STD Services Delivery Arrangements in Georgia County Health Departments

Background: Uniformity, standardization, and evidence-based public health practice are needed to improve the efficiency and quality of services in local health departments (LHDs). Among the highest priority and most common public health services delivered by LHDs are services related to sexually transmitted diseases (STDs) and sexually transmitted infections (STIs).Objective: The purpose of this study was to examine potential variations in the delivery of sexually transmitted disease (STD) services among county health departments (CHD) in Georgia, to determine if potential variations were due to varied administrative practices, and to understand delivery arrangements so that future cost studies can be supported.Methods: Web-based surveys were collected from 134 county health departments in Georgia in 2015.Results: Screening for gonorrhea, chlamydia and syphilis occurred in all the surveyed CHDs. Sixty-eight percent of the CHDs had one or more staff who performed investigations for persons already screened positive for STDs. Partner notification services provided by the CHD staff occurred in only 35 percent of the surveyed CHDs.Conclusions: Variances regarding diagnostic methodologies, work time expenditures, and staff responsibilities likely had an influence on the delivery of STD services across Georgia's CHDs. There are opportunities for uniformity and standardization of administrative practices

Electronic Health Records and Meaningful Use in Local Health Departments: Updates From the 2015 NACCHO Informatics Assessment Survey

Background: Electronic health records (EHRs) are evolving the scope of operations, practices, and outcomes of population health in the United States. Local health departments (LHDs) need adequate health informatics capacities to handle the quantity and quality of population health data. Purpose: The purpose of this study was to gain an updated view using the most recent data to identify the primary storage of clinical data, status of data for meaningful use, and characteristics associated with the implementation of EHRs in LHDs. Methods: Data were drawn from the 2015 Informatics Capacity and Needs Assessment Survey, which used a stratified random sampling design of LHD populations. Oversampling of larger LHDs was conducted and sampling weights were applied. Data were analyzed using descriptive statistics and logistic regression in SPSS. Results: Forty-two percent of LHDs indicated the use of an EHR system compared with 58% that use a non-EHR system for the storage of primary health data. Seventy-one percent of LHDs had reviewed some or all of the current systems to determine whether they needed to be improved or replaced, whereas only 6% formally conducted a readiness assessment for health information exchange. Twenty-seven percent of the LHDs had conducted informatics training within the past 12 months. LHD characteristics statistically associated with having an EHR system were having state or centralized governance, not having created a strategic plan related to informatics within the past 2 years throughout LHDs, provided informatics training in the past 12 months, and various levels of control over decisions regarding hardware allocation or acquisition, software selection, software support, and information technology budget allocation. Conclusion: A focus on EHR implementation in public health is pertinent to examining the impact of public health programming and interventions for the positive change in population health

Child labour: a public health issue

Child labour is a global practice and has many negative outcomes. According to International Labour Organization, child labour is the important source of child exploitation and child abuse in the world today. The Human Rights Commission of Pakistan has estimated the number of Pakistani working children to be around 11-12 millions, out of which, at least, half the children are under the age of ten years. It portrays the society\u27s attitude towards child care. It is therefore, essential to break this vicious cycle and hence, enable the society to produce healthy citizens. This article analyzes the determinants of child labour in the Pakistani context and its implications for child\u27s life, in specific, and for the nation, in general, utilizing the model developed by Clemen-stone & McGuire (1991). Since this practice has complex web of causation, a multidisciplinary approach is required to combat this issue through proposed recommendations

Promoting motivation towards community health care: A qualitative study from nurses in Pakistan

Based on the extensive health care needs of Pakistani population, the idea of Community Health Nursing was introduced in 1985. The educational nursing institutes adopted nursing curriculum in order to produce competent nurses to meet the rising demands of society. However, very few numbers of nurses choose community health nursing as their career pathway in Pakistan. Based on the current observation, enhancing motivation among graduate nurses has always been viewed as a great challenge for the academic nursing institutions. This study was intended to explore motivating and de motivating factors in nurses towards community Health Nursing. By utilizing self concept based model of motivation, semi structured interviews were conducted with newly graduated nurses, nurse educators and nursing students. The findings revealed that certain traits, values and competencies are required to motivate nurses as well as to build their capacity towards working effectively in the community setting. Moreover, through this study several realistic recommendations by the participants are highlighted that could foster motivation among future nurses towards this field

