bluuebunny/crossref_metadata_2025 huggingface dataset:
How the largest slum in India flattened the COVID curve? A Case Study
Authors: Sahu Monalisha , Dobe Madhumita
Published: May 2023

Mumbai-The economic capital of India, shrivelled with panic as its infamous slum ‘Dharavi’ recorded its first positive case of COVID-19 on 1st April 2020. Dharavi is the largest slum in India and one of the most densely populated areas in the world. Its narrow lanes, teeming with people and chock-a-block with settlements, make physical distancing practically impossible- posing as an excellent breeding ground for the deadly virus. However, with a policy of ‘chasing the virus’ based on strategy of ‘Tracing Tracking Testing and Treating’ Dharavi flattened its epidemic curve within a hundred days. This was achieved through the immediate public health response with strict containment measures, aggressive active and passive surveillance and integration of resources from government and private sectors to provide essential services. In this paper, we have summarized the ongoing measures for successful prevention and control of COVID-19 in Dharavi, which could provide useful learning for other similar settings worldwide.
Level of competencies of family physicians from patients’ viewpoint in post-war Kosovo
Authors: Bojaj Gazmend , Czabanowska Katarzyna , Skeraj Fitim
Published: May 2023

Aim: Besides the health professionals’ perspective, it is equally important to assess the perceptions of the users of health care services with regard to abilities, skills andcompetencies of their family physicians. Our aim was to assess the level of competencies of family physicians from patients’ viewpoint in transitional Kosovo.
Methods: A nationwide survey was conducted in Kosovo in 2013, including a representative sample of 1340 primary health care users aged ≥18 years (49% males aged 50.7±18.4 years and 51% females aged 50.4±17.4 years; response rate: 89%). Participants were asked to assess the level of competencies of their respective family physicians regarding different domains of the medical encounter. The self-administered questionnaire included 37 items structured into six domains. Answers for each item of the instrument ranged from one (“novice” physicians) to five (“expert” physicians). An overall summary score related to family physicians’ competencies was calculated for each participant [range: from 37 (minimalcompetencies) to 185 (maximal competencies)]. Furthermore, demographic andsocioeconomic data were collected. General Linear Model was used to assess thedemographic and socioeconomic correlates of the overall level of family physicians’competences according to patients’ perspective.
Results: Mean value of the overall summary score for the 37-item instrument was118.0±19.7. It was higher among the younger and the low-income participants, and in patients who reported frequent health visits and those not satisfied with the quality of the medical encounter. Conversely, no sex, or educational differences were noted.
Conclusions: Our findings indicate a relatively high level of competencies of familyphysicians from patients’ perspective in post-war Kosovo. Future studies shouldcomprehensively assess the main determinants of self-perceived competencies of family physicians among primary health care users in Kosovo.
Women in Montenegro exhibit a high degree of happiness and life satisfaction: Data from the Multiple Independent Cluster Survey 2018
Authors: Ljaljevic Agima , Wenzel Helmut , Laaser Ulrich
Published: May 2023

Aim: Montenegrin government is increasingly aware of the key role of women in the society and attempts to improve social cohesion among Montenegrin people. Precondition is a high degree of life satisfaction and happiness.
Methods: We used the Multiple Indicator Cluster Survey (MICS) of 2018 to analyse the distribution and interaction of 22 potential determinants out of 383 variables available. The participation rate was 77.7 or 2,276 women aged 15-49 years out of 2,928 invited. As data quality turned out to be limited, we employed a data mining approach, i.e. an interactive Classification and Regression Tree (C&RT). Happiness was measured ranging from very happy to very unhappy on a categorical scale of 5 steps
Results: Of all Montenegrin women 70.7% declared themselves as very happy. Likewise, a 10-point scale of life satisfaction classifies 82.0% of the sample in the top ranks 8-10. Furthermore, 73.6% of the women expect the next year to be even better. Wealth, younger age, and marriage or living in union determine the status of happiness.
Conclusion: Women in Montenegro exhibit a high degree of self-reported happiness and life satisfaction. Montenegrin policies should continue to support the role of women in the society.
Prevalence of chronic obstructive pulmonary disease (COPD) in Albania
Authors: Tafa Holta , Mema Donika , Mezini Arian , Nikolla Jolanda , Teferici Alma , Todri Dafina , Burazeri Genc , Hafizi Hasan
Published: May 2023

