Search results for: public healthcare services

Authors: Erez Yerushalmi, Sani Ziv

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

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

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Authors: Uchenna Cosmas Ugwu, Osmond Chukwuemeka Ene

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Globally, older adults are considered the most vulnerable groups to age-related diseases including diabetes mellitus, obesity, cardiovascular diseases, cancer and osteoporosis. With improved access to quality healthcare services, these complications can be prevented and the incidence rates reduced to the least occurrence. The aim of this study is to validate appropriate measures for improving quality healthcare services utilization among elderly persons in Nigeria and also to determine the significant association within demographic variables. A cross-sectional survey research design was adopted. Using a convenient sampling technique, a total of 400 experts (150 registered nurses and 250 public health professionals) with minimum of doctoral degree qualification were sampled and studied. A structured instrument titled “Expert-Based Healthcare Services Utilization Questionnaire (EBHSUQ) with .83 reliability index was used for data collection. All the statistical data analysis was completed using frequency counts, percentage scores and chi-square statistics. The results were significant at p≤0.05. It was found that quality healthcare services utilization by elderly persons in Nigeria would be improved if the services are: available (83%), affordable (82%), accessible (79%), suitable (77%), acceptable (77%), continuous (75%) and stress-free (75%). Statistically, significant association existed on quality healthcare services utilization with gender (p=.03<.05) and age (p=.01<.05) while none was observed on work experience (p=.23>.05), marital status (p=.11>.05) and employment category (p=.09>.05). To improve quality healthcare services utilization for elderly persons in Nigeria, the adoption of appropriate measures by Nigerian government and professionals in healthcare sectors are paramount. Therefore, there is need for collaborative efforts by the Nigerian government and healthcare professionals geared towards educating the general public through mass sensitization, awareness campaign, conferences, seminars and workshops for the importance of accessing healthcare services.

Keywords: elderly persons, healthcare services, cross-sectional survey research design, utilization.

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Authors: Samuel Bonato, Cineia Santos, Roberta Leite, Carla Ten Caten

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This paper aims to apply the A3 strategy deployment in a local department for healthcare. As a literature review, it was evaluated articles related to the period 2009 - 2018, considering the key-words A3, healthcare, public services and strategy deployment. The methodology used was action research, involving all the actors inside the secretary, beginning with the top management and deploying it through meetings and evaluation conferences with the participation of all secretary coordination. As main results, it is possible to highlight the development of 8 A3, one as the "mother A3" and 7 as "son A3", each one related to each coordination. In each A3, past results, new goals, new projects to achieve these goals and control deadlines were defined and implemented to a management strategy. In addition to this result, this paper is planning to present the use of this A3 during 6 months in 2019.

Keywords: A3 Strategy, strategy deployment, healthcare, Public services

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Authors: Nilgün Katrancı, Pınar Göv

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The privatization of public services has intensified and extended the delivery of healthcare services at hospitals, which leads to an increase in health and safety risks for healthcare professionals. More efficient and effective delivery of healthcare services can be realized through the provision of occupational safety of healthcare professionals. However, healthcare professionals are exposed to more dangers, accidents, and diseases because of such reasons as present working conditions, hospital infections, lack of ergonomic design, medication, wastes, excessive work load, negligent attitudes of workers, violence, psychological risks, etc. Unsafe working conditions cause fear, injury and wearing impacts in healthcare professionals in many countries. Thus, it is emphasized that the protection of the health of healthcare professionals is important to have educated, healthy workers and adequate workforce. Occupational health and safety measures applied in health facilities are aimed at protecting workers and providing the safety of services and facilities. All activities to be undertaken at hospitals with regard to occupational safety in accordance with these goals will help to reduce costs and provide continuous services. At the same time, a safe working environment will increase worker satisfaction and motivation, sense of institutional belonging and indirectly patient safety and satisfaction. In addition, the control and correction of occupational safety activities are also as important as the implementation. Occupational health and safety practices in the facilities will also lead to positive developments for national economy and society. This study emphasizes that approaching occupational safety practices for healthcare professionals in a sensitive manner is important for enabling healthcare professionals to do more productive works in terms of physical, social and psychological aspects, maintaining the continuity of healthcare services and social and economic contributions.

