Search results for: public health informatics

Authors: Rubaiat S. Ahmed, Jemer Garrido, Sergey M. Motov

Abstract:

Clinical informatics (CI) enables the transformation of data into a systematic organization that improves the quality of care and the generation of positive health outcomes.Innovative technology through informatics that compiles accurate data on analgesic utilization in the emergency department can enhance pain management in this important clinical setting. We aim to establish a simplified reporting system through CI to examine and assess the analgesic prescribing practices in the EDthrough executing a U.S. federal grant project on opioid reduction initiatives. Queried data points of interest from a level-one trauma ED’s electronic medical records were used to create data sets and develop informational/visual reporting dashboards (on Microsoft Excel and Google Sheets) concerning analgesic usage across several pre-defined parameters and performance metrics using CI. The data was then qualitatively analyzed to evaluate ED analgesic prescribing trends by departmental clinicians and leadership. During a 12-month reporting period (Dec. 1, 2020 – Nov. 30, 2021) for the ongoing project, about 41% of all ED patient visits (N = 91,747) were for pain conditions, of which 81.6% received analgesics in the ED and at discharge (D/C). Of those treated with analgesics, 24.3% received opioids compared to 75.7% receiving opioid alternatives in the ED and at D/C, including non-pharmacological modalities. Demographics showed among patients receiving analgesics, 56.7% were aged between 18-64, 51.8% were male, 51.7% were white, and 66.2% had government funded health insurance. Ninety-one percent of all opioids prescribed were in the ED, with intravenous (IV) morphine, IV fentanyl, and morphine sulfate immediate release (MSIR) tablets accounting for 88.0% of ED dispensed opioids. With 9.3% of all opioids prescribed at D/C, MSIR was dispensed 72.1% of the time. Hydrocodone, oxycodone, and tramadol usage to only 10-15% of the time, and hydromorphone at 0%. Of opioid alternatives, non-steroidal anti-inflammatory drugs were utilized 60.3% of the time, 23.5% with local anesthetics and ultrasound-guided nerve blocks, and 7.9% with acetaminophen as the primary non-opioid drug categories prescribed by ED providers. Non-pharmacological analgesia included virtual reality and other modalities. An average of 18.5 ED opioid orders and 1.9 opioid D/C prescriptions per 102.4 daily ED patient visits was observed for the period. Compared to other specialties within our institution, 2.0% of opioid D/C prescriptions are given by ED providers, compared to the national average of 4.8%. Opioid alternatives accounted for 69.7% and 30.3% usage, versus 90.7% and 9.3% for opioids in the ED and D/C, respectively.There is a pressing need for concise, relevant, and reliable clinical data on analgesic utilization for ED providers and leadership to evaluate prescribing practices and make data-driven decisions. Basic computer software can be used to create effective visual reporting dashboards with indicators that convey relevant and timely information in an easy-to-digest manner. We accurately examined our ED's analgesic prescribing practices using CI through dashboard reporting. Such reporting tools can quickly identify key performance indicators and prioritize data to enhance pain management and promote safe prescribing practices in the emergency setting.

Keywords: clinical informatics, dashboards, emergency department, health informatics, healthcare informatics, medical informatics, opioids, pain management, technology

Procedia PDF Downloads 117

Authors: Zubair Ahmad

Abstract:

The management of solid waste, from its collection to disposal, is a widespread issue all around the world. This is a stinging issue in the rural and urban areas of the developing and developed states of the world. The mismanagement in Pakistan in the context of solid waste is required to be recognized because it is not only affecting the health of the public but also affecting the health of the environment. Therefore, this study conducts qualitative research methodology and conducted interviews in Lahore, Karachi, Quetta, Peshawar and Islamabad’s solid waste management’s officials and waste pickers for analyzing uses Grounded theory for the lens of thematic analysis to highlight how public value is being destroyed by the mismanagement of solid waste in Pakistan. This study inspects and critically discusses the effect of corruption, mismanagement, lawlessness, lack of accountability, budgetary issues, and no-proper methods for the disposal of solid waste as the major causes that are destroying public value. These factors should be recognized and should be addressed in order to better the system of solid waste management in Pakistan.

