Background: The availability of healthcare services is limited in Paraiso, Dominican Republic with the nearest full-service hospital located 34.1 km away. A local, underutilized clinic was unaware of the needs of this disadvantaged community.
Method: Researchers adapted a World Health Organization assessment survey with the goals of determining residents’ priority needs and an appraisal of the current clinic capabilities and gaps in services in order to provide the community with relevant healthcare. 106 families were randomly selected in seven separate geographic areas of Paraiso to participate in the self-report assessment. Researchers, along with a community volunteer, conducted interviews utilizing the 63 question instrument. 105 families agreed to participate representing 504 individuals

Cole, Michelle A.

Gunther, Christina B.

Sadigh, Majid

English

Sacred Heart University: DigitalCommons@SHU

Sacred Heart University DigitalCommons@SHU Nursing Faculty Publications Dr. Susan L. Davis, R.N. and Richard J. Henley College of Nursing 5-2016 Coordinating Community Healthcare Needs to Local Services in Paraiso, Dominican Republic Through Strategic Assessment Strategies Michelle A. Cole Sacred Heart University Christina B. Gunther Sacred Heart University Majid Sadigh Western Connecticut Health Network Follow this and additional works at: https://digitalcommons.sacredheart.edu/nurs_fac  Part of the Public Health and Community Nursing Commons Recommended Citation Cole, M., Gunther, C., Sadigh, M. (2016). Coordinating community healthcare needs to lcoal services in Paraiso, Dominican Republic through strategic assessment strategies. Annals of Global Health, 82(3), 463-464 doi: 10.1016/j.aogh.2016.04.272 This Peer-Reviewed Abstract is brought to you for free and open access by the Dr. Susan L. Davis, R.N. and Richard J. Henley College of Nursing at DigitalCommons@SHU. It has been accepted for inclusion in Nursing Faculty Publications by an authorized administrator of DigitalCommons@SHU. For more information, please contact ferribyp@sacredheart.edu, lysobeyb@sacredheart.edu. DAY 2 , APR I L 1 0 , 2 0 16F I NANC I A L AND OPERAT IONAL SUSTA INAB I L I T YSeasonal patterns of initial domestic health assessment forrefugees in New York State, 2013Zahra Alaali1, Christina Ehret2, Elizabeth Dufort3, Colette Gargiulo3,Diane Miller3, Susan Towne3, Stephen Hughes3, Debra Blog3; 1Schoolof Public Health, State University of New York, Albany, NY, USA,2State University of New York, Albany, NY, USA, 3NYS Department ofHealth, Albany, NY, USABackground: Refugee health assessments (RHA) are a crucialmilestone that ensure the continuum of refugee healthcare, preventspread of communicable diseases, and monitor disease prevalence.Refugees should receive an initial RHA upon arrival. In NYS,this is provided by one of NYS Refugee Health Program’s(NYSRHP) contracted providers, preferably within 90 days afterarrival in the U.S. RHA is designed to ensure that unobserved ordeveloped health conditions after overseas exam are referred toprimary and specialty care. Eliminating barriers to complete theinitial assessment including transportation, hours of service, waittimes, and poor weather is essential for successful resettlement.Methods: We conducted a retrospective review of NYSRHP datafrom January 1 to December 31, 2013. Country of origin, arrivaldate, RHA completion date, season of arrival, county of resettle-ment, and resettlement agency were analyzed. Data were then eval-uated using descriptive analyses.Findings: In 2013, 3762 refugees resettled in NYS. Overall, 30%of the refugees did not complete the initial RHA within 90 daysafter arrival. Numbers of incomplete health assessments increasedin the fall and winter seasons to reach 47% and 45%, respectively,compared to 24% in spring and 25% in summer. Resettlementagencies were surveyed to assess services provided, 64% providetransportation from office, 27% from central stop, and 9% by taxiand none of them provide any special winter accommodation.Interpretation: These pilot data suggest seasonal variation in thecompletion rate of initial domestic refugee health assessments. Limita-tions of this data include a fiscal federal shutdown in October of 2013,which may have impacted refugee resettlement patterns compared totypical large arrival numbers in the fall season. Further research isneeded to address barriers to healthcare that refugees face post-resettle-ment, including season variation. Rresults suggest a need for additionalevaluations and interventions of current services provided to refugees toensure appropriate resources allocation and better health access.Funding: None.Abstract #: 2.001_FOSThe economic burden of noncommunicable diseases onAmerica’s youth: an analysis of children’s healthcarespending in the United States from 1996-2012A.L. Bui1, H. Hamavid2, R. Baral3, M. Birger2, A. Bulchis3,C. Horst2, E.K. Johnson4, J. Joseph2, L. Lomsadze2, H.Duber2,J.L. Dieleman2; 1David Geffen School of Medicine at University ofCalifornia, Los Angeles, 2Institute for Health Metrics and Evaluation,University of Washington, 3Global Health Group, University of Cal-ifornia, San Francisco, 