Keywords: health facilities, healthcare professional, occupational health, occupational safety

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Authors: Ammatu Alhassan

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Quality healthcare delivery is a crucial indicator in assessing the overall developmental status of a country. There are many limitations in the Ghanaian healthcare supply chain due to the lack of studies about the correlation between quality health service and the healthcare supply chain. Patients who visit various healthcare providers face unpleasant experiences such as delays in the availability of their medications. In this study, an assessment of the quality of services provided to Ghanaian outpatients who visit public healthcare providers was investigated to establish its effect on the healthcare supply chain using a conceptual model. The Donabedian’s structure, process, and outcome theory for service quality evaluation were used to analyse 20 Ghanaian hospitals. The data obtained was tested using the structural equation model (SEM). The findings from this research will help us to improve the overall quality of the Ghanaian healthcare supply chain. The model which will be developed will help us to understand better the linkage between quality healthcare and the healthcare supply chain as well as serving as a reference tool for future healthcare research in Ghana.

Keywords: Ghana, healthcare, outpatients, supply chain

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Authors: Shishir Kumar, Chhaya Gangwal, Seema Raj

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Public health informatics (PHI) which has seen successful implementation in the developed world, become the buzzword in the developing countries in providing improved healthcare with enhanced access. In rural areas especially, where a huge gap exists between demand and supply of healthcare facilities, PHI is being seen as a major solution. There are factors such as growing network infrastructure and the technological adoption by the health fraternity which provide support to these claims. Public health informatics has opportunities in healthcare by providing opportunities to diagnose patients, provide intra-operative assistance and consultation from a remote site. It also has certain barriers in the awareness, adaptation, network infrastructure, funding and policy related areas. There are certain medico-legal aspects involving all the stakeholders which need to be standardized to enable a working system. This paper aims to analyze the potential and challenges of public health informatics services in rural communities.

Keywords: PHI, e-health, public health, health informatics

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Authors: Safeer Ahmad, Pratheek Sudhakran, M. Arif Kamal, Tarique Anwar

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In Healthcare facility designing, Efficient MEP services are very crucial because the built environment not only affects patients and family but also Healthcare staff and their outcomes. This paper shall cover the basics of Value engineering and its different phases that can be implemented to the MEP Designing stage for Healthcare facility optimization, also VE can improve the product cost the unnecessary costs associated with healthcare services. This paper explores Healthcare facility services and their Value engineering Job plan for the successful application of the VE technique by conducting a Workshop with end-users, designing team and associate experts shall be carried out using certain concepts, tools, methods and mechanism developed to achieve the purpose of selecting what is actually appropriate and ideal among many value engineering processes and tools that have long proven their ability to enhance the value by following the concept of Total quality management while achieving the most efficient resources allocation to satisfy the key functions and requirements of the project without sacrificing the targeted level of service for all design metrics. Detail study has been discussed with analysis been carried out by this process to achieve a better outcome, Various tools are used for the Analysis of the product at different phases used, at the end the results obtained after implementation of techniques are discussed.

Keywords: value engineering, healthcare facility, design, services

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Authors: Rattakorn Poonsuph

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Technological innovation plays a crucial role in virtual healthcare services. A growing number of telehealth platforms are concentrating on using digital tools to improve the quality and availability of care. As a result, telehealth represents an opportunity to redesign the way health services are delivered. The research objective is to discover a new business model for digital health services and related industries to participate with telehealth solutions. The business opportunity is valuable for healthcare investors as a startup company to further investigations or implement the telehealth platform. The paper presents a digital healthcare business model and business opportunities to related industries. These include digital healthcare services extending from a traditional business model and use cases of business opportunities to related industries. Although there are enormous business opportunities, telehealth is still challenging due to the patient adaption and digital transformation process within a healthcare organization.

