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1.
Esc. Anna Nery Rev. Enferm ; 26: e20210083, 2022. graf
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1346056

RESUMEN

RESUMO Objetivo compreender as representações sociais de adolescentes sobre vulnerabilidades e riscos para contrair o HIV/Aids nas relações sexuais. Método estudo de representações sociais, realizado a partir de entrevistas individuais com 15 adolescentes e grupo focal com oito adolescentes de uma escola pública do Recife, Pernambuco, Brasil. Os dados foram coletados no período de maio a outubro de 2016. Para tratamento dos dados, empregou-se a técnica de análise de conteúdo temática-categorial com o auxílio do Software QSR Nvivo11. Resultados as categorias: riscos de contrair HIV/Aids nas relações sexuais; e dos riscos de contrair HIV/Aids nas relações sexuais às vulnerabilidades abrigam os temas não usar preservativo, ter usado álcool e/ou drogas, ter vários parceiros, ter dificuldades de acesso aos serviços de saúde e de educação sexual nas escolas; e não ter conversas com os pais ou familiares. Conclusão e implicações para a prática compreendeu-se que as representações sociais circulam no imaginário e no ambiente escolar, interferindo na realidade dos adolescentes. Propõe-se priorizar políticas públicas focadas nas dimensões emocionais, afetivas e sociais.


RESUMEN Objetivo comprender las representaciones sociales de adolescentes acerca de las vulnerabilidades y riesgos de contraer el VIH/SIDA en relaciones sexuales. Método estudio de representaciones sociales realizado a partir de entrevistas individuales con 15 adolescentes y un grupo focal con ocho adolescentes de una escuela pública en Recife, Pernambuco, Brasil. Los datos se recolectaron entre mayo y octubre de 2016. Para el tratamiento de los datos, se utilizó la técnica de análisis de contenido temático-categórico, con la ayuda del software QSR Nvivo11. Resultados las categorías riesgos de contraer el VIH/SIDA en las relaciones sexuales; y de los riesgos de contraer el VIH/SIDA en las relaciones sexuales a las vulnerabilidades que cubren los temas de no usar condón, haber consumido alcohol y/o drogas, tener varios pares, tener dificultades para acceder a los servicios de salud y de educación sexual en las escuelas; y no tener conversaciones con los padres o miembros de la familia. Conclusión e implicaciones para la práctica se entendió que las representaciones sociales circulan en el imaginario y en el ámbito escolar, interfiriendo en la realidad de los adolescentes. Se propone priorizar políticas públicas enfocadas en las dimensiones emocionales, afectivas y sociales.


ABSTRACT Objective To understand social representations of adolescents about vulnerabilities and risks of contracting HIV/AIDS in sexual relations. Method Study of social representations, based on individual interviews with 15 adolescents and a focus group with eight adolescents from a public school in Recife, Pernambuco, Brazil. Data were collected from May to October 2016. For the processing of data, the thematic-categorial content analysis technique was used with the aid of the QSR Nvivo11 Software. Results The categories: risks of contracting HIV/AIDS in sexual relations; and from the risks of contracting HIV/AIDS in sexual relations to the vulnerabilities cover the themes of not using condoms, having used alcohol and/or drugs, having several partners, having difficulties in accessing health and sex education services in schools; and not having conversations with parents or family members. Conclusion and implications for practice it was understood that social representations circulate in the imaginary and in the school environment, interfering in the reality of adolescents. It is proposed to prioritize public policies focused on the emotional, affective and social dimensions.


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Percepción Social , Infecciones por VIH/transmisión , Coito , Salud del Adolescente , Vulnerabilidad en Salud , Pobreza , Educación Sexual , Consumo de Bebidas Alcohólicas , Parejas Sexuales , Condones , Trastornos Relacionados con Sustancias , Investigación Cualitativa , Sexo Inseguro , Relaciones Familiares , Accesibilidad a los Servicios de Salud
2.
Thorac Surg Clin ; 32(1): 1-11, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34801189

RESUMEN

Civil Rights legislation and court decisions influenced health care policy, which attempted to provide health care to elderly and low-income populations. Passing Medicaid and Medicare was monumental in increasing access to health insurance. The Affordable Care Act aimed to increase access to and affordability of health care to alleviate some disparities in health care. The Affordable Care Act established the National Institute of Minority and Health Disparity and Offices of Minority Health. However, disparities of access, care, morbidity, and mortality among marginalized populations persist. We in the thoracic community must leverage all means to mitigate the injustice of health disparities.


