bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors influencing the choice of facilities among enrolees of a prepayment scheme in Ibadan, Southwest Nigeria
Authors: Adewole David Ayobami , Ilori Temitope
Published: May 2023

Aims: Factors that influence the personal choice of a health care facility among health care consumers vary. Currently, what influences the choice of health facilities among enrollees under the National Health Insurance Scheme (NHIS) is not known. This study aimed to as-sess what influences the choice of facilities in the NHIS of Nigeria.
Methods: This was a descriptive cross-sectional study conducted among enrollees in selected NHIS facilities in the 11 Local Government Areas (LGAs) of Ibadan, Nigeria. A total of 432 enrollees were selected and were interviewed. A WHO-USAID semi-structured interviewer-administered questionnaire was used to obtain relevant data. Data collection was between Oc-tober and December 2019. Data were analyzed using STATA version 12.0 (α =0.05).Results: At unadjusted OR, older respondents (OR 3.24, CI = 2.52-4.18, p = <0.0001), and those who had attained the tertiary level of education (OR 3.30, CI 2.57-4.23, p <0.0001) were more likely to make a personal choice of health care facilities. A similar pattern was ob-served among respondents who were in the high socioeconomic group (OR 4.10, CI 3.01-5.59, p = <0.0001). However, at Adjusted OR, only high socio-economic status was a predic-tor of personal choice of health care facility (OR 1.92, CI 1.21-3.05, p = 0.005).
Conclusion: This study is suggestive that a need for and the ability to afford the cost of care influence the choice of health facilities. Policies that promote health literacy in the general populace will enhance the capability of individuals to make a personal choice of health facili-ties. Stakeholders should prioritize this for policy.Recommended citation: David A. Adewole, Temitope Ilori. Factors influencing the choice of facilities among enrolees of a prepayment scheme in Ibadan, Southwest Nigeria
Acknowledgments: The authors wish to acknowledge study participants for permission to interview them in the course of the data collection of this study.Authors' contributions: David Adewole conceived and designed the study. Temitope Ilori did data collection and analysis. Both authors contributed equally to the manuscript write-up. The two authors also read through the manuscript draft the second time and agreed to the final manuscript.
Conflict of interests: None declared.
Assessment of the prevalence and risk factors of low back pain in operating room health workers: An observational study in Italy
Authors: Brauneis Stefano , Sorrentino Enza , Lisa Vincenza Di , Galluccio Gabriella , Piras Barbara , Carella Francesca , Palozzi Edoardo , Generali Carmela , Maggiacomo Simona , Aurelio SilviaD’ , Backhaus Insa , La Torre Filippo , Villani Ciro , La Torre Giuseppe
Published: May 2023

Aim: The aim of this study was to assess the prevalence of low back pain (LBP) among healthprofessionals and the possible risk factors.
Methods: The study was carried out from April 2018 to October 2018 among all health workers of theOrthopaedic Clinic and the Emergency Department of “Policlinico Umberto I” in Rome. LBP wasassessed using the Nordic Questionnaire Musculoskeletal Disorders in the section on lumbar pain.The type of physical activity carried out as prevention was investigated by use of theInternational Physical Activity Questionnaires. The overall state of health and lifestyle wasdeter- mined by the Short Form 12-item Health Survey. Job satisfaction and perceived work stresswere assessed through the 15-questions of Karasek’s Questionnaire. The intensity of the low backpain was assessed using a Numerical Rating Scale. A univariate analysis was conducted to assess theassociations between socio-demographic and working variables. Multiple logistic regression mod- elswere used to assess independent correlates of LBP.
Results: One hundred thirteen subjects were enrolled, 52 women and 61 men. The annual period-prevalence of lumbar musculoskeletal disorder was found on 79.6% of participants with LBP.Mean value evidence of NRS was 2.66. The highest LBP risk over the 12 months was found in groupswith high job demand (OR = 1.18; 95%CI: 1.01 – 1.38), low decision-making opportunities (fordecision latitude OR = 0.87; (0-76 – 1.0), and low levels of physical activity (OR = 0.75; 95%CI:0.64 – 0.89).
Conclusion: The working environment is a potential risk factor for the development of LBP and issuitable for prevention programmes. The protective effect of physical activity and work-relatedstress management indicate room for improvements for the prevention of LBP in these HCWs.
Conflicts of interest: None declared.
Contribution of Information-Education-Communication in the adoption of Universal Health Coverage by the populations in the Economic and Monetary Community of Central Africa in 2020.
Authors: Ledaga Nathalie Ambounda , Mamche Robertine , Woromogo Sylvain Honore , Antaon Esse Saint Saba , Saar Fatou Sow
Published: May 2023

Aims: This study aims to assess the knowledge of people from Central Africa about Universal Health Coverage and show the contribution of Information-Education-Communication for its adoption.
Methods: a cross-sectional analytical study across 4 of 6 Central African Countries was conducted. Independent variables are sociodemographic characteristics. Dependent variables are knowledge about Information-Education-Communication and Universal Health Coverage. The questionnaire was disseminated by WhatsApp images or word file or copy/paste of the text and send to the contacted and trained focal points. From the Smartphone, the filmed or transferred data were entered into a CSpro 5.0 input form. Mean score calculations and Odd Ratio with 95 % Confidence Interval for p < 0.005 were used to make associations.
 