Aim: The objective of this study was to determine the prevalence of COPD and its associated factors among adults in Albania.
Methods: This was a cross-sectional study conducted in Albania in 2013-14. A nation-wide representative sample of 1200 adults aged ≥40 years was selected using multistage cluster sampling technique. All participants were interviewed about socio-demographic characteristics, respiratory symptoms, smoking status and clinical characteristics. Spirometry was performed according to standard methods. COPD was defined as post-bronchodilator FEV1/FVC ratio <70% predicted.
Results: Of the 1200 adults invited to participate, 939 adults or 78% (467 men and 472 women) were eligible for the study. The overall COPD prevalence (GOLD stage 1 or higher) was 12.4%; it was higher in men (17.4%) than in women (7.7%). Using Lower Limit of Normal (LLN), the prevalence of COPD was 9.9%, again higher in men (13.2%) than women (6.6%). The prevalence of doctor-diagnosed COPD was 1.3% (1.9% in men, 0.6 % in women). Male sex, smoking and increasing age were significantly associated with COPD diagnosis.
Conclusion: The overall prevalence of COPD in Albania was 9.9% using BOLD standards. Smoking and increasing age were the main risk factors for COPD. The study highlights the importance of raising awareness of COPD among health professionals.
National disaster preparedness and emergency response of nurses in Germany: An exploratory qualitative study
Authors: Grochtdreis Thomas , Schröder-Bäck Peter , Harenberg Niels , Görres Stefan , Jong Nynke de
Published: May 2023

Aim: This study aimed to explore the German nurses’ perceptions of their knowledge, roles and experience in the field of national preparedness and emergency response.
Methods: An exploratory qualitative design was used with open-ended questions during semi-structured interviews with qualified nurses currently working in hospitals. The setting of the study consisted of wards of different hospitals in three northern federal states of Germany. The data analysis was done by summarizing analysis of the contents. From a convenient sample of n=31 hospitals, n=13 nurses were included in the study.
Results: The median age of the participants was 45 years and 38% were female. Within the three professional socialization fields, knowledge, roles and experience, 17 themes were clustered.
Conclusion: Within the themes of knowledge, role and experience in national disaster prepared-ness and emergency response, similarities and differences were explored in comparison to inter-national literature.
Can Russia’s high mortality return until 2030 to trajectory of the 1980-ies and reach the SDGs evenly across the country?
Authors: Chernyavskiy Valery , Wenzel Helmut , Mikhailova Julia , Ivanova Alla , Zem-lyanova Elena , Bjegovic-Mikanovic Vesna , Mikhailov Alexander , Laaser Ulrich
Published: May 2023

Aim: This study reviews the ability of the Russian Federation to reduce the high mortality until 2030 evenly across the country and in accordance with the Sustainable Development Goals (SDG).
Methods: We adopted the method suggested by Haenszel for estimating Premature Years of Life Lost for the age group <70 years and applied a projected reduction of 33% by 2030 as proposed for SDG 3.4. To calculate the potential time gap we used the model of the United Nations Development Programme and standardized the rates by the OECD 1980 Standard Population employing the direct method.
 
Results: If Russia keeps the present level of effort the reduction by one third of the level of premature mortality as in 2013 will be in reach already in 2024 i.e. 5.9 years in advance of the SDG 3 target for 2030. This target is achieved quite evenly also throughout the 8 districts of the Russian Federation between 10.6 and 5.0 years in advance and in selected special districts/republics with the highest and lowest mortality rates.
 
Conclusion: After the steep decrease of life expectancy during the 1990ies the Russian Federation returned to the original trajectory.
Professionalization of Public Health – an exploratory case study
Authors: Mansholt Hilke , Czabanowska Katarzyna , Otok Robert , Nooijer Jascha de
Published: May 2023

Introduction: Public health is continuously challenged by a shortage of workforce. There are various reasons for this: 1) public health is less visible than traditional health professions and people may be unfamiliar with the nature and opportunities involved in entering this career field; 2) lack of official recognition of public health as a professional category; and 3) no umbrella organization that supports its members and governs professional standards as is the case of other more established professions. To adequately address the challenges of public health for the 21st century, a key policy element will need to focus on adequately cultivating, training and growing the future workforce of professionals in the field. The aim of this study was to examine why professionalization of public health in Europe is not as robust as it deserves to be and what steps can be taken to assure an adequate supply of professionals with the proper education and training background, and career guidance to tackle the public health needs of the future.
Method: A case study approach was used collecting data via a scoping literature review, a focus group with public health students and interviews with public health experts for convergence. Data was analysed using directed content analysis and pattern matching logic.
Results: Public health fulfilled five out of seven attributes of a profession, such as skills, training and education, certification and an altruistic service. Recognition of Public Health as multidisciplinary and multi-professional field, derived from the interviews as an additional characteristic. A code of ethics and professional conduct and a formal organization were missing.
Conclusion: Public health professionals and organisations that govern best practices in this field should consider introducing a shared code of ethics and professional conduct as well as establishing a coordinated body to help advance the public status as a the profession to increase interest in studying and specializing in this area.
Childhood adversity and leisure time physical and sports activity in older adults: A cross-sectional analysis from the International Mobility in Aging Study
Authors: Hwang Phoebe W. , Gomes Cristiano dos Santos , Auais Mohammad , Braun Kathryn L. , Pirkle Catherine M.
Published: May 2023

