12,665 results
Search Results
2. "A piece of paper is not the same as having someone to talk to": accessing post-diagnostic dementia care before and since COVID-19 and associated inequalities.
- Author
-
Giebel C, Hanna K, Tetlow H, Ward K, Shenton J, Cannon J, Butchard S, Komuravelli A, Gaughan A, Eley R, Rogers C, Rajagopal M, Limbert S, Callaghan S, Whittington R, Shaw L, and Gabbay M
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, SARS-CoV-2, COVID-19 epidemiology, Caregivers psychology, Dementia psychology, Health Services Accessibility economics, Health Services Accessibility standards, Healthcare Disparities, Social Work
- Abstract
Background: Social support services such as day care centres are important in post-diagnostic dementia care to enable people living with dementia stay at home for longer. Little research has addressed potential inequalities in access, with no research on variations before and since COVID-19. The aim of this study was to explore inequalities in social support service usage before and since the pandemic., Methods: Unpaid carers and people living with dementia were interviewed over the phone about their experiences of accessing social support services before and since the COVID-19 pandemic. Transcripts were analysed for key themes using inductive and deductive thematic analysis., Results: Fifty participants (42 unpaid carers; eight people living with dementia) were interviewed, and five themes identified: (1) Service issues; (2) Access issues; (3) Relying on own initiative; (4) New inequalities due to COVID-19; and (5) Missing out on the benefits of support services. Participants reported transport, finances, and location as factors reducing their ability to access support service pre-COVID, with inequalities remaining and at times exacerbated since. Carers and people living with dementia also reported struggling with accessing basic necessities during COVID, including food and medicines., Conclusions: Considering the benefits of accessing support services, resourced procedures and facilities are needed to maintain access to support services with more accessible remote support provision, enabling people from all backgrounds to access the care they need.
- Published
- 2021
- Full Text
- View/download PDF
3. "No Papers. No Doctor" : A Qualitative Study of Access to Maternity Care Services for Undocumented Immigrant Women in Denmark.
- Author
-
Funge JK, Boye MC, Johnsen H, and Nørredam M
- Subjects
- Adult, Child, Denmark, Female, Humans, Pregnancy, Qualitative Research, Emigrants and Immigrants, Health Services Accessibility, Maternal Health Services, Undocumented Immigrants
- Abstract
The purpose of this study is to explore undocumented immigrant women's experiences of, as well as their access to, maternity care services during pregnancy in Denmark. Recruiting through the two branches of a non-governmental organization (NGO)-driven health clinic in Denmark, we conducted 21 semi-structured interviews with undocumented immigrant women in Denmark from January 2018 to January 2019. The undocumented immigrant women experienced barriers such as fear of deportation, concerns about payment for services, and uncertainties about rules for access. Many of them described depending on NGO-driven initiatives to access maternity care services and found these as providing a safe environment for care. Our findings contribute insights towards understanding the health behavior of undocumented immigrant women and highlight the need for inclusive care to safeguard the health of the women and their children.
- Published
- 2020
- Full Text
- View/download PDF
4. Exercise-based Rehabilitation to Improve Exercise Tolerance of Severe COVID-19 Survivors: A Review Paper.
- Author
-
Nazir, Arnengsih, Tiksnadi, Badai Bhatara, and Ridzki, Mochammad Farhan Fajrial Aditama
- Subjects
HEALTH services accessibility ,HUMAN services programs ,THERAPEUTICS ,EXERCISE therapy ,SEVERITY of illness index ,EXERCISE intensity ,STRENGTH training ,EXERCISE tolerance ,AEROBIC exercises ,QUALITY of life ,ENDURANCE sports training ,COVID-19 ,CARDIAC rehabilitation ,POSTURAL balance - Abstract
Objectives: This review aimed to determine the form, results, and barriers to exercise-based rehabilitation programs for severe COVID-19 survivors. Methods: Searching for the article was carried out from August to October 2021. We used the PubMed database as a search media with the keywords (['COVID-19' OR 'COVID 19' OR 'SARS CoV-2'... [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
5. Contrasting current challenges from the Brazilian and Canadian national health systems: The Besrour Papers: a series on the state of family medicine in Canada and Brazil.
- Author
-
Ponka D, Pinto LF, Whalen-Browne M, Meuser A, Prado JC Jr, Michaelides O, and Rouleau K
- Subjects
- Brazil, Canada, Capacity Building, Delivery of Health Care, Integrated trends, Family Practice education, Global Health, Health Services Accessibility organization & administration, Humans, Poverty, Primary Health Care organization & administration, Delivery of Health Care, Integrated standards, Family Practice standards, Health Services Accessibility standards, Primary Health Care standards
- Abstract
Objective: To compare the national health systems of Canada and Brazil and how both countries have addressed similar challenges in their primary care sectors., Composition of the Committee: A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with colleagues in Brazil and collaborated to undertake a between-country comparison, comparing and contrasting various elements of both countries' efforts to strengthen primary care over the past few decades., Methods: Following a literature review, the authors collectively reflected on their experiences in an attempt to explore the past and current state of family medicine in Canada and Brazil., Report: The Brazilian and Canadian primary care systems are faced with similar challenges, including geography, demographic changes, population health inequities, and gaps in universal access to comprehensive primary care services. Although the approaches to addressing these challenges are different in both settings, they highlight the central importance of family physicians in both systems. Both countries continue to face considerable challenges in the context of mental health services in primary care. It remains important for Canada to draw lessons from the primary care systems and reforms of other countries, such as Brazil., (Copyright© the College of Family Physicians of Canada.)