Keywords: telehealth, Internet hospital, HealthTech, InsurTech

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Authors: Adeniyi Onasanya, Maher Elshakankiri

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In recent years, the Internet of Things (IoT) has constituted a driving force of modern technological advancement, and it has become increasingly common as its impacts are seen in a variety of application domains, including healthcare. IoT is characterized by the interconnectivity of smart sensors, objects, devices, data, and applications. With the unprecedented use of IoT in industrial, commercial and domestic, it becomes very imperative to harness the benefits and functionalities associated with the IoT technology in (re)assessing the provision and positioning of healthcare to ensure efficient and improved healthcare delivery. In this research, we are focusing on two important services in healthcare systems, which are cancer care services and business analytics/cloud services. These services incorporate the implementation of an IoT that provides solution and framework for analyzing health data gathered from IoT through various sensor networks and other smart devices in order to improve healthcare delivery and to help health care providers in their decision-making process for enhanced and efficient cancer treatment. In addition, we discuss the wireless sensor network (WSN), WSN routing and data transmission in the healthcare environment. Finally, some operational challenges and security issues with IoT-based healthcare system are discussed.

Keywords: IoT, smart health care system, business analytics, (wireless) sensor network, cancer care services, cloud services

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Authors: Akiko Kondo, Akio Kondo

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We are facing regional problems to low birth rate and longevity in Japan. Under this situation, there are some local municipalities which lose their vitality. The aims of this study are to clarify the present state of local public transportation services in local municipalities and relation between local public transportation services and population quantitatively. We conducted a questionnaire survey concerning regional agenda in all local municipalities in Japan. We obtained responses concerning the present state of convenience in use of public transportation and local public transportation services. Based on the data gathered from the survey, it is apparent that we should some sort of measures concerning public transportation services. Convenience in use of public transportation becomes an object of public concern in many rural regions. It is also clarified that some local municipalities introduce a demand bus for the purpose of promotion of administrative and financial efficiency. They also introduce a demand taxi in order to secure transportation to weak people in transportation and eliminate of blank area related to public transportation services. In addition, we construct a population model which includes explanatory variables of present states of local public transportation services. From this result, we can clarify the relation between public transportation services and population quantitatively.

Keywords: public transportation, local municipality, regional analysis, regional issue

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Authors: Hadeer Hegazy, Wael Ewieda, Ranin Soliman, Samah Elway, Asmaa Tawfik, Ragaa Sayed, Sahar Mousa

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The current healthcare system is facing major challenges in terms of cost, quality of care, and access to services. In response, the concept of value-based healthcare has emerged as a new approach to healthcare delivery. This concept puts the focus on patient values rather than on the traditional medical model of care. To achieve this, healthcare organizations must be agile and able to anticipate and respond quickly to changing needs. Agile management is essential for healthcare organizations to achieve value-based care, as it allows them to rapidly adjust their strategies to changing circumstances. Additionally, it is argued that agile management can help healthcare organizations gain a better understanding of the needs of their patients and develop better care delivery models. Besides, it can help healthcare organizations develop new services, innovate, and become more efficient. The authors provide evidence to support their argument, drawing on examples from successful value-based healthcare initiatives at children’s cancer hospital Egypt-57357. The paper offers insight into how agile management can be used to facilitate the shift towards value-based healthcare and how it can be used to maximize value in the healthcare system.