Aim: The purpose is to examine the relationship between childhood adversity and leisure time physical activity (LTPA) among community-dwelling older adults from high and middle-income sites.
Methods: Cross-sectional analysis of 2012 data from older adult ages 64-75 years old from King-ston, Canada; St. Hyacinthe, Canada; Tirana, Albania; Manizales, Colombia; and Natal, Brazil. Principal exposure variables were childhood social and economic adversity. Covariates included participant age, sex, income, and educational attainment. Outcome variables were LTPA and lei-sure time sports activity (LTSA).
Results: High-income sites had higher LTPA prevalence than middle-income sites. Females were less likely to engage in LTPA compared to males in Tirana (OR:0.53, 95%CI:0.30-0.94), but were more likely to engage in LTPA in Manizales (OR:2.54, 95%CI:1.54-4.18). Low education was less likely than high education to engage in LTPA in Kingston (OR:0.38, 95%CI:0.19-0.73) and Natal (OR: 0.52, 95%CI:0.28-0.97). Low income was less likely than high income to engage in LTPA in St. Hyacinthe (OR: 0.42, 95%CI:0.20-0.89) and Manizales (OR:0.33, 95%CI:0.16-0.55). In Tirana, low income was more likely than high income to engage in LTPA (OR:5.27, 95%CI:2.06-13.51).
Conclusions: Childhood economic and social adversity were not significantly associated with LTPA. Sex, income, and education were associated with older adult PA engagement, however the direction of the association varied by site location. This suggests that the paradigms surrounding PA behavior may vary from city to city. Understanding the site-specific risk factors to PA engage-ment may better inform clinical recommendations and public health approaches to increase PA engagement among older adults across the globe.
The health of the public: What has gone wrong?
Authors: Alderslade Richard , Kokeny Mihaly , Tsouros Agis
Published: May 2023

COVID-19, a new pandemic, has swept the world. How could this have happened? In theory the world should have been prepared, armed as it has been since 2005 with a new set of International Health Regulations with universal commitment by WHO Member States. Yet disaster has struck. The authors of this paper consider that fundamental rethinking is needed, with a new review of the post-World War 2 international system for global governance for health. Whilst WHO and its present and future actions will be scrutinized, the organization is fundamentally made up of 194 Member States, which must share the responsibility for ensuring better global health protection in the future. It is clear the world needs a more effective WHO, but it also needs countries to support and develop their public health infrastructure to face today’s more complex health challenges, which can only grow in scope and complexity over coming years. The paper proposes several key steps to achieve these goals.
Submission Invitation to South Eastern European Journal of Public Health (SEEJPH), Special Section “Women in Health Leadership”
Authors: Czabanowska Kasia , Siepmann Ines
Published: May 2023

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COVID -19 Pandemic -Increasing the African Access to VaccinationA Strategy to Curb the Global Spread of Infection
Authors: Bishaw Tewabech
Published: May 2023

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Assessment of knowledge, attitudes and practices about public health nutrition among students of the University of Medicine in Tirana, Albania
Authors: Hyska Jolanda , Mersini Ehadu
Published: May 2023

