas of data exchange and standards and medical informatics in Saudi Arabia and UK, a list of steps required towards the development of national health data standards was constructed. Main steps are the existence of: a national formal reference for health data standards, an agreed national strategic direction for medical data exchange, a national medical information management plan and a national accreditation body, and more important is the change management at the national and organizational level. The outcome of this study can be used by academics and practitioners to develop the planning of health data standards, and in particular those in developing countries.

Keywords: interoperabilty, medical data exchange, health data standards, case study, Saudi Arabia

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Authors: Sumanta Kumar Saha, Jie Qin

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This study analyzes the impact of financial inclusion on gender inequality in 126 countries belonging to different income groups during the 2005–2019 period. Due to its positive influence on poverty alleviation, economic growth, women empowerment, and income inequality reduction, financial inclusion may help reduce gender equality. This study constructs a novel composite financial inclusion index and applies both fixed-effect panel estimation and instrumental variable approach to examine the impact of financial inclusion on gender inequality. The results indicate that financial inclusion can reduce gender inequality in developing and low- and lower-middle-income countries, but not in higher-income countries. The impact is not always immediate. Past financial inclusion initiatives have a significant influence on future gender inequality. Financial inclusion is also significant if the poverty level is high and women's access to financial services is low compared to men. When the poverty level is low, or women have equal access to financial services, financial inclusion does not significantly affect gender inequality. The study finds that compulsory education and improvement in institutional quality promote gender equality in developing countries apart from financial inclusion. The study proposes that lower-income countries use financial inclusion initiatives to improve gender equality. Other countries need to focus on other aspects such as promoting educational support and institutional quality improvements to achieve gender equality.

Keywords: financial inclusion, gender inequality, institutional quality, women empowerment

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Authors: Cassandra Seery

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During the twentieth century, the notion of child rights at the international level began with the League of Nations’ Geneva Declaration of the Rights of the Child 1924, culminating in the development and adoption of the UN Convention on the Rights of the Child (‘the Convention’) in 1989. A key foundation of child rights lies in the development of the ‘best interests of the child’ principle and its subsequent incorporation into domestic legislation across the globe. This principle has become a key concept in child rights protection and has become a widely recognized principle in the protection of child rights. However, despite its status as the primary operating standard in child and family law and its ‘deepening hold in domestic and international instruments’, the meaning of the ‘best interests of the child’ principle has been criticised as open-ended and vague. This paper explores the evolution and development of the principle in the context of parental separation at international law throughout the 21st century and identifies opportunities for the Nation States to further improve legislative responses in associated child protection cases. An extensive review of relevant United Nations documentation (including instruments, resolutions and comments, jurisprudence, reports, guidelines and policies, training materials and so forth) explores: (i) what progress has been made to further develop the principle at the international level with regard to parental separation; and (ii) what developments participating the Nation States should consider as part of future legal and social policy reforms in this space. It will highlight opportunities for improvement and explore the benefit and relevance of international approaches for the Nation States moving forward.

Keywords: international human rights, best interests of the child, legal and social policy, child rights

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Authors: Khaled Klib, Yousri Azzam, Ibrahim Maarouf

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Tourism is one of the most important and fastest growing economic activities in the world, which has a prominent role in the growth and development of countries and has become increasingly important as business and trade after the World War II. The tourism development is one of the most important aspects of urban development, which aims to plan and develop tourist attractions and improve the urban environment within cities. Tourism development has become a priority for the urban development policy of cities, particularly those which have many tourist potentials. Complementary services, such as infrastructure, roads’ networks, transportation, and communications are needed for these potentials to function properly. In order to achieve these functionalities, also a new planning for the new areas as an expansion is required, or developing and renovating the existing urban areas according to pre-prepared plans to avoid random expansion of the urban structure of the city. This paper aims to determine the tourist attractions of Al-Khomse city, by reviewing the most important tourist attractions such as the Roman city (Leptis Magna), the geographical location on the Mediterranean coast, the temperate climate and diversity of the natural environment. The paper also examines the reality of the infrastructure and tourist services in the city and its suitability to serve the tourism sector. The paper also includes a proposed for tourism development in the city as one of the city's urban expansion trends, which can guide the development strategy in the future. The paper concludes with a vision for the tourism development areas as one of the trends for urban expansion in the future. The paper also concludes tourism development will have an effective role in the growth and development of urban, economic and social, in addition to preserving the natural environment. The paper recommended the need to emphasize the role of tourism development as one of the pillars and trends for the development policy and expansion of Al-Khomse city, preservation of tourist attractions and natural resources and developing infrastructure and tourist services such as accommodation, entertainment, mobility, and accessibility.