Keywords: solid waste management, public value destruction, health, environment, accountability, grounded theory

Procedia PDF Downloads 65

Authors: Enjia Zhang

Abstract:

During the prevention and control of the COVID-19 pandemic, all communities in China were gated and under strict management, which was highly effective in preventing the spread of the epidemic from spreading. Based on the TRIZ theory, this paper intends to propose green design strategies of community control in response to public health emergencies and to optimize community control facilities according to the principle of minimum transformation. Through the questionnaire method, this paper investigates and summarizes the situation and problems of community control during the COVID-19 pandemic. Based on these problems, the TRIZ theory is introduced to figure out the problems and associates them with prefabricated facilities. Afterward, the innovation points and solutions of prefabricated community control measures are proposed by using the contradiction matrix. This paper summarizes the current situation of community control under public health emergencies and concludes the problems such as simple forms of temporary roadblocks, sudden increase of community traffic pressure, and difficulties to access public spaces. The importance of entrance and exit control in community control is emphasized. Therefore, the community control measures are supposed to focus on traffic control, and the external access control measures, including motor vehicles, non-motor vehicles, residents and non-residents access control, and internal public space access control measures, including public space control shared with the society or adjacent communities, are proposed in order to make the community keep the open characteristics and have the flexibility to deal with sudden public health emergencies in the future.

Keywords: green design, community control, prefabricated structure, public health emergency

Procedia PDF Downloads 94

Authors: Marco E. O. Jardim, Frederico A. M. Souza, Valeria M. Bastos, Myrian C. A. Costa, Nelson F. F. Ebecken

Abstract:

Urban public transportation in Rio de Janeiro is based on bus lines, powered by diesel, and four limited metro lines that support only some neighborhoods. This work presents an infrastructure built to better understand microclimate variations related to massive urban transportation in some specific areas of the city. The use of sensor nodes with small analytics capacity provides environmental information to population or public services. The analyses of data collected from a few small sensors positioned near some heavy traffic streets show the harmful impact due to poor bus route plan.

Keywords: big data, IoT, public transportation, public health system

Procedia PDF Downloads 214

Authors: Mayank Mishra

Abstract:

Market Economy can be broadly defined as economic system where supply and demand regulate the economy and in which decisions pertaining to production, consumption, allocation of resources, price and competition are made by collective actions of individuals or organisations with limited government intervention. On the other hand Market Society is one where instead of the economy being embedded in social relations, social relations are embedded in the economy. A market economy becomes a market society when all of land, labour and capital are commodified. This transition also has effect on people’s attitude and values. Such a transition commence impacting the non-material aspect of life such as public education, public health and the like. The inception of neoliberal policies in non-market norms altered the nature of social goods like public health that raised the following questions. What impact would the transition to a market society make on people in terms of accessibility to public health? Is healthcare a commodity that can be subjected to a competitive market place? What kind of private investments are being made in public health and how do private investments alter the nature of a public good like healthcare? This research problem will employ empirical-analytical approach that includes deductive reasoning which will be using the existing concept of market economy and market society as a foundation for the analytical framework and the hypotheses to be examined. The research also intends to inculcate the naturalistic elements of qualitative methodology which refers to studying of real world situations as they unfold. The research will analyse the existing literature available on the subject. Concomitantly the research intends to access the primary literature which includes reports from the World Bank, World Health Organisation (WHO) and the different departments of respective ministries of the countries for the analysis. This paper endeavours to highlight how the issue of commodification of public health would lead to perpetual increase in its inaccessibility leading to stratification of healthcare services where one can avail the better services depending on the extent of one’s ability to pay. Since the fundamental maxim of private investments is to churn out profits, these kinds of trends would pose a detrimental effect on the society at large perpetuating the lacuna between the have and the have-nots.The increasing private investments, both, domestic and foreign, in public health sector are leading to increasing inaccessibility of public health services. Despite the increase in various public health schemes the quality and impact of government public health services are on a continuous decline.