Aim: the aim of this survey was twofold: (i): to assess medical students’ knowledge, attitudes and practices regarding nutrition in general, in order to identify their level of competences in the field of nutrition which will be useful in their future role of providers/health care professionals, and; (ii) to assess the knowledge, attitudes and practices regarding the discipline of public health nutrition in order to identify the needs for improving the curriculum of this subject in all the branches of the University of Medicine in Tirana.
Methods: A cross-sectional study was conducted in June-July 2013 including a representative sample of 347 students at the University of Medicine in Tirana, Albania (61% females and 39% males; overall mean age: 23±2 years; response rate: 87%). A nutritional questionnaire, adopted according to the models used in previous international studies, was used to assess the level of knowledge, attitudes and practices among the university students.
Results: Overall, about one third of the students was not satisfied with the quality and quantity of nutritional education and demanded a more scientifically rigorous curriculum. In general, students’ knowledge about infant feeding practices was adequate. However, there were gaps in the students’ knowledge regarding the commencement of breastfeeding, or the duration of exclusive breast-feeding. Furthermore, there was evidence of an insufficient level of knowledge among students regarding diet and nutrition in general and their health impact, especially on development and prevention of chronic diseases.
Conclusion: This survey identified significant gaps in the current curriculum of public health nutrition at the University of Medicine in Tirana. Our findings suggest the need for intervention programs to improve both the quantitative and the qualitative aspects of nutrition curricula in all the branches of the University of Medicine Tirana, in accordance with the professional expectations of this teaching institution, as well as the urge for a movement towards a more integrated curriculum and problem-based learning approach.
Preventive check-up programme for strengthening people-centred primary health care services in Albania: Case study and lessons learnt
Authors: Ylli Alban , Jurgutis Arnoldas , Burazeri Genc , Bejtja Gazmend , Artykova Nazira , Sentell Tetine
Published: May 2023

Non-communicable Diseases (NCDs) in Albania are increasing, yet the country has a low number of outpatient visits per inhabitant per year. A primary health care (PHC) based programme of medical check-ups, with a focus on prevention, was set up in the country in 2015 aiming to address this issue, among others. This manuscript describes the development and status of the programme at key time points after its implementation, and considers some of its outcomes.The current analysis was based on data gathered from the check-up programme information system and the registry of diseases at PHC centres, and guided by the European Framework for Action on Integrated Health Services Delivery.Based on PHC registered cases, a 13% and 34% increase in the prevalence of elevated blood pres-sure and diabetes were observed in 2015 respectively, following the introduction of the check-up programme compared to the previous year. Three years after implementation, about 60% of the population aged 35–70 years old had used the programme at least once, with 61% of the total 954 667 visits provided to women.Overall, the check-up programme in Albania has identified a substantial number of new cases of NCD as well as their associated risk factors in its population. The early detection of NCDs is expected to contribute to the prevention of complications, premature mortality and their associated costs. Albanian politicians and decision-makers should regularly revise and introduce appropriate changes to the check-up programme in the future. In particular, the issue of sustainability and long-term resource mobilization is of particular concern and warrants careful consideration.
 
Conflict of interests: None declared.
Chocolate intake is associated with a lower body mass index in adult men and women in transitional Albania
Authors: Mone Iris , Kraja Bledar , Hyska Jolanda , Burazeri Genc
Published: May 2023

Aim: In light of the controversial evidence regarding health effects of chocolate intake, we aimed to assess its association with body mass index (BMI) among adult individuals in Albania, a transitional post-communist country in South Eastern Europe which has traditionally employed a Mediterranean dietary pattern.  
 
Methods: A cross-sectional study was conducted in 2003-2006 involving a population-based sample of 737 Tirana residents aged 35-74 years (469 men, 268 women; overall response: 70%). Of these, 565 individuals (373 men and 192 women) provided data on chocolate intake and anthropometrics (77% of the sample). A 105-item food frequency questionnaire, including chocolate consumption, was administered to all individuals. Nine categories were used to assess the average frequency of intake of each food item in the past 12 months. In the analysis, chocolate intake was dichotomized into: consumption of <1/month vs. ≥1/month. A physical examination included measurement of weight and height. Furthermore, information on socio-demographic characteristics and classical risk factors was collected. Multivariable-adjusted general linear model was used to calculate the mean BMI values by chocolate intake groupings.
 
Results: Upon simultaneous adjustment for socio-demographic characteristics, classical risk factors and nutritional factors, there was an inverse association between BMI and chocolate intake in both sexes (sex-pooled mean BMI: 26.1 among participants who consumed chocolate <1/month vs. 27.0 in those with an intake of ≥1/month; P<0.001).
 
Conclusions: This study points to a beneficial effect of moderate chocolate intake on lowering BMI, which deserves further vigorous investigation and replication in prospective studies in Albania and other populations.
Easter Eggs & ‘Easter Eggs’: Alcohol Branded Chocolate Eggs & Intoxigenic Environments in Ireland
Authors: Houghton Frank
Published: May 2023

Alcohol branded Easter Eggs were observed in a mainstream Irish supermarket. The Public Health (Alcohol) Act, 2018 fails to deal with such child-friendly marketing. An amendment to the current legislation to counter this deficit is urgently required. The absence of such legislation is particularly notable given the longstanding inclusion of clauses to this effect in tobacco control legislation in Ireland.
Conflict of interests: None declared.
Survey exploring the opinion of corresponding authors of articles published in the South Eastern European Journal of Public Health during 2014-2021
Authors: Petrela Kreshnik , Roshi Meri , Laaser Ulrich , Burazeri Genc
Published: May 2023