Asunto(s)
Medicare , Patient Protection and Affordable Care Act , Anciano , Política de Salud , Accesibilidad a los Servicios de Salud , Humanos , Medicaid , Estados Unidos/epidemiología
3.
J Med Virol ; 94(1): 7-10, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34506635

RESUMEN

Hepatitis, a significant cause of mortality worldwide, results in around 1.34 million deaths each year globally. Africa is not exempt from the plague of Hepatitis. Around 100 million estimated individuals are infected with Hepatitis B or C. Egypt has the highest prevalence of cases of Hepatitis followed by Cameroon and Burundi. The continent is severely affected by the onset of the COVID-19 pandemic, as the virus has added an additional burden on the already fragile continent. With the pandemic, it is presumable that Hepatitis like other viral diseases will pose a threat to collapsing healthcare system. Therefore, for Africa to become more resilient in the face of such menaces, including Hepatitis, further prevention policies are required to be implemented.


Asunto(s)
COVID-19/epidemiología , Accesibilidad a los Servicios de Salud , Hepatitis B Crónica/epidemiología , Hepatitis C Crónica/epidemiología , Países en Desarrollo , Egipto/epidemiología , Hepacivirus/patogenicidad , Virus de la Hepatitis B/patogenicidad , Hepatitis B Crónica/prevención & control , Hepatitis B Crónica/terapia , Hepatitis C Crónica/prevención & control , Hepatitis C Crónica/terapia , Humanos , Hígado/lesiones , Hígado/patología , Hígado/virología , Prevalencia , SARS-CoV-2
4.
Estima (Online) ; 19(1): e0921, jan.-dez. 2021.
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1280948

RESUMEN

Objetivo:descrever o processo de implementação da Rede de Atenção à Saúde em Lesões Cutâneas no município de Divinópolis − MG. Método: trata-se de um relato de experiência sobre a implementação de uma Rede de Atenção à Saúde em Lesões Cutâneas a partir do Programa de Educação Pelo Trabalho para Saúde (PET-Saúde/GraduaSUS), no período de maio de 2016 a abril de 2018. Participaram das ações professores e alunos de uma universidade pública e profissionais enfermeiros vinculados à Secretaria Municipal de Saúde do município. Resultados: foi possível implementar a Rede de Atenção à Saúde para prevenção e tratamento de lesões cutâneas de maneira estruturada e sistematizada. Foi estabelecido um fluxo de atendimento, supervisão de casos e acompanhamento clínico por meio da construção de um protocolo assistencial. Conclusão: a habilidade prática e o conhecimento científico de alunos e profissionais de saúde para o tratamento e manejo de lesões cutâneas foram desenvolvidos fortalecendo, assim, a tríade ensino-serviço-comunidade.


Objective: describe the process of implementing the Rede de Atenção à Saúde em Lesões Cutâneas (Health Care Network for Skin Injuries) in the municipality of Divinópolis - MG. Method: it is an experience report on the implementation of a Health Care Network for Skin Injuries from the Programa de Educação Pelo Trabalho para Saúde (PET-Saúde/GraduaSUS) (Education Through Work for Health Program), from May 2016 to April 2018. Teachers and students from a public university and professional nurses linked to the Municipal Health Secretariat of the municipality participated in the actions. Results: it was possible to implement the Health Care Network for the prevention and treatment of skin lesions in a structured and systematic way. A flow of care, case supervision and clinical follow-up was established through the construction of an assistance protocol. Conclusion: the practical skill and scientific knowledge of students and health professionals for the treatment and management of skin lesions were developed, thus strengthening the teaching-service-community triad.