Keywords: commodity, India and Pakistan, market society, public health

Procedia PDF Downloads 280

Authors: T. Holecki, J. Wozniak-Holecka, P. Romaniuk

Abstract:

Due to the highly centralized model of financing health care in Poland, local self-government rarely undertook their own initiatives in the field of public health, particularly health promotion. However, since 2017 the possibility of applying for a subsidy to health policy programs has been allowed, with the additional resources to be retrieved from the National Health Fund, which is the dominant payer in the health system. The amount of subsidy depends on the number of inhabitants in a given unit and ranges about 40% of the total cost of the program. The aim of this paper is to assess the impact of newly implemented solutions in financing health policy on the management of public finances, as well as on the activity provided by local self-government in health promotion. An effort to estimate the amount of expenses that both local governments, and the National Health Fund, spent on local health policy programs while implementing the new solutions. The research method is the analysis of financial data obtained from the National Health Fund and from local government units, as well as reports published by the Agency for Health Technology Assessment and Pricing, which holds substantive control over the health policy programs, and releases permission for their implementation. The study was based on a comparative analysis of expenditures on the implementation of health programs in Poland in years 2010-2018. The presentation of the results includes the inclusion of average annual expenditures of local government units per 1 inhabitant, the total number of positively evaluated applications and the percentage share in total expenditures of local governments (16 voivodships areas). The most essential purpose is to determine whether the assumptions of the subsidy program are working correctly in practice, and what are the real effects of introducing legislative changes into local government levels in the context of public health tasks. The assumption of the study was that the use of a new motivation tool in the field of public management would result in multiplication of resources invested in the provision of health policy programs. Preliminary conclusions show that financial expenditures changed significantly after the introduction of public funding at the level of 40%, obtaining an increase in funding from own funds of local governments at the level of 80 to 90%.

Keywords: health care system, health policy programs, local self-governments, public health management

Procedia PDF Downloads 134

Authors: Elizabeth Waleola Afolabi-Soyemi

Abstract:

As the population of older adults continues to grow, improving health outcomes for this demographic has become an increasingly important public health goal. Health promotion interventions have been developed to address the unique health needs and challenges faced by older adults. This abstract reviews the literature on health promotion interventions for older adults and their effectiveness in improving health outcomes. Various interventions have been found to be effective, including physical activity programs, nutrition education, medication management, and social support programs. These interventions have been shown to improve outcomes such as functional status, quality of life, and disease management. Despite the success of these interventions, there are still barriers to their implementation, such as a lack of access to resources and inadequate funding. Further research is needed to identify effective strategies for overcoming these barriers and to develop more tailored interventions for specific populations of older adults. Overall, health promotion interventions have great potential to improve the health outcomes and quality of life of older adults and should be a priority for public health efforts.

Keywords: health, humanity, health promotion, older adults

Procedia PDF Downloads 61

Authors: Mattia Testuzza

Abstract:

Public health is a social endeavour, which involves many different actors: from extremely stratified, structured health systems to unofficial networks of people and knowledge. Health and diseases are an intertwined individual and social experiences. Both patients and health workers navigate this public space through relations of trust. Trust in healthcare goes from the personal trust between a patient and her/his doctor to the trust of both the patient and the health worker in the medical knowledge and the healthcare system. Trust it is not a given, but it is continuously negotiated, given and gained. The key to understand these essential relations of trust in health is to recognise them as a social practice, which therefore implies agency and power. In these terms, health is constantly public and made public, as trust emerges as a meaningfully political phenomenon. Trust as a power relation can be observed at play in the implementation of public health policies such as the WHO’s Directly-Observed Theraphy Short-course (DOTS), and with the increasing concern for drug-resistance that tuberculosis pose, looking at the role of trust in the healthcare delivery system and implementation of public health policies becomes significantly relevant. The ethnographic fieldwork was carried out in four months through observation of the daily practices at the National Tuberculosis Center of Nepal, and semi-structured interviews with MultiDrug-Resistant Tuberculosis (MDR-TB) patients at different stages of the treatment, their relatives, MDR-TB specialised nurses, and doctors. Throughout the research, the role which trust plays in tuberculosis treatment emerged as one fundamental ax that cuts through all the different factors intertwined with drug-resistance development, unfolding a tension between the DOTS policy, which undermines trust, and the day-to-day healthcare relations and practices which cannot function without trust. Trust also stands out as a key component of the solutions to unforeseen issues which develop from the overall uncertainty of the context - for example, political instability and extreme poverty - in which tuberculosis treatment is carried out in Nepal.