Results: the Universal Health Coverage had never been heard of by 56.3% of the participants. The Universal Health Coverage was defined as health insurance by (43.9%), free care (30.3%). Respondents with secondary and higher education are more likely to have heard of the UHC than respondents with no education or those with elementary education [OR = 2.95 (1.01-8.64), p = 0.021] and [OR = 4.27 (1.50 – 12.16), p = 0.002] respectively.
Conclusion: 9.3% of the Economic and Monetary Community of Central Africa (CEMAC) population is aware of the Universal Health Coverage; 89.4% of these accept universal health coverage in their country, and 87.4% of them think that the Information Education Communication could enable better adherence to the Universal Health Communication. Implemention of Universal Health Coverage for the general population and adoption of Information-Education-Communication to promote Universal Health Coverage and pool efforts and affiliation procedures in the CEMAC zone is very important
Voluntary blood donation promotion in Haute Matsiatra region of Madagascar
Authors: Fenomanana Jocia , Ramaminiaina Heritiana Gisèle , Randriatsarafara Fidiniaina Mamy , Randriamanantany Zely Arivelo
Published: May 2023

Aims:  Access to sufficient, secure supplies of blood and safe transfusion services is an essential part of any strong health system. The Haute Matsiatra region has a need for blood and blood products that exceeds current availability (only 7% of needs are met). The aim of this study ls to assess community knowledge, attitude, and practice regarding voluntary blood donation in order to identify the obstacles.
 
Methods: We have conducted a community-based cross-sectional study from 26th to 31th July 2019 within a sample of 300 subjects using a structured questionnaire and face-to-face interview. Data were analyzed using R software version 4.0.2.
 
Results: All participants were unanimous about vital role of blood so that 62.3% were willing to donate blood but only 13% have ever donated blood. The majority of respondents (60.0%) had never heard sensitization about blood donation. The reason for non-donation were related to fears of needlestick injuries during the blood collect (38.3%), fear of blood borne diseases (17%), the lack of sensitization (6%). There was a positive significant relationship between level of education and willingness to donate blood (p-value <0, 05). The likelihood of blood donation was found to be higher among male participant 28 (71.8%) p<0.05, and among >45 years group (21.4 %) p= 0.03. Among those who ever donated blood, only 37 (26.6%) of them have received sensitization about donation.
 
Conclusion: There is growing interest in blood donation among the population. Activities to promote blood volunteer donation should take into account the demotivating reasons for blood donation.
 
Source of funding : None
 
Conflict of interest statement: The authors report no conflicts of interest in this work.
 
Authors’ contributions : All authors contributed toward data analysis, drafting and critically revising the paper and agree to be accountable for all aspects of the work.
 
Acknowledgments : We thank all those who, directly or indirectly, have contributed to this publication.
Improving service delivery at primary healthcare facilities for achieving Universal Health Coverage: Examining the effects of insecurity in such facilities in Enugu State, Nigeria
Authors: Agwu Prince , Onwujekwe Obinna , Uzochukwu Benjamin , Mulenga Modest
Published: May 2023

Background: Availability of health services at the primary healthcare (PHC) level is crucial to the achievement of Universal Health Coverage (UHC). However, insecurity of PHC facilities inspires unavailability of health services. From perspectives of primary health service providers, we examined the effects of insecurity at rural and urban PHC facilities in Enugu, Nigeria.
Methodology: The study adopts a qualitative method using in-depth interviews and non-participant observation. The study sites were eight (8) PHC facilities (rural/urban) that were purposively selected. The first author interacted with the health workers and made extensive observations on infrastructure, policing, and other security gaps affecting the facilities.
Findings: While health workers wish to provide services as stipulated, the fear of getting hurt or losing their properties to hoodlums scares them, especially during the dusk hours. Owing to infrastructure deficits and lack of security personnel, incidents of losing phones, stolen babies and facility items/consumables, and patients being attacked were said to be recurring. The absence of power supply during the dusk hours tend to heighten their fears, hence health workers close before it gets dark, not minding the consequences on health service users.
Conclusion: The issue of insecurity of lives of both the health workers and their clients is paramount to the optimal use of services in the PHC facilities. Insecurity is a priority concern for the health workers, and if not addressed could cause them to completely shun working in certain areas, or shun their jobs completely, with dire consequences for the achievement of UHC.
Contribution of Information-Education-Communication in the adoption of Universal Health Coverage by the populations in the Economic and Monetary Community of Central Africa in 2020.
Authors: Ledaga Nathalie Ambounda , Mamche Robertine , Woromogo Sylvain Honore , Antaon Jesse Saint Saba , Saar Fatou Sow
Published: May 2023