Asunto(s)
Heridas y Lesiones , Relaciones Comunidad-Institución , Atención a la Salud , Accesibilidad a los Servicios de Salud
5.
Multimedia | Recursos Multimedia | ID: multimedia-9321

RESUMEN

O premiado diretor Adam Wishart autorizou a Colabore com o Futuro a legendar e divulgar no Brasil o documentário "O Preço da Vida" (The Price of Life). Nesse filme patrocinado pela BBC Two, Adam mostra como foi feita a decisão sobre a incorporação do Lenalidomida (importante medicamento para mieloma múltiplo) pela NICE (Agência Sanitária do Reino Unido). Muito interessante assistir para entender melhor como funciona o processo de ATS - Avaliação de Novas Tecnologias - sob o aspecto do paciente que precisa do medicamento, do governo que tem um orçamento limitado, e do fabricante, que tem um custo alto para produzir a droga e por isso precisa cobrar caro pela mesma. Os conflitos muito humanos que surgem abrem para debate uma questão moral maior - quanto vale a vida e quanto deve pagar a sociedade?


Asunto(s)
Mieloma Múltiple/tratamiento farmacológico , Lenalidomida/uso terapéutico , Política Nacional de Medicamentos , Servicios Farmacéuticos/legislación & jurisprudencia , Costos de la Atención en Salud , Gasto Público en Salud/políticas , Vigilancia Sanitaria , Aprobación de Drogas/legislación & jurisprudencia , Reino Unido , Documentarios Cinematográficos , Industria Farmacéutica/economía , Accesibilidad a los Servicios de Salud , Precio de Medicamento
6.
BMC Med Educ ; 21(1): 561, 2021 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-34732178

RESUMEN

BACKGROUND: Transgender (trans) women face constrained access to gender-affirming HIV prevention and care. This is fueled in part by the convergence of limited trans knowledge and competency with anti-trans and HIV-related stigmas among social and healthcare providers. To advance gender-affirming HIV service delivery we implemented and evaluated 'Transgender Education for Affirmative and Competent HIV and Healthcare (TEACHH)'. This theoretically-informed community-developed intervention aimed to increase providers' gender-affirming HIV prevention and care knowledge and competency and reduce negative attitudes and biases among providers towards trans women living with and/or affected by HIV. METHODS: Healthcare and social service providers and providers in-training (e.g., physicians, nurses, social workers) working with trans women living with and/or affected by HIV (n = 78) participated in a non-randomized multi-site pilot study evaluating TEACHH with a pre-post-test design. Pre- and post-intervention surveys assessed participant characteristics, intervention feasibility (e.g., workshop completion rate) and acceptability (e.g., willingness to attend another training). Paired sample t-tests were conducted to assess pre-post intervention differences in perceived competency, attitudes/biases, and knowledge to provide gender-affirming HIV care to trans women living with HIV and trans persons. RESULTS: The intervention was feasible (100% workshop completion) and acceptable (91.9% indicated interest in future gender-affirming HIV care trainings). Post-intervention scores indicated significant improvement in: 1) knowledge, attitudes/biases and perceived competency in gender-affirming HIV care (score mean difference (MD) 8.49 (95% CI of MD: 6.12-10.86, p < 0.001, possible score range: 16-96), and 2) knowledge, attitudes/biases and perceived competency in gender-affirming healthcare (MD = 3.21; 95% CI of MD: 1.90-4.90, p < 0.001, possible score range: 9-63). Greater change in outcome measures from pre- to post-intervention was experienced by those with fewer trans and transfeminine clients served in the past year, in indirect service roles, and having received less prior training. CONCLUSIONS: This brief healthcare and social service provider intervention showed promise in improving gender-affirming provider knowledge, perceived competency, and attitudes/biases, particularly among those with less trans and HIV experience. Scale-up of TEACHH may increase access to gender-affirming health services and HIV prevention and care, increase healthcare access, and reduce HIV disparities among trans women. TRIAL REGISTRATION: ClinicalTrials.gov ( NCT04096053 ).


Asunto(s)
Infecciones por VIH , Personas Transgénero , Femenino , Infecciones por VIH/prevención & control , Personal de Salud , Accesibilidad a los Servicios de Salud , Humanos , Proyectos Piloto
7.
BMC Health Serv Res ; 21(1): 1197, 2021 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-34736434