Keywords: trust, tuberculosis, drug-resistance, politics of health

Procedia PDF Downloads 218

Authors: Karina Guimaraes, Lilian Santos

Abstract:

This study has the purpose of planning and instituting monitoring actions as a way of knowing the scenario of assistance to the patient with stoma, treated in the public health network in Brazil, from January to November of the year 2016, from the elaboration of a technical document containing the survey of the number of procedures offered and the value of the ostomy services, accredited in the Unified Health System-SUS. The purpose of this document is to improve the quality of these services in the efficient management of available financial resources, making it indispensable for the creation of strategies for the implementation and implementation of care services for people with stomata as a strategic tool in the promotion, prevention, qualification and efficiency in health care.

Keywords: health economic, management, ostomy, unified health system

Procedia PDF Downloads 281

Authors: Joe Voshall, Leigha Shoup

Abstract:

In 2022, the Ohio Peace Officer Training Council and the Attorney General required officers to complete a minimum of 24 hours of continued professional training for the year. Much of the training was based on Mental Health or similarly related topics. This includes Officer Wellness and Officer Mental Health. It is becoming clearer that the stigma of Officer / First Responder Mental Health is a topic that is becoming more prevalently faced. To assist officers and first responders in facing mental health issues, we are developing new training. This training will aid in recognizing mental health-related issues in officers/first responders and citizens, as well as further using the same information to better respond and interact with one another and the public. In general, society has many varying views of mental health, much of which is largely over-sensationalized by television, movies, and other forms of entertainment. There has also been a stigma in law enforcement / first responders related to mental health and being weak as a result of on-the-job-related trauma-induced struggles. It is our hope this new training will assist officers and first responders in not only positively facing and addressing their mental health but using their own experience and education to recognize signs and symptoms of mental health within individuals in the community. Further, we hope that through this recognition, officers and first responders can use their experiences and more in-depth understanding to better interact within the field and with the public. Through recognition and better understanding of mental health issues and more positive interaction with the public, additional achievements are likely to result. This includes in the removal of bias and stigma for everyone.

Keywords: law enforcement, mental health, officer related mental health, trauma

Procedia PDF Downloads 114

Authors: Ricky Leung

Abstract:

Artificial intelligence (AI) and machine learning (ML) have revolutionized the way health organizations approach social media. The sheer volume of data generated through social media can be overwhelming, but AI and ML can help organizations effectively manage this information to improve the health and well-being of individuals and communities. One way AI can be used to enhance social media in health organizations is through sentiment analysis. This involves analyzing the emotions expressed in social media posts to better understand public opinion and respond accordingly. This can help organizations gauge the impact of their campaigns, track the spread of misinformation, and improve communication with the public. While social media is a useful tool, researchers and practitioners have expressed fear that it will be used for the spread of misinformation, which can have serious consequences for public health. Health organizations must work to ensure that AI systems are transparent, trustworthy, and unbiased so they can help minimize the spread of misinformation. In conclusion, AI and ML have the potential to greatly enhance the use of social media in health organizations. These technologies can help organizations effectively manage large amounts of data and understand stakeholders' sentiments. However, it is important to carefully consider the potential consequences and ensure that these systems are carefully designed to minimize the spread of misinformation.

