Quality of Services and Health Financing Efficiency of Community Health Insurance (Jamkesmas) at 21 General and Specialty Hospitals in Indonesia

Background: Community Health Insurance (Jamkesmas) has been implementing maintained since 2008 with 76.4million individual quota increased to 86.4 million in 2012. The major problem of involved is unfairness (inequity) in the quality and financing of health services for participants. This study aims to analyse the quality and financing of health perspective of Jamkesmas participants in the hospital. Method: This study was conducted in 21 general and specialty hospitals in Indonesia, The sample were selected purposively They were 9 Central Government hospitals (RSUP), Regional hospital and 3 specialty hospital ie cancer hospital, cardiologie hospital and stroke hospital. Those hospital involved covers 8 RSU Class A General Hospital. 8 RSU Class B, 2 RSU Class Cand 3 Specialty Hospital. Primary data wascollected by interviewing 1700 outpatient and inpatients, and 280 hospital staffs. Secondary data were human resources, finance and coverage. Results: Quality of services review on the adequacy of the physician's quality was very varied.There were 570–2372 outpatient visits per physician, and 37-674 inpatients per doctor visit. Adequacy of nursing staff(nurses and midwives) was better, 123–671 outpatient visits per nursing staff and 3–127 inpatient visits per nursing staff.Quality of services according to health officers perceptions on equipment and facilities was good and complete. Quality ofservices according to patients' expectations and reality was appropriate, never the less the direct heath services, were low. Hospital financing was very large, 33–460 billion, and one third for Jamkesmas and Regency Community Health Insurance (Jamkesda) services. Proportion Jamkesda funding in RSUD was larger than Jamkesmas while in RSUP, Jamkesda was smaller than Jamkesmas. Jamkesmas financing perspective according to the staff, was most of them stated that funding for Jamkesmas was matched and appropriate the number of served patients served, Recommendation: Improving the quality of health services particularly in the completeness of equipment and facilities (technical domain) and the availability of doctors, as well as retaining to BPJS 2014 is very needed and important

Activity book : activities and tips for healthy eating

This book contains puzzles and activities for teaching children healthy eating habits. There are also tips for parents

How can rural health be improved through community participation?

Executive summary Rural Australians generally experience poorer health than their city counterparts. Rural Australia is a vast geographical region, with significant diversity, where there is good health and prosperity, as well as disadvantage. The purpose of this issue brief is to provide evidence on how the health of rural Australians can be improved through community participation initiatives, which are currently being funded and delivered by health services and networks. Rural Australians need innovative health services that are tailored to the local context and meet increasing healthcare demands, without increases to expenditure. There are community participation approaches supported by research that can improve existing practice. Avoiding duplication, including the current work of Medicare Locals and Local Hospital Networks, is important for ensuring good outcomes from community participation initiatives. The following recommendations are made to improve practice: New ways to contract and pay for health services are needed, which use ideas developed with communities, within current budgets State and federal government competitive grants and tenders should prioritise proposals that demonstrate effective community participation approaches Community-based services, such as community health centres, Medicare Locals and Local Health Networks, have an important role to play in facilitating community participation, including: Building partnerships between existing services and leveraging existing participation strategies, rather than developing new services or standalone initiatives—to leverage available funds and maximise outcomes Employment of a jointly-appointed, paid community leadership position across existing community-based health services, to avoid duplication and overcome barriers of over-consultation and volunteer fatigue Formal and robust evaluation of initiatives is necessary to guide future policy and research A national innovative online knowledge sharing portal is required to share best practice in rural community participation, save time and money on ineffective approaches, and to support the rural health workforce

Building community resilience in mine impacted communities : a study on delivery of health services in Papua New Guinea : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Development Studies at Massey University, Palmerston North, New Zealand

The purpose of this study was to explore the building of Community Resilience in mine-impacted communities in Papua New Guinea (PNG). The study aimed to establish the general relationship between community resilience, community capitals and the delivery of health services. It investigated the delivery of health services in three mining communities in PNG to see how these services contribute to or detract from the building of resilience. The study investigated relevant models of community resilience from the literature, and how the way policy functions in PNG can be related to these models. The study also developed a way of quantifying the impact of mining on health service delivery (through the use of community capitals) and the building of resilience in these communities. Furthermore, the thesis develops an indigenous, Melanesian-centric ‘Bilum Framework’ approach to resilience to create greater understanding of how resilience in the mining communities can be strengthened through improved access to health services. Three mining communities were selected as case studies, each representing a different stage of mining: (i) the beginning; (ii) the operational; and, (iii) post-mine closure. A mixed method approach comprising both quantitative and qualitative methods was used to collect data for this study. A survey questionnaire was designed to collect views of community members who accessed health services in their respective communities. Results from the survey questionnaire were converted to proxy indicators and led to the development of a Community Resilience Index (CRI) to provide a measure of resilience in each community. The qualitative research methods included document analysis, semi-structured interviews, and purposive observations. Document analysis was important in reviewing relevant policy documents and other literature to link theories to the experiences of the people while the latter methods contributed to describing people’s encounters in accessing health services. Analysis showed inconsistencies in the levels of resilience in these communities that varied with the stages of mining: both the beginning and post- mine closure stages demonstrated significantly lower levels of community resilience than the operational phase. Findings from the research indicated a lack of access to health services – a key influence in building resilience – is the result a range of factors including insufficient finances, weak sector governance, and the need for infrastructure and transport. The Bilum Framework is proposed as an approach that allows decision-makers to target assistance to strengthen and support specific community capitals and hence more effectively build community resilience in the mining communities in PNG

