School Health Needs Assessment in Chanchamayo, Peru: A Health Promoting School Project

Background: School-based health promotion can be particularly valuable in developing countries. However, there is a lack of information about the health needs of Peruvian school students. The purpose of this study was to conduct a health needs assessment to develop strategies for a school health promotion program in a jungle and indigent region in Chanchamayo, Peru. Methods: This study was conducted using a mixed method approach that included a literature review, national and local statistics, stakeholder interviews, and a survey. Participants of the survey were 210 teachers, 2,504 elementary school students, and 2,834 secondary school students from six 'schools in two planned project implementation regions. A self-administered questionnaire for students was developed based on WHO's Global School-based Student Health Survey. Collected data were analyzed using descriptive statistics, chi-square tests, and t-tests for the survey data and content analysis for the interviews. Results: Weak school health systems were identified, including school health policies, curriculum, trained health care personnel, and health-related facilities and equipment. Common health problems of students were anemia, nutritional deficiency, infectious diseases, tuberculosis, drug abuse, poor hygiene, and sex-related problems. High absence rates from school due to family problems and high dropout rates due to pregnancy were also critical issues. Teachers identified personal hygiene, nutrition, reproductive health, and sex education as high priorities for school health education, while students identified prevention of infectious diseases, nutrition education, psychological health, and healthy lifestyles as priorities. Identified strategies included: establishment of school health policies, curriculum-based interventions, increasing community participation and raising school health awareness, capacity building for health care promotors, training of trainers, and partnership between schools and communities. Conclusions: Findings from this study will help guide the development and implementation of a school-based health promotion program in Chanchamayo. Multicomponent school-based interventions that consider feasibility and sustainability will be developed and evaluated based on WHO's Health Promoting School concepts.ope

A retrospective review of vaccine wastage and associated risk factors in the Littoral region of Cameroon during 2016-2017

Background: Immunization is an effective preventive health intervention. In Cameroon, the Expanded Program on Immunization (EPI) aims to vaccinate children under 5 years of age for free, but vaccination coverage has consistently remained below the national target. Vaccines are distributed based on the target population size, factoring in wastage norms. However, the vaccine wastage rate (VWR) may differ among various settings. Our study aimed to assess vaccine wastage for different site settings, seasonality, and vaccine types in comparison to vaccination coverage in order to provide comprehensive insights on vaccine wastage. Methods: A retrospective data collection and analysis were conducted on immunization and vaccine wastage data in the Littoral Region of Cameroon during 2016 and 2017. Health districts were classified as urban or rural, seasonality was categorized as rainy or dry season, and vaccine types were grouped into liquid, lyophilized, oral, and injectable vaccines. VWRs and vaccination coverage rates (VCRs) were calculated, and the vaccine waste factor was investigated. Results: The VWR of Bacillus Calmette-Guérin (BCG; 32.19%) was the highest, followed by measles and rubella (MR; 19.05%) and yellow fever (YF; 18.34%) among all EPI vaccines in the Littoral Region of Cameroon during 2016 and 2017. Single-dose vaccine vials exhibited lower VWRs than multi-dose vials. Dry season was associated with higher VWRs for most vaccines, although more lyophilized vaccines (BCG, MR, YF vaccines) were wasted in rainy season in 2016. The VWR was persistently higher in rural than urban health districts. The months of February and November saw a decrease in VCRs. The study found an overall negative correlation between VCR and VWR. Conclusions: Multiple factors may cause wastage of EPI vaccines in Cameroon. Vaccination area characteristics, seasonality, types of vaccines such as multi- or single-dose, lyophilized or injectable vaccines are related to VWRs in Littoral Region. Further research on vaccine wastage and vaccination coverage across Cameroon is needed to better understand the socio-behavioral aspect of vaccine in-take that may affect the level of vaccination and vaccine wastage. Public health system strengthening is warranted to adapt more real-time monitoring of the VWR and VCR for each vaccine in the government's immunization programs.ope

An analysis of the policy participation of field response nurses in South Korea: COVID-19 response guidelines and the infectious disease act revision