Aims: This study aims to assess the knowledge of people from Central Africa about Universal Health Coverage and show the contribution of Information-Education-Communication for its adoption.
Methods: a cross-sectional analytical study across 4 of 6 Central African Countries was conducted. Independent variables are sociodemographic characteristics. Dependent variables are knowledge about Information-Education-Communication and Universal Health Coverage. The questionnaire was disseminated by WhatsApp images or word file or copy/paste of the text and send to the contacted and trained focal points. From the Smartphone, the filmed or transferred data were entered into a CSpro 5.0 input form. Mean score calculations and Odd Ratio with 95 % Confidence Interval for p < 0.005 were used to make associations.
Results: the Universal Health Coverage had never been heard of by 56.3% of the participants. The Universal Health Coverage was defined as health insurance by (43.9%), free care (30.3%). Respondents with secondary and higher education are more likely to have heard of the UHC than respondents with no education or those with elementary education [OR = 2.95 (1.01-8.64), p = 0.021] and [OR = 4.27 (1.50 – 12.16), p = 0.002] respectively.
Conclusion: 9.3% of the Economic and Monetary Community of Central Africa (CEMAC) population is aware of the Universal Health Coverage; 89.4% of these accept universal health coverage in their country, and 87.4% of them think that the Information Education Communication could enable better adherence to the Universal Health Communication. Implemention of Universal Health Coverage for the general population and adoption of Information-Education-Communication to promote Universal Health Coverage and pool efforts and affiliation procedures in the CEMAC zone is very important
Incorporating mHealth Interventions into Kenya’s Health Infrastructure to Augment Universal Health Coverage, Service Delivery Improvement Approach
Authors: Oduor Kevin , Ogweno Stephen , Ajwang Danor , Okinyi Nyawade
Published: May 2023

mHealth is the use of mobile and wireless devices to improve health outcomes, healthcare services, and health research. An estimated 68% of the world’s population own mobile phones, with Kenya having approximately 80% of mobile phone penetration. This makes it feasible to accelerate the uptake of mHealth interventions to improve health services delivery. While some evidence has shown how various forms of mHealth interventions have been used to transform health services, health outcomes, and health research in Kenya and globally, many remain largely anecdotal or undocumented. This paper examines the various forms of mHealth interventions that have been incorporated into Kenya’s health infrastructure, and their effectiveness in improving health services delivery in Kenya. A systematic review of peer-reviewed articles, policy briefs, and credible materials published on mHealth have shown that mHealth has succeeded in the health infrastructure such as in collecting and transferring health and patient data, remote diagnosis, treatment, and patient follow-up. The paper also examines the barriers around the uptake of mHealth interventions and recommends how these interventions can be integrated into Kenya’s health infrastructure. Even though there is every reason to believe that mHealth can allow limited resource settings to “leapfrog” over more advanced settings in using mobile technologies to improve health services delivery, mHealth is not a panacea. There are limited will and resources to scale up and integrate mHealth into the health infrastructure with attempted integration met with a negative attitude from the strained health workforce who still view mHealth as additional work, among other challenges. Despite the challenges, there may be an opportunity for Kenya’s Government to leverage mobile and wireless devices to improve the delivery of health services to areas that were previously unreachable, thereby fast-tracking its commitment to achieving Universal Health Coverage.
National health systems strengthening as the primary strategy to achieve Universal Health Coverage in African countries
Authors: Elhadi Yasir Ahmed Mohammed , Adebisi Yusuff Adebayo , Abel Uchechukwu Victor , Daniel Ekpoh Mfonobong , Zaghloul Ashraf , Lucero-Prisno III Don Eliseo
Published: May 2023

Africa is the second largest continent and has its socioeconomic and health peculiarities. Countries are faced with varying challenges towards its Universal Health Coverage (UHC) achievement and hence the region requires health system reforms to drive equitable and balanced medical services to its populace. The main objectives of the paper were to explore the complexities of the African health systems, subsequently highlighting major challenges to UHC and to provide a framework for strategic approaches to health system strengthening to ensure realization of UHC. Information presented in this paper was collected from published literature and reports on Rwanda, Kenya, Nigeria, Tanzania, Ghana, Tunisia, Democratic Republic of Congo, Zambia, Egypt and South Africa, amidst other African countries. The published literature points to the presence of a somewhat slow progress towards UHC or at least an existent knowledge of it. However, common challenges faced can be grouped into 1) Financial constraints which include low levels of government expenditure on health and increased out-of-pocket percentages, (2) Lack of coverage of key services which includes majorly immunization rates and existence of health insurance for citizens, (3) Input constraints ranging from drug availability to skilled healthcare workforce, information and research and (4) Lack of political support and commitment towards universal health coverage. To overcome the above-stated constraints, two broad groups of interventions were identified; General interventions largely focusing on reprioritization of health budget, quality and improved services, equipped facilities and efficient social protection systems; and Specific interventions which emphasizes the importance of eliminating shortage of health workers, ensuring availability of essential medicines/ products, embracing decentralization at supply chain management, validating data/ information system and advocacy for impactful health education/promotion. Although there will be strength and weakness for whatever reforms adopted, implementation is totally contextual and contingent upon countries' specific health system bottlenecks.
Sources of Funding
None
Conflicts of Interest
The authors declare no conflict of interest
Acknowledgement
We would like to thank Dr. AugustinoTing Mayai for assistance and mentorship
Towards Universal Health Coverage in Africa: Relevance of Telemedicine and Mobile Clinics
Authors: Adedeji Oluwakorede Joshua , Babatunde Yusuf Olalekan , Ib-rahim Abdulmumin Damilola , Adebisi Yusuff Adebayo , Lucero-Prisno III Don Eliseo
Published: May 2023