The aim of this survey was to assess the intentions of corresponding authors for publishing again in the South Eastern European Journal of Public Health (SEEJPH), the aspects that they like most about the jour- nal, and things which can be improved by SEEJPH in order to be more attractive to potential contributors. A three-item questionnaire was sent out by email to all corresponding authors (N=89) who published in the 16 volumes of the SEEJPH journal between 2014 and 2021. Among 84 eligible corresponding authors, we collected 26 answers, or 31%.
There were generally favourable and constructive comments, which is encouraging. The wide array of coun- tries of the corresponding authors represents the successful global orientation of SEEJPH. Also, more than half of all related articles are classified as original papers, and the average of four authors per represented paper is satisfying. Furthermore, all corresponding authors would publish again in SEEJPH (“definitely”, or “probably”), and their numbers are almost equally distributed throughout 2014-2021.
Acknowledgments: We express our gratitude to our Publisher Dr. Hans Jacobs, Sebastian Wolf, and all our supporters in the University of Bielefeld/Germany, our Boards of Editors, and our authors, friends, and colleagues.
How can we champion young women working in public health?
Authors: Siepmann Ines , Chen Tara , Andelic Petra
Published: May 2023

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Editorial
Authors: Burazeri Genc , Roshi Meri , Laaser Ulrich
Published: May 2023

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Neglect, abuse and violence against older women: Definitions and research frameworks
Authors: Brownell Patricia
Published: May 2023

The aging of the global population with women living longer than men, resulting in the feminization of aging, focuses attention on the intersection of gender and age. Women across the lifespan can be victims of violence but there has been little attention to date to the neglect, abuse and violence against older women. Because of this gap in knowledge and remedies, little is known about neglect, abuse and violence against older women, particularly its prevalence as well as evidence-based prevention and intervention strategies. Several definitions of neglect, abuse and violence are reviewed here, along with conceptual frameworks that operationalize these definitions differently, resulting in differences in findings on prevalence as well as fragmentation in the way that older women victims of abuse are viewed. Three definitions of older adult abuse are discussed, including those formulated by the Toronto Declaration, the National Research Council, and the United States Center forDisease Control. Each focuses on a different aspect of abuse of older women: active ageing, old age dependency, and domestic violence in later life. A fourth conceptual framework, the human rights perspective, shows promise for addressing abuse of older women in a more holistic manner than the other definitions, but Is not fully developed as a way of understanding neglect, abuse and violence against older women. This is the first of a four-part series on older women and abuse.
Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage
Authors: Ahmad Jameel Ismail , Jibril Murtala , Ahmad Barroon Isma’eel , Suleiman Abdurrahman , Inuwa Nasir Sani , Ali Abdullahi Garba , Ismai Salihu Ibrahim
Published: May 2023

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem.
Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0.
Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents.  Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare.  Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 - $6.56 and $3.28 – $6.56, respectively.
Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria.
Pattern of population coverage of a social health insurance scheme in a Southwest Nigeria State: A 3-year post implementation evaluation
Authors: AyobamiAdewole David , Ilori Temitope , Ladepo Wuraola , Akande Olusola Augustus , Owolabi Ganiyu
Published: May 2023

Aims: Social health insurance scheme is capable of minimizing inequity of access to health services, and thereby enhance an improvement in population health outcomes. Recently the National Health Insurance Scheme (NHIS) of Nigeria decentralized its management to the sub-national levels, thus the emergence of State Health Insurance Schemes (SHIS).  The SHIS of Oyo State Nigeria started operations about three years ago (June 2017). There is limited/sparse evidence on the performance of the scheme since its inception. Therefore, the aim of this study was to assess the scheme’s level of population coverage in the first three years of implementation. The findings will also provide an evidence base to inform the repositioning of the scheme for improved performance and enable it achieve the purpose of its establishment. 
Methods: Service data from the server of Oyo SHIS were downloaded, collated and analyzed with excel software. Data extraction, cleaning and analysis covered a period of three months (September – October, 2020). Descriptive statistics were used to summarise the data. Population coverage distributions were expressed as frequency and percentages. Frequency tables and graphs were generated to disaggregate the findings.
Conclusion: Stakeholders in the Oyo State SHIS need to re-strategize to reposition the scheme for an accelerated population coverage as a proxy for performance assessment.
Acknowledgements:
Authors wish to acknowledge Oyo State Health Insurance Agency for the permission to make use of the data and to submit the manuscript for publication. We authors would like to sincerely acknowledge the contributions of Prof. Charles Wiysonge and that of Dr. Chukwudi Nnaji for the comprehensive review and suggestions made on this manuscript. Many thanks.
 