Introduction: The Republic of Korea's response to Coronavirus disease 2019 was divided before and after global vaccine development at the end of 2020. It also varied according to the size of confirmed patients in the non-pharmaceutical intervention. Therefore, this study aimed to analyze the contribution of frontline nurses to the policy and law revision on infectious diseases and suggest health and nursing policies for emerging infectious diseases in the future. Design: This case evaluation study analyzed the significant policy decisions that nurses' roles brought on changes in the infectious disease response system in the Republic of Korea and applying the health system model and those capacities on resilience under emerging infectious diseases. Methods: Objective data that contributed directly to the revision of infectious disease-related Acts and policies in 2020 were collected and analyzed through literature search and information disclosure claims from the first to third waves of Coronavirus disease 2019 in one city. Results: With the rapid outbreak of COVID-19 confirmed cases at the end of February 2020, a pan-government support group was formed and dispatched to D City. In addition, central quarantine officials worked with local quarantine officials to share real-time situations and find out on-site difficulties and support requests. As a result, inquiry of opinions to working staff before changing the "response guidelines to Coronavirus disease 2019" was reflected in major contents on the revision of "policy on infectious disease response" and "Infectious Disease Prevention and Management Act." With the establishment of an epidemiological investigation team in September 2020, the number of new nurses in 17 cities and provinces increased by 19.1% compared to the previous year, the most significant increase compared to doctors (-2.3), dentists (-1.6), and health workers (3.7). Conclusion: The experience of responding to Coronavirus was a reminder that the curriculum needed to be improved so that nurses will be recognized to have leadership competencies and as field experts regarding social determinants of health for population groups in the decision-making process. In the initial COVID-19 response process, nurses showed excellence in analyzing patient interviews and various information as field epidemiological investigation response personnel, making comprehensive judgments, and solving problems in cooperation with related agencies and severe patients' bedside nursing care. Continuous primary care and management of infectious diseases for the vulnerable should be prepared on an ongoing basis to assure the quality of care. Clinical relevance: Action strategies for developing leadership to enable nurses to have participated in the social determinants of health and the nursing policy formation for health equity should be applied in nursing education and practice, and global monitoring efforts were accelerated.ope

Factors Associated with the Implementation of an Improved Community Health Fund in the Ubungo Municipality Area, Dar es Salaam Region, Tanzania

Community-based health insurance schemes help households to afford healthcare services. This paper describes healthcare facilities and community factors that are associated with the Improved Community Health Fund (iCHF) scheme in the Ubungo district of Tanzania. A cross-sectional descriptive study was conducted using online questionnaires that were completed by healthcare providers and community members in public-owned healthcare facilities in the Ubungo Municipal Council district of Dar es Salaam, Tanzania, between October and November 2021. The data were analyzed using descriptive statistics and the chi-squared test of association. We found a statistically significant relationship between income level and satisfaction with the iCHF scheme. For community-related factors, income level was statistically significant in the level of involvement in iCHF implementation among local leaders. Further, income level was statistically significant in relation to community behavior/culture toward the iCHF. Occupation was statistically significant in iCHF implementation, iCHF premiums, and iCHF membership size. A statistically significant relationship was also found between income, iCHF membership size, and iCHF premiums. Moreover, people would be willing to pay the required premiums if the quality of the healthcare services under the iCHF scheme improves. Therefore, the government should allocate resources to reduce the challenges that are facing iCHF implementation, such as the preference for a user fee scheme over the iCHF, the issues that are faced by enrollment officers, and inadequate iCHF premiums and membership size.ope

School-Based Participatory Response for Reopening During the COVID-19 Pandemic: A Case Study of a Metropolitan High School Implementing the Health Promoting School

Purpose: This study aimed to analyze how a private high school in Seoul developed and executed a “school disinfection strategy” to ensure the students' right to study in a safe environment, and also to analyze the lessons learned from this process. Methods: This was a case study of school health in a community-based school reopening during the COVID-19 pandemic. The study target was a 64-year-old private high school with 12 classes for each grade with a total of 1,100 students. Results: A “school disinfection strategy” was set up at individual and class environment levels to protect students from the risk of infection. In addition, school health activities were carried out with a “personal protection safety belt” and “community protection safety belt” for effective implementation. To ensure a safe educational environment for high school students and to ensure smooth execution of face-to-face classes (in-person teaching), the “prevention safety belt strategy” was introduced in accordance with governmental guidelines to sequentially implement various preventive measures necessary to guarantee environmental safety of schools. Activating personal prevention safety belts by checking the symptoms of students when entering the school and during each class, and providing self-made disinfectants by spraying alcohol on wet-wipes were cost-effective and sustainable methods used in this school to prevent the spread of infection. Conclusions: The experience of developing a prevention safety belt strategy to adapt the guidelines of the local education office to the school situation was presented. Focusing on the school community, as well as individual students and teachers, the concept of prevention safety belts helped to unite and stimulate voluntary participation of students in health promotion activities.ope