- Published
- 2019
6. Maternal and neonatal implementation for equitable systems. A study design paper.
- Author
-
Ekirapa-Kiracho E, Tetui M, Bua J, Muhumuza Kananura R, Waiswa P, Makumbi F, Atuyambe L, Ajeani J, George A, Mutebi A, Kakaire A, Namazzi G, Paina L, and Namusoke Kiwanuka S
- Subjects
- Adult, Female, Focus Groups, Health Services Research, Humans, Infant, Newborn, Maternal Health Services standards, Power, Psychological, Pregnancy, Prenatal Care organization & administration, Quality of Health Care standards, Research Design, Rural Health Services standards, Uganda, Capacity Building organization & administration, Health Services Accessibility organization & administration, Maternal Health Services organization & administration, Quality of Health Care organization & administration, Rural Health Services organization & administration
- Abstract
Background: Evidence on effective ways of improving maternal and neonatal health outcomes is widely available. The challenge that most low-income countries grapple with is implementation at scale and sustainability., Objectives: The study aimed at improving access to quality maternal and neonatal health services in a sustainable manner by using a participatory action research approach., Methods: The study consisted of a quasi-experimental design, with a participatory action research approach to implementation in three rural districts (Pallisa, Kibuku and Kamuli) in Eastern Uganda. The intervention had two main components; namely, community empowerment for comprehensive birth preparedness, and health provider and management capacity-building. We collected data using both quantitative and qualitative methods using household and facility-level structured surveys, record reviews, key informant interviews and focus group discussions. We purposively selected the participants for the qualitative data collection, while for the surveys we interviewed all eligible participants in the sampled households and health facilities. Descriptive statistics were used to describe the data, while the difference in difference analysis was used to measure the effect of the intervention. Qualitative data were analysed using thematic analysis., Conclusions: This study was implemented to generate evidence on how to increase access to quality maternal and newborn health services in a sustainable manner using a multisectoral participatory approach.
- Published
- 2017
- Full Text
- View/download PDF
7. Developing family practice to respond to global health challenges: The Besrour Papers: a series on the state of family medicine in the world.
- Author
-
Arya N, Dahlman B, Gibson C, Ponka D, Haq C, Rouleau K, and Hansel S
- Subjects
- Africa South of the Sahara, Capacity Building, Cuba, Delivery of Health Care, Integrated trends, Family Practice education, Global Health, Health Services Accessibility organization & administration, Humans, Poverty, Primary Health Care organization & administration, Delivery of Health Care, Integrated standards, Family Practice standards, Health Services Accessibility standards, Primary Health Care standards
- Abstract
Objective: To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally., Composition of the Committee: A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally., Methods: Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts., Report: With the failure of vertical, disease-oriented models to provide sustained improvements in health outcomes, the need to develop integrated primary care involving the most appropriate health professionals for differing contexts is becoming apparent worldwide. Health system planning is required to develop policies on health professional training to achieve this. Advocating and offering appropriate incentives for, and coordination of, local opportunities within the health system also becomes paramount. The adaptability and generalist nature of family medicine allows it to respond to the unique needs of a given population. Family physicians with adequate financial and physical resources can function most effectively as members of interdisciplinary teams, thus providing valuable, comprehensive health services in any area of the world., (Copyright© the College of Family Physicians of Canada.)
- Published
- 2017
8. Joint position paper on rural surgery and operative delivery.
- Author
-
Iglesias S, Kornelsen J, Woollard R, Caron N, Warnock G, Friesen R, Miles P, Vogt Haines V, Batchelor B, Blake J, Mazowita G, Wyman R, Geller B, and de Klerk B
- Subjects
- Canada, Delivery, Obstetric standards, Family Practice, Female, General Surgery education, General Surgery standards, Gynecology education, Gynecology standards, Health Planning, Health Policy, Humans, Obstetrics education, Obstetrics standards, Patient Safety, Pregnancy, Program Evaluation, Rural Health, Societies, Medical, Workforce, Cesarean Section standards, Community Networks, Health Services Accessibility, Health Services Needs and Demand, Maternal Health Services standards, Physicians supply & distribution, Rural Health Services standards, Surgical Procedures, Operative standards
- Abstract
Our professional organizations have prepared this paper as part of an integrated, multidisciplinary plan to ensure the availability of well-trained practitioner teams to sustain safe, effective and high-quality rural surgical and operative delivery services. Without these robust local (or nearby) surgical services, sustaining rural maternity care is much more difficult. This paper describes the "network model" as a health human resources solution to meet the surgical needs, including operative delivery, of rural residents; outlines necessary policy directions for achieving this solution; and poses a series of enabling recommendations.
- Published
- 2015
9. Method paper--distance and travel time to casualty clinics in Norway based on crowdsourced postcode coordinates: a comparison with other methods.
- Author
-
Raknes G and Hunskaar S
- Subjects
- Cities, Nonlinear Dynamics, Norway, Referral and Consultation, Regression Analysis, Time Factors, Crowdsourcing methods, Health Services Accessibility, Travel
- Abstract
We describe a method that uses crowdsourced postcode coordinates and Google maps to estimate average distance and travel time for inhabitants of a municipality to a casualty clinic in Norway. The new method was compared with methods based on population centroids, median distance and town hall location, and we used it to examine how distance affects the utilisation of out-of-hours primary care services. At short distances our method showed good correlation with mean travel time and distance. The utilisation of out-of-hours services correlated with postcode based distances similar to previous research. The results show that our method is a reliable and useful tool for estimating average travel distances and travel times.
- Published
- 2014
- Full Text
- View/download PDF
10. A concept paper: using the outcomes of common surgical conditions as quality metrics to benchmark district surgical services in South Africa as part of a systematic quality improvement programme.
- Author
-
Clarke DL, Kong VY, Handley J, and Aldous C
- Subjects
- Appendicitis surgery, Benchmarking, General Surgery statistics & numerical data, Healthcare Disparities, Humans, South Africa, General Surgery standards, Health Services Accessibility, Quality Improvement, Quality Indicators, Health Care
- Abstract
The fourth, fifth and sixth Millennium Development Goals relate directly to improving global healthcare and health outcomes. The focus is to improve global health outcomes by reducing maternal and childhood mortality and the burden of infectious diseases such as HIV/AIDS, tuberculosis and malaria. Specific targets and time frames have been set for these diseases. There is, however, no specific mention of surgically treated diseases in these goals, reflecting a bias that is slowly changing with emerging consensus that surgical care is an integral part of primary healthcare systems in the developing world. The disparities between the developed and developing world in terms of wealth and social indicators are reflected in disparities in access to surgical care. Health administrators must develop plans and strategies to reduce these disparities. However, any strategic plan that addresses deficits in healthcare must have a system of metrics, which benchmark the current quality of care so that specific improvement targets may be set.This concept paper outlines the role of surgical services in a primary healthcare system, highlights the ongoing disparities in access to surgical care and outcomes of surgical care, discusses the importance of a systems-based approach to healthcare and quality improvement, and reviews the current state of surgical care at district hospitals in South Africa. Finally, it proposes that the results from a recently published study on acute appendicitis, as well as data from a number of other common surgical conditions, can provide measurable outcomes across a healthcare system and so act as an indicator for judging improvements in surgical care. This would provide a framework for the introduction of collection of these outcomes as a routine epidemiological health policy tool.