Health Information Services Available for People Living With HIV/AIDS: Perspectives of Library and Information Professionals

There is an urgent need for availability of life-saving health information services as well as adequate marketing, advertising, and dissemination strategies to people living with HIV/AIDS (PLWHAs), and to the broader public at large, especially in the context of a recent UNAIDS estimation that the number of people living with HIV in the United States, at the end of 2003, exceeded one million for the first time. This study explores the HIV/AIDS health information services that are available within the local community of Knoxville, Tennessee, and presents focus group perspectives of nine library and information professionals about awareness and use of these services by PLWHAs. The study forms part of a larger plan to apply a community informatics (CI) approach to examine the provision of health information services for PLWHAs in terms of how PLWHAs and other stakeholders including health care service providers, academic community at the University of Tennessee, community leaders and activists, and faith-based organizations, use and apply information and communication technologies (ICTs) to empower and enable PLWHAs to meet their information needs, goals, and aspirations. Here we report findings from the project’s first phase of documenting perspectives of library and information professionals about existing HIV/AIDS information services, users of these services, barriers and challenges to effective use, and the role of health information professionals in the context of developing ideal information support services for PLWHAs

Healthy school-age kids (HSAK) program

The Healthy School-Age Kids (HSAK) program is a joint initiative of the Department of Health and Community Services and the Department of Employment, Education and Training and it works within the health promoting school model. It recognises the need for schools, health services, families and communities to work in partnership.   Its aim is to improve the health, well-being and learning outcomes of school-age children living in remote communities of the Northern Territory. This can be achieved by health and education staff working together with children, families and community for health promotion, education and provision of health services. The program components: health promotion in the school and community setting integration of other services and programs for school-age children health checks (screening). This manual is for: nurses, aboriginal health workers and doctors in remote communities school teachers and support staff in remote communities visiting health and education staff to remote communities community members of remote areas. A video Healthy School-Age Kids “Working Together” accompanies this manual and demonstrates how to carry out health checks

Primary care groups - Modernising primary and community health services

Developing primary and community health services is a key component of the government's plans for modernising the NHS. Primary care groups and trusts have a vital part to play in overcoming the variability, fragmentation, and isolation that have been the weaknesses of primary health care in the NHS. Primary care groups and trusts have introduced initiatives to promote greater collaboration between general practices and to share expertise and resources. Improving access to care is an important feature of the modernisation plan, and most groups and trusts are actively promoting access, particularly for people who have been poorly served traditionally. Groups and trusts are tackling staff shortages by using clinical specialists and promoting extended roles for nurses and pharmacist

'Working our way to health': Final Evaluation Report

This summary presents the findings of an independent evaluation of the ‘Working our Way to Health’ programme. This programme was delivered by Sefton PCT, funded through the Neighbourhood Renewal Fund, and was aimed at improving the health of men in three of the most deprived wards in its locality. It aimed to encourage men to be health aware and increase access to health and leisure services in order to improve key lifestyle behaviours and advance gender equity. The programme included: • Community agency and health staff training • Peer mentoring programme • Healthy lifestyle programme It aimed to promote community partnerships to assist the expansion of health advice and services into a new community arena and engage a previously unattainable section of the male population in healthier lifestyle interventions

ADDRESSING GAPS IN THE DELIVERY OF COMMUNITY SERVICES: THE CASE OF ONE INNER-CITY COMMUNITY

The need for more effective approaches to the delivery of health and social services in inner-city communities is well established. Attempts to improve service delivery in such areas as housing, health care and job training usually concentrate on strengthening\u27 community education efforts and other strategies designed to motivate potential users of community services. Little emphasis has been placed on increasing the communication between different community service providers to achieve better coordination among organizations responsible for service delivery in inner-city communities. As a consequence, major service gaps exist including such problems as duplication of services, limited accessiblity [accessibility], and the absence of essential services. Such service gaps may go unnoticed unless community service providers and inner-city residents organize to address these problems. This paper reports on a study of community service providers who are working with residents to deal with the problem of service gaps in their inner-city community

Respite Partnership Collaborative (RPC) Innovation Project Evaluation: Report 2

The Mental Health Services Act (MHSA)—funded by Proposition 63—supports five unique components: (1) Community Services and Supports, (2) Prevention and Early Intervention, (3) Workforce Education and Training, (4) Capital Facilities and Technology, and (5) Innovative Programs. In September 2010, the Sacramento County Division of Behavioral Health Services (DBHS) initiated a community planning process to develop Sacramento's first Innovation Project. DBHS convened an Innovation Workgroup that developed the Innovation Plan and the Respite Partnership Collaborative (RPC) Innovation Project. American Institutes for Research (AIR) is conducting an evaluation of the RPC Innovation Project. Evaluation objectives are to assess the extent to which the RPC Innovation Project does the following:Promote successful collaboration between public and private organizations (i.e., DBHS and the Sierra Health Foundation: The Center for Health Program Management [the Center]) in Sacramento CountyDemonstrate a community-driven processImprove the quality and outcomes of respite services in Sacramento CountyTo address the evaluation objectives; the evaluation includes interviews, an RPC survey, a community survey, and a document review. This report presents findings from evaluation activities conducted from June 2014 to April 2015 to DBHS, RPC members, and the Center