RESUMEN

BACKGROUND: Government responses to the pandemic varied in terms of timing, duration, and stringency, seeking to protect healthcare systems, whose pre-pandemic state varied significantly. Therefore, the severity of Covid-19 and, thus, excess mortality have been unequal across counties. This paper explores the geography of excess mortality and its underlying factors in 2020, highlighting the effects of health policies pre-pandemic and strategies devised by governments to cope with Covid-19. METHODS: Excess mortality is estimated for 79 high, medium and low-income countries. The factors of excess mortality are examined employing median quantile regression analysis. RESULTS: Health privatization, healthcare underfunding, and late implementation of containment and mitigation strategies were powerful drivers of excess mortality. By contrast, the results suggest a negative association of excess mortality with health expenditure, number of doctors and hospital beds, share of population covered by health insurance and test and trace capacity. CONCLUSIONS: The evidence highlights the importance of sufficiently funded healthcare systems with universal access and strong primary healthcare in the battle against the pandemic. An early response to Covid-19, including borders' controls and a strong test and trace capacity, could improve epidemiological surveillance and minimize excess mortality, with stringent and lengthy lockdowns not providing a significant benefit.


Asunto(s)
COVID-19 , Mortalidad , Pandemias , Control de Enfermedades Transmisibles , Atención a la Salud , Accesibilidad a los Servicios de Salud , Humanos , Atención Primaria de Salud
8.
Acad Pediatr ; 21(8S): S126-S133, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34740419

RESUMEN

Nearly 1 in 5 children in the United States live in rural areas. Rural children experience health and health care disparities compared to their urban peers and represent a unique and vulnerable pediatric patient population. Important disparities exist in all-cause mortality, suicide, firearm-related unintentional injury, and obesity. Rural children experience decreased availability and accessibility of primary care and specialty care (especially mental health care) due to a decreased number of health care providers as well as geographical and transportation-related barriers. Other geographic and socioeconomic determinants, especially concerning poverty and substandard housing conditions, are likely important contributors to the observed health disparities. Increased funding for research focused on rural populations is needed to provide innovative solutions for the unique health needs of rural children. Policy changes positioned to correct the trajectory of poor health among children should consider the needs of rural children as an under-researched and under-resourced vulnerable population.


Asunto(s)
Pobreza , Población Rural , Niño , Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Humanos , Factores Socioeconómicos , Estados Unidos/epidemiología , Población Urbana , Poblaciones Vulnerables
9.
Acad Pediatr ; 21(8S): S146-S153, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34740422

RESUMEN

Over the past 20 years, the United States greatly expanded eligibility for public health insurance under the Medicaid and Child Health Insurance Program programs. This expansion improved children's access to health care and their health, ultimately lowering preventable hospitalizations, chronic conditions, and mortality rates in the most vulnerable children at a cost that is 4 times lower than the average per capita cost for the elderly. They also had broader antipoverty effects, increasing economic security, children's educational attainments, and their eventual employment and earnings opportunities. However, in recent years, this progress has been rolled back in many states. Remarkably, although income eligibility cutoffs have remained largely constant, states have reduced child coverage through a number of administrative measures ranging from increased paperwork, to reduced outreach, new parental work requirements, changes to public charge rules for immigrants, and waivers of federal requirements to provide retroactive coverage to new applicants. The number of uninsured children was rising for the first time in decades even prior to the pandemic. With rising numbers who have lost their jobs in the pandemic-induced recession, it is more important than ever to defend and restore and improve access to public health insurance for our children.


Asunto(s)
Servicios de Salud del Niño , Medicaid , Anciano , Niño , Salud del Niño , Accesibilidad a los Servicios de Salud , Humanos , Seguro de Salud , Pobreza , Estados Unidos
10.
Reprod Health ; 18(1): 221, 2021 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-34743705