Role of community health nurse in earthquake affected areas

The role of Community Health Nurses (CHNs) outside the traditional hospital setting is meant to provide and promote the health care needs of the community. Such nurses can play a substantial role in the community setting including emergencies like disasters. This became evident after the earthquake of October 8, 2005 in Pakistan. The objective was to address the issues, faced by primary healthcare providers working in earthquake-affected areas focusing on participatory approach. The experience of the interventions done by CHN by a guided frame work (assessment, planning, implementation and evaluation components) is described. Issues identified by CHN included: lack of training of health care providers, lack of collaboration, communication between the medical and management staff due to poor infrastructure of the healthcare facilities. The interventions were carried out, utilizing existing resources. Efforts were directed to build capacity of health care providers at grass root level to fill in gaps of health care delivery system for sustainable change. Overall, working in the earthquake affected areas is challenging. Health leadership should foresee role of CHN in emergencies where quality healthcare interventions are essential

Supporting the provision of pharmacy medication reviews to marginalised (medically underserved) groups: a before/ after questionnaire study investigating the impact of a patient-professional co-produced digital educational intervention.

Objectives People who are marginalised (medically underserved) experience significant health disparities and their voices are often ‘seldom heard’. Interventions to improve professional awareness and engagement with these groups are urgently needed. This study uses a co-production approach to develop an online digital educational intervention in order to improve pharmacy staffs’ intention to offer a community pharmacy medication review service to medically underserved groups. Design Before/after (3 months) self-completion online questionnaire. Setting Community pharmacies in the Nottinghamshire (England) geographical area. Participants Community pharmacy staff. Intervention Online digital educational intervention. Primary and secondary outcome measures The primary outcome measure was ‘behaviour change intention’ using a validated 12-item survey measure. The secondary outcome measure was pharmacist self-reported recruitment of underserved groups to the medication review service. Results All pharmacies in the Nottinghamshire area (n=237) were approached in June 2017 and responses were received from 149 staff (from 122 pharmacies). At 3 months (after completing the baseline questionnaire), 96 participants (from 80 pharmacies) completed a follow-up questionnaire, of which two-thirds (n=62) reported completing the e-learning. A before/after comparison analysis found an improving trend in all the five constructs of behaviour change intention (intention, social influence, beliefs about capabilities, moral norms and beliefs about consequences), with a significant increase in mean score of participants’ ‘beliefs about capabilities’ (0.44; 95% CI 0.11 to 0.76, p=0.009). In the short-term, no significant change was detected in the number of patients being offered and the patient completing a medication review. Conclusions Although increases in the numbers of patients being offered a medication review was not detected, the intervention has the potential to significantly improve pharmacy professionals’ 'beliefs about capabilities' in the short-term. Wider organisational and policy barriers to engagement with marginasied groups may need to be addressed. Future research should focus on the interplay between digital learning and practice to better identify and understand effective practice change pathways

Morbidity and mortality meetings; a new digital portal to enhance learning and objectivity

Morbidity and mortality meetings have long been part of surgical education and practice. They have undergone several modifications over time to include improvement in patient safety and outcomes as an essential utility of conducting morbidity and mortality meetings. Time and again, it has been proposed in literature that standardisation of case discussion results in the efficiency of these meetings. Learning opportunities can be compiled for system improvement. The current review article was planned to present a newly implemented digital morbidity and mortality portal at the Aga Khan University Hospital (AKUH), Karachi, aiming at homogenising the discussion and to add objectivity to the outcome. It is believed that this uniform system across all surgical specialties may play a significant role in enhancing surgical trainees\u27 learning experience

The influence of psychosocial factors on academic performance of adolescents: a quality assurance project

Adolescence is a time of rapid psychological and physiological changes and is associated with anxiety and mental distress. This project looks at the potential of school-based programs to reduce these negative effects of academic performance in both the short- and long-term. This study was conducted in a private school in Karachi, Pakistan between October 1998 and December 2006 on 305 students with low academic performance. Results show that students scoring low grades had a mean of 55 + 2.8 and postintervention score of 56 + 2.6. The intervention package significantly created a difference in reducing the number of students receiving low grades. Qualitative analysis showed that study participants had enhanced self-esteem, confidence levels, positive attitudes towards learning, improved time management and decision-making skills. This suggests that in an academic institution, the presence of a professional support system enhances learning and coping mechanisms