Discover health systems最新文献

{"title":"Addressing malaria incidence in Africa through health care expenditure and access to basic sanitation services","authors":"Alfred Eboh, Aderonke Omotayo Adebayo","doi":"10.1007/s44250-023-00052-8","DOIUrl":"https://doi.org/10.1007/s44250-023-00052-8","url":null,"abstract":"Abstract Background Malaria is a significant public health concern, particularly in sub-Saharan Africa. This study examined the impact of health care expenditure and access to basic sanitation services on malaria incidence in 28 selected African countries from 2000 to 2019. Methods The study was anchored on Health Production Function [HPF] model while General Panel Linear Model was adopted to examine the relationships between the variables. The retrospective research design was utilised. The statistical diagnostics tests were performed to check for multicollinearity, hereroskedasticity, normality and model specification using correlation matrix, Breusch Pagan/Cook Weisberg, Shapiro–Wilk and the Hausman specification. The hypotheses were tested at the 5% significance level and the analysis of the data was aided by the use of the STATA 13.0. Results Domestic Government General Health Expenditure [DGGHE] had a positive relationship with Malaria Incidence [MI], although it was not statistically significant [coefficient = 0.0454708, p -value = 0.604]. Out-Of-Pocket Health Expenditure [OOPHE] demonstrated a statistically significant positive association with MI [coefficient = 0.2839394, p -value = 0.009]. External Health Expenditure [EHE] showed a statistically significant negative relationship with MI [coefficient = − 0.1452344, p -value = 0.012]. Moreover, People using at least Basic Sanitation Services [PBSS] exhibited a statistically significant negative relationship with MI [coefficient = − 0.3854207, p -value = 0.000]. Conclusions The results suggested that while government health expenditure alone may not significantly impact malaria incidence, increased out-of-pocket expenditure and external health expenditure, as well as improved access to basic sanitation services, are associated with a higher likelihood of reducing malaria incidence in the selected African countries. Addressing malaria incidence in Africa requires a comprehensive approach that includes adequate government health care expenditure, reduction of out-of-pocket costs, increased external funding, and improved access to basic sanitation services. By implementing these recommendations, policymakers can make significant progress in reducing the burden of malaria and improving public health outcomes in affected African countries.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":" 30","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135340921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Know, comply, and live: the implications of protocols for COVID-19 management in sub-Saharan Africa","authors":"Anthony Amoah","doi":"10.1007/s44250-023-00042-w","DOIUrl":"https://doi.org/10.1007/s44250-023-00042-w","url":null,"abstract":"Abstract The aim of this study is to examine the factors influencing compliance with COVID-19 preventive management strategies in sub-Saharan Africa (SSA). To address the lack of national data associated with this study, a comprehensive cross-sectional panel dataset by GeoPoll, encompassing 12 SSA countries, is used. The study employs a novel index and a cross-sectional pooled logit econometric regression with predicted margins to identify the determinants of behavioural responses to COVID-19 management strategies. The findings reveal that demographic factors, institutional measures, and country-specific characteristics significantly impact compliance with COVID-19 management strategies in SSA. Additionally, a gender analysis of disaggregated COVID-19 pandemic management protocols revealed that females exhibit different compliance behaviours compared to males, specifically in relation to public transport, hygiene practices, handwashing, and social distancing. However, no significant gender differences are observed in behaviours such as avoiding public places and working from home. Surprisingly, the composite index, which measures overall compliance with all protocols, does not demonstrate any gender differences. Based on the findings, policies aimed at enhancing compliance should consider demographic, institutional, and country-specific factors while also accounting for gender differences in specific compliance behaviours.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"2 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135589384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case history factors and audiological screening outcomes in HEU and HIV unexposed neonates at a district level hospital in Gauteng, South Africa","authors":"Katijah Khoza-Shangase, Julia Nesbitt","doi":"10.1007/s44250-023-00049-3","DOIUrl":"https://doi.org/10.1007/s44250-023-00049-3","url":null,"abstract":"Abstract While progress has been made in reducing vertical Mother to Child Transmission (MTCT) of HIV, limited research exists on the health needs of HIV-exposed uninfected (HEU) neonates, particularly in the field of audiology. This lack of research and evidence could impact early detection and intervention efforts. This study aimed to establish relationships and compare outcomes between case history factors and audiological screening results in HEU and HIV-unexposed neonates at a district-level hospital in Gauteng, South Africa. A non-experimental quantitative, descriptive, cross-sectional, comparative research design was employed. Data was collected with a sample size of 212 participants (100 HEU, 112 HIV-unexposed