4Columbia University, School of Internationaland Public AffairsBackground: Over 17 percent of U.S. gross domestic product isspent on health. Little research has focused on spending on children.We produced estimates of healthcare spending of children and youthin the U.S. from 1996 through 2012 across types of goods and services,age groups, sex groups, and causes of illness and healthcare events. Wecompare spending between noncommunicable disease (NCDs),communicable and neonatal disorders, and injuries. Lastly, we explainchanges in healthcare spending among children and youth over time.Methods: We use National Health Expenditure Accounts (NHEA)data to provide total healthcare spending across different categories ofgoods or services. We use eight U.S. surveys and administrative datasets to estimate the composition of healthcare spending across agegroups, sex groups, and causes of illness or healthcare events withineach category. Causes of illness are aggregated across NCDs, commu-nicable and neonatal disorders, or injuries. Healthcare spendingestimates are analyzed across levels and changes. A decompositionmethod is employed to explain changes in healthcare spending acrossincreases in population, prevalence, utilization, and prices.Results: From 1996 to 2012 children’s healthcare spending increasedfrom $161 billion to $259 billion, the most of which was ambulatorycare spending. Congenital disorders, skin disorders, neonatal pretermconditions, chronic upper respiratory disorders, endocrine disorders,otitis, attention-deficit/hyperactivity disorder (ADHD), asthma, falls,and depression contribute to the top 36% of all healthcare costs in chil-dren. Among these top 10 conditions, 7 are NCDs. In total, NCDscontribute to nearly two-thirds of healthcare spending. Per capita (perchild) healthcare spending is greatest for under-1-year-olds and islowest for 5-9-year-olds. The $98 billion increase in spending wasmostly due to increases in prices over the time period.Interpretations: NCDs contribute to more healthcare spendingamong children as opposed to conditions traditionally associated withchildren, such as neonatal disorders and communicable conditions likerespiratory infections and otitis. Investments in prevention of NCDsin childhood could help combat increasing prevalence of NCDs andcurb future growth in healthcare spending. These findings can aid inmore efficient health resource allocation and planning for children.Funding: Bill and Melinda Gates Foundation.Abstract #: 2.002_FOSCoordinating community healthcare needs to local servicesin Paraiso, Dominican Republic through strategic assessmentstrategiesM. Cole1, C. Gunther1, M. Sadigh2,3; 1Sacred Heart University,College of Nursing, 2Western Connecticut Health Network, 3Universityof Vermont, College of MedicineA n n a l s o f G l o b a l H e a l t hª 2 0 1 6 I c a h n S c h o o l o f M e d i c i n e a t M o u n t S i n a iV O L . 8 2 , N O . 3 , 2 0 1 6I S S N 2 2 1 4 - 9 9 9 6 / $ 3 6 . 0 0Background: The availability of healthcare services is limited inParaiso, Dominican Republic with the nearest full-service hospitallocated 34.1 km away. A local, underutilized clinic was unawareof the needs of this disadvantaged community.Method: Researchers adapted a World Health Organization assess-ment survey with the goals of determining residents’ priority needs andan appraisal of the current clinic capabilities and gaps in services in orderto provide the community with relevant healthcare. 106 families wererandomly selected in seven separate geographic areas of Paraiso to partic-ipate in the self-report assessment. Researchers, alongwith a communityvolunteer, conducted interviews utilizing the 63 question instrument.105 families agreed to participate representing 504 individuals.Findings: The findings highlighted community concerns;depressed economy (54%), health concerns and lack of access toadequate healthcare (63%). Other findings include the presence ofcommunicable disease, disease comorbidity, parasitic infectionsand the discovery that chikungunya is present (10.5%). Participantsindicated a desire for hospital services in the community: fullhospital services (48%); women’s health (23%); access to medica-tions (38%), all lacking within the present clinic.Interpretation: Results fromthe assessmentwill serveas a foundationfor the development of strategies to best meet community needs andcreate a financial and operational sustainability model. The collecteddata is being utilized in the development of a collaborative plan witha localDominican, non-governmental organization (InstitutoDomini-cano de Desarrollo Integral), a hospital network in the U.S. (WesternConnecticut Health Network/Danbury Hospital in partnership withUniversity of Vermont College ofMedicine) and a College of Nursingin the U.S. (Sacred Heart University in Fairfield, CT) to transform thecurrent clinic into a 35 bed hospital. Other plans include the educationand training of a healthcare team, including a lead physician, to providesustainable healthcare that will match the needs of the community.Funding: Western Connecticut Health Network; SacredHeart Univer-sity, College of Nursing; University of