Keywords: tourism, tourist attractions, tourism development, urban expansion

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Authors: Rana Praween Kumar

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Preterm-low birth weight delivery is a major cause of infant morbidity and mortality in developing countries and has been linked to poor periodontal health during pregnancy. Gingivitis and chronic periodontitis are highly prevalent chronic inflammatory oral diseases. The detection and diagnosis of these common diseases is a fundamentally important component of oral health care. This study is intended to investigate predisposing and enabling factors as determinants of oral health indicators in pregnancy as well as the association between periodontal problems during pregnancy with age and socio economic status of the individual. A community –based prospective cohort study will be conducted in Jamshedpur, Jharkhand, India among pregnant women using completed interviews and a full mouth oral clinical examination using the CPITN (Community Periodontal Index of Treatment Need) and OHI-S (Simplified Oral Hygiene) indices with adequate sample size and informed consent to the patient following proper inclusion and exclusion criteria. Multiple logistic regression analyses will be used to identify independent determinants of periodontal problems and use of dental services during pregnancy. Analysis of covariance (ANCOVA) will be used to investigate the relationship between periodontal problems with the age and socioeconomic status. The result will help in proper monitoring of periodontal health during pregnancy encouraging the delivery of healthy child and the maintenance of proper health of the mother.

Keywords: infant, periodontal problems, pregnancy, pre-term-low birth weight delivery

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Authors: Yusuf Ismaila

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The developing countries are characterized by inefficient production systems and unequal distribution of wealth. Developing countries are largely populated, yet under developed. This can be attributed partly to the unplanned efforts towards the development of human capital through education and training. In the developed nations a huge attention is accorded to indices such as life expectancy, literacy, infant mortality, education, and the efficient delivery of social services. This is the reason why many developing countries have been scored low by the United Nations in terms of its human development indicators. The population growth continued to expand far beyond the rate of economic growth, a situation that gave rise to increasing poverty. This paper examines the effect of selected human development indicators on the economic development. Thus human capital development is one of the fundamental solutions to enter the international arena. Both quantitative and qualitative analyses were used to demonstrate the effect of selected human capital indices and related literatures were also reviewed for exposition of the human capital concept. It was found that there are no conscious efforts in human capital planning. This has therefore resulted to continuing dwindling of production system and poverty. Recommendations made to redress the situation include that human capital development should be planned and adequately funded in line with the needs of the economy and by applying international standards. Specifically, developing countries must invest necessary resources in developing human capital which tend to have a great impact on sustainable development. Information about the labour market should improve while government policy should favour labour mobility. HCD strategy must focus on improving the skills of the workforce, reducing the cost of doing business and making available the resources business needs to compete and thrive in a fast globalizing economy. There should be regular interaction of planners, employers and builders of human capital to facilitate the process of meaningful national development.

Keywords: economic development, human capital, economic growth, developing countries

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

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

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

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Authors: Waepa Wanhussen

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The Ministry of Public Health has established policies accelerating health promotion to prevent public health problems in five border provinces of Thailand. One of these policies employs the religion to guide the community development and solve health issues consistent with the lifestyle and culture of those people. This policy is an important strategy to solve the problems due to the unrest and conflicts in the southern border provinces. This participatory action research aimed to develop mosques as healthy religion places in Narathiwat Province. In the development, the participatory action, consisting of 5 stages, was conducted from October 2012 - May 2013. Stage I: Conducting a survey for problems and needs for developing healthy religion places by employing community participation. Stage II: Analyzing problems and situations at a workshop containing informal interviews and group conversations with 200 participants (health providers at district level, Imams (the Muslim leaders), and community leaders). Stage III: Planning for developing healthy religion places by health providers, Imams, community leaders. Stage IV: Implementing the plan according to the conditions of problems and needs of the community in order to develop healthy religion places. Stage V: Evaluating the implementation by using the instrument, a criteria of being healthy religion place, for collecting data. Data were analyzed by using percentage. It was found that out of 630 mosques 575 (90.12%) passed the criteria of being a healthy religion place. Among these mosques, 190 mosques (30.15%) were in good and very good level, in which, after the implementation, the number of being good and very good healthy mosques increased by 22.58%. The researcher suggested that the developing sustainably healthy religion places require the participation of residences in the community and agencies such as local government, the Islamic Council of Narathiwat Province, and Council of Culture of Narathiwat Province. The healthy religion places can be used to strengthen and sustain health promotion and disease prevention in the community as health learning centers.