neonates) recruited using quota sampling. The hearing screening process involved case history assessment, medical file review, otoscopy, tympanometry testing, Distortion Product Evoked Otoacoustic Emissions (DPOAE), and Automated Auditory Brainstem Response (AABR) measurements. Descriptive and inferential statistics, including measures of central tendency and parametric tests, were used for data analysis. The findings indicated that 43% of HEU neonates exhibited refer findings on DPOAE, and 43% on AABR, compared to 26% and 25% respectively in the HIV-unexposed neonatal group. Therefore, a statistically significant relationship was established when comparing audiological results between the HEU and HIV-unexposed groups. Case history factors such as mode of delivery, birth weight, and Apgar scores were not associated with hearing loss in either group. However, in the HEU group, a higher proportion of participants referred on the overall screening in the maternal Retroviral Disease (RVD) stage IV group, although statistical significance was not established. This study fills an evidence gap regarding HEU neonates and highlights the need to include this vulnerable population in policy and clinical guidelines related to early hearing detection, intervention, and preventive audiology initiatives.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"16 1‐2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Years of Life Lost due to COVID-19 over the first two years of the pandemic in Cyprus: comparisons across areas, age, and sex","authors":"Periklis Charalampous, Juanita A. Haagsma, Sarah Cuschieri, Brecht Devleesschauwer, Sara M. Pires, Suzanne Polinder, Grant M. A. Wyper, Amalia Hatziyianni, Elena Pallari","doi":"10.1007/s44250-023-00051-9","DOIUrl":"https://doi.org/10.1007/s44250-023-00051-9","url":null,"abstract":"Abstract Knowledge about the extent of the COVID-19 mortality burden is important to inform policy-making decisions. To gain greater insights into the population health impact of COVID-19 mortality, Years of Life Lost (YLL) can be estimated. We aimed to determine YLL linked to COVID-19 over the first two years (March 2020–March 2022) of the pandemic in Cyprus, by areas, and by age and sex. COVID-19 YLL was estimated by multiplying COVID-19 mortality counts by age-conditional life expectancy from the 2019 Global Burden of Disease life table. COVID-19 accounted for 16,704 YLL over the first two years of the pandemic—approximately 18.5 years lost per individual who died due to COVID-19 and 1881 YLL per 100,000 population. YLL per 100,000 was higher among males compared to females (2485 versus 1303 per 100,000) and higher among older than younger individuals. COVID-19 deaths and YLL per 100,000 were higher in high population-dense areas of Cyprus, such as Limassol. Continued evaluations of COVID-19 YLL are needed to inform on the proportionate population impact of COVID-19, over time and across areas of Cyprus.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"90 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135933194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcome domains and measurement instruments of patient-relevant improvement of structure and processes as a new set of outcomes for evaluating and approving digital health applications: systematic review","authors":"Madlen Scheibe, Andreas Knapp, Lorenz Harst, Jochen Schmitt","doi":"10.1007/s44250-023-00046-6","DOIUrl":"https://doi.org/10.1007/s44250-023-00046-6","url":null,"abstract":"Abstract Background In October 2020, digital health applications (DiGAs) became part of standard care in Germany. For approval, DiGA manufacturers must demonstrate medical benefit or patient-relevant improvement of structure and processes (PISP). PISP refers to an innovative outcome core area in terms of proof of benefits and reimbursement decisions. These are subdivided into 9 outcome domains, including for example health literacy, facilitating access to care, and coping with illness-related difficulties in everyday life. Their implementation aims at empowering patients, encouraging shared decision-making, and increasing patient-centeredness in healthcare delivery. Given the novelty of PISP, no standardized set of outcomes and outcome measurement instruments currently exists to operationalize the domains. Learning from previous evaluation studies can help operationalize and standardize PISPs for evaluation studies of digital health applications. Therefore, we investigated the outcomes and outcome measurement instruments, used in controlled trials to assess DiGA-compliant applications, published before the Digital Health Applications Ordinance of April 2020. Methods We conducted a systematic review of studies published between 01/2015 and 04/2020, via MEDLINE and Embase, complemented by forward/backward searches. Controlled trials assessing interventions adhering to the definition of DiGA were eligible, if they applied a validated outcome measurement instrument, and if results were presented in German or English. Title-abstract screening, full-text screening, data extraction and narrative synthesis were conducted independently by two researchers. Results Out of 2,671 references identified, 6 studies collecting a total of 48 outcomes were included. 14 outcomes (29.2%) addressed PISP by using 13 different measurement instruments. The outcomes corresponded to 5 of 9 PISP outcome domains with health literacy being the most common (7/14, 50.0%). Conclusions This review provides an overview of the characteristics of PISPs used in previous evaluation studies of DiGA-compliant applications. It shows which outcomes and validated outcome measurement instruments can be used to measure PISP and where knowledge is still lacking. These results serve as a starting point for operationalizing and standardizing PISPs and help to increase the outcome measurement quality of PISPs.