- Published
- 2013
- Full Text
- View/download PDF
11. [In regard to the paper: Developments in the necessity and coverage of the syringe exchange program in Spanish prisons, 1992-2009. Estimation after correction].
- Author
-
Acín García EJ
- Subjects
- Humans, Health Services Accessibility statistics & numerical data, Health Services Needs and Demand, Needle-Exchange Programs supply & distribution, Prisons organization & administration
- Published
- 2013
- Full Text
- View/download PDF
12. Conceptual framework on barriers and facilitators to implementing perinatal mental health care and treatment for women: the MATRIx evidence synthesis.
- Author
-
Webb R, Ford E, Shakespeare J, Easter A, Alderdice F, Holly J, Coates R, Hogg S, Cheyne H, McMullen S, Gilbody S, Salmon D, and Ayers S
- Subjects
- Female, Humans, Pregnancy, Health Services Accessibility organization & administration, Mental Disorders therapy, Mental Health Services organization & administration, Perinatal Care organization & administration
- Abstract
Background: Perinatal mental health difficulties can occur during pregnancy or after birth and mental illness is a leading cause of maternal death. It is therefore important to identify the barriers and facilitators to implementing and accessing perinatal mental health care., Objectives: Our research objective was to develop a conceptual framework of barriers and facilitators to perinatal mental health care (defined as identification, assessment, care and treatment) to inform perinatal mental health services., Methods: Two systematic reviews were conducted to synthesise the evidence on: Review 1 barriers and facilitators to implementing perinatal mental health care; and Review 2 barriers to women accessing perinatal mental health care. Results were used to develop a conceptual framework which was then refined through consultations with stakeholders., Data Sources: Pre-planned searches were conducted on MEDLINE, EMBASE, PsychInfo and CINAHL. Review 2 also included Scopus and the Cochrane Database of Systematic Reviews., Review Methods: In Review 1, studies were included if they examined barriers or facilitators to implementing perinatal mental health care. In Review 2, systematic reviews were included if they examined barriers and facilitators to women seeking help, accessing help and engaging in perinatal mental health care; and they used systematic search strategies. Only qualitative papers were identified from the searches. Results were analysed using thematic synthesis and themes were mapped on to a theoretically informed multi-level model then grouped to reflect different stages of the care pathway., Results: Review 1 included 46 studies. Most were carried out in higher income countries and evaluated as good quality with low risk of bias. Review 2 included 32 systematic reviews. Most were carried out in higher income countries and evaluated as having low confidence in the results. Barriers and facilitators to perinatal mental health care were identified at seven levels: Individual (e.g. beliefs about mental illness); Health professional (e.g. confidence addressing perinatal mental illness); Interpersonal (e.g. relationship between women and health professionals); Organisational (e.g. continuity of carer); Commissioner (e.g. referral pathways); Political (e.g. women's economic status); and Societal (e.g. stigma). These factors impacted on perinatal mental health care at different stages of the care pathway. Results from reviews were synthesised to develop two MATRIx conceptual frameworks of the (1) barriers and (2) facilitators to perinatal mental health care. These provide pictorial representations of 66 barriers and 39 facilitators that intersect across the care pathway and at different levels., Limitations: In Review 1 only 10% of abstracts were double screened and 10% of included papers methodologically appraised by two reviewers. The majority of reviews included in Review 2 were evaluated as having low ( n = 14) or critically low ( n = 5) confidence in their results. Both reviews only included papers published in academic journals and written in English., Conclusions: The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing perinatal mental health care and effective implementation of perinatal mental health services., Recommendations for Health Policy and Practice: These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to perinatal mental health care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to do it., Future Work: Further research is needed to examine access to perinatal mental health care for specific groups, such as fathers, immigrants or those in lower income countries., Trial Registration: This trial is registered as PROSPERO: (R1) CRD42019142854; (R2) CRD42020193107., Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR 128068) and is published in full in Health and Social Care Delivery Research ; Vol. 12, No. 2. See the NIHR Funding and Awards website for further award information.
- Published
- 2024
- Full Text
- View/download PDF
13. AGD issues white paper on access to care.
- Subjects
- Humans, United States, Dental Care, General Practice, Dental organization & administration, Health Care Reform, Health Services Accessibility
- Published
- 2009
14. Debate on the paper by David Vlahov & David D. Celentano.
- Author
-
Kalichman A
- Subjects
- Brazil epidemiology, Female, HIV Infections drug therapy, HIV Infections prevention & control, Humans, Incidence, Male, Survival Rate, Antiretroviral Therapy, Highly Active, HIV Infections mortality, Health Services Accessibility, Substance Abuse, Intravenous complications
- Published
- 2006
- Full Text
- View/download PDF
15. Debate on the paper by David Vlahov & David D. Celentano. HIV infection, injection drug users and bioethics.
- Author
-
Palácios M
- Subjects
- Humans, Antiretroviral Therapy, Highly Active ethics, Bioethical Issues, HIV Infections drug therapy, Health Services Accessibility ethics, Patient Selection ethics, Substance Abuse, Intravenous complications
- Published
- 2006
- Full Text
- View/download PDF
16. Debate on the paper by David Vlahov & David D. Celentano. Access to AIDS treatment: appropriateness and correctness in the pursuit of good practice.
- Author
-
Ayres JR
- Subjects
- Brazil, Evidence-Based Medicine, Humans, Patient Compliance, Prejudice, Anti-Retroviral Agents therapeutic use, HIV Infections drug therapy, Health Services Accessibility ethics, Professional Practice ethics, Substance Abuse, Intravenous
- Published
- 2006
- Full Text
- View/download PDF
17. Position paper/statement by members of the Ponte di Legno Group on the right of children to have full access to essential treatment for acute lymphoblastic leukemia.
- Subjects
- Child, Clinical Trials as Topic, Health Policy, Humans, International Cooperation, Child Welfare, Health Services Accessibility, Patient Advocacy, Precursor Cell Lymphoblastic Leukemia-Lymphoma therapy
- Published
- 2004
18. [Research in, about, and for health services: an international panorama and questions for health research in Brazil. Debate on the paper by Hillegonda Maria Dutilh Novaes].