Access to essential healthcare services is limited in Africa, resulting in preventable mortalities. Telemedicine, which can be defined as the use of information and communication technologies in the delivery of healthcare services, is applied in various fields of medicine and at multiple times. Some telemedicine projects have been implemented in different African countries. Some successes were recorded, as well as failures. Despite challenges, such as high cost, that inhibit telemedicine coverage, telemedicine still presents excellent opportunities in increasing access to basic healthcare and expert services. Mobile clinics provide the opportunity to expand access to health services across a region. They can be implemented as an extension of fixed1hospitals that are often situated away from remote villages, serve in the heart of communities, and aid in preventive screenings and epidemiological monitoring. Africa has limited resources but leveraging these existing resources most cost-effectively is key to achieving universal health coverage in the region.
Source of funding: None
Conflicting Interest: The authors declare no conflict of interest.
Authors' Contributions: Oluwakorede Joshua Adedeji conceptualized the study. Oluwakorede Joshua Adedeji, Yusuf Olalekan Babatunde and Abdulmumin Damilola Ibrahim acquired, analysed and interpreted the data for the work. Yusuff Adebayo Adebisi and Don Eliseo Lucero-Prisno III revised it critically for important intellectual content. All authors agree to be accountable for all aspects of the work in ensuring that all questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Managing Antimicrobial Resistance from Medical and Veterinary Health Sys-tems Perspectives to Achieving Universal Health Coverage in the African Re-gion
Authors: Joshua Istifanus Anekoson , Bauche Joel , Abdulla Salim
Published: May 2023

Antimicrobial resistance (AMR) is a threat to global health security and may reverse the gains in preventive medicine. This is worsened by the fact that development of resistance out-paces that of new antimicrobials. The factors driving the development of AMR range from health systems to socio-economic and environmental factors. These include poor antimicrobial stewardship, poor access to quality drugs, prescribing antimicrobials without susceptibility laboratory tests, use of antimicrobials in crop, animal production and aquaculture farming. Others are lack of coordinated medical and veterinary health systems strengthening, poor universal health coverage and practice of one health. The burden of the problem is of public health importance especially in Africa where there is high incidence of poverty, high incidence of out-of-pocket health expenditure, lack of basic social amenities and weak health systems with poor collaboration. The impact of AMR includes increased burden on the healthcare system, hospital admission, cost of patient treatment, poor clinical outcomes and impact on food security, among others. In view of the interplay of various systems and factors in the development and emergence of AMR, there is need for multi-sectoral and interdisciplinary approach at global, regional, national and local levels for its prevention and mitigation. Strengthening of health systems from the medical and veterinary perspectives and universal health coverage are critical in the fight against AMR. The relevant stakeholders include political leaders, community leaders, health professionals, academics, and research institutions, federal and state ministries of health, agriculture, education and Nongovernmental organisations among others.
Conflict of interest: None declared
Effective communication approaches as tool for achieving Universal Health Coverage through social health insurance in Nigeria.
Authors: Hassan Salisu , Mohammed JamilaAliyu
Published: May 2023

National Health Insurance Scheme (NHIS) designed various Social Health Insurance programmes to achieve universal coverage in healthcare delivery in the country. The Scheme is adjudged to have failed to achieve its primary objective, especially in the informal sector, due to communication lapses. This study has employed an integrative literature review method to appraise the principles underlying effective health communication, the communication approaches of the NHIS, and recommended plausible alternatives. Media integration, advocacy campaign, social media, domestications of ICTs, communication in multiple languages, and active involvement of communities in the programme were found to imbibe some practical communication principles that can help improve communications to a target audience.
Community and Informal Care Providers at the Heart of Universal Health Coverage in sub-Saharan Africa: A Position Paper
Authors: Kisangala Ephraim , Mbivnjo Etheldreda Leinyuy , Okeah Bernard Ojiambo , Khan Mohammed Azhar
Published: May 2023