Keywords: AI, ML, social media, health organizations

Procedia PDF Downloads 63

Authors: Ali Raza

Abstract:

The dynamic landscape of communication has brought about significant advancements that intersect with the realms of public health and journalism. This abstract explores the evolving synergy between these fields, highlighting how their intersection has contributed to informed societies and improved public health outcomes. In the digital age, communication plays a pivotal role in shaping public perception, policy formulation, and collective action. Public health, concerned with safeguarding and improving community well-being, relies on effective communication to disseminate information, encourage healthy behaviors, and mitigate health risks. Simultaneously, journalism, with its commitment to accurate and timely reporting, serves as the conduit through which health information reaches the masses. Advancements in communication technologies have revolutionized the ways in which public health information is both generated and shared. The advent of social media platforms, mobile applications, and online forums has democratized the dissemination of health-related news and insights. This democratization, however, brings challenges, such as the rapid spread of misinformation and the need for nuanced strategies to engage diverse audiences. Effective collaboration between public health professionals and journalists is pivotal in countering these challenges, ensuring that accurate information prevails. The synergy between public health and journalism is most evident during public health crises. The COVID-19 pandemic underscored the pivotal role of journalism in providing accurate and up-to-date information to the public. However, it also highlighted the importance of responsible reporting, as sensationalism and misinformation could exacerbate the crisis. Collaborative efforts between public health experts and journalists led to the amplification of preventive measures, the debunking of myths, and the promotion of evidence-based interventions. Moreover, the accessibility of information in the digital era necessitates a strategic approach to health communication. Behavioral economics and data analytics offer insights into human decision-making and allow tailored health messages to resonate more effectively with specific audiences. This approach, when integrated into journalism, enables the crafting of narratives that not only inform but also influence positive health behaviors. Ethical considerations emerge prominently in this alliance. The responsibility to balance the public's right to know with the potential consequences of sensational reporting underscores the significance of ethical journalism. Health journalists must meticulously source information from reputable experts and institutions to maintain credibility, thus fortifying the bridge between public health and the public. As both public health and journalism undergo transformative shifts, fostering collaboration between these domains becomes essential. Training programs that familiarize journalists with public health concepts and practices can enhance their capacity to report accurately and comprehensively on health issues. Likewise, public health professionals can gain insights into effective communication strategies from seasoned journalists, ensuring that health information reaches a wider audience. In conclusion, the convergence of public health and journalism, facilitated by communication advancements, is a cornerstone of informed societies. Effective communication strategies, driven by collaboration, ensure the accurate dissemination of health information and foster positive behavior change. As the world navigates complex health challenges, the continued evolution of this synergy holds the promise of healthier communities and a more engaged and educated public.

Keywords: public awareness, journalism ethics, health promotion, media influence, health literacy

Procedia PDF Downloads 40

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

Abstract:

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

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

Procedia PDF Downloads 535

Authors: Farnoosh Faal

Abstract:

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

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

Procedia PDF Downloads 120

Authors: Kristen Erekson, Sarah Spendlove Caswell

Abstract:

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

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

Procedia PDF Downloads 49

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

Abstract:

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

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

Procedia PDF Downloads 293

Authors: Arun Karoriya, Mrinal Agrawal

Abstract:

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

Keywords: degradation, flourish, multidimensional, policies

Procedia PDF Downloads 320

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

Abstract:

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

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

Procedia PDF Downloads 364

Authors: Vasuki Rayapati, Bhanu Duggal

Abstract:

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

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

Procedia PDF Downloads 75

Authors: Jason Salim, Zhouyang Lu

Abstract:

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

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

Procedia PDF Downloads 666

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

Abstract:

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

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

Procedia PDF Downloads 310

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

Abstract:

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

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

Procedia PDF Downloads 488

Authors: Kalsoom Sumra

Abstract:

The increasing concern of public sector reforms brings new challenges to public service ethics in developing countries not only at central level but also at local level. This paper aims to identify perceptions on public service ethics of public officials and examines more generally the understanding of public servants in Pakistan towards public service ethics in local public organizations. The study uses an independently administered structured questionnaire to collect data to know the extent of the recognition of public service ethics in local organizations. A total of 150 completed questionnaires are analyzed received from public servants working at the local level in Pakistan. The analysis explores how traditional, social patterns and cultural ethics can provide us with a rounded picture of the main antecedents, moderators of public service ethics in Pakistan. Moreover, the findings of this study contribute in association of public service ethics which are crucial in ongoing political and administrative culture of Pakistan, the most crucial core for public organizational ethical climate. This study also has numerous implications for local public administration and it highlights the importance of expanding research agenda on public service ethics in developing settings with challenging institutional contexts with imperfect training and operating environments. This study may well be particularly important for practice of public service ethics in developing countries in public administration. To the best of author’s knowledge, this study is the first of its kind to provide an initial step in practical implications to emphasize relevant public service ethics in public administration in developing transparent and accountable organization.