- Author
-
Almeida C
- Subjects
- Brazil, Humans, Health Policy, Health Services Accessibility, Health Services Research, Quality of Health Care
- Published
- 2004
- Full Text
- View/download PDF
19. A comprehensive investigation of barriers to adult immunization: a methods paper.
- Author
-
Zimmerman RK, Silverman M, Janosky JE, Mieczkowski TA, Wilson SA, Bardella IJ, Medsger AR, Terry MA, Ball JA, and Nowalk MP
- Subjects
- Aged, Female, Focus Groups, Guideline Adherence standards, Guideline Adherence statistics & numerical data, Health Services Research, Humans, Male, Minority Groups education, Minority Groups psychology, Models, Psychological, Organizational Culture, Patient Acceptance of Health Care statistics & numerical data, Pennsylvania, Practice Guidelines as Topic, Regression Analysis, Surveys and Questionnaires, Family Practice organization & administration, Health Knowledge, Attitudes, Practice, Health Services Accessibility organization & administration, Immunization psychology, Immunization statistics & numerical data, Influenza Vaccines, Patient Acceptance of Health Care psychology, Pneumococcal Vaccines, Practice Patterns, Physicians' statistics & numerical data
- Abstract
Objective: Immunization rates for influenza and pneumococcal vaccines among the elderly (especially minority elderly) are below desired levels. We sought to answer 4 questions: (1) What factors explain most missed immunizations? (2) How are patient beliefs and practices regarding adult immunization affected by racial or cultural factors? (3) How are immunizations and patient beliefs affected by physician, organizational, and operational factors? and (4) Based on the relationships identified, can typologies be created that foster the tailoring of interventions to improve immunization rates?, Study Design: A multidisciplinary team chose the PRECEDE-PROCEED framework, the Awareness-to-Adherence model of clinician response to guidelines, and the Triandis model of consumer decision making as the best models to assess barriers to and facilitators of immunization. Our data collection methods included focus groups, face-to-face and telephone interviews, self-administered surveys, site visits, participant observation, and medical record review., Population: To encounter a broad spectrum of patients, facilities, systems, and interventions, we sampled from 4 strata: inner-city neighborhood health centers, clinics in Veterans Administration facilities, rural practices in a network, and urban/suburban practices in a network. In stage 1, a stratified random cluster sample of 60 primary care clinicians was selected, 15 in each of the strata. In stage 2, a random sample of 15 patients was selected from each clinician's list of patients, aiming for 900 total interviews., Conclusions: This multicomponent approach is well suited to identifying barriers to and facilitators of adult immunizations among a variety of populations, including the disadvantaged.
- Published
- 2001
20. Preserving consumer choice in an era of religious/secular health industry mergers (position paper).
- Subjects
- Abortion, Induced, Family Planning Policy, Female, Humans, Pregnancy, Protestantism, Research, United States, Advance Directives, Fetal Tissue Transplantation, Health Facility Merger, Health Policy, Health Services Accessibility, Religion, Reproductive Medicine
- Published
- 2001
- Full Text
- View/download PDF
21. Supporting access to midwifery services in the United States (position paper).
- Subjects
- Female, Humans, Nurse Midwives, Pregnancy, United States, Health Policy, Health Services Accessibility, Midwifery
- Published
- 2001
- Full Text
- View/download PDF
22. Meeting health needs of asylum seekers. White paper will make access to health care more difficult.
- Author
-
Hogan H
- Subjects
- Health Policy, Humans, United Kingdom, Health Services Accessibility, Refugees
- Published
- 1999
- Full Text
- View/download PDF
23. The impact of health insurance on hypertension care: a household fixed effects study in India.
- Author
-
Feng Z, Chen Q, Jiao L, Ma X, Atun R, Geldsetzer P, Bärnighausen T, and Chen S
- Subjects
- Humans, India, Adult, Middle Aged, Male, Female, Adolescent, Young Adult, Health Surveys, Family Characteristics, Hypertension epidemiology, Hypertension therapy, Insurance, Health statistics & numerical data, Insurance Coverage statistics & numerical data, Health Services Accessibility statistics & numerical data
- Abstract
Introduction: Hypertension is highly prevalent in India, but the proportion of patients achieving blood pressure control remains low. Efforts have been made to expand health insurance coverage nationwide with the aim of improving overall healthcare access. It is critical to understand the role of health insurance coverage in improving hypertension care., Methods: We used secondary data from the nationally representative sample of adults aged 15-49 years from the 2015-2016 National Family Health Survey (NFHS) in India. We defined the hypertension care cascade as four successive steps of (1) screened, (2) diagnosed, (3) treated, and (4) controlled, and operationalized these variables using blood pressure measurements and self-reports. We employed household fixed effect models that conceptually matched people with and without insurance within the household, to estimate the impact of insurance coverage on the likelihood of reaching each care cascade step, while controlling for a wide range of additional individual-level variables., Results: In all 130,151 included individuals with hypertension, 20.4% reported having health insurance. For the insured hypertensive population, 79.8% (95% Confidence Interval: 79.3%-80.3%) were screened, 49.6% (49.0%-50.2%) diagnosed, 14.3% (13.9%-14.7%) treated, and 7.9% (7.6%-8.2%) controlled, marginally higher than the percentages for the uninsured 79.8% (79.5%-80.0%), 48.2% (47.9%-48.6%), 13.3% (13.1%-13.5%), and 7.5% (7.4%-7.7%) for each cascade step, respectively. From the household fixed effects model, health insurance did not show significant impact on the hypertension care cascade, with the estimated relative risks of health insurance 0.97 (0.93-1.02), 0.97 (0.91-1.03), 0.95 (0.77-1.30), and 0.97 (0.65-1.10) for each cascade step, respectively. We further performed stratified analyses by sociodemographic and behavioral risk factors and a sensitivity analysis with district fixed effects, all of which yielded results that confirmed the robustness of our main findings., Conclusions: Health insurance did not show significant impact on improving hypertension care cascade among young and middle-aged adults with hypertension in India. Innovative strategies for overcoming practical barriers to healthcare services in addition to improving financial access are needed to address the large unmet need for hypertension care., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
24. Clinical Nutrition and Human Rights. An International Position Paper
- Author
-
Régis Hankard, Diana Cardenas, Rocco Barazzoni, Gil Hardy, Dolores Rodriguez-Ventimilla, Maria Isabel Toulson Davisson Correia, Winai Ungpinitpong, Juan B. Ochoa, Katerina Zakka, André Briend, Cristina Cuerda, Teresa Pounds, Karin Papapietro, Charles Bermúdez, Cardenas, D., Correia, M. I. T. D., Ochoa, J. B., Hardy, G., Rodriguez-Ventimilla, D., Bermudez, C. E., Papapietro, K., Hankard, R., Briend, A., Ungpinitpong, W., Zakka, K. M., Pounds, T., Cuerda, C., and Barazzoni, R.