Globally, increased demand on often scarce healthcare resources and those challenges incumbent in responding to the coexistence of infectious and non-communicable diseases warrant the need to address persistent health inequities. Understanding the complex intersectionality of vulnerability and reaching those in most critical need of healthcare lies at the heart of fostering and sustaining resilient healthcare systems. Harnessing the long-recognised value of Community and Informal Care Providers (CICPs) is instrumental to Universal Health Coverage (UHC). The present COVID-19 context serves as a poignant example of where access to formal healthcare services by many has become increasingly difficult. Here, the value of informal or volunteer-led health services has been a lifeline for many. For several decades, formal reportage has evidenced the established role of CICPs, particularly across Sub-Saharan Africa with quantifiable efficacy across a number of domains, such as, maternal and child health, neglected tropical disease prevention, tuberculosis care and malaria control.  CICPs have been sustainable and effective as a conduit between the formal and informal health sectors, and between health facilities and the remotest of communities. Maximising the function of CICPs relies on socio-culturally, geographically sensitive, and bespoke support; psychosocial, practical, and logistical capacitation coupled with situationally and culturally appropriate monitoring and evaluation. The Astana Declaration highlights the centrality of building on existing knowledge, insight and resource.  We therefore argue that CICPs are indispensable in Africa’s move towards UHC, and hold promise for acceptable, accessible, affordable, and quality healthcare to everyone who needs to get, be and stay healthy.
Factors Affecting the Uptake of COVID-19 Vaccine amongDubai Airport's Professionals
Authors: Taryam Manal , Alawadhi Dhoha , Aburayya Ahmad , Mubarak Sara , Aljasmi Maryam , Salloum Said A. , Mouzaek Talal
Published: May 2023

Aim: Comprehending the elements that influence COVID-19 vaccination acceptability and recognizing expediters for vaccination decisions are critical components of developing effective ways to increase vaccine coverage in the general population. This study aims to investigate the main factors affecting COVID-19 vaccination uptake among Dubai 'Airport's employees. In addition, it seeks to explore the main signs and symptoms that appeared on vaccinated employees after taking the COVID-19 vaccination, hence, track the vaccine's safety.
Methods: Employees at Dubai's airport in the United Arab Emirates (UAE), mainly in Dubai, provided data. To gather data online utilising the Google Forms platform, a questionnaire was used as the main quantitative tool. As 2000 questionnaires got distributed, 1007 employees participated in the survey, yielding a 50.4% response rate.
Results: The results show that employees overwhelmingly agree with the assertion that the factors of accessibility and affordability have a significant effect on their decision to receive the COVID-19 vaccine, followed by a trust in vaccine, knowledge, vaccine safety, advice and information, and beliefs on the vaccine. In this study, the agreement level on factors affecting the COVID-19 vaccine uptake was found significantly to be higher in females (88.6%) who were married (91.6%) and those aged over 60 years (89.2%) at P <.05. In addition, the results show that 53.7% of vaccinated staff was found to have one or more side effects of the vaccine, where none of them was hospitalized after immunization. The binary logistic regression analysis in this study shows that females were two times more likely to have 'vaccine's symptoms after vaccination than males (Exp (B): 1.6; 95%CI: 1.127 - 2.351, P< .01). It further reveals that participants in the age group over 50 were three times more likely to have 'vaccine's symptoms after vaccination than participants in the age group 20-29 (Exp (B): 2.9; 95%CI: 2.497-9.681, P< .001). Finally, it indicates that individuals with previous SARS-CoV-2 infection were 2 times more likely to have 'vaccine's symptoms after vaccination than those without known past infection (Exp (B): 1.9; 95%CI: 1.272 - 2.542, P< .01).
Conclusion: There are several factors that playing a significant role in population’s decision to receive the COVID-19 vaccine, where the accessibility and affordability factors were found to have the greatest effect on their decision to uptake the vaccine. The current study concluded that COVID-19 vaccination is safe and that adverse effects from a vaccine are usually modest and affected by several factors such as age, gender, and COVID-19 infection history.
Smoking E-CigaRette and HEat-noT-burn Products: the SECRHET study, a large observational survey among young people in Italy
Authors: Torre Giuseppe La , Dorelli Barbara , Lia Lorenza , Grassucci Daniele , Gelardini Marcello , Ardizzone Carla , Grassi Maria Caterina , Mannocci Alice
Published: May 2023

Aim: Electronic cigarettes (eCig) and heated tobacco products (HTP), that heat a solution (e-liquid) to create vapour and tobacco at a temperature below the point of combustion, respectively, are emerging forms of smoking device widely diffused. The aim of this study was to investigate knowledge, attitudes and behaviour toward HTP among young people in Italy.
Methods: The Smoking E-CigaRette and HEat-noT-burn products (SECRHET) study was an online survey carried out in April 2019 using the platform Skuola.net, a platform where 2.5 million students are registered. Questions were related to knowledge about new generation smoking products, such as “Do you know what happens to tobacco when you use a heat-not-burn product?”, “Do you think electronic cigarettes create addiction?”, “Are products that use heated tobacco harmful to health?”, “Are electronic cigarettes harmful to health?”, “Have you ever heard of products that use heated tobacco?”, “Is nicotine present in products that use heated tobacco?” 
Results: A total of 13882 people completed the questionnaire, of which 8056 (58%) were females. Regarding smoking habits, 3393 (24.4%) declared to be current cigarette smokers, while 802 (5.8%) and 3173 (22.9%) were current and former e-cigarette smokers, respectively. Moreover, 715 (5.2%) and 1148 (8.3%) declared to be current and former heat-not-burn cigarette smokers. The variables associated to both eCig and HTP use were current smoking, age over 18 years, male gender, and residence in Central and Southern Regions. Concerning knowledge issues, almost half of respondents believe that electronic cigarettes are addictive and are harmful to health. Moreover, most of respondents do not know what happens to tobacco when using a heated tobacco device and if heated tobacco products are harmful to health.
Conclusion: The prevalence of eCig and HTP use is higher among young people in Italy compared to adults and older people, and requires adequate public health interventions.
Measles, a re-emerging disease in Albania: Epidemiology and clinical presentations
Authors: Çomo Najada , Meta Esmeralda , Qato Migena , Kraja Dhimiter , Pipero Pellumb , Fico Albana
Published: May 2023