Keywords: healthy religion places, development of community participation, nursing informatics, health

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Authors: Charles Masulani Mwale

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Background: It is argued that 85% of children with the disability live in resource-poor countries where there are few available disability services. A majority of these children, including their parents, suffer a lot as a result of the disability and its associated stigmatization, leading to a marginalized life. These parents also experience more stress and mental health problems such as depression, compared with families of normal developing children. There is little research from Africa addressing these issues especially among parents of intellectually disabled children. WHO encourages research on the impact that child with a disability have on their family and appropriate training and support to the families so that they can promote the child’s development and well-being. This study investigated the parenting experiences, mechanisms of coping with these challenges and psychosocial needs while caring for children with intellectual disabilities in both rural and urban settings of Lilongwe and Mzuzu. Methods: This is part of a larger Mixed-methods study aimed at developing a contextualized psychosocial intervention for parents of intellectually disabled children. 16 focus group discussions and four in-depth interviews were conducted with parents in catchments areas for St John of God and Children of Blessings in Mzuzu and Lilongwe cities respectively. Ethical clearance was obtained from COMREC. Data were stored in NVivo software for easy retrieval and management. All interviews were tape-recorded, transcribed and translated into English. Note-taking was performed during all the observations. Data triangulation from the interviews, note taking and the observations were done for validation and reliability. Results: Caring for intellectually disabled children comes with a number of challenges. Parents experience stigma and discrimination; fear for the child’s future; have self-blame and guilt; get coerced by neighbors to kill the disabled child; and fear violence by and to the child. Their needs include respite relief, improved access to disability services, education on disability management and financial support. For their emotional stability, parents cope by sharing with others and turning to God while other use poor coping mechanisms like alcohol use. Discussion and Recommendation: Apart from neighbors’ coercion to eliminate the child life, the findings of this study are similar to those done in other countries like Kenya and Pakistan. It is recommended that parents get educated on disability, its causes, and management to array fears of unknown. Community education is also crucial to promote community inclusiveness and correct prevailing myths associated with disability. Disability institutions ought to intensify individual as well as group counseling services to these parents. Further studies need to be done to design culturally appropriate and specific psychosocial interventions for the parents to promote their psychological resilience.

Keywords: psychological distress, intellectual disability, psychosocial interventions, mental health, psychological resilience, children

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Authors: Javed Younas

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Fiscal challenges pervade the electricity sector in many developing countries. Low bill payment and high theft mean utility customers have little incentive to conserve. It also means electricity distribution companies have less to invest in infrastructure maintenance, modernization, and technical upgrades. The low-quality electricity services can result impair the economic benefits from connections to the electrical grid. We study the impacts of two interventions implemented in Karachi, Pakistan, with the goal of reducing distribution losses and increasing revenue recovery: infrastructure improvements that made illegal connections physically more difficult and institutional innovations designed to increase communities’ trust in and cooperation with the utility. Using differences in implementation timing across space, we estimate the interventions’ impacts before the COVID-19 pandemic and their role in mitigating the pandemic’s effects on electricity services. Results indicate that the infrastructure improvements reduced losses, as well as the electricity delivered to the distribution system, a proxy for a generation. The institutional innovations significantly impacted revenue recovery, but not losses in their initial months; however, the efforts mitigated the pandemic’s negative effect on the utility finances.