Authors' contributions:
David Adewole conceived and designed the study. Wuraola Ladepo and Temitope Ilori did data collection and analysis.  Adewole, Owolabi and Akande contributed equally to the manuscript write up. All authors read through the manuscript draft the second time. All authors agreed to the final manuscript.
 
Conflict of interests: None declared.
Evaluation of determinants of the use of health mutuals by the population of the Ziguinchor region in Senegal
Authors: Bop Martial Coly , Akoetey Kossivi , Gueye Boubacar , Diop Cheikh Tacko , Sow Papa Gallo , Ka Ouseynou , Diop Abdoulaye , Sow Fatou Sarr
Published: May 2023

Access to health services is a concern around the world. Different strategies were developed, but Africa’s rate remains the lowest. This article aims to contribute to the population's access to healthcare, and to assess the determinants of the use of mutual health insurance by the population of the Ziguinchor region in Senegal. 
 
Methods: The study is transversal and descriptive, carried out from July to August 2018. Through the quota method we defined the number of patients to be interviewed. Thus, by a geographic stratification according to the departments and a second-degree stratification taking into account the staff of the different hospital departments, 392 patients were selected.
 
Results: 73% at the Regional Hospital Center and 27% at the Regional Peace Hospital. Response rate: 97%, women 60% and men 40%. The enrollment for women (24%) is slightly higher than that for men (21%). Socio-economic factors. The rate of adherence is the highest of for patients with university level, followed by high school; income:  the highest rate for patients with a monthly income between 200,000 and 500,000 FCFA, followed by patients with an income monthly between 100,000 and 200,000 FCFA. Factors linked to the provision of care: the rate of Mutual Health Insurance adherence follows distances from patients' homes. Concerning the relation to satisfaction, education, distance and information are more determining than adherence rate. 
 
Recommendations: 1) State: actions on education and distance; 2) Sensitizing the population on mutual health insurance; 3) Urging healthcare providers to reduce waiting times and respect schedules as well as appointments.
Improving access to health services in Malawi
Authors: Msokwa Robert
Published: May 2023

Background: Timely access to health care can substantially reduce mortality. The United Nations Sustainable Development Goal 3, target eight recommends provision of quality care to all must include usually underserved groups by 2030. Universal access to healthcare remains unavailable particularly in rural areas, due to a shortage of labor, a lack of basic health-facility infrastructure, poor management practices, and insufficient financing In Malawi, universal access to healthcare remains unavailable particularly in rural areas, however, no data is available from villagers themselves on improving access to health services. The aim of the study was to find ways of improving access to health services in Malawi with focus on people staying in rural areas.
Methods: Quantitative cross-sectional study. Simple random sampling. Face to face interview was conducted.
Results: The survey included 126 people, 97(77%) were women and 29 (23%) were men. 52 % participants were farmers, 7% of participants were employed, and 5%   attainted tertiary education. Common barriers to access health services which participants (35%) mentioned were lack of drugs and medical equipment, shortage of health personnel (25%), another 25% complained of long distance to nearest health facility. 10 % of participants fail to access health services due to poor design of hospitals   and 5% failed to access health services due to rudeness of health workers. Accessibility of health services in Malawi can be improved by increasing number of clinics which was suggested by 28% of participants, 25% of study participants suggested training more health workers, 23% suggested of setting up of community fund to transport patients in cases of emergency, 20% of participants suggested of introducing mobile clinics and 4% suggested of designing of tricycle to be used for transport in rural areas.
Conclusion: Access to health services in Malawi can be achieved by Training more health workers, introducing community funds, empowering local people to own the health facilities, increasing number of health facilities, designing tricycle which could travel in rural areas and improve drug supply and quality of medical equipment through increased funding from central government
The role of health service delivery networks in achieving universal health coverage in Africa
Authors: Simfukwe Knovicks , Adebisi Yusuff Adebayo , Oladunni Amos Abimbola , Mohammed Salma Elmukashfi Eltahir , Lucero-Prisno II Don Eliseo
Published: May 2023

