bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.
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
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.