Keywords: electricity, infrastructure, losses, revenue recovery

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Authors: M. G. Cattaneo

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The non-effectiveness of certain codified human rights is particularly apparent with reference to the lack of access to essential drugs in developing countries, which represents a breach of the human right to receive adequate health assistance. This paper underlines the conflict and the legal contradictions between human rights, namely health rights, international Intellectual Property Rights, in particular patent law, as well as international trade law. The paper discusses the crucial links between R&D costs for innovation, patents and new medical drugs, with the goal of reformulating the hierarchies of priorities and of interests at stake in the international intellectual property (IP) law system. Different from what happens today, International patent law should be a legal instrument apt at rebalancing an axiological asymmetry between the (conflicting) needs at stake The core argument in the paper is the proposal of an alternative pathway, namely a feasible proposal for a patent law reform. IP laws tend to balance the benefits deriving from innovation with the costs of the provided monopoly, but since developing countries and industrialized countries are in completely different political and economic situations, it is necessary to (re)modulate such exchange according to the different needs. Based on this critical analysis, the paper puts forward a proposal, called Trading Time for Space (TTS), whereby a longer time for patent exclusive life in western countries (Time) is offered to the patent holder company, in exchange for the latter selling the medical drug at cost price in developing countries (Space). Accordingly, pharmaceutical companies should sell drugs in developing countries at the cost price, or alternatively grant a free license for the sale in such countries, without any royalties or fees. However, such social service shall be duly compensated. Therefore, the consideration for such a service shall be an extension of the temporal duration of the patent’s exclusive in the country of origin that will compensate the reduced profits caused by the supply at the price cost in developing countries.

Keywords: global health, global justice, patent law reform, access to drugs

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Authors: K. Mellou, G. Anastopoulos, T. Zakinthinos, C. Botsi, A. Terzidis

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‘PHILOS – Emergency health response to refugee crisis’ is a programme of the Greek Ministry of Health, implemented by the Hellenic Center for Disease Control and Prevention (HCDCP). The programme is funded by the Asylum, Migration and Integration Fund (AMIF) of EU’s DG Migration and Home Affairs. With the EU Member States accepting, the last period, accelerating migration flows, Greece inevitably occupies a prominent position in the migratory map due to this geographical location. The main objectives of the programme are a) reinforcement of the capacity of the public health system and enhancement of the epidemiological surveillance in order to cover refugees/migrant population, b) provision of on-site primary health care and psychological support services, and c) strengthening of national health care system task-force. The basic methods for achieving the aforementioned goals are: a) implementation of syndromic surveillance system at camps and enhancement of public health response with the use of mobile medical units (Sub-action A), b) enhancement of health care services inside the camps via increasing human resources and implementing standard operating procedures (Sub-action B), and c) reinforcement of the national health care system (primary healthcare units, hospitals, and emergency care spots) of affected regions with personnel (Sub-action C). As a result, 58 health professionals were recruited under sub-action 2 and 10 mobile unit teams (one or two at each health region) were formed. The main actions taken so far by the mobile units are the evaluation, of syndromic surveillance, of living conditions at camps and medical services. Also, vaccination coverage of children population was assessed, and more than 600 catch-up vaccinations were performed by the end of June 2017. Mobile units supported transportation of refugees/migrants from camps to medical services reducing the load of the National Center for Emergency Care (more than 350 transportations performed). The total number of health professionals (MD, nurses, etc.) placed at camps was 104. Common practices were implemented in the recording and collection of psychological and medical history forms at the camps. Protocols regarding maternity care, gender based violence and handling of violent incidents were produced and distributed at personnel working at camps. Finally, 290 health care professionals were placed at primary healthcare units, public hospitals and the National Center for Emergency Care at affected regions. The program has, also, supported training activities inside the camps and resulted to better coordination of offered services on site.

Keywords: migrants, refugees, public health, syndromic surveillance, national health care system, primary care, emergency health response

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Authors: M. Mohemmed Sha Mohamed Kunju, Abdalla A. Al-Ameen Abdurahman, T. Manesh Thankappan, A. Mohamed Mustaq Ahmed Hameed

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Web service composition is an effective approach to complete the web based tasks with desired quality. A single web service with limited functionality is inadequate to execute a specific task with series of action. So, it is very much required to combine multiple web services with different functionalities to reach the target. Also, it will become more and more challenging, when these services are from different providers with identical functionalities and varying QoS, so while composing the web services, the overall QoS is considered to be the major factor. Also, it is not true that the expected QoS is always attained when the task is completed. A single web service in the composed chain may affect the overall performance of the task. So care should be taken in different aspects such as functionality of the service, while composition. Dynamic and automatic service composition is one of the main option available. But to achieve the actual functionality of the task, quality of the individual web services are also important. Normally the QoS of the individual service can be evaluated by using the non-functional parameters such as response time, throughput, reliability, availability, etc. At the same time, the QoS is not needed to be at the same level for all the composed services. So this paper proposes a framework that allows composing the services in terms of QoS by setting the appropriate weight to the non-functional parameters of each individual web service involved in the task. Experimental results show that the importance given to the non-functional parameter while composition will definitely improve the performance of the web services.