Keywords: public service ethics, accountability and transparency, public service reforms, public administration, organizational ethical climate

Procedia PDF Downloads 313

Authors: Kiran Bala

Abstract:

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

Keywords: health, election manifestos, public perception, policies

Procedia PDF Downloads 328

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

Abstract:

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

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

Procedia PDF Downloads 313

Authors: Erez Yerushalmi, Sani Ziv

Abstract:

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

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

Procedia PDF Downloads 117

Authors: Eiko Takaoka, Yoshiyuki Fukushima, Koichiro Hirose, Tadashi Hasegawa

Abstract:

Although all high school students in Japan are required to learn informatics, many of them do not learn this topic sufficiently. In response to this situation, we propose a support package for high school informatics classes. To examine what students learned and if they sufficiently understood the context of the lessons, a questionnaire survey was distributed to 186 students. We analyzed the results of the questionnaire and determined the weakest units, which were “basic computer configuration” and “memory and secondary storage”. We then developed a package for teaching these units. We propose that our package be applied in high school classrooms.

Keywords: computer science unplugged, computer science outreach, high school curriculum, experimental evaluation

Procedia PDF Downloads 359

Authors: Rafla Hchaichi

Abstract:

The public administration is currently experiencing in the field of quality unprecedented effervescence. However, in a globalized world more and more competitive, public services are confronted with the need to improve their performances which push public companies to implement quality approaches. Quality approaches have taken diverse forms such as service commitment, labels, certifications and the Common Assessment Framework. This paper provides an overview on the strategy for administrative development in Tunisia since the Carthaginian civilization until today. It outlines the evolution of quality management in the Tunisian public context while focusing on the National Referential of Quality of Administrative Services.

Keywords: quality approach, the common assessment framework, service commitment, label, certification, quality of public service, performance of public service, Tunisian Public Service

Procedia PDF Downloads 516

Authors: Routsukol Sunalai

Abstract:

The purpose of this study is to examine the impact of public enterprise reform policy on the attributes of organizational commitments in the public energy enterprises in Thailand. It compares three structural types of public energy enterprises: Totally state-owned public enterprises (type I), partially transformed public enterprises (type II), and totally transformed public enterprises (type III), based on the degree of state partially transformed public enterprises (type II), and totally transformed public enterprises (type III),based on the degree of reformed organizations, by analyzing the presence of the desirable attributes of organizational commitment as perceived by employees. Findings indicate that there are statistically significant differences in the level of some dimensions of organizational commitment (affective commitment and normative commitment) between the three types of public energy enterprises. The lack of a structural type difference holds for only continuance commitment. The results also indicate empirical evidence concerning the causal relationship between the antecedents and including organizational commitment also.

Keywords: management control, organizational commitment, public enterprises in Thailand, public enterprise reform

Procedia PDF Downloads 259

Authors: Sanghamitra Sadhu

Abstract:

A paradigm shift from capitalism to information technology is discerned in the era globalisation. The idea of public sphere, which was theorized in terms of its decline in the wake of the rise of commercial mass media has now emerged as a transnational or global sphere with the discourse being dominated by the ‘network society’. In other words, the dynamic of globalisation has brought about ‘a spatial turn’ in the social and political sciences which is also manifested in the public sphere, Especially the global public sphere. The paper revisits the Habermasian concept of the public sphere and focuses on the various social networking sites with their plausibility to create a virtual global public sphere. Situating Habermas’s notion of the bourgeois public sphere in the present context of global public sphere, it considers the changing dimensions of the public sphere across time and examines the concept of the ‘public’ with its shifting transformation from the concrete collective to the fluid ‘imagined’ category. The paper addresses the problematic of multimodal self-portraiture in the social networking sites as well as various online diaries/journals with an attempt to explore the nuances of the networked self.

Keywords: globalisation, network society, public sphere, self-fashioning, identity, autonomy

Procedia PDF Downloads 386