- Subjects
0301 basic medicine ,Human Rights ,030309 nutrition & dietetics ,media_common.quotation_subject ,Medicine (miscellaneous) ,030209 endocrinology & metabolism ,Clinical nutrition ,Critical Care and Intensive Care Medicine ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Right to Health ,Nursing ,Disease-related malnutrition ,Human rights ,Medicine ,Humans ,Disease ,Medical nutrition therapy ,Obligation ,media_common ,0303 health sciences ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Right to health ,business.industry ,Nutritional Support ,Malnutrition ,medicine.disease ,Artificial nutrition therapy ,Patient Rights ,Nutrition Assessment ,Right to food ,Food ,Health ,Position paper ,030211 gastroenterology & hepatology ,Nutrition Therapy ,business - Abstract
The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political, and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.
- Published
- 2021
25. Barriers and delays in access to abortion care: a cross-sectional study of people traveling to obtain care in England and the Netherlands from European countries where abortion is legal on broad grounds.
- Author
-
Wollum A, De Zordo S, Zanini G, Mishtal J, Garnsey C, and Gerdts C
- Subjects
- Pregnancy, Female, Humans, Cross-Sectional Studies, Netherlands, England, Abortion, Legal, Health Services Accessibility, Abortion, Induced
- Abstract
Introduction: This study characterized the extent to which (1) financial barriers and (2) abortion care-seeking within a person's country of residence were associated with delays in abortion access among those travelling to England and the Netherlands for abortion care from European countries where abortion is legal on broad grounds in the first trimester but where access past the first trimester is limited to specific circumstances., Methodology: We drew on cross-sectional survey data collected at five abortion clinics in England and the Netherlands from 2017 to 2019 (n = 164). We assessed the relationship between difficulty paying for the abortion/travel, acute financial insecurity, and in-country care seeking on delays to abortion using multivariable discrete-time hazards models., Results: Participants who reported facing both difficulty paying for the abortion procedure and/or travel and difficulty covering basic living costs in the last month reported longer delays in accessing care than those who had no financial difficulty (adjusted hazard odds ratio: 0.39 95% CI 0.21-0.74). This group delayed paying other expenses (39%) or sold something of value (13%) to fund their abortion, resulting in ~ 60% of those with financial difficulty reporting it took them over a week to raise the funds needed for their abortion. Having contacted or visited an abortion provider in the country of residence was associated with delays in presenting abroad for an abortion., Discussion: These findings point to inequities in access to timely abortion care based on socioeconomic status. Legal time limits on abortion may intersect with individuals' interactions with the health care system to delay care., (© 2024. The Author(s).)
- Published
- 2024
- Full Text
- View/download PDF
26. The health of detainees and the role of primary care: Position paper of the European Forum for Primary Care.
- Author
-
Groenewegen, Peter, Dirkzwager, Anja, van Dam, Anke, Massalimova, Dina, Sirdifield, Coral, and Smith, Lauren
- Subjects
- *
HEALTH services accessibility , *PRISONERS , *PRIMARY health care , *CONTINUUM of care , *POLICY sciences , *MEDICAL needs assessment - Abstract
This position paper aims to increase awareness among primary care practitioners and policymakers about the specific and complex health needs of people who experience incarceration. We focus on the importance of primary care and of continuity of care between prison and community. We highlight what is known from the literature on the health of people who experience incarceration, on the organisation of prison health care, and on the role of primary care both during and after detention. We present three case descriptions of detainees' encounters with the organisation of prison health care in three European countries. Finally, we describe the position that the European Forum for Primary Care takes. Prisoners and ex-prisoners have a worse physical and mental health compared with a cross-section of the population. However, access to good quality treatment and care is often worse than in the outside situation. In particular, well-organised primary care in the prison context could benefit prisoners and, indirectly, society at large. Moreover, continuity of care between the community and the prison situation needs improvement. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
27. Exploring the health consequences of armed conflict: the perspective of Northeast Ethiopia, 2022: a qualitative study.
- Author
-
Arage MW, Kumsa H, Asfaw MS, Kassaw AT, Dagnew EM, Tunta A, Kassahun W, Addisu A, Yigzaw M, Hailu T, and Tenaw LA
- Subjects
- Humans, Female, Pregnancy, Aged, Ethiopia, Qualitative Research, Armed Conflicts, Health Services Accessibility, Violence
- Abstract
Background: Conflict is a complicated topic with a multidimensional consequences for community health. Its effects have a broad pattern, starting from direct war-related morbidity and mortality caused by bullets and bombs to indirect consequences due to the interruption of the delivery of preventive and curative health services. This study aimed to explore the health consequences of the northern Ethiopian conflict in the North Wollo zone, northeast Ethiopia, in 2022., Methods: This descriptive qualitative study was conducted from May to June 2022 on six conflict-affected Woredas in the north Wollo zone. A total of 100 purposively selected participants, which included patients, pregnant women, elders, community and religious leaders, and health professionals, were interviewed using IDI and FGD. The data was entered, coded, and analyzed using Open Code version 4.03. Thematic analysis approach employed to conduct the interpretation. Data was presented using descriptive statistics in the form of texts and tables., Results: The findings indicate that the conflict has caused a profound consequence on population health. It has resulted in a wide range of direct and indirect consequences, ranging from war-related casualties, famine, and disruptions of supply chains and forced displacement to instances of violence and rape associated with insecurity. The conflict also caused a breakdown in the health system by causing distraction of health infrastructure, fleeing of health workers and shortage of medication, together with insecurity and lack of transportation, which greatly affected the provision and utilization of health services. Additionally, the conflict has resulted in long-term consequences, such as the destruction of health facilities, interruption of immunization services, posttraumatic stress disorders, and lifelong disabilities. The coping strategies utilized were using available traditional medicines and home remedies, obtaining medications from conflict-unaffected areas, and implementing home-to-home healthcare services using available supplies., Conclusion: The Northern Ethiopian conflict has an impact on community health both directly and indirectly through conflict-related causalities and the breakdown of the health system and health-supporting structures. Therefore, this study recommends immediate rehabilitation interventions for damaged health infrastructure and affected individuals., (© 2023. BioMed Central Ltd., part of Springer Nature.)