RESUMEN

BACKGROUND: Quality of care (QOC) is increasingly identified as an important contributor to healthcare outcomes, however little agreement exists on what constitutes quality in abortion care or the recommended indicators from the service-user perspective. Our study aimed to explore perceptions and experiences of abortion QOC in England and Wales. METHODS: We performed in-depth interviews (via phone or in-person) with participants who had an abortion at a nationwide independent sector provider in the previous 6 months. We explored their experiences of the abortion service at each point in the care pathway, their perspectives on what contributed to and detracted from the experience meeting their definitions of quality, and their reflections on different aspects of QOC. We used content analysis to generate themes. RESULTS: From December 2018 to July 2019, we conducted 24 interviews. Ten participants had a surgical and 14 had a medical abortion. Seventeen (71%) were treated in the first 12 weeks of pregnancy and 7 (29%) beyond that, with an average gestational age of 10 weeks + 5 days (range 5-23 + 6). We identified 4 major themes that contributed to participant's perception of high quality care: (1) interpersonal interactions with staff or other patients, (2) being informed and prepared, (3) participation and choices in care and (4) accessibility. Nearly all participants identified interpersonal interactions with staff as an important contributor to quality with positive interactions often cited as the best part of their abortion experience and negative interactions as the worst. For information and preparation, participant described not only the importance of being well prepared, but how incongruencies between information and the actual experience detracted from quality. Participants said that making choices about their care, for example, method of abortion, was a positive contributor. Finally, participants identified access to care, specifically in relation to waiting times and travel, as an important aspect of QOC. CONCLUSIONS: Participants situated quality in abortion care in 4 domains: interpersonal aspects of care, information and preparation, choices, and accessibility. Indicators identified can be used to develop standard metrics to ensure care meets service-user needs.


Asunto(s)
Aborto Inducido , Accesibilidad a los Servicios de Salud , Inglaterra , Femenino , Humanos , Lactante , Percepción , Embarazo , Investigación Cualitativa , Gales
11.
Rev Med Chil ; 149(6): 906-912, 2021 Jun.
Artículo en Español | MEDLINE | ID: mdl-34751350

RESUMEN

The Disability Qualification System in Chile and its regulations have inequities as they are applied in a general way and do not consider the peculiar characteristics of vulnerable populations. These people, who are mostly unprotected, have less access to health care levels and receive a lower quality of services. The authors, using a clinical case, we analyze the three main obstacles to obtain a disability pensión. A change in applicants' evaluation, considering a broader range of information on the process, a greater symmetry in the evaluated parameters, including biopsychosocial aspects and a better interrelation between Health Services and the Evaluation System would narrow the existing gap between vulnerable and non-vulnerable populations.


Asunto(s)
Personas con Discapacidad , Chile , Accesibilidad a los Servicios de Salud , Humanos , Poblaciones Vulnerables
12.
Health Syst Reform ; 7(1): e1984865, 2021 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-34748436

RESUMEN

Evidence shows that those with non-communicable diseases (NCDs) are at higher risk for serious illness and mortality from COVID-19. In Kenya, about 50% of the COVID-19 patients who have died had an NCD. We sought to describe the challenges faced in accessing NCD medicines in Kenya during the pandemic, through a descriptive narrative informed by key stakeholders engaged in NCD service delivery and decision-making. Access to NCD medicines was affected at three levels, service delivery, health facility information systems and the medicines supply chain to health facilities. In response to these gaps, the Ministry of Health released clear directives and interim guidelines for continuity of NCD service delivery. However, implementation of guidelines was not apparent from conversations with county officials or from assessment of county services by the Ministry. Rather, heterogeneity was observed in counties' responsiveness to patient needs, where 5 out of 13 counties used mHealth technologies, while 5 had no established system to reach patients. COVID-19 amplified gaps that already existed in the system-particularly around lack of robust supply chains and sub-optimal health information systems. This descriptive paper will be useful to policy makers to provide a summary of the key challenges faced in accessing NCD medicines, identify gaps in medicines delivery, and make case for establishment of a more equitable health system to meet the needs of lower-income NCD patients.


Asunto(s)
COVID-19 , Enfermedades no Transmisibles , Accesibilidad a los Servicios de Salud , Humanos , Kenia , Enfermedades no Transmisibles/tratamiento farmacológico , Enfermedades no Transmisibles/epidemiología , SARS-CoV-2
13.
BMC Health Serv Res ; 21(1): 1212, 2021 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-34753465

RESUMEN

BACKGROUND: Health insurance is an essential aspect of healthcare. This is because it enables the insured to acquire timely and essential healthcare services, besides offering financial protection from catastrophic treatment costs. This paper seeks to establish gender differentials and determinants of health insurance coverage in Zambia. METHODS: The data used in this study was obtained from the 2018 Zambia Demographic and Health Survey. Data were analyzed using STATA 13.0 software and focused on descriptive and Probit regression analyses. RESULTS: The study reveals that for women and men, age, wealth category, education, and professional occupation are positively associated with health insurance while being self-employed in the agricultural sector negatively influences health insurance coverage for both sexes. Other variables have gender-specific effects. For instance, being in marital union and having a clerical occupation increases the probability of having health insurance for women while being in the services, skilled, and unskilled manual occupations increases the probability of having health insurance for men. Further, residing in rural areas reduces the probability of having health insurance for men. CONCLUSION: The study concludes that there are differences in factors that influence health insurance between women and men. Hence, this study highlights the need to enhance health insurance coverage by addressing the different factors that influence health insurance coverage among men and women. These factors include enhancing education, job creation, diversifying insurance schemes, and gender consideration in the design of National Health Insurance Scheme.