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"95 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135813149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving community health volunteers’ knowledge on cervical cancer using dialogue-based training in rural Kisumu County","authors":"Edwin Onyango Ochomo, David Masinde, Collins Ouma","doi":"10.1007/s44250-023-00047-5","DOIUrl":"https://doi.org/10.1007/s44250-023-00047-5","url":null,"abstract":"Abstract Background The global burden of cervical cancer continue to rise with the low- and middle-income countries bearing the greatest burden. East Africa recorded about 54560 cases and 36497 deaths attributed to cervical cancer in 2020 with 5236 cases and 3211 deaths being reported annually. This high burden can be attributed to low screening rates and late diagnosis, which lead to undesirable outcomes. Kenya still has low screening rates with only 16.4% of the eligible women screened against the WHO target of 70% by 2030. Kisumu has a lower screening rate of about 5.7% according to KHIS 2019 data. This low screening rate is due to lack of proper community health education. We evaluated the effectiveness of dialogue-based training in improving community health volunteers’ (CHV) knowledge on cervical cancer in Nyando. Methods The study adopted a pre-and-post, longitudinal study design. The CHVs knowledge was assessed before and after the training. We calculated the proportion net change in the number of CHVs with improved knowledge after the intervention. Statistical significance was assessed at p ≤ 0.05. Results The pre-test mean score was 30.1%, this improved to 53.4% at post-test following the dialogue-based training of the CHVs. The knowledge on the various aspects: risk factors ( p < 0.0001), signs and symptoms ( p < 0.0001) and screening ( p < 0.0001) significantly improved at the post-test following the dialogue-based training. The overall score also significantly improved (p < 0.0001) following the training among the CHVs. Occupation ( p < 0.0001) was found to be significantly associated with knowledge on cervical cancer. Conclusion The CHVs’ knowledge was inadequate but significantly improved following the dialogue-based training.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"79 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136023155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost efficiency of primary health care facilities in Ghana: stochastic frontier analysis","authors":"Kwadwo Arhin, Eric Fosu Oteng-Abayie, Jacob Novignon","doi":"10.1007/s44250-023-00044-8","DOIUrl":"https://doi.org/10.1007/s44250-023-00044-8","url":null,"abstract":"Abstract Primary health care (PHC) is a universally accepted key strategy to achieve universal health coverage (UHC) and Sustainable Development Goal 3 (SDG 3) due to its potential to produce a range of economic benefits through improved health outcomes, health quality, and health system efficiency. However, little evidence exists about the cost efficiency of primary health care facilities (PHCFs) in Sub-Saharan Africa. This study evaluates the cost efficiency of two main types of PHCFs in Ghana that are at the forefront of delivering PHC services to a greater proportion of the population: Community Health Centers (HCs) and Community-Based Health Planning Services (CHPS) compounds. The dataset we used for this study included 39 HCs and 55 CHPS facilities. Furthermore, it examines the factors that influence the cost efficiency of these facilities. The study applies the stochastic frontier analysis (SFA) technique to panel data. The estimated cost efficiency for HCs and CHPS is 61.6% and 85.8%, respectively. The study further revealed that facility size, medical staff density, and facility age are the main factors that explain the differences in the cost efficiency of PHCFs in Ghana. The study's policy recommendation is that the Ghana Health Service should consider utilizing modern technology such as telehealth and telemedicine to enhance access to PHC services for people living in hard-to-reach and densely populated communities. This strategic approach can significantly contribute to improving the cost-efficiency of PHCFs.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135779245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure measurement knowledge and counselling among hospital pharmacists - an interventional study","authors":"Akinniyi Akinbiyi Aje, Jumoke Oyeladun Adeyemo","doi":"10.1007/s44250-023-00048-4","DOIUrl":"https://doi.org/10.1007/s44250-023-00048-4","url":null,"abstract":"Abstract Background Pharmacists occupy a vantage position to educate patients with hypertension on self-monitoring of blood pressure (BP). An update on their knowledge and counselling on BP measurement is needful to ascertain proper information dissemination to patients. Methods An interventional study was carried out for a six-month period among consecutively sampled pharmacists working at a tertiary healthcare facility, using a semi-structured questionnaire for data collection. Sequel to preintervention assessment of pharmacists’ knowledge and counselling on BP measurement, an educational intervention comprising didactic lecture, case studies, demonstrations, and interactive question and answer sessions was carried out to address the gaps observed. Knowledge and counselling were then reassessed one-month postintervention to find out the impact of the intervention. Data was summarized