40,259 research outputs found

    Final Report on Sex Therapy and Counseling Licensure in California

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    Members:Assemblyman Gordon Duffy, ChairmanAssemblywoman Leona Egeland Assemblyman John GaramendiAssemblyman Walter IngallsAssemblyman Barry KeeneAssemblyman Bob McLennanAssemblyman Herschel Rosenthal Staff:Steven Zatkin, ConsultantMrs. Patricia Landsness, Secretar

    The Determinants of Health Personnel Performance in Tuberculosis Control Using “Achieve”Model

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    Background: Tuberculosis (TB) remains a major public health problem in the world that causes morbidity and mortality. The role of health personnel is important in the implementation of lung TB control program. Health personnel performance that is not optimal can cause the TB case to remain high. Little is known about the factors affecting the performance of health personnel in Indonesia. This study aimed to examine the determinants of health personnel performance in TB control using “ACHIEVE” model. Subjects and Method: This was an analytic observational study with a cross-sectional design. The study was conducted in community health center in Jember, East Java. A sample of 45 health personnel of TB program implementation was selected for this study by simple random sampling. The dependent variable was health personnel performance, which included TB case finding, observation, and monitoring of TB patients. The independent variables were ability, clarity, help, incentive, evaluation, validity, and environment (ACHIEVE). The data were collected by questionnaire and analyzed by logistic regression in SPSS 16. Results: Of all health personnel under study, 43 (93.4%) had good ability, 75.6% received positive organizational support, and 84.5% received appropriate evaluation. Health personnel performance was determined by ability (OR= 2.98; p= 0.002), clarity (OR= 1.18; p= 0.013), help (OR= 2.98; p= 0.002), incentive (OR= 0.98; p= 0.054), evaluation (OR= 1.18; p= 0.013), and environment (OR= 0.80; p= 0.047). Conclusion: Health personnel performanceis determined by ACHIEVE model, except validity which was not examine in this study. Keywords: tuberculosis program, health personnel, performance, ACHIEVE mode

    Experiences, Opportunities and Challenges of Implementing Task Shifting in Underserved Remote Settings: The Case of Kongwa District, Central Tanzania.

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    Tanzania is experiencing acute shortages of Health Workers (HWs), a situation which has forced health managers, especially in the underserved districts, to hastily cope with health workers' shortages by adopting task shifting. This has however been due to limited options for dealing with the crisis of health personnel. There are on-going discussions in the country on whether to scale up task shifting as one of the strategies for addressing health personnel crisis. However, these discussions are not backed up by rigorous scientific evidence. The aim of this paper is two-fold. Firstly, to describe the current situation of implementing task shifting in the context of acute shortages of health workers and, secondly, to provide a descriptive account of the potential opportunities or benefits and the likely challenges which might ensue as a result of implementing task shifting. We employed in-depth interviews with informants at the district level and supplemented the information with additional interviews with informants at the national level. Interviews focussed on the informants' practical experiences of implementing task shifting in their respective health facilities (district level) and their opinions regarding opportunities and challenges which might be associated with implementation of task shifting practices. At the national level, the main focus was on policy issues related to management of health personnel in the context of implementation of task shifting, in addition to seeking their opinions and perceptions regarding opportunities and challenges of implementing task shifting if formally adopted. Task shifting has been in practice for many years in Tanzania and has been perceived as an inevitable coping mechanism due to limited options for addressing health personnel shortages in the country. Majority of informants had the concern that quality of services is likely to be affected if appropriate policy infrastructures are not in place before formalising tasks shifting. There was also a perception that implementation of task shifting has ensured access to services especially in underserved remote areas. Professional discontent and challenges related to the management of health personnel policies were also perceived as important issues to consider when implementing task shifting practices. Additional resources for additional training and supervisory tasks were also considered important in the implementation of task shifting in order to make it deliver much the same way as it is for conventional modalities of delivering care. Task shifting implementation occurs as an ad hoc coping mechanism to the existing shortages of health workers in many undeserved areas of the country, not just in the study site whose findings are reported in this paper. It is recommended that the most important thing to do now is not to determine whether task shifting is possible or effective but to define the limits of task shifting so as to reach a consensus on where it can have the strongest and most sustainable impact in the delivery of quality health services. Any action towards this end needs to be evidence-based

    Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review

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    Background: Improved access to skilled health personnel for childbirth is a priority strategy to improve maternal health. This study investigates interventions to achieve this where traditional birth attendants were providers of childbirth care and asks: what has been done and what has worked? Methods and Findings: We systematically reviewed published and unpublished literature, searching 26 databases and contacting experts to find relevant studies. We included references from all time periods and locations. 132 items from 41 countries met our inclusion criteria and are included in an inventory; six were intervention evaluations of high or moderate quality which we further analysed. Four studies report on interventions to deploy midwives closer to communities: two studies in Indonesia reported an increase in use of skilled health personnel; another Indonesian study showed increased uptake of caesarean sections as midwives per population increased; one study in Bangladesh reported decreased risk of maternal death. Two studies report on interventions to address financial barriers: one in Bangladesh reported an increase in use of skilled health personnel where financial barriers for users were addressed and incentives were given to skilled care providers; another in Peru reported that use of emergency obstetric care increased by subsidies for preventive and maternity care, but not by improved quality of care. Conclusions: The interventions had positive outcomes for relevant maternal health indicators. However, three of the studies evaluate the village midwife programme in Indonesia, which limits the generalizability of conclusions. Most studies report on a main intervention, despite other activities, such as community mobilization or partnerships with traditional birth attendants. Many authors note that multiple factors including distance, transport, family preferences/support also need to be addressed. Case studies of interventions in the inventory illustrate how different countries attempted to address these complexities. Few high quality studies that measure effectiveness of interventions exist