Most countries in Africa are faced with health system problems that vary from one to the next. Countries with a low Human Development Index (HDI) seem to be more prone to challenges in health service delivery. To mark its 70th anniversary on World Health Day, the World Health Organization (WHO) selected the theme “Universal Health Coverage (UHC): Everyone, Everywhere” and the slogan “Health for All. ”UHC refers to ensuring that all people have access to needed health services (including prevention, promotion, treatment, rehabilitation, and palliation) of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship. UHC is a WHO’s priority objective. Most governments have made it their major goal.
This paper provides a perspective on the challenges of achieving UHC in Sub-Saharan Africa (SSA). It also endeavors to spotlight the successful models of Health Service Delivery Networks (HSDNs) that make significant strides in making progress towards achieving UHC. HSDNs propose models that facilitate the attainment of affordability and accessibility while maintaining quality in delivering health services. Additionally, it brings up to speed the challenges associated with setting up HSDNs in health systems in SSA. It then makes propositions of what measures and strategic approaches should be implemented to strengthen HSDNs in SSA. This paper further argues that UHC is not only technically feasible but it is also attainable if countries embrace HSDNs in SSA.
Innovative Strategies to Strengthen Health Service Delivery for Universal Health Coverage in Africa – A Scoping Literature Review
Authors: Salawu Mobolaji Modinat , Onwujekwe ObinnaEmmanuel , Fawole Olufunmilayo Ibitola
Published: May 2023

African nations have failed to achieve the mandate of health for all forty years after Alma Ata declaration. To achieve Universal Health Coverage (UHC), government alone are unable to solve the problems of health service delivery such as lack of good infrastructure, poor management, inter-cadre conflicts, lack of skilled birth attendants amongst others. This review assessed the involvement of non-state actors (private sector/philanthropists) in achieving UHC in Africa.
We explored eight databases and search engines using specific search terms. We retrieved and conducted a detailed review of 47 publications comprising published literature and reports focused on private sector/philanthropy involvement in achieving UHC in Africa, and explored the challenges and opportunities. We included both qualitative and quantitative studies published in English.
Inequity and a wide gap exist in countries’ health care service delivery due to numerous challenges such as chronic economic instability, bureaucracy, poor healthcare financing, corruption among others. Review of existing literature suggests that as Africa embarks on reforms toward UHC there is a great need for involvement of private sector/philanthropists to support government in addressing challenges facing health care system.  The type of involvement revealed were; provision of infrastructure (hospital buildings/facility, good roads), technical support, technological innovations, provision of diagnostic and therapeutic equipment, financial support and other support services. 
This scoping review showed that private and philanthropist actors’ involvement in healthcare system have huge potentials to improve, restore and maintain health service delivery in African nations. This will accelerate progress towards the achieving UHC by 2030.
A practical and applied approach to assessing the cross cutting nature of child injury prevention as a basis for policy making at the local level
Authors: Scholtes Beatrice , Schröder-Bäck Peter , Mackay Morag , Vincenten Joanne , Brand Helmut
Published: May 2023

Aim: Risk factors for child injury are multi-faceted. Social, environmental and economic factors place responsibility for prevention upon many stakeholders across traditional sectors such as health, justice, environment and education. Multi-sectoral collaboration for injury prevention is thus essential. In addition, co-benefits due to injury prevention initiatives exist. However, multi-sectoral collaboration is often difficult to establish and maintain. We present an applied approach for practitioners and policy makers at the local level to use to explore and address the multi-sectoral nature of child injury.
Methods: We combined elements of the Haddon Matrix and the Lens and Telescope model, to develop a new approach for practitioners and policy makers at the local level.
Results: The approach offers the opportunity for diverse sectors at the local level to work together to identify their role in child injury prevention. Based on ecological injury prevention and life-course epidemiology it encourages multi-disciplinary team building from the outset. The process has three phases: first, visualising the multi-sectoral responsibilities for child injury prevention in the local area; second,  demonstrating the need for multi-sectoral collaboration and helping plan prevention activities together; and third, visualising potential co-benefits to other sectors and age groups that may arise from child injury prevention initiatives.
Conclusion: The approach and process encourages inter-sectoral collaboration for child injury prevention at the local level. It is a useful addition for child injury  prevention at the local level, however testing the practicality of the approach in a real-world setting, and refinement of the process would improve it further.
Unlocking the power of communities to achieve Universal Health Coverage in Africa
Authors: Ndejjo Rawlance , Musinguzi Geofrey , Musoke David , Wanyenze Rhoda K.
Published: May 2023