Aim: Measles is a highly contagious disease caused by the measles virus. Albania is one of many European countries that have successfully interrupted endemic transmission of this disease. However, during the years 2018-2019, an outbreak of measles occurred in Albania. The aim of this study was to describe the clinical features and complications of hospitalized measles patients in Tirana, Albania, as related to age-group and risk factors.
Methods: All patients hospitalized for over 24 hours from January 2018 to December 2019 at the Service of Infectious Diseases, University Hospital Centre “Mother Teresa” in Tirana were included in this study. We included patients over 14 years old as this is an Infectious Diseases Service for adult patients only. Clinical and laboratory data were analysed.
Results: Of the 318 hospitalized patients (139 females), about 35%, 26%, 17%, 14%, and 7% were 15-24, 25-34, 35-44, 45-54, and over 55 years old, respectively. Females constituted 37% of the total number of patients. The average and median ages were 30.9 years and 28.5 years, respectively. Average time from the first symptom to the hospital presentation was 3.8 days. Contact with other patients with measles was noted in 21% of the patients. Body rashes were identified as maculopapular in 96% of the patients. Pathognomonic enanthema or Koplik spots and conjunctivitis were detected in 62% and 52% of the patients, respectively. Measles-related complications were noted in 53% of the patients; pneumonia/pneumonitis, hepatitis, neurological complications were presented by 24%, 26%, and 3% of the patients, respectively. Average duration of hospitalization was 5.4 days, whereas mortality was 0.3%.
Conclusion: This study provides valuable evidence about the distribution and clinical features of measles in Albania. Measles is a highly contagious disease and, as long as the measles virus is circulating, the risk of transmission remains high.
Assessment of the training needs and interests among directors of health care services in the Kyrgyz Republic
Authors: Bjegovic-Mikanovic Vesna , Matovic-Miljanovic Sanja , Seitalieva Chinara , Makarova Tatyana , Murzalieva Gulgun , Kozhokeev Kanatbek
Published: May 2023

Aim: An assessment of the training needs and interests of health managers working in the health care facilities of the Kyrgyz Republic was conducted, aiming to tailor and shape future training interventions.
Methods: A rapid assessment was organized among directors of health care services in the Kyrgyz Republic, using a web-based questionnaire. Due to the pandemic situation (COVID-19), it was impossible to involve all healthcare facilities as initially planned. Therefore, a convenient sample of 75 directors was drawn with a response rate of 77.3%, or 58 filled-in questionnaires.
Results: Among respondents, 60.3% were female and 39.7% male managers, with an average age of 53.5 years. Most of the respondents (89.7%) came to a managerial position by direct appointment, while only 10.3% were appointed through competitive process. More than half of health managers (63.8%) do not have any managerial category, and only 25.7% indicated that they have membership in the Association of Health Administrators of Kyrgyzstan[1]. All respondents reported the need to develop computer skills.
Discussion: There is a high demand in all aspects of the management of health organizations. The respondents are deciding about involvement in management training based on (a) the full range of training' topics, (b) the quality of the training content, and (c) the focus on developing practical skills. The most cited training needs are digital health (E-Health), financing management, planning, and quality control; the interest in distance learning courses is excellent. Almost two-thirds of managers reported that the Ministry of Health and Social Development (MOHSD KR) did not evaluate their work.
Conclusion: The main implications derived from this assessment are related to the culture of lifelong learning among the population of Kyrgyz health managers.
The Athena SWAN Process to Promote Gender Equity in Third-Level Education in Ireland
Authors: Houghton Frank
Published: May 2023

Introduction: Sexism and misogyny remains an ongoing threat to optimal health and medical services. An important factor in health and medical services is the education and training pipeline into these careers. A substantial body of literature demonstrates the impacts of sexism in third-level education and training institutions developing future health service staff. Athena SWAN accreditation is a benchmark designed to counter such institutional and individual sexist practices in education settings to foster equality. In recent years the Athena SWAN process has expanded to include professional and administrative staff, as well as academics. This process has also evolved to move beyond a narrow focus on gender, to also include other crucial issues such as race, sexuality and gender identity.
Methods: This examination is based on the author’s role as a participant observer and critiques the Athena SWAN process in an Institute of Technology in Ireland.
Results: This examination identifies a substantial number of deficits in the Athena SWAN process, as well as also identifying institutional resistance strategies to such gender equality work.
Conclusion: The current Athena SWAN process in Ireland is critically flawed. Suggested strategies for those engaged in such work into the future are outlined.
Diverse and inclusive leadership teams in public health schools: the change agents for sustainable and inclusive public health education
Authors: Böbel Simone , Bormans Max , Siepmann Ines , Tirekidis Ilia , Wall Kristin , Kalaitzi Valia
Published: May 2023

Context: An inclusive and diverse public health workforce maximizes health outcomes. However, little is known about the current diversity and inclusiveness profile of professionals, leaders and students of public health. To obtain a diverse and inclusive (D&I) public health workforce in the future, D&I leadership in Public Health Schools is necessary to encourage a D&I student body.
                                   