Keywords: value-based healthcare, agility in healthcare, nursing department, patients outcomes

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Authors: Rodrigo Guimarães Santos

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The quality of public transport services has been considered as a critical factor by their users and also by users of individual transport. Thus, this dissertation aims to adapt a model that assesses the quality of public transport and determines its level of service based on the views of its users. The methodology is widely used by marketers and allows measuring the quality of services by assessing the perceptions and expectations of users. The adapted SERVQUAL was tested with users of public transport service users and car in Brasília-DF, city of Brazil. This research involved 241 questionnaires answered by people living in the various administrative regions of Brasília-DF. The analysis of the determinants pointed out that the quality of the public transport service offered in the city is low and users of public transport and cars have a high degree of expectations for improvement in all tested determinants. This method enabled the identification of the most critical determinants and those needing strategic actions for continuous improvement of quality. Adapting the SERVQUAL for a public transport service was satisfactory and demonstrated applicability to internal and external services, including measuring the public transport services in other cities with the opinion of the users.

Keywords: transportation services, quality services, servqual scale and marketing services

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Authors: Mona Almanasef, Dalia Almaghaslah, Geetha Kandasamy, Rajalakshimi Vasudevan, Sadia Batool

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Background: Community pharmacists are one of the most accessible healthcare practitioners worldwide and their services are used by a large proportion of the population. Expanding the roles of community pharmacists could contribute to reducing pressure on general health practice and other areas of health services. This research aimed to evaluate the contribution of community pharmacists in the provision of public health services and to investigate the perceived barriers to the provision of these services in Saudi Arabia. Materials and Methods: This study followed a cross-sectional design using an online anonymous self-administered questionnaire. The study took place in the Asir region, Saudi Arabia, between September 2019 and February 2020. A convenience sampling strategy was used to select and recruit the study participants. The questionnaire was adapted from previous research and involved three sections: demographics, involvement in public health services and barriers to practicing public health roles. Results: The total number of respondents was 193. The proportion of respondents who reported that they were “very involved” or “involved” in each service was 61.7% for weight management, 60.6% for sexual health, 57.5% for healthy eating, 53.4% for physical activity promotion, 51.3% for dental health, 46.1% for smoking cessation, 39.4% for screening for diabetes, 35.7% for screening for hypertension, 31.1% for alcohol dependence and drug misuse counseling, 30.6% for screening for dyslipidaemia, and 21.8% for vaccination and immunization. Most of the barriers in the current research were rated as having low relevance to the provision of public health services. Conclusion: Findings in the current research suggest that community pharmacists in the Asir region have varying levels of involvement in public health roles. Further research needs to be undertaken to understand the barriers to the provision of public health services and what strategies would be beneficial for enhancing the public health role of community pharmacists in Saudi Arabia.

Keywords: community pharmacist, public health, Asir region, Saudi Arabia

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Authors: Mayank Mishra

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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

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Authors: Mehwish Sarfaraz Ahmad

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

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

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Authors: Manal Sultan Alhussein, Xiang Michelle Liu

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Telehealth is an advanced technology using digital information and telecommunication facilities that provide access to health services from a distance. It slows the transmission factor of COVID-19, especially for elderly patients and patients with chronic diseases during the pandemic. Therefore, understanding patient perspectives on telehealth services and the factors impacting their option of telehealth service will shed light on the measures that healthcare providers can take to improve the quality of telehealth services. This study aimed to evaluate perceptions of telehealth services among different patient groups and explore various aspects of telehealth utilization in the United States during the COVID-19 pandemic. An online survey distributed via social media platforms was used to collect research data. In addition to the descriptive statistics, both correlation and regression analyses were conducted to test research hypotheses. The empirical results highlighted that the factors such as accessibility to telehealth services and the type of specialty clinics that the patients required play important roles in the effectiveness of telehealth services they received. However, the results found that patients’ waiting time to receive telehealth services and their annual income did not significantly influence their desire to select receiving healthcare services via telehealth. The limitations of the study and future research directions are discussed.