Africa is at a critical time undergoing demographic, epidemiological, political and socio-economic transitions and faced with repeated outbreaks of emerging and remerging diseases amidst other broader challenges of climate change, environmental degradation and pollution testing the resilience of its health systems and hindering progress to achieve health for all. Five years into the journey towards Sustainable Development Goals (SDGs), the continent – similar to the rest of the world – has been gripped with the Corona virus disease pandemic that has caused significant morbidity and mortality as well as severely disrupted health systems and the underlying socioeconomic determinants of health. One of the most significant SDG targets is the achievement of Universal Health Coverage (UHC) where all people have access to quality health services they need without inflicting a financial hardship on them. However, progress towards this target has been slow on the continent and requires rethinking the current approaches employed. We argue that Africa’s key strength lies in the communities whose potential should be unlocked to build cost effective and sustainable bottom-up health systems founded on Primary Health Care (PHC). Such systems should be founded on community-based services, designed around individuals, families and the community involving community health workers and other actors, and capitalising on health promotion and disease prevention approaches. A strong community health system should be adequately linked to district, regional and national levels working together to empower and serve populations to make health for all a reality.
COVID-19 pandemic providing a window of opportunity for higher education: Case study of a three-country teaching-learning experience
Authors: Poirier Mathieu JP , Hard Julie , Holst Jens
Published: May 2023

Aim: Since March 2020, the COVID-19 pandemic has been causing unprecedented challenges to higher education by disrupting traditional face-to-face teaching as well as international mobility of students, faculty and staff. The factual knock-out of established modes of teaching and learning and the restriction of international travel called for rapid action and a shift towards remote learning and teaching.
Methods: Within the framework of a pragmatic approach, global health faculty from Fulda University of Applied Sciences in Germany and York University in Canada, including a small group of public health students from Cluj in Romania, established a globally networked learning environment. Between November and December 2020, a total of 147 students participated in joint virtual lectures and international collaborative group projects. To capture the acceptance and effectiveness of the innovative didactic experience, a semi-structured student survey was conducted directly after the last session.
Results: The overall rating of internet-based cross-university teaching-learning was positive: Students reported benefits of an enriched learning experience through the sharing of different perspectives, approaches and debates with international professors and peers. Success and overcoming challenges for collaboration among students depended strongly on the level of coordination relating to time differences and expectations.
Conclusion: The COVID-19 pandemic has revealed that transnational inter-university teaching-learning is feasible, provides a beneficial pedagogic option and points promising ways to the future.
Conflict of interest: None declared.
Acknowledgements: We gratefully acknowledge the contributions of Prof. Dr. Kai Michelsen and Prof. Dr. Marius I. Ungureanu to the development of the three-country teaching-learning experience.
Infection prevention and control in healthcare facilities in Albania
Authors: Qirjako Gentiana , Qosja Alketa , Draçini Xheladin , Çomo Najada , Hyska Jolanda , Fico Albana , Bukli Mariana , Burazeri Genc
Published: May 2023

Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated.  
 
Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women; response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher’s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants.      
 
Results: About 47% of health facilities did not have a designated focal point for IPC issues; the lack of one patient per bed standard was evident in more than one-third of health facilities (37%); and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled.
 
Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care.
Feasibility and clinical utility of Bates-Jensen wound assessment tool among nurses caring of patients having pressure ulcers
Authors: Younis Wejdan Y. , Abdalrahim Maysoon S. , Zeilani Ruqayya S. , Albusoul Randa , Alosaimi Dalyal , Hamdan-Mansour Ayman M.
Published: May 2023

Aims: One of the vital roles of nurses is to perform pressure ulcer risk assessment that enables them to appropriately assess and track healing progress of wound and pressure ulcers among patients. Our aim was to assess the feasibility and clinical utility of the Bates-Jensen Wound Assessment Tool (BWAT) among nurses caring of patients with pressure ulcer.
Methods: A descriptive cross-sectional design used to collect data from 177 registered nurses caring of patients who developed or have a risk of developing pressure ulcers working in three hospitals in Jordan.
Results: The mean feasibility score of the BWAT was 28.3 out of 36 (SD=3.4) with a median score of 29. Most of nurses reported that the BWAT was easy to use on a scale of 1-4 (best) (M=3.40/4, SD=0.62) and can successfully assess wound characteristics (M=3.40/4, SD=0.59). The mean utility score of the BWAT was 21.3 out of 28 (SD=2.7) with a median of 21. Nurses had a perception that using the BWAT enhances care of patients with wounds (M=3.36/4, SD=0.61) and makes communication easier between nurses and physicians. 
Conclusion: This study provided evidence that support the use of the Bates-Jensen Wound Assessment Tool for patients with pressure ulcer. Nurses perceived BWAT as easy to use, understandable, and relevant for assessing patients with pressure ulcers.
Funding statement: This work was supported by supported and funded by The Deanship of Scientific Research at The University of Jordan, Amman, Jordan [number1953/2017/19].