Policy Options: A variety of policy responses can be utilized to diversify schools of public health (SPH). Response types include (i) exploratory policies that instigate D&I research with the aim to increase knowledge and build hypotheses, (ii) regulatory (and financial) policies that change the environment by placing rules, restrictions, or expectations on the institution to increase and promote D&I and (iii) soft options, which are non-binding actions that aim to change the institutional culture surrounding D&I. However, policies are often not specifically tailored to their school and are therefore unsuccessful.
 
Recommendations: To understand the composition and identify gaps within the current diversity and inclusion (D&I) profile of leadership in European Schools of Public Health (SPH) an exploratory needs assessment is advised. A baseline assessment will be the much needed first step of this paper’s proposed project: The Diverse and Inclusive Public Health Schools (DIPHS) Project. A needs assessment should be seen as a baseline evaluation of the current D&I profile among leaders in European Schools of Public Health (SPH). This information should then build the basis to encourage institution-tailored policy interventions for SPH to actively promote a diverse and inclusive public health workforce.
Systematic versus opportunistic risk assessment for the primary prevention of cardiovascular disease: Cochrane systematic review protocol
Authors: Dyakova Mariana , Drew Christian , Wright Nicola , Clarke Aileen , Rees Karen
Published: May 2023

A large number of people, considered at increased risk of vascular disease, remainunidentified, untreated and not reached by lifestyle advice or intervention, despite publichealth and clinical efforts. This has prompted the initiation of national  screening/systematic risk assessment programmes for vascular disease in healthy populations. These exist in addition to the more ad hoc opportunistic risk assessment initiatives undertaken worldwide. There is currently not enough indisputable evidence either showing clear clinical or economic benefits of systematic screening-like programmes over opportunistic risk assessment of cardiovascular disease (CVD) in primary care. We present the rationale and methodology of a Cochrane systematic review, assessing the effectiveness, costs and adverse effects of systematic risk assessment compared to opportunistic risk assessment for the primary prevention of CVD.
Committed collaboration to address homelessness in the Netherlands
Authors: Argyrou Flora , Hirschler Josefine , Karan Filip , Kugel Raika , Romancenca Elena , Neicun Jessica
Published: May 2023

Context: In the Netherlands, the number of homeless people increased from 17.800 in 2009 to 39.300 in 2018. Due to the COVID-19 pandemic and its socioeconomic consequences, the needs of marginalized people have increased worldwide in terms of access to services and relevant information. In the Netherlands, along with the Red Cross, other humanitarian organizations such as the Salvation Army, the Rainbow Foundation, and the Foundation for the Homeless are already providing people in need with primary needs such as food and housing, but also with healthcare and legal support.  Cooperation between services for the homeless is also gaining attention. However, collaboration between relevant stakeholders is still insufficient and urges to be expanded. Moreover, centralized monitoring is challenging as different services are provided (shelters, assisted housing) by different stakeholders and there is no central data collection system or pre-defined indicators. Recent, comprehensive data on homelessness figures are needed to understand the needs and how these may have changed, given the exacerbated consequences of COVID-19 pandemic on those in socioeconomic vulnerability, in order safeguard the health, safety and dignity of homeless people.
Pay-for-performance and tools for quality assurance in health care
Authors: Donev Doncho M.
Published: May 2023

Ongoing health care reforms in the countries of Southeast Europe (SEE) to modernise and promote the health sector include the introduction of innovative payment methods for health care providers in hospitals and outpatient services. The idea of remunerating health workers according to the work they do and the results they achieve has been present in the countries of SEE for more than four decades. This includes the need to develop and implement objective measures and criteria to regulate the work of health facilities and health professionals. Implementing the "Pay-for-performance" (P4P) model is a major challenge with the risk of compromising the quality of health services in all countries, and positive experiences for quality assurance have been modest in many countries around the world. Standards and norms (S/N), clinical pathways (CPW) and checklists (CL) are necessary regulatory tools that complement each other to protect the quality of health services and implement the "Payment for success" (P4S) model. The absence of S/N, CPW and CL in the implementation of the P4P model leads to inefficiencies, inadequate/unrealistic numbers, and poor quality of health services, as well as more frequent medical errors. With the development, introduction and implementation of S/N, CPW and CL in the application of the P4S model, everyone benefits: patients, healthcare organisations and their employees, health insurance companies, ministries of health and the state.
The Effectiveness of the Health Economy: A case study of the Federal Republic of Germany
Authors: Henke Klaus-Dirk
Published: May 2023

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YOUNG INDONESIAN SCIENTISTS WRITE ON PUBLIC HEALTH
Authors: Laaser Ulrich
Published: May 2023