Asunto(s)
Seguro de Salud , Programas Nacionales de Salud , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Cobertura del Seguro , Masculino , Zambia/epidemiología
14.
J Contemp Dent Pract ; 22(8): 894-899, 2021 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-34753841

RESUMEN

AIM AND OBJECTIVE: The aim of the study was to evaluate the satisfaction of an oral health promotion program among parents and caregivers of children with special healthcare needs (CSHCN) in Riyadh, Saudi Arabia. MATERIALS AND METHODS: A digital survey using Google forms was used during an event to commemorate the World Disability Day. Stalls for oral health education and training were set up at Disabled Children Society, Riyadh, Saudi Arabia. Oral health education was carried out using written pamphlets, brochures, and videos. Live demonstration on dental models was used for tooth-brushing training using a powered toothbrush. Parents and caregivers were asked to complete a survey about oral health education during the event. An overall 189 parents and caregivers of CSHCN including 62 males and 127 females completed the survey. The responses were entered digitally prior to being evaluated. RESULTS: The respondents were parents and/or caregivers of children mostly having cerebral palsy followed by autism. Females consisted of 67% of the respondents. Eight-one percent of respondents rated it as highly satisfied. Ninety-one percent of the respondents perceived that the information provided was new for them regarding oral healthcare for CSHCN. Ninety-eight percent of respondents were likely to attend a similar event in the future. CONCLUSION: Majority of parents and caregivers of CSHCN were highly satisfied by the oral health education during the event. They felt that they can take better care of the oral health of their CSHCN after the oral health education and training. CLINICAL SIGNIFICANCE: Oral health among CSHCN is neglected when compared to children among the general population. CSHCN exhibit many barriers to oral health care. Oral health promotion among CSHCN is important as they have a high unmet oral health need.


Asunto(s)
Cuidadores , Niños con Discapacidad , Niño , Femenino , Educación en Salud Dental , Accesibilidad a los Servicios de Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Masculino , Padres , Satisfacción Personal , Arabia Saudita , Estados Unidos
15.
Pan Afr Med J ; 40: 12, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34733380

RESUMEN

The severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is a new virus that is responsible for COVID-19, a disease that complicate health conditions and results in death. The total diversion of attention of government and health care workers (HCWs) to prevent the escalation of the pandemic disease has placed a great barrier to diagnosis and treatment of other illnesses that share common symptoms with COVID-19, and that has consequently enabled the endemic practice of self-antimicrobial medication to increase in Nigeria. Development of secondary infections in COVID-19 and in other conditions, caused by antibiotic resistant pathogens could make them more deadly now or in the future. The mitigation strategies adopted in Nigeria and its States, which include enforcing social distancing, partial or total lockdown, and restricting access to health care facilities for non COVID-19 patients, have further increased the demand of antimicrobial agents from unauthorized outlets in communities for inappropriate use. A cross-sectional survey of 162 randomly selected individuals that visited medical stores and 170 medical store owners to evaluates the level of self-medication with five oral broad spectrum antibiotics and antimalaria during the lockdown revealed an increase (68.5%) in practice of self-medication with at least one of the antimicrobial and emergence of new abusers. Blind treatment of symptoms of malaria and common cold without diagnosis and health care consultation was nearly 100%. Irrational use of sanitizers, disinfectants and other cidal agents that can fuel antimicrobial resistance has drastically increased in communities. Exposure of microorganisms in the environment without caution to large volume of fumigants is increasing on daily basis. We strongly recommend that while mitigating SARS-CoV-2 virus spread, efficacious and feasible technological, social, economic and behavioral interventions that will also control the evolution and spread antimicrobial resistant microorganisms should be applied.