with descriptive and inferential statistics with significance level set at p < 0.05. Results One hundred and forty-four pharmacists completed the study. Preintervention knowledge and counselling on BP measurement among the pharmacists was poor. Median scores of pharmacists’ knowledge on BP measurement increased significantly from 13.00 preintervention to 25.00 postintervention (p < 0.001); while their counselling on BP measurement also increased significantly from 1.00 preintervention to 12.00 postintervention (p < 0.001). The knowledge category of the pharmacists’ improved as majority who were categorized as having either “poor” (67, 46.5%) or “fair” (68, 47.2%) knowledge preintervention advanced to “excellent” (99, 68.7%) knowledge postintervention. Similarly, the pharmacists’ counselling category was upgraded from the majority categorized as poor (141, 97.9%) preintervention to excellent (87, 60.4%) postintervention. Prior to the educational intervention, only 62 (43.1%) pharmacists knew that BP measurement had to be carried out in both arms for a first-time patient. Also, when asked the question “What BP reading will be recorded for a patient whose BP readings when taken thrice were 149/82 mmHg, 141/78 mmHg, and 139/78 mmHg?” only 38 (26.4%) provided the right answer. Similarly, majority of the pharmacists (51, 35.4%) could only state one out of five precautions during blood pressure measurement. In this study, pharmacists’ gender, additional educational qualification, and work experience did not significantly influence their knowledge and counselling on BP measurement. Conclusions The educational intervention significantly improved pharmacists’ knowledge and counselling on BP measurement.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135778640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Governance basics for the physician-scientist considering business ventures. Lessons from Theranos","authors":"Theodore J. Witek, David Klein","doi":"10.1007/s44250-023-00045-7","DOIUrl":"https://doi.org/10.1007/s44250-023-00045-7","url":null,"abstract":"Abstract The prospect of an innovative laboratory device capable of an array of testing from a tiny amount of blood caught the intense attention of both the medical and investment community. The device, however, was never properly validated, with several false and misleading claims made by its founder. This venture in the business of science went very badly for the firm Theranos with ensuing criminal convictions. Using public domain reports from trial testimony provided a unique opportunity to distill facts for key learnings for future stakeholders in the business of science. Several lessons related to basic governance unfolded during the trial’s testimony and are the basis for this brief case study. These include (1) a board make-up that had a suboptimal understanding of the technology, (2) advisors that did not sufficiently engage, (3) management/employee trust was tarnished and (4) investors failing to perform optimal diligence prior to funding. These lessons are particularly important for the physician-scientist and health executive who may find themselves at the interface of health and commerce. Points to consider in such ventures are discussed toward fostering the avoidance of these breakdowns.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135995523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Designing an online educational program to improve immunisation service delivery for migrants and refugees in Australia and New Zealand","authors":"Abela Mahimbo, Preeti Tiwari, Ikram Abdi, Holly Seale, Nadia Charania, Anita E. Heywood","doi":"10.1007/s44250-023-00043-9","DOIUrl":"https://doi.org/10.1007/s44250-023-00043-9","url":null,"abstract":"Abstract Migrants and refugees are likely to be under-immunised according to the host country's national immunisation schedule and may remain under-immunised post-resettlement for various reasons. In Australia and Aotearoa New Zealand, primary health care professionals including general practitioners and nurses provide the majority of routine and catch-up immunisations for migrants and refugees. However, immunisation service delivery for migrants and refugees is complex, with evidence that unmet training needs for immunisation providers, particularly in the development of catch-up plans, is a significant barrier to immunisation service delivery for this group. Targeted professional development opportunities for immunisation providers are essential to improve their awareness, confidence, and capability to improve immunisation service delivery for migrants and refugees. We developed an educational program to support learning for immunisation providers and equip them with the requisite knowledge and confidence to improve immunisation service delivery for refugees and migrants. The development of the multi-module online educational program drew on evidence-based web design principles, adult learning theories, and its content aimed to complement general immunisation training and align with the continuing professional development standards of Australian and New Zealand general practice and nursing colleges. Input from experts and feedback from a few selected providers in Australia and New Zealand added to the robustness of the program. This program has the potential to improve the understanding and capacity of immunisation providers, to improve vaccination experiences and increase overall vaccine uptake among migrants and refugees.","PeriodicalId":72826,"journal":{"name":"Discover health systems","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136209454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}