Keywords: composition, non-functional parameters, quality of service, web service

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Authors: Naila Awan, Shahrukh Inam

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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.

Keywords: community health session, basic health units, outpatient department, tuberculosis

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Authors: Noel Smith

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To achieve professional registration, UK social workers need to complete a programme of education and training which meets standards set down by central government. When it comes to practice, social work in local authorities must fulfil requirements of national legislation but there is considerable local variation in the organisation and delivery of services. This presentation discusses the on-going reform of social work education by central government in the context of research of social work services in a local authority. In doing so it highlights that the ‘direction of travel’ of the national reform of social work education seems at odds with the trajectory of development of local social work services. In terms of education reform, the presentation cites key government initiatives including the knowledge and skills requirements which have been published separately for, respectively, child and family social work and adult social work. Also relevant is the Government’s new ‘teaching partnership’ pilot which focuses exclusively on social work in local government, in isolation from social work in NGOs. In terms of research, the presentation discusses two studies undertaken by Professor Smith in Suffolk County Council, a local authority in the east of England. The first is an equality impact analysis of the introduction of a new model for the delivery of adult and community services in Suffolk. This is based on qualitative research with local government representatives and NGOs involved in social work with older people and people with disabilities. The second study is an on-going, mixed method evaluation of the introduction of a new model of social care for children and young people in Suffolk. This new model is based on the international ‘Signs of Safety’ approach, which is applied in this model to a wide range of services from early intervention to child protection. While both studies are localised, the service models they examine are good illustrations of the way services are developing nationally. Analysis of these studies suggest that, if services continue to develop as they currently are, then social workers will require particular skills which are not be adequately addressed in the Government’s plans for social work education. Two issues arise. First, education reform concentrates on social work within local government while increasingly local authorities are outsourcing service provision to NGOs, expecting greater community involvement in providing care, and integrating social care with health care services. Second, education reform focuses on the different skills required for working with older and disabled adults and working with children and families, to the point where potentially the profession would be fragmented into two different classes of social worker. In contrast, the development of adult and children’s services in local authorities re-asserts the importance of common social work skills relating to personalisation, prevention and community development. The presentation highlights the importance for social work education in the UK to be forward looking, in terms of the changing design of service delivery, and outward looking, in terms of lessons to be drawn from international social work.

Keywords: adult social work, children and families social work, European social work, social work education

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Authors: A. Nazilah

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Floods are classified among sudden onset phenomenon and the highest natural disasters happen in Malaysia. Floods have a negative impact on mental health. Measuring the psychopathology symptoms among flood victims is an important step for intervention and treatment. However, there is a gap of a valid, reliable and an efficient instrument to measure flood victims' mental health, especially in Malaysia. This study aims to replicate the earlier studies of developing e-Psychological Instrument for Flood Victims (e-PIFV). The e-PIFV is a digital self-report inventory that has 84 items with 4 dimension scales namely stress, anxiety, depression, and trauma. Two replicated studies have been done to validate the instrument using expert judgment method. Results showed that content coefficient validity for each sub-scale of the instrument ranging from moderate to very strong validity. In study I, coefficient values of stress was 0.7, anxiety was 0.9, depression was 1.0, trauma was 0.6 and overall was 0.8. In study II, the coefficient values for two subscales and overall scale were increased. The coefficient value of stress was 0.8, anxiety was 0.9, depression was 1.0, trauma was 0.8 and overall was 0.9. This study supports the theoretical framework and provides practical implication in the field of clinical psychology and flood management.

Keywords: developing e-psychological instrument, content validity, instrument, mental health management, flood victims, psychopathology, validity

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Authors: Cheryl M. Bowen

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Understanding that children thrive in a multi-systems approach to mental health development, a growing number of schools often promote school-based positive youth development however, there is scant empirical evidence investigating effective school-based “wraparound” mental health services for low income, Latinx children and their families. This 10-month case study utilizes a sample of 281 low-income, Latinx parents and their children, and 23 K-5th grade teachers living in northern California to test the hypothesis that a school-based mental health program can strengthen students’ developmental asset attainment and positively impact the school environment. The study utilized triangulated data to ascertain the effects of two program levels - (a) mental health and (b) positive child development services. All services were site-based and meant to target a wide variety of families. Findings from the study report that the universal mental health program increased the developmental asset attainment in 5 out of 8 thriving indicators thus transforming the child within his/her environment. Data collected from the administrative referral report demonstrate that the project also positively impacted the school climate. Parents and teachers felt more connected to the school, and referrals were down for discipline (35%), academics (66%), and suspensions (51%). The study concludes that a transformational ecology model of positive child development is the most effective means to nurture connections to all socializing agencies in a child’s ecosystem.