Keywords: telehealth, patient satisfaction, pandemic, healthcare, survey

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Authors: Rafla Hchaichi

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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

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Authors: Sohayla Khaled El Fakahany

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

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

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Authors: Pariya Sheykhmaleki, Debajyoti Pati

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Rural areas in the United States face numerous challenges in providing quality and assessable primary healthcare services, especially during emergencies such as natural disasters or pandemics. This study showcases a cutting-edge flexible module that aims to overcome these challenges by offering adaptable healthcare facilities capable of providing comprehensive health services in remote and disaster-prone regions. According to the Health Resources and Services Administration (HRSA), approximately 62 million Americans, or 1 in 5 individuals, live in areas designated as Health Professional Shortage Areas (HPSAs) for primary care. These areas are characterized by limited access to healthcare facilities, shortage of healthcare professionals, transportation barriers, inadequate healthcare infrastructure, higher rates of chronic diseases, mental health disparities, and limited availability of specialized care, including urgent circumstances like pandemics that can exacerbate this issue. To address these challenges, the literature study began by examining primary health solutions in very remote areas, e.g., spaceships, to identify the state-of-the-art technologies and the methods used to facilitate primary care needs. The literature study on flexibility in architecture and interior design was also adapted to develop a conceptual design for rural areas. The designed flexible module provides an innovative solution. This module can be prefabricated as all parts are standardized. The flexibility of the module allows the structure to be modified based on local and geographical requirements as well as the ability to expand as required. It has been designed to stand either by itself or work in tandem with public buildings. By utilizing sustainable approaches and flexible spatial configurations, the module optimizes the utilization of limited resources while ensuring efficient and effective healthcare delivery. Furthermore, the poster highlights the key features of this flexible module, including its ability to support telemedicine and telehealth services for all five levels of urgent care conditions, i.e., from facilitating fast tracks to supporting emergency room services, in two divided zones. The module's versatility enables its deployment in rural areas located far from urban centers and disaster-stricken regions, ensuring access to critical healthcare services in times of need. This module is also capable of responding in urban areas when the need for primary health becomes vastly urgent, e.g., during a pandemic. It emphasizes the module's potential to bridge the healthcare gap between rural and urban areas and mitigate the impact of rural health challenges.

Keywords: rural health, healthcare challenges, flexible modular design, telemedicine, telehealth

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Authors: Li Pan

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The recently prevalent government procurement of public services in China boasts a new form of government’s provision of public service through the purchasing of social work from social organizations, a new measure of the transformation in governmental functions as well as an unprecedented opportunity for the development of social organizations. For the past few years, the phenomenon of a surge in the number of social work organizations and social work staff emerged right with the initiatives of energetically carrying out the purchase of public services by the government. Such efforts have presented the strong determination of the Chinese government in building a small government by streamlining administration and delegating part of the governmental power to social organizations. This paper is based on the 2012-2014 performance appraisal project of the Guangzhou municipal government’s purchasing of public services and the project was carried out in the summer of 2015. During the process of the appraisal, several general problems hindering the sustainable development of government purchasing of public service have been observed. As Guangzhou is among the rank of pioneer cities in the conduct of the reform, it is representative and imperative to study the sustainability of government purchasing of public service. In 2012, Guangzhou local government started contracting out public service to the community social organizations to provide general family services and special services to community residents, since when integrated family service centers and special service centers were established as platforms to provide public social service in a city-wide range. Consequently, taking an example of the current rapid development of government purchase of the integrated family services and special services in Guangzhou, this paper puts up several proposals for the sustainable development of Guangzhou municipal government’s procurement of public services on the perspective of social work’s resource dependence.

Keywords: government procurement of public services, Guangzhou, integrated family service center, social work, sustainability.