    NAFTA and the Mobility of Highly Skilled Workers: The Case of Canadian Nurses

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    This article examines the impact of trade treaties on health professionals' international mobility. It presents a case study of the impact of labour mobility clauses in trade agreements on the Canadian nursing labour market. It provides statistical evidence on the impact of NAFTA's Chapter 16 on the cross-border movement of Canadian nurses in the 1990s. We observed that an increasingly large number of Canadian nurses went to work in the United States using the NAFTA facilitation mechanism but that this growth could not be attributed to the trade agreement alone; domestic labour market conditions are key to understanding this cross-border movement. The article concludes that trade treaties and international migration of health personnel do not offer simple solutions to health personnel shortages, but can pose a danger to precarious health systems in developing countries.labour mobility, NAFTA, nurses, International Relations/Trade, Labor and Human Capital,

    Multilevel Analysis of Community Health Center, Performance of Health Personnel: Evidence from Ngawi, East Java

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    Background: Quality health services are one of the priorities and development goals in the health sector. Community Health Center as the first-line public services in the health sector are expected to provide quality services for the community. The quality of health services in community health center can be seen from the performance of the health personnel. This study aims to determine the factors that determine the performance of health personnel in health centers.Subjects and Method: This study used an observational analytic method with a cross sectional approach. The study was conducted in 24 community health center in Ngawi, East Java on June-July 2019. The total sample of 216 health personnel of the community health center was selected based on proportional random sampling. The dependent variable of this study was the perform­ance of health personnel. The independent variables in this study were accreditation status, edu­cation, income, work length, motivation, satisfaction, and workload. The data collections used questionnaires and were analyzed using multilevel linear regression test with Stata 13.Results: The performance of health personnel significantly improved with good accreditation status (b = 2.87; 95% CI= 0.03 to 5.71; p= 0.048), high education (b= 0.63; 95% CI = 0.13 to 1.13; p= 0.013), and high workload (b= 0.86; 95% CI= 0.34 to 1.39; p= 0.001). There was a contextual effect of the performance health personnel (ICC= 53.69%).Conclusion: Good accreditation status, higher education and high work responsibilities increase the performance of the health personnel. There was a contextual effect of health centers on the health personnel.Keywords: performance of health personnel, community health center, multilevel linear regressionCorrespondence:Rahayu Zulaikah, Ngawi Health Office, Jl. S. Parman 25 A, Ngawi, East Java. Email: dokter­[email protected]. Mobile phone: 081946059306Journal of Health Policy and Management (2020), 5(1): 13-22https://doi.org/10.26911/thejhpm.2020.05.01.0

    Energy Consumption of Lactating Mothers: Current Situation and Problems

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    Recommendations on the adequacy of nutrient intake indicate that lactating mothers have higher nutritional needs than do pregnant mothers. High nutrient intake is necessary to help mothers recover after childbirth, produce milk, and maintain the quantity and quality of breast milk. It also prevents maternal malnutrition. Research has shown, however, that the dietary energy consumption of mothers during lactation was significantly lower than that during pregnancy. The current study explored the factors associated with decreased nutritional intake during maternal lactation. The study was conducted in March–April 2013, and the subjects were mothers with infants aged >6 months. Results revealed that the factors causing low dietary energy consumption among breastfeeding mothers were poor nutritional knowledge and attitude toward high energy intake requirements during lactation, lack of time to cook and eat because of infant care, reduced consumption of milk and supplements, dietary restrictions and prohibitions, and suboptimal advice from midwives/health personnel. Beginning from the antenatal care visit, health personnel should conduct effective counseling on the importance of nutrient intake during lactation. Advice should be provided not only to mothers, but also to their families to enable them to thoroughly support the mothers as they breastfeed their infants

    Access to health care among Somali forced migrants in Johannesburg

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    Student Number 9705165A Master of Arts in Forced Migration Studies Faculty of HumanitiesObjective: To identify and investigate barriers faced by Somali forced migrants when accessing health care in Johannesburg. In particular, the study seeks to compare perceptions of health personnel and migrants as to the nature of such access constraints. Design and Methods: The study made use of semi-structured and in-depth interviews with a snowball sample of health personnel and migrants. Ten health personnel were interviewed and twenty migrants (ten male and ten female). Results: Constraints of language and xenophobia were identified by both health personnel and forced migrant interviewed. Constraints related to the shortage of resources and the poor functioning of the referral system are experienced by all users of the public health system, irrespective of their nationality. No mention was made of traditional or allopathic medicine. Conclusions: There exists a gap between the access to health care guaranteed in the Refugees Act and practices at facility level. There are many similarities across interviews in the constraints identified by migrants and some agreement in the constraints identified by migrants and health personnel. These results confirm that migrants experience a fairly severe level of constraint when attempting to utilize formal health care services in Johannesburg

    Technology based Health care an Indian perspective : opportunities and challenges

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    Healthcare technology is in use for a decade or more in India. The use of technology in healthcare especially in public health is very common due to the recent development in Information Communication Technology. The cost of equipments in ICT in general are falling. But in healthcare, some of the equipments costs very high. Such equipments are commissioned in various locations in India. This includes some of the remote areas. The present talk is an attempt to assess the effect of such technology on the public health system. The utilisation of such systems depends on various factors. They include, costs involved in maintaining such systems, the benefits of such systems to the health personnel and the general population, what are the advantages of such systems over the traditional systems, what are the benefits of such systems on the administration, the impact on the managerial efficiency, how does the system address the HR needs in the public health, what the skills expected out of the health personnel and the general population for using such systems.IT facilitated Health, Health, Telemedicine, Telehealth, HIS
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