Vermont, College of Medicine.Abstract #: 2.003_FOSInnovative, but what about sustainability? Lessons learnedin nursing and midwifery workforce developmentK.N. Hosey1, J. Voss2, M. Kelley3; 1University of Washington School ofNursing, Seattle, WA, USA, 2Case Western Reserve University,Cleveland, OH, USA, 3Emory University, Atlanta, Georgia, USAProgram/Project Purpose: Sustainability is a word used in globalhealth to discuss successful projects or interventions, as it is essentialfor the work to be continued after the initial pilot and developmentstages. Often this is a challenge in resource-limited settings, especiallywhen funding cycles are finished, donor organizations shift their prior-ities, or even when there is not sufficient buy-in from stakeholders.Buy-in was never a problem in the development of a continuing andprofessional development library for nurses and midwives in east,central and southern Africa as the need and interest in having online,mobile-friendly trainings accessible was expressed by leaders in theregion. Human resources and infrastructure, however, are the chal-lenges in the sustainability this project. Continued investment bynursing leaders has been underway to make this a lasting resource forthe region, as often providers cannot attend in-person trainings inorder to stay updated for relicensure purposes. Sustainability of thecontinuing and professional development library hosted on the East,Central and Southern Africa College of Nursing (ECSACON)website has been the focus of this project since the beginning;however, after the launch of the website in 2014 information tech-nology challenges persisted and as resources dwindled a partiallyfunctioning website was the result. This was the leading barrier inseeking donor support to sustain this nearly completed project.Structure/Method/Design: Creation of a sustainability plan is thepriority. Meetings and interviews were held with nursing leaderswhen funding was completed in July 2015. A stakeholder analysiswas conducted and another meeting was held with nursing leaders inHarare, Zimbabwe in November 2015 to develop a sustainability plan.Outcome & Evaluation: To date nursing and midwifery support isstill high for this project, and continued buy-in will be generatedwith global health leaders after the November 2015 African HealthProfession Regulatory Collaborative for Nurses and Midwives(ARC) Summative Congress Meeting in Harare, Zimbabwe, result-ing in an updated sustainability plan for the library.Going Forward: Sustainability for this program is key in order for thislibrary to be a lasting resource for nurses and midwives in the region.Funding: This project was supported by the Afya Bora ConsortiumFellowship funded by the National Institute of Health, Office ofAIDS Research, and Health Resources and Services Administrationgrant number U91HA06801 and a 2014 Afya Bora Career Develop-ment award supplement toKristenHosey from theUniversity ofWash-ington Center for AIDS Research (CFAR), an NIH funded programunder awardnumberP30AI027757which is supportedby the followingNIH Institutes andCenters (NIAID,NCI,NIMH,NIDA,NICHD,NHLBI, NIA, NIGMS, NIDDK). Funding for the development ofECSACON’s on-lineCPD librarywasprovidedby theU.S.President’sEmergency Plan for AIDS Relief (PEPFAR) through a cooperativeagreement from the U.S. Centers for Disease Control and Prevention(CDC) to the Emory University on behalf of The African HealthProfession Regulatory Collaborative for Nurses and Midwives (ARC).Abstract #: 2.004_FOSAsili: Evaluating a novel multi-disciplinary social enterpriseintervention on population health in the Democratic Republicof CongoA. Talib1, H. Buesseler2, T. Fadgen2, N.A. Federspiel3, J. Altamirano1,J. Inungu4, Y. Maldonado1; 1Stanford University School of Medicine,Department of Pediatrics, Stanford, CA, USA, 2American RefugeeCommittee, Minneapolis, MN, USA, 3Stanford University School ofMedicine, SPARK Translational Research Program, Stanford, CA,USA, 4Centre Africain pour la Recherche et le Developpement, Kinshasa,Democratic Republic of the CongoProgram/Project Purpose: Child mortality in the DemocraticRepublic of Congo (DRC) occurs at a rate of 108 deaths per1,000 live births, the 5th highest in the world, with more than 1in 10 children dying before reaching age 5. The eastern region ofDRC, is still recovering from decades of conflict that destroyedinfrastructure, ruined livelihoods, and caused massive displacement.Innovative strategies are needed to improve child health. The Amer-ican Refugee Committee and Ideo.org co-created Asili (foundationFinancial and Operational Sustainability A n n a l s o f G l o b a l H e a l t h , V O L . 8 2 , N O . 3 , 2 0 1 6M a yeJ u n e 2 0 1 6 : 4 6 3 – 4 6 6464

Coordinating Community Healthcare Needs to Local Services in Paraiso, Dominican Republic Through Strategic Assessment Strategies

https://digitalcommons.sacredheart.edu/cgi/viewcontent.cgi?article=1102&context=nurs_fac

Coordinating Community Healthcare Needs to Local Services in Paraiso, Dominican Republic Through Strategic Assessment Strategies

Abstract

Similar works

Full text

Available Versions

Sacred Heart University: DigitalCommons@SHU