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Authors: S. Ithai, A. Oloo

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The emergence of globalization has cultivated an international consensus that without economic development; it is very unlikely that a country may realize social or political development. It is equally important to note that the economic effect on social development automatically influence the country healthcare services as healthcare systems are improved and adopted. For decades and before 1980's, the colonial and the Governments of Kenya had pursued a goal to provide free healthcare services to its citizen with minimal success; but as population increased, this endeavor became almost a mirage. The challenge called for a change of strategy with introduction of cost sharing which also could not guarantee sustainability of healthcare services in the country due to increased number of poor people and poverty. An involvement of multisectral approach to provision of health individual, collaboration and adoption of all dimensions through globalization provides a ray of hope to not only economic, political and social development but also guaranteed equitable and reliable healthcare systems in Kenya and specifically referral healthcare services at KNH. With the advent of globalization, KNH has made positive strides that have guaranteed patients with reliable healthcare services. These include increased donor funding, collaboration levels, training and research as well as enhanced the hospital relations with international partners. During this period, the hospital has increased number of local doctors and nurses, enhanced transfer of skills, innovations and technologies which are driving forces to quality and efficient healthcare services. The period has also brought in challenges for the hospital which include increased competition, attraction of qualified nurses and doctors to international are some the issues that have made the hospital to spend more resources in research and development in order to stay afloat. This paper reveals the link between globalization and healthcare and its influence on institution policy choice. However, the process is not expected to take place automatically without institutional initiatives if KNH is to reap the benefits of globalization. KNH need to make use of the existing infrastructure, human resources and donor confidence, the opportunities that are indeed important in propelling KNH toward Vision 2030 and achieving the desired Millennium Development Goals (MDGs).

Keywords: globalization, Kenyatta National Hospital, native, healthcare

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Authors: Pinar Dogan, Merve Tarhan, Ahu Kurklu

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Syrian refugees who sheltering due to war has protected by the Government of Turkey since 2011. Since Syria was a medium-low income country prior to the war, it is known that chronic health problems weren’t common among citizens. However, it is also known that they frequently use health services in our country because of the spread of infectious and acute diseases due to insufficient sanitation and crowding after the war. This study was planned to compare the social distances of the community against the Syrian refugees and the perceptions of accessing health care services. The descriptive-cross sectional study was carried out on 1262 individuals living in Istanbul. A questionnaire form consisted of Personal Information Form, The Bogardus Social Distance Scale (BSDS) and The Survey of Access to Healthcare Services (AHS) was used as data collection tool. Descriptive tests and chi-square test were used for statistical analysis. It was found that the majorities of participants was satisfied with the health services and were waiting for more than 40 minutes to be examined. It was determined that participants have high scores from BSDS. At the same time, the majority of participants stated that their level of access to health care is diminishing due to refugees. Participants who experienced disruption in access to health services due to refugees were found to have higher scores from BSDS. The data collection process in the study will continue until 2400 individuals are reached. With these conclusions, it is considered necessary that the effect of the presence of the refugees in reaching the health services and nursing care of the society should be revealed through extensive researches to be conducted in Turkey.

Keywords: health care services, nursing care, social distances, Syrian refugees

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Authors: E. O. Fakoya, B. G. Abiona, J. O. Soetan

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The study determined Perception of Agricultural Extension Agents of Private Sector Participation in Extension Services in Ogun State, Nigeria. Data were collected from 80 respondents with a well-structured questionnaire. The result of the findings showed that there is need for private sector participation in extension services (=4.313), private extension services has facilities than public extension services (=4.97). Private sector participated in extension services by: giving of loans and credits to farmers (=4.50). Major constraints identified by the respondents were: Transportation problem (=2.88) and lack of fund (=2.77) A significant relationship (P<0.05) exists between factors affecting public extension services(r = 0.641, p = 0.00) and private sector participation in extension services. It was concluded from the study that there is need for private sector to participate in extension service in order to improve productivity of the farmers.