Keywords: case study, child development, positive youth development, developmental assets, ecological systems theory

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

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Adolescent Birth rate (ABR) is an important indicator of both gender equality and equity in the country. This is the number of births to women aged between 15 and 19 years per 1000 live births. There has been a decreasing trend in ABR in Zimbabwe since 2014. However, the difference between rural areas and urban areas has continued to widen. A secondary analysis was conducted to assess the differences in ABR between the rural areas of Zimbabwe and the urban areas. This was also done to determine the root causes of high ABR in rural areas compared to urban areas and the impact this may cause to the economic development of the nation. The analysis was done according to geographical characteristics (provinces). A total of 69,335 females aged 10 to 19 years had live births among a total population of 791,914 females aged 15 to 19 years. The total Adolescent Birth rate in Zimbabwe is 87/1000 live births, while in rural areas, it is 114.4/1000 live births compared to urban areas, which is 49.7/1000 live births. A decrease in the ABR trends has been recorded since 2014 from 143/1000 live births among adolescents in rural areas to 97/1000 live births in urban areas. This shows that rural areas still have high rates of ABR compared to their urban counterparts, and the gap is still wide. High ABR is a result of early child marriages, teenage pregnancies as well as poverty. Most of these marriages (46%) are intergenerational relationships and have resulted in an increase in gender-based violence cases among adolescents, poor health outcomes, including pregnancy complications such as eclampsia, Cephalous Pelvic Disproportion (CPD), and obstructed labour. Maternal deaths among adolescence is also high compared to adults. Furthermore, the increase of school dropouts among adolescent girls is on the rise due to teen pregnancies. These challenges are being faced mostly by rural adolescent girls as compared to their urban counterparts. The widening gap in ABR between urban areas and rural areas is a matter of concern and needs to be addressed. There is a need to inform policy, programming, and interventions targeting rural areas to address the challenges and gaps in reducing ABR. This abstract is to inform policymakers on the strategies and resources required to address the challenges currently distressing adolescents. There is a need to improve access to Sexual and Reproductive Health (SRH) Services by adolescents and reduce the age of consent to access SRH services should be reduced from 18 years for ease access to young people to reduce teenage pregnancies. Comprehensive sexuality education, both in-school and out of school, should be strengthened to increase knowledge among young people on sexuality.

Keywords: adolescence birth rate, live birth, teenage pregnancies, SRH services

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Authors: Rowland Brucken

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This paper argues that nation-building theories that prioritize democratic governance best explain the successful post-independence development of Botswana. Three main competing schools of thought exist regarding the sequencing of policies that should occur to re-build weakened or failed states. The first posits that economic development should receive foremost attention, while democratization and a binding sense of nationalism can wait. A second group of experts identified constructing a sense of nationalism among a populace is necessary first, so that the state receives popular legitimacy and obedience that are prerequisites for development. Botswana, though, transitioned into a multi-party democracy and prosperous open economy due to the utilization of traditional democratic structures, enlightened and accountable leadership, and an educated technocratic civil service. With these political foundations already in place when the discovery of diamonds occurred, the resulting revenues were spent wisely on projects that grew the economy, improved basic living standards, and attracted foreign investment. Thus democratization preceded, and therefore provided an accountable basis for, economic development that might otherwise have been squandered by greedy and isolated elites to the detriment of the greater population. Botswana was one of the poorest nations in the world at the time of its independence in 1966, with little infrastructure, a dependence on apartheid South Africa for trade, and a largely subsistence economy. Over the next thirty years, though, its economy grew the fastest of any nation in the world. The transparent and judicious use of diamond returns is only a partial explanation, as the government also pursued economic diversification, mass education, and rural development in response to public needs. As nation-building has become a project undertaken by nations and multilateral agencies such as the United Nations and the North Atlantic Treaty Organization, Botswana may provide best practices that others should follow in attempting to reconstruct economically and politically unstable states.

Keywords: Botswana, democratization, economic development, nation-building

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