- Published
- 2023
- Full Text
- View/download PDF
28. Rethinking 'need' for clinical support in transgender and gender non‐conforming children without clinical classification: Learning from 'the paper I almost wrote'.
- Author
-
Horowicz, Edmund
- Subjects
- *
SOCIAL support , *HEALTH services accessibility , *SOCIAL stigma , *GENDER dysphoria , *GENDER identity , *GENDER nonconformity , *NEEDS assessment , *NEED (Psychology) , *MEDICAL needs assessment , *BIOETHICS , *CHILDREN - Abstract
There have been ongoing debates as to how, or even whether, we should clinically classify gender diversity in children through clinical classification manuals. So‐called 'depathologizing' is argued as being vital to address the stigma that these children are somehow disordered or sick. Yet one argument in favour of continued clinical classification for transgender and gender non‐conforming children is that it better facilitates access to specialist psychological support. I argue that whilst continued clinical classification offers a seemingly pragmatic solution to ensuring access, it does in fact obscure our understanding of the individual needs of these children. In this paper I address fundamental issues that aim to better our understanding of need and thus why a child may benefit from specialist support. I do so by critiquing a paper I nearly wrote, which argued for the ongoing continued classification of gender incongruence in children. Ultimately, I argue that specialist psychological support and care should be driven by the needs of the individual child, as determined by the child and those involved with their care. By bettering our understanding as to why specialist psychological support may be beneficial for some, we move past the focus of such specialist support being provided because of the child's gender diversity. Methodologically the paper may be unusual, in comparison to traditional normative counter‐argumentative bioethical position papers, but by presenting an argument for depathologization of gender diversity of children in this way there is also an alternative insight into the methods of bioethics. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
29. Strategies to optimise culturally appropriate perioperative care for Aboriginal and Torres Strait Islander peoples: A discussion paper.
- Author
-
Joye, Maureen and Foran, Paula
- Subjects
PERIOPERATIVE care ,INDIGENOUS Australians ,NURSE liaisons ,HEALTH services accessibility ,PATIENT advocacy ,OPERATING room nurses ,NURSE-patient relationships ,HEALTH equity ,EVIDENCE-based nursing ,NURSING interventions ,TRUST - Abstract
The disparity in health outcomes between Indigenous and non-indigenous Australians continues to increase. Barriers to accessing health care, particularly surgical treatment, contribute to health inequalities among Indigenous Australians. Despite a positive correlation between improved patient experiences and health outcomes, there is little research available on nursing interventions to improve Indigenous patients' perioperative health care treatment. This discussion paper investigates culturally appropriate and evidence- based nursing interventions that can be applied in the perioperative setting to improve the surgical experience of Indigenous patients. It was shown that establishing trust among Aboriginal and Torres Strait Islander patients through anaesthetic nurse practices and advocating for family involvement is critical in providing culturally safe care and enhancing patient experiences. Indigenous health liaison officers were also identified as a valuable resource in bridging cultural and communication gaps between health care providers and Indigenous patients. These findings demonstrate that using tailored nursing strategies while providing perioperative care to Indigenous Australians can enhance their perioperative health care experience and contribute to improving health outcomes of Indigenous Australians. It is therefore recommended that perioperative nurses adopt these strategies; however, further research is needed to investigate implementation of an enhanced role for anaesthetic nurses, advocating for family involvement and referral to Indigenous health liaison officers. Such research should evaluate the impact of these new holistic and patient-centred approaches on the health outcomes and experiencecs of Indigenous patients. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
30. Meningococcal vaccines: WHO position paper on the use of multivalent meningococcal conjugate vaccines in countries of the African meningitis belt.
- Subjects
- *
PREVENTION of epidemics , *HEALTH policy , *PUBLIC health surveillance , *IMMUNIZATION , *HEALTH services accessibility , *CROWDS , *PUBLIC health , *BACTERIAL meningitis , *MENINGOCOCCAL vaccines , *MEDICAL protocols , *RISK assessment , *VACCINATION mandates , *INFECTIOUS disease transmission - Abstract
The article presents an addendum to the position paper on the use of meningococcal conjugate vaccines (MMCV) in the African meningitis belt issued by the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on Immunization at its meeting in September 2023. Topics include the WHO off-label recommendations for meningococcal vaccines and vaccination that apply to countries in the African meningitis belt and research priorities on the impact of Men5CV vaccine.