Keywords: agricultural extension, extension agent, private sector, perception

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Authors: S. Cheng, C. Catallo

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Introduction: Canada's healthcare and social services systems are failing high risk, vulnerable older adults. Care for vulnerable older Canadians (65 and older) is not optimal in Canada. It does not address the care needs of vulnerable, high risk adults using a holistic approach. Given the growing aging population, and the care needs for seniors with complex conditions is one of the highest in Canada's health care system, there is a sense of urgency to optimize care. Integration of health and social services is an emerging trend in Canada when compared to European countries. There is no common and universal understanding of healthcare and social services integration within the country. Consequently, a clear understanding and definition of integrated health and social services are absent in Canada. Objectives: A study was undertaken to develop a case definition for integrated health and social care initiatives that serve older adults, which was then tested against three Canadian integrated initiatives. Methodology: A limited literature review was undertaken to identify common characteristics of integrated health and social care initiatives that serve older adults, and comprised both scientific and grey literature, in order to develop a case definition. Three Canadian integrated initiatives that are located in the province of Ontario, were identified using an online search and a screening process. They were surveyed to determine if the literature-based integration definition applied to them. Results: The literature showed that there were 24 common healthcare and social services integration characteristics that could be categorized into ten themes: 1) patient-care approach; 2) program goals; 3) measurement; 4) service and care quality; 5) accountability and responsibility; 6) information sharing; 7) Decision-making and problem-solving; 8) culture; 9) leadership; and 10) staff and professional interaction. The three initiatives showed agreement on all the integration characteristics except for those characteristics associated with healthcare and social care professional interaction, collaborative leadership and shared culture. This disagreement may be due to several reasons, including the existing governance divide between the healthcare and social services sectors within the province of Ontario that has created a ripple effect in how professions in the two different sectors interact. In addition, the three initiatives may be at maturing levels of integration, which may explain disagreement on the characteristics associated with leadership and culture. Conclusions: The development of a case definition for healthcare and social services integration that incorporates common integration characteristics can act as a useful instrument in identifying integrated healthcare and social services, particularly given the emerging and evolutionary state of this phenomenon within Canada.

Keywords: Canada, case definition, healthcare and social services integration, integration, seniors health, services delivery

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Authors: A. Sathiya Susuman

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Background: The importance of maternal and child healthcare services cannot be stressed enough. These services are very important for the health and health outcomes of the mother and that of the child and in ensuring that both maternal and child deaths are prevented. The objective of the study is to inspire good quality maternal and child health care services in Swaziland. Specifically, is Swaziland on track with the 2015 Millennium Development Goals? Methods: The study used secondary data from the Swaziland Demographic and Health Survey 2006-07. This is an explorative and descriptive study which used pre-selected variables to study factors influencing the use of maternal and child healthcare services in Swaziland. Different types of examinations, such as univariate, bivariate, and multivariate statistical analysis were adopted. Results: The study findings showed a high use rate of antenatal care (97.3%) and delivery care (74.0%), and a low rate of postnatal care use (20.5%). The uptake childhood immunization is also high in the country, averaging more than 80.0%. Moreover, certain factors which were found to be influencing the use of maternal healthcare and childhood immunization include: woman’s age, parity, media exposure, maternal education, wealth status, and residence. The findings also revealed that these factors affect the use of maternal and child health differently. Conclusion: It is important to study factors related to maternal and child health uptake to inform relevant stakeholders about possible areas of improvement. Programs to educate families about the importance of maternal and child healthcare services should be implemented. Swaziland needs to work hard on child survival and maternal health care services, no doubt it is on track with the MDG 4 & 5.

Keywords: maternal healthcare, antenatal care, delivery care, postnatal care, child health, immunization, socio-economic and demographic factors

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Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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Authors: Usman Ahmed Adam, Umar Ibrahim, Ezra S. Gbaje

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This study is posed to explore the practice of Public Access Computers (PACs) in academic libraries in Kaduna State, Nigeria. The study aimed to determine the computers and other tools available, their services and challenges of the practices. Three questions were framed to identify number of public computers and tools available, their services and problems faced during the practice. The study used qualitative research design along with semi-constructed interview and observation as tools for data collection. Descriptive analysis was employed to analyze the data. The sample size of the study comprises 52 librarian and IT staff from the seven academic institutions in Kaduna State. The findings revealed that, PACs were provided for access to the Internet, digital resources, library catalogue and training services. The study further explored that, despite the limit number of the computers, users were not allowed to enjoy many services. The study recommends that libraries in Kaduna state should provide more public computers to be able to cover the population of their users; libraries should allow users to use the computers without limitations and restrictions.