Asunto(s)
Antibacterianos/uso terapéutico , COVID-19/prevención & control , Control de Enfermedades Transmisibles , Farmacorresistencia Microbiana , Pandemias/prevención & control , Automedicación , COVID-19/epidemiología , Accesibilidad a los Servicios de Salud , Humanos , Nigeria/epidemiología , Distanciamiento Físico , SARS-CoV-2 , Automedicación/efectos adversos
16.
Pan Afr Med J ; 40: 26, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34733394

RESUMEN

Introduction: the COVID-19 pandemic since its emergence has posed a great danger to the health of the general populace while impacting the Nigerian healthcare delivery significantly. Since its emergence, the health system has been stretched with overwhelming responsibilities. The study assessed health providers´ perceived impact of coronavirus pandemic on the uptake of health care services in South West Nigeria. Methods: a descriptive cross-sectional design using an online structured survey was used to elicit responses from 385 Nigerian health workers selected by convenience sampling technique. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 26. Comparison of the uptake of healthcare before and during the COVID-19 pandemic was performed using the Chi-square test. Results: findings revealed a significant difference between the uptake of health care prior and during the COVID-19 pandemic (χ2= 92.77, p=0.000) as 253 respondents (65.7%) reported that the hospital recorded a low turn-out of patients during the pandemic and 184 (47.8%) indicated that some of the facility units/departments were temporarily closed due to COVID-19 pandemic. Similarly, there was a significant difference between health-related conditions requiring hospital admission before and during COVID-19 pandemic (χ2=3.334 p=0.046). Factors influencing uptake of health services during the COVID-19 pandemic are: fear of nosocomial infection, fear of stigmatization, and misconception/misinformation on COVID-19 diseases and care. Conclusion: the Nigerian health system in the past months has been remarkably impacted by the pandemic. This calls for immediate restructuring to maintain an equitable distribution of care, while minimizing risk to patients and health providers.


Asunto(s)
COVID-19/psicología , Atención a la Salud/estadística & datos numéricos , Servicios de Salud/estadística & datos numéricos , Pandemias/prevención & control , Adulto , Ansiedad , COVID-19/epidemiología , COVID-19/prevención & control , Estudios Transversales , Miedo , Femenino , Personal de Salud , Accesibilidad a los Servicios de Salud , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Aceptación de la Atención de Salud/psicología , SARS-CoV-2 , Encuestas y Cuestionarios
17.
Int J Equity Health ; 20(1): 240, 2021 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-34736455

RESUMEN

Co-design as a participatory method aims to improve health service design and implementation. It is being used more frequently by researchers and practitioners in various health and social care settings. Co-design has the potential for achieving positive outcomes for the end users involved in the process; however, involvement of diverse ethnic minority population in the process remains limited. While the need to engage with diverse voices is identified, there is less information available on how to achieve meaningful engagement with these groups. Ethnic minorities are super-diverse population and the diversity between and within these groups need consideration for optimising their participation in co-design. Based on our experience of working with diverse ethnic minority groups towards the co-design of consumer engagement strategies to improve patient safety in cancer services as part of the two nationally-funded research projects in Australia, we outline reflections and practical techniques to optimise co-design with people from diverse ethnic backgrounds. We identify three key aspects of the co-design process pertinent to the involvement of this population; 1) starting at the pre-commencement stage to ensure diverse, seldom heard consumers are invited to and included in co-design work, 2) considering logistics and adequate resources to provide appropriate support to address needs before, during and beyond the co-design process, and 3) supporting and enabling a diversity of contributions via the co-design process.


Asunto(s)
Grupos Étnicos , Grupos Minoritarios , Servicios de Salud , Accesibilidad a los Servicios de Salud , Humanos , Investigadores
18.
Int J Equity Health ; 20(1): 239, 2021 11 04.
Artículo en Inglés | MEDLINE | ID: mdl-34736459

RESUMEN

BACKGROUND: For many low and middle-income countries poor quality health care is now responsible for a greater number of deaths than insufficient access to care. This has in turn raised concerns around the distribution of quality of care in LMICs: do the poor have access to lower quality health care compared to the rich? The aim of this study is to investigate the extent of inequalities in the availability of quality health services across the Indonesian health system with a particular focus on differences between care delivered in the public and private sectors. METHODS: Using the Indonesian Family Life Survey (wave 5, 2015), 15,877 households in 312 communities were linked with a representative sample of both public and private health facilities available in the same communities. Quality of health facilities was assessed using both a facility service readiness score and a knowledge score constructed using clinical vignettes. Ordinary least squares regression models were used to investigate the determinants of quality in public and private health facilities. RESULTS: In both sectors, inequalities in both quality scores existed between major islands. In public facilities, inequalities in readiness scores persisted between rural and urban areas, and to a lesser extent between rich and poor communities. CONCLUSION: In order to reach the ambitious stated goal of reaching Universal Health Coverage in Indonesia, priority should be given to redressing current inequalities in the quality of care.


Asunto(s)
Instituciones de Salud , Accesibilidad a los Servicios de Salud , Instituciones de Atención Ambulatoria , Humanos , Indonesia , Atención Primaria de Salud , Calidad de la Atención de Salud
19.
Artículo en Inglés | MEDLINE | ID: mdl-34770060

RESUMEN

Accessibility to healthcare and rehabilitation services for children with a disability (CWD) is essential to improving their health and wellbeing. However, access to the services, especially in many settings in developing countries with scarcity of resources, is still limited. As part of a qualitative study exploring impacts of caring for CWD on mothers or female caregivers and their coping strategies, this paper describes barriers for access to healthcare and rehabilitation services for CWD in Belu district, Indonesia. One-on-one, in-depth interviews were conducted with 22 mothers or female caregivers of CWD. Participants were recruited using a combination of purposive and snowball sampling techniques. These were supplemented with interviews with two staff of disability rehabilitation centers in Belu to understand any additional barriers. Data analysis was guided by a qualitative data analysis framework. Our analysis identified that lack of affordability of healthcare services (high costs and low financial capacity of mothers) was the key barrier for access to healthcare and rehabilitation services CWD. Religious or faith-based factors, such as being a non-Catholic (Belu is predominantly Catholic), converting from Catholic to other religions, and the belief in children's disability condition as "God's will", were also influencing factors for lack of access to the services. Shortage of staff, distrust in the therapy skills of staff at rehabilitation centers, and unavailability of appropriately trained healthcare professionals were structural or system-related barriers. The findings indicate the need for government-owned and run disability rehabilitation centers (not faith-based), the provision of fully subsidised health insurance to provide free services, and the provision of qualified therapists and healthcare professionals (to build trust) in Belu and other similar settings in Indonesia.


Asunto(s)
Cuidadores , Niños con Discapacidad , Niño , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Indonesia , Madres
20.
Artículo en Inglés | MEDLINE | ID: mdl-34770072

RESUMEN

Oral health concerns in Eritrean refugees have been an overlooked subject. This qualitative study explored the access of Eritrean refugees and asylum-seekers (ERNRAS) to oral health care services in Heidelberg, Germany, as well as their perceptions and attitudes towards oral health care. It involved 25 participants. We employed online semi-structured interviews (n = 15) and focus group discussions (n = 2). The data was recorded, transcribed, and analysed, using thematic analysis. The study found out that most of the participants have a relatively realistic perception and understanding of oral health. However, they have poor dental care practices, whilst a few have certain misconceptions of the conventional oral hygiene tools. Along with the majority's concerns regarding psychosocial attributes of poor oral health, some participants are routinely consuming Berbere (a traditional spice-blended pepper) to prevent bad breath. Structural or supply-side barriers to oral healthcare services included: communication hurdles; difficulty in identifying and navigating the German health system; gaps in transculturally, professionally, and communicationally competent oral health professionals; cost of dental treatment; entitlement issues (asylum-seekers); and appointment mechanisms. Individual or demand-side barriers comprised: lack of self-sufficiency; issue related to dental care beliefs, trust, and expectation from dentists; negligence and lack of adherence to dental treatment follow-up; and fear or apprehension of dental treatment. To address the oral health burdens of ERNRAS, it is advised to consider oral health education, language-specific, inclusive, and culturally and professionally appropriate healthcare services.


Asunto(s)
Refugiados , Actitud , Alemania , Accesibilidad a los Servicios de Salud , Humanos , Investigación Cualitativa
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