- Published
- 2024
31. White paper for global Palliative Care advocacy: recommendations from a PAL-LIFE expert advisory Group of the Pontifical Academy for Life, Vatican City
- Author
-
Mary Callaway, Julianna Yong, M. R. Rajagopal, Sami Alsirafy, Katherine Pettus, Eduardo Bruera, Eduardo Garralda, Emmanuel Luyirika, Thomas Sitte, Daniela Mosoiu, Christina M. Puchalski, John Y. Rhee, Nunziata Comoretto, Carlos Centeno, Liliana De Lima, and Kathleen M. Foley
- Subjects
Position statement ,Palliative care ,Certification ,Consensus ,Delphi Technique ,Attitude of Health Personnel ,Advisory Committees ,Development ,Global Health ,Vatican City ,Health Services Accessibility ,Academic institution ,03 medical and health sciences ,0302 clinical medicine ,White paper ,Medicine ,Humans ,030212 general & internal medicine ,Palliative Medicine ,development ,General Nursing ,Medical education ,advocacy ,palliative care ,business.industry ,Catholicism ,position statement ,Global ,General Medicine ,Advocacy ,Holy See ,global ,Anesthesiology and Pain Medicine ,Special Reports ,030220 oncology & carcinogenesis ,Ciencias de la Salud [Materias Investigacion] ,business - Abstract
Background: The Pontifical Academy for Life (PAV) is an academic institution of the Holy See (Vatican), which aims to develop and promote Catholic teachings on questions of biomedical ethics. Palliative care (PC) experts from around the world professing different faiths were invited by the PAV to develop strategic recommendations for the global development of PC (“PAL-LIFE group”). Design: Thirteen experts in PC advocacy participated in an online Delphi process. In four iterative rounds, participants were asked to identify the most significant stakeholder groups and then propose for each, strategic recommendations to advance PC. Each round incorporated the feedback from previous rounds until consensus was achieved on the most important recommendations. In a last step, the ad hoc group was asked to rank the stakeholders' groups by order of importance on a 13-point scale and to propose suggestions for implementation. A cluster analysis provided a classification of the stakeholders in different levels of importance for PC development. Results: Thirteen stakeholder groups and 43 recommendations resulted from the first round, and, of those, 13 recommendations were chosen as the most important (1 for each stakeholder group). Five groups had higher scores. The recommendation chosen for these top 5 groups were as follows: (1) Policy makers: Ensure universal access to PC; (2) Academia: Offer mandatory PC courses to undergraduates; (3) Healthcare workers: PC professionals should receive adequate certification; (4) Hospitals and healthcare centers: Every healthcare center should ensure access to PC medicines; and (5) PC associations: National Associations should be effective advocates and work with their governments in the process of implementing international policy framework. A recommendation for each of the remaining eight groups is also presented. Discussion: This white paper represents a position statement of the PAV developed through a consensus process in regard to advocacy strategies for the advancement of PC in the world.
- Published
- 2018
32. 'A piece of paper is not the same as having someone to talk to': accessing post-diagnostic dementia care before and since COVID-19 and associated inequalities
- Author
-
Sarah Butchard, Aravind Komuravelli, Ruth Eley, Steve Callaghan, Jacqueline Cannon, Hilary Tetlow, Carol Rogers, Justine Shenton, Manoj Rajagopal, Rosie Whittington, Clarissa Giebel, Stan Limbert, Mark Gabbay, Lisa Shaw, Kerry Hanna, Kym Ward, and Anna Gaughan
- Subjects
Adult ,Male ,Social Work ,Day care ,Health Services Accessibility ,03 medical and health sciences ,Social support ,0302 clinical medicine ,Nursing ,medicine ,Humans ,Dementia ,030212 general & internal medicine ,Healthcare Disparities ,Aged ,Social policy ,Service (business) ,030214 geriatrics ,Social work ,SARS-CoV-2 ,Research ,lcsh:Public aspects of medicine ,Health Policy ,Public Health, Environmental and Occupational Health ,Health services research ,COVID-19 ,lcsh:RA1-1270 ,Middle Aged ,medicine.disease ,Caregivers ,Female ,Thematic analysis ,Psychology - Abstract
Background Social support services such as day care centres are important in post-diagnostic dementia care to enable people living with dementia stay at home for longer. Little research has addressed potential inequalities in access, with no research on variations before and since COVID-19. The aim of this study was to explore inequalities in social support service usage before and since the pandemic. Methods Unpaid carers and people living with dementia were interviewed over the phone about their experiences of accessing social support services before and since the COVID-19 pandemic. Transcripts were analysed for key themes using inductive and deductive thematic analysis. Results Fifty participants (42 unpaid carers; eight people living with dementia) were interviewed, and five themes identified: (1) Service issues; (2) Access issues; (3) Relying on own initiative; (4) New inequalities due to COVID-19; and (5) Missing out on the benefits of support services. Participants reported transport, finances, and location as factors reducing their ability to access support service pre-COVID, with inequalities remaining and at times exacerbated since. Carers and people living with dementia also reported struggling with accessing basic necessities during COVID, including food and medicines. Conclusions Considering the benefits of accessing support services, resourced procedures and facilities are needed to maintain access to support services with more accessible remote support provision, enabling people from all backgrounds to access the care they need.
- Published
- 2021
33. Canadian Association of Radiologists White Paper on De-identification of Medical Imaging: Part 2, Practical Considerations.
- Author
-
Parker, William, Jaremko, Jacob L., Cicero, Mark, Azar, Marleine, El-Emam, Khaled, Gray, Bruce G., Hurrell, Casey, Lavoie-Cardinal, Flavie, Desjardins, Benoit, Lum, Andrea, Sheremeta, Lori, Lee, Emil, Reinhold, Caroline, Tang, An, and Bromwich, Rebecca
- Subjects
- *
ALGORITHMS , *ARTIFICIAL intelligence , *DATA encryption , *DATABASE management , *DIAGNOSTIC imaging , *HEALTH services accessibility , *MACHINE learning , *MEDICAL protocols , *DICOM (Computer network protocol) , *COVID-19 pandemic - Abstract
The application of big data, radiomics, machine learning, and artificial intelligence (AI) algorithms in radiology requires access to large data sets containing personal health information. Because machine learning projects often require collaboration between different sites or data transfer to a third party, precautions are required to safeguard patient privacy. Safety measures are required to prevent inadvertent access to and transfer of identifiable information. The Canadian Association of Radiologists (CAR) is the national voice of radiology committed to promoting the highest standards in patient-centered imaging, lifelong learning, and research. The CAR has created an AI Ethical and Legal standing committee with the mandate to guide the medical imaging community in terms of best practices in data management, access to health care data, de-identification, and accountability practices. Part 2 of this article will inform CAR members on the practical aspects of medical imaging de-identification, strengths and limitations of de-identification approaches, list of de-identification software and tools available, and perspectives on future directions. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
34. Patient blood management in India - Review of current practices and feasibility of applying appropriate standard of care guidelines. A position paper by an interdisciplinary expert group.