Keywords: academic libraries, computers in library, digital libraries, public computers

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Authors: A. Drong, K. S. Kerkhoff

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Migration affects women’s sexual and reproductive health and rights. This paper reports on the social constructs of gender, and livelihood pursuits as beauty parlours workers amongst the young Garo women in Bangladesh, and studies changes in their accessibility to the healthcare services due to migration and livelihood. The paper is based on in-depth interviews and participant-led group discussions with 30 women working in various beauty parlours across the city. The data indicate that social perceptions of ‘good’, ‘bad’ and ‘respectable’ determine the expression of sexuality, and often dictates sexual and reproductive practices for these women. This study also reveals that unregulated work conditions, and the current cost of local healthcare services, have a strong impact on the women’s accessibility to the healthcare services; thus often limiting their choices to only customary and/or unqualified practitioners for abortions and child-births. Development programmes on migrant indigenous women’s health must, therefore, take the contextual gender norms and livelihood choices into account.

Keywords: gender, indigenous women, reproductive rights, sexual rights, Garo, migration, livelihood, healthcare

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Authors: Guanglin Song

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(Objective) Situated within the context of China's tiered medical treatment system, this study aims to analyze spatial causes of urban healthcare access difficulties from the perspective of the configuration of healthcare facilities. (Methods) A social network analysis approach is employed to construct a healthcare demand and supply flow network between major residential clusters and various tiers of hospitals in the city.(Conclusion) The findings reveal that:1.there exists overall maldistribution and over-concentration of healthcare resources in Study Area, characterized by structural imbalance; 2.the low rate of primary care utilization in Study Area is a key factor contributing to congestion at higher-tier hospitals, as excessive reliance on these institutions by neighboring communities exacerbates the problem; 3.gradual optimization of the healthcare facility layout in Study Area, encompassing holistic, local, and individual institutional levels, can enhance systemic efficiency and resource balance.(Prospects) This research proposes a method for evaluating urban healthcare resource distribution structures based on service flows within hierarchical networks. It offers spatially targeted optimization suggestions for promoting the implementation of the tiered healthcare system and alleviating challenges related to accessibility and congestion in seeking medical care. Provide some new ideas for researchers and healthcare managers in countries, cities, and healthcare management around the world with similar challenges.

Keywords: flow of public services, urban networks, healthcare facilities, spatial planning, urban networks

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Authors: Jessica Hemberg, Mikaela Miller

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Unreasonable workload and work-related stress can reduce nurse leaders’ job satisfaction and productivity and can increase absence and burnout. Nurse leaders’ workload in public healthcare settings is relatively unresearched. The aim of this study was to investigate nurse leaders’ perceptions of workload and task distribution with relation to leading work tasks in public healthcare. A qualitative explorative design was used. The data material consisted of texts from interviews with nurse leaders in public healthcare (N=8). The method was inspired by content analysis. The COREQ checklist was used. Informed consent was sought from the participants regarding study participation and the storage and handling of data for research purposes. Six main themes were found: Increased and unreasonable workload, Length of work experience as nurse leader affects perception of workload, Number of staff and staff characteristics affect perception of workload, Versatile and flexible task distribution, Working overtime as a way of managing high workload, and Insufficient time for leadership mission. The workload for nurse leaders in a public healthcare setting was perceived to be unreasonable. Common measures for managing high workload included working overtime, delegating work tasks and organizing more staff resources in the form of additional staff. How nurse leaders perceive their workload was linked to both the number of staff and staff characteristics. These should both be considered equally important when determining staff levels and measuring nurse leaders’ workload. Future research should focus on investigating workload and task distribution from nurses’ perspectives.

Keywords: nurse leaders, workload, task distribution, public healthcare, qualitative

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