Editorial: An insight into university medical and health science courses

ope

Primary health care physicians’ perception of electronic health records adoption in Timor-Leste: a cross-sectional study

Background This study aimed to identify the factors affecting the successful operation of electronic health records (EHRs) during the initial pilot implementation period from 2015 to 2017. The EHR system in Timor-Leste was first launched in 2015 after the VI Constitutional Government introduced the “Saúde na Familia” initiative. In January 2019, the system was discontinued after being disrupted by a political impasse between 2017 and 2018. The new Minister of Health reactivated the adoption of the EHR system as of August 2020. Methods This study included a cross-sectional survey. The questionnaire covered benefits, barriers, and satisfaction categories along with sociodemographic variables. Results Statistically significant differences between age groups were noted for the benefits, perceived barriers (such as the ability to use computers), and overall satisfaction of the EHR system. The slope of the benefit category (β = 0.497, t = 11.361) was a statistically significant predictor of satisfaction with EHR system implementation. However, the slope of the barrier category had a negative statistical significance for satisfaction (β = −0.086, t = −1.794). Satisfaction with the EHR system was influenced by its perceived benefit and reduced perceived barriers due to individuals’ utilization of the information and communication technology system. Conclusion Continuous political commitment to health policy, financial support, friendly end-user applications, improved quality of Internet service, and a positive attitude toward the system were crucial for its successful implementation.ope

Relationship among Nursing Professionalism, Nursing Work Environment, and Patient Safety Nursing Activities in General Hospital Nurses

Purpose : This study was done to identify the relationships among nursing professionalism, nursing work environment, and patient safety activities, and to analyze the factors influencing nurses’ patient safety nursing activities. Methods : This descriptive study included 270 nurses from six general hospitals. Questionnaires were used to collect data between August 20 and September 21, 2018, using questionnaires. Analyses included descriptive statistics, t-test, analysis of variance, Pearson correlation coefficient, and stepwise multiple regression, conducted using IBM SPSS/WIN 21.0. Results : Mean scores on nursing professionalism, nursing work environment, and patient safety nursing activities were 3.51±0.41, 2.44±0.45, and 4.39±0.50, respectively. The patient safety nursing activities score was positively correlated with subscales of nursing professionalism variable: professional self-concept (r=.15, p=.019), social recognition (r=.10, p=.036), professional identity in nursing (r=.24, p<.001), role of nursing practice (r=.16, p=.012), nursing foundation for quality of care (r=.19, p=.003), and nurse manager’s ability (r=.14, p=.031). Patient safety nursing activities were influenced by professional identity in nursing (β=.22, p=.001) and nursing foundation for quality of care (β=.15, p=.001), which explained 8.0% of the variance. Conclusion : These results suggest that nurse managers should focus on creating an appropriate nursing environment and facilitating nursing professionalism to enhance hospital nurses’ patient safety nursing activities.ope

Infectious Disease Control and Management in Ethiopia: A Case Study of Cholera

Cholera remains a significant public health problem among the vulnerable populations living in many resource-limited settings with poor access to safe and clean water and hygiene practice. Around 2.86 million cholera cases and 95,000 deaths are estimated to occur in endemic countries. In Ethiopia, cholera has been one of the major epidemic diseases since 1634 when the first cholera outbreak was recorded in-country. Several cholera epidemics occurred with recent outbreaks in 2019-2021. Cholera has been often reported as acute watery diarrhea due to limited diagnostic capacity in remote areas in Ethiopia and sensitivities around cholera outbreaks. The government of Ethiopia has been executing several phases of multi-year health sector development plan in the past decades and has recently developed a national cholera control plan. Here, we aim to present the existing cholera control guidelines and health system in Ethiopia, including case detection and reporting, outbreak declaration, case management, and transmission control. Challenges and way forward on further research and public health interventions are also discussed to address the knowledge and health service gaps related to cholera control in Ethiopia.ope

Editorial: Women in science: Public Health Education and Promotion 2022

ope