- Author
-
Gandhi, Ajay, Görlinger, Klaus, Nair, Sukesh, Kapoor, Poonam, Trikha, Anjan, Mehta, Yatin, Handoo, Anil, Karlekar, Anil, Kotwal, Jyoti, John, Joseph, Apte, Shashikant, Vohra, Vijay, Gupta, Gajendra, Tiwari, Aseem, Rani, Anjali, and Singh, Shweta
- Subjects
- *
MEDICAL personnel , *HEALTH facilities , *PLATELET function tests , *HEALTH services accessibility , *HEMORRHAGE - Abstract
In a developing country like India, with limited resources and access to healthcare facilities, dealing with massive hemorrhage is a major challenge. This challenge gets compounded by pre-existing anemia, hemostatic disorders, and logistic issues of timely transfer of such patients from peripheral hospitals to centers with adequate resources and management expertise. Despite the awareness amongst healthcare providers regarding management modalities of bleeding patients, no uniform Patient Blood Management (PBM) or perioperative bleeding management protocols have been implemented in India, yet. In light of this, an interdisciplinary expert group came together, comprising of experts working in transfusion medicine, hematology, obstetrics, anesthesiology and intensive care, to review current practices in management of bleeding in Indian healthcare institutions and evaluating the feasibility of implementing uniform PBM guidelines. The specific intent was to perform a gap analysis between the ideal and the current status in terms of practices and resources. The expert group identified interdisciplinary education in PBM and bleeding management, bleeding history, viscoelastic and platelet function testing, and the implementation of validated, setting-specific bleeding management protocols (algorithms) as important tools in PBM and perioperative bleeding management. Here, trauma, major surgery, postpartum hemorrhage, cardiac and liver surgery are the most common clinical settings associated with massive blood loss. Accordingly, PBM should be implemented as a multidisciplinary and practically applicable concept in India in a timely manner in order to optimize the use the precious resource blood and to increase patients' safety. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
35. Culturally Congruent Health Care of COVID-19 in Minorities in the United States: A Clinical Practice Paper From the National Coalition of Ethnic Minority Nurse Associations
- Author
-
Martha A. Dawson, Sandy Littlejohn, Leo-Felix M. Jurado, Elizabeth Aquino, Lillian Tom-Orme, Norma G. Cuellar, Young Shin Lee, Mary Joy Garcia-Dia, Eun-Ok Im, and Debra A. Toney
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,Ethnic group ,Health Services Accessibility ,03 medical and health sciences ,Race (biology) ,Betacoronavirus ,0302 clinical medicine ,Nursing ,Health care ,Epidemiology ,medicine ,Ethnicity ,Humans ,030212 general & internal medicine ,Social determinants of health ,Sociology ,Healthcare Disparities ,Pandemics ,General Nursing ,Minority Groups ,030504 nursing ,business.industry ,SARS-CoV-2 ,COVID-19 ,Health Status Disparities ,Health equity ,United States ,Clinical Practice ,Socioeconomic Factors ,0305 other medical science ,business ,Coronavirus Infections - Abstract
Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial–ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method: NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial–ethnic groups. Results: Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion: This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country.
- Published
- 2020
36. Feasibility and acceptability of involving bilingual community navigators to improve access to health and social care services in general practice setting of Australia.
- Author
-
Mistry SK, Harris E, Li X, and Harris MF
- Subjects
- Humans, Feasibility Studies, Australia, Social Support, Health Services Accessibility, General Practice
- Abstract
Background: Patients from culturally and linguistically diverse (CALD) backgrounds often face difficulties in accessing health and social care services. This study explored the feasibility and acceptability of involving community health workers (CHWs) as bilingual community navigators (BCNs) in general practice setting, to help patients from CALD backgrounds access health and social care services in Australia., Methods: This research was conducted in two general practices in Sydney where most patients are from specific CALD backgrounds (Chinese in one practice and Samoan in other). Three CHWs trained as BCNs were placed in these practices to help patients access health and social care service. A mixed-method design was followed to explore the feasibility and acceptability of this intervention including analysis of a record of services provided by BCNs and post-intervention qualitative interviews with patients, practice staff and BCNs exploring the feasibility and acceptability of the BCNs' role. The record was analyzed using descriptive statistics and interviews were audio-recorded, transcribed, and thematically analyzed., Results: BCNs served a total of 95 patients, providing help with referral to other services (52.6%), information about appointments (46.3%), local resources (12.6%) or available social benefits (23.2%). Most patients received one service from BCNs with the average duration of appointments being half an hour. Overall, BCNs fitted in well within the practices and patients as well as staff of participating practices accepted them well. Their role was facilitated by patients' felt need for and acceptance of BCNs' services, recruitment of BCNs from the patient community, as well as BCNs' training and motivation for their role. Major barriers for patients to access BCNs' services included lack of awareness of the BCNs' roles among some patients and practice staff, unavailability of information about local culture specific services, and inadequate time and health system knowledge by BCNs. Limited funding support and the short timeframe of the project were major limitations of the project., Conclusion: BCNs' placement in general practice was feasible and acceptable to patients and staff in these practices. This first step needs to be followed by accredited training, development of the workforce and establishing systems for supervision in order to sustain the program. Future research is needed on the extension of the intrevention to other practices and culture groups., (© 2023. The Author(s).)
- Published
- 2023
- Full Text
- View/download PDF
37. Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities.
- Author
-
Grossman A, Prata N, Williams N, Ganatra B, Lavelanet A, Läser L, Asmani C, Elamin H, Ouedraogo L, Rahman MM, Conneh-Duworko MJ, Tehoungue BZ, Chanza H, Phiri H, Bhattarai B, Dhakal NP, Ojo OA, Afolabi K, Kabuteni TJ, Hailu BG, Moses F, Dlamini-Nqeketo S, Zulu T, and Rehnström Loi U
- Subjects
- Female, Humans, Pregnancy, Mifepristone, Misoprostol, South Africa, Drug Industry legislation & jurisprudence, Abortion, Induced legislation & jurisprudence, Abortion, Induced methods, Abortifacient Agents, Internationality legislation & jurisprudence, Health Services Accessibility legislation & jurisprudence
- Abstract
Background: In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider's knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels., Methods: Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020., Results: Registration of abortion medicines-misoprostol or a combination of mifepristone and misoprostol-was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone-countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula-no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option., Conclusion: Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access., (© 2023. World Health Organization.)
- Published
- 2023
- Full Text
- View/download PDF
38. Identifying critical steps towards improved access to innovation in cancer care: a European CanCer Organisation position paper
- Author
-
Luzia Travado, Denis Lacombe, Martine Piccart, Peter Naredi, Pierre Bedossa, Gunnar Saeter, Etienne Brain, Ian Banks, David Cameron, Paolo G. Casali, Arturo Chiti, Katrine Riklund, Matti Aapro, Suzanne Wait, Riccardo Soffietti, Martin Schrappe, Philip Poