Universal Health Coverage Policy and Progress towards the Attainment of Universal Sexual and Reproductive Health and Rights Services in Ethiopia.

Critical interpretive analysis of literature review was applied to shed light on the status of universal access to Sexual and Reproductive Health and Rights (SRHR) and the progress towards Universal Health Coverage (UHC) in Ethiopia. Special emphasis was given to the determinations of the Ethiopian health policy frameworks to include comprehensive SRHR services in the UHC benefit package. Clinical services for pregnant women and newborn, abortion care, family planning, Female Genital Mutilation (FGM) complication treatment, Comprehensive Sexuality Education (CSE), and sexual health services are included in the national cost exempted services, but the latter three are not yet included in the health programs with defined objective and work plan. Capital intensive Sexual and Reproductive Health (SRH) services (such as infertility and reproductive cancers diagnosis and treatment) are not included in the UHC benefit package. Over the last two decades, a substantive progress is made in family planning service and maternal and child health, probably because they were taken as Millennium Development Goals (MDGs) indicators and have got better financial protection and political commitment. In order to include other SRHR services in the benefit package in due course and attain universal SRHR services without financial hardship in the Primary Health Care (PHC) setting, the domestic financing should be endorsed as a driving force. To make the multi-sectoral efforts towards achieving UHC and sustainable development goals (SDGs) complete, building resilient health systems through the humanitarian-development nexus for health systems strengthening in fragile setting should be equally prioritized, thereby leaving no one behind underserved.

Factors associated with medication adherence among people with diabetes mellitus in poor urban areas of Cambodia: A cross-sectional study.

BACKGROUND: In Cambodia, the age-standardized prevalence of diabetes mellitus has increased in both men and women. The main objective of this study was to identify factors associated with diabetes medication adherence among people with diabetes mellitus in poor urban areas of Phnom Penh, Cambodia. METHODS: A cross-sectional study was conducted in 2017 using a structured questionnaire for face-to-face interviews by trained interviewers. The participants were people with diabetes mellitus who were the active members of a peer educator network, lived in poor urban areas of Phnom Penh, and attended weekly educational sessions during the survey period. Diabetes medication adherence was measured using four items of modified Morisky Medication Adherence Scale. Participants were classified into two groups based on their adherence score: 0 (high adherence) and from 1 to 4 (medium or low adherence). Sociodemographic characteristics; medical history; accessibility to health services; and knowledge, attitude, and practices related to diabetes mellitus were examined. A multiple logistic regression analysis was conducted adjusting for sex, age, marital status, and education levels. RESULTS: Data from 773 people with diabetes were included in the analyses. Of the total, 49.3% had a high level of diabetes medication adherence. A high level of adherence was associated with higher family income (≥50 USD per month) (adjusted odds ratio [AOR] = 5.00, 95% confidence interval [CI] = 2.25-11.08), absence of diabetes mellitus-related complications (AOR = 1.66, 95% CI = 1.19-2.32), use of health services more than once per month (AOR = 2.87, 95% CI = 1.64-5.04), following special diet for diabetes mellitus (AOR = 1.81, 95% CI = 1.17-2.81), and absence of alcohol consumption (AOR = 13.67, 95% CI = 2.86-65.34). CONCLUSIONS: High diabetes medication adherence was associated with better family economic conditions, absence of diabetes mellitus-related complications, and healthy behaviors. It would be crucial to improve affordable access to regular follow-ups including promotion of healthy behaviors through health education and control of diabetes mellitus-related complications.

Factors associated with patient information sharing among home-visiting nurses in Japan: a cross-sectional study.

BACKGROUND: Home-visiting nurses are expected to enhance their ability to provide adequate nursing care in a relatively isolated work environment. However, the isolated work environment leads to less opportunity to share patient information. We investigated factors relevant to better patient information sharing among home-visiting nurses, which would contribute to the improved care performance of these nurses. METHODS: A cross-sectional study with anonymous self-administered questionnaire was conducted between June 2015 and September 2015 in two districts of Japan. Home-visiting nurses who were working at home health care agencies were recruited. The questionnaires consisted of items on demographic data, job-related variables, communication in the workplace, the current state of patient information sharing, opportunities (or measures) of patient information sharing in the workplace, and job satisfaction. Descriptive analyses were performed on all variables, using the Chi-square test, Fisher's exact test, or Mann-Whitney U-test. Logistic regression analyses were conducted to identify the factors associated with better information sharing, adjusting the years of home-visiting nursing experience as the control variable. RESULTS: Of 762 anonymous self-administered questionnaires were mailed, data from 482 participants who consented to this study and had no missing answer were analyzed. Of the total, 77.2% shared the patients' information. Having a friendly adviser (OR = 2.51, 95% CI = 1.14-5.55, p = 0.023), attending some conferences (OR = 2.32, 95% CI = 1.12-4.82, p = 0.024), joining workshops (OR = 1.89, 95% CI = 1.15-3.10, p = 0.012), and years of home-visiting nursing experience (OR = 1.27, 95% CI = 1.03-1.57, p = 0.025) were significantly associated with sufficient sharing of the information. Nurses sufficiently sharing the information were well satisfied with their job (OR = 5.38, 95% CI =3.19-9.09, p < 0.001) and highly preferred a career in home-visiting nursing care (OR = 5.62, 95% CI =3.41-9.27, p < 0.001). CONCLUSIONS: The results suggested that having opportunities to discuss face-to-face such as at conferences and workshops as well as promoting good relationships among colleagues in the workplace will contribute to better information sharing among home-visiting nurses. Home-visiting nurses with less years of experience need to be supported in order to share the information sufficiently. Additionally, sufficient information sharing was also associated with job satisfaction and preference for home-visiting nursing care, which might lead to job retention for home-visiting nurses.