The impact of strike action by Ghana registered nurses and midwives on the access to and utilization of healthcare services.

BACKGROUND: As the largest professional group, nurses and midwives play instrumental roles in healthcare delivery, supporting the smooth administration and operation of the health system. Consequently, the withdrawal of nursing and midwifery services via strike action has direct and indirect detrimental effects on access to healthcare. OBJECTIVE: The current study examined the impact of strike action by nurses and midwives with respect to access to and use of health services. METHOD: Data were collected retrospectively from a total of 181 health facilities from all the 16 administrative regions of Ghana, with the support of field officers. Because the strike lasted for 3 days, the data collection span three consecutive days before the strike, three days of the strike and three consecutive days after the strike. Data analysis was focused comparing the utilization of healthcare services before, during and after strike. Data were analysed and presented on the various healthcare services. This was done separately for the health facility type and the 16 administrative regions. FINDINGS: The results showed that; (1) the average number of patients or clients who accessed healthcare services reduced drastically during the strike period, compared with before the strike. Majority of the regions recorded more than 70% decrease in service use during the strike period; (2) the average number of patients or clients who accessed healthcare services after the strike increased by more than 100% across majority of the regions. CONCLUSION: The study showed that strike action by nurses and midwives negatively affected access to and utilization of healthcare services.

Awareness, treatment, control, and determinants of dyslipidemia among adults in China.

Effective management of dyslipidemia is important. This study aimed to determine the awareness, treatment, control, and determinants of dyslipidemia in middle-aged and older Chinese adults in China. Using data from the 2015 China National Stroke Screening and Prevention Project (CNSSPP), a nationally representative sample of 135,403 Chinese adults aged 40 years or more were included in this analysis. Dyslipidemia was defined by the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults final report (NCEP-ATP III) and the 2016 Chinese guidelines for the management of dyslipidemia in adults. Models were constructed to adjust for subjects' characteristics with bivariate and multivariable logistic regression analyses. Overall, 51.1% of the subjects were women. Sixty-four percent were aware of their condition, of whom 18.9% received treatment, and of whom 7.2% had adequately controlled dyslipidemia. Dyslipidemia treatment was higher in men from rural areas than their urban counterparts. The multivariable logistic regression models revealed that women, urban residents, and general obesity were positively related to awareness. Women, married respondents, and current drinkers had higher odds of treatment. Age group, overweight, general obesity, urban residence, and women were independent determinants of control. Dyslipidemia awareness rate was moderately high, but treatment and control rates were low. Results can be used to develop policies and health promotion strategies with special focus on middle-aged and older adults.