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Management of Medical Record Unit Services for Covid-19 Patients in Type C Hospitals: A Study of Legal Aspects.
Authors: Setijaningsih Retno Astuti , Suyoko Suyoko , Sukamto Mellinia , Wijayanti Arinimar Shaffa , Vaninda Brissa Gustaviar , Rochmah Eva Nur , Wahyuni Ngesti , Nufus Sabrina Hayatun , Isworo Slamet
Published: May 2023

Background: The impact of the pandemic on medical record health service procedures has induced significant changes. The duplication of Covid-19 patient numbers in the patient medical record unit is an important concern. This study aims to analyze the legal aspects of managing medical record services during the Covid-19 pandemic in hospitals.
Methods: This type of research is descriptive and quantitative with a cross-sectional approach. The key informants are 15 registration and medical record unit officers, using online interview techniques, employed in three hospitals in Semarang with a focus on group discussions. The object of research includes the management of medical records and service standards for Covid-19 patients as regulations in the medical record unit of the Semarang city general hospital.
Results: Policies and standards for medical record services for Covid-19 patients, have not been adjusted to the provisions based on Circular Letter Number HM.01.01/001/III/2020 concerning procedures for work in situations of the Covid-19 outbreak. The medical record service for Covid-19 patients still applies paper-based or semi-electronic medical records so that errors can occur. This can cause legal problems for hospitals; therefore, medical record service standards must meet legal aspects as legal evidence that can protect the interests of various parties.
Conclusions: It is necessary to manage a medical resume form design that is better, complete, electronical, and in accordance with legal aspects.
Fetal outcome of adolescent pregnancy in a tertiary care center in western Nepal: A case control study
Authors: Mahato Sweta , Younjan Sanjeev , Mahato Anamika
Published: May 2023

Background: The incidence of adolescent pregnancy is decreasing in developed countries, whereas developing countries like Nepal still report a high incidence.
Aims: To compare the fetal outcomes of adolescent pregnancies with those of the optimal reproductive age group in a country that accounts for 95% of teenage pregnancies, in contrast to 11% worldwide. 
Method: A hospital-based case-control study was conducted with 150 pregnant women with singleton gestation admitted to Kathmandu University Hospital. An adolescent pregnancy (<19 yrs.) was considered a case, and pregnant women of the optimal age group (20-35 yrs.) were considered the control. The data were collected from Jan 5, 2018, to Jan 5, 2019. The control group was selected by matching the parity of the cases in the study groups during the same study period. Respondents were interviewed and examined with a pre-structured tool. Odds Ratio (OR) and 95% Confidence Interval (CI) were calculated using conditional logistic regression (P<0.05 considered significant).
Results: The mean age of adolescent mothers was 17 years, the majority being primigravida. This study identified that fetal complications were higher in adolescent pregnancies (61% vs. 40%). The fetal complications like low birth weight (OR 2.42, 95%CI :1.044-5.43, P=0.03), NICU admission (OR 3.27, 95%CI:1.48-7.25, P=0.003), low APGAR score (OR 2.32, 95%CI:1.05-5.11, P=0.034) and Neonatal Death (OR 3.72, 95%CI:1.15-12.01, P=0.04) were associated with the adolescent pregnancies respectively.
Conclusion: Adolescent pregnancies are at increased risk of fetal complications compared to pregnancies in the optimal reproductive group. Adolescent pregnancies were at increased risk of low birth weight, neonatal death, low APGAR score, and higher admission in NICU. Therefore, an adequate antenatal visiting program for early detection and timely management likely will reduce the fetal complications during adolescent pregnancy.
Tuberculosis literacy and stigma: female activists in five areas with the lowest treatment success rate in Semarang, Indonesia
Authors: Mubarokah Kismi , Nurjanah Nurjanah , Handayani Sri , Astarini Hermin Rhema , Maharani Adelia Wahyuningtyas , Masitoh Dewi , Salisa Merisha Dea , Yulianah Sri Dian
Published: May 2023

Background: The Case Detection Rate of Tuberculosis (TB) in Semarang city increased from 2014 to 2018, while the Treatment Success Rate declined. Low literacy can trigger stigma in society, especially among women, resulting in low awareness of suspect TB for treatment.
Objectives: The aims are to analyze the correlation between TB literacy and stigma expressed among female health and social activists.
Methods: Cross-sectional research was conducted in five public health centers with the lowest Treatment Success Rate (TSR). A valid and reliable self-administered online questionnaire collected data that involved 391 respondents predominantly in the urban areas. Rank Spearman test was used to analyze the data with a confidence interval of 95%.
Results: The respondents were mostly elderly (>45 years; 61.6%), health activists with high school graduation, didn't have a family with a health background and did not work. Most of them showed low TB literacy (Me:60; SD±6.62) and high stigma (Me: 76; SD±10.36). They were also difficult to access, understand, assess, and apply information about TB. Age (p.0.03; r.-0.110), being health activist (p.0.081; r.-0.088), and TB literacy (p.0.001; r.0.165) correlated significantly with stigma.
Conclusions: Public Health Center's officers require inserting literacy education materials related to stigma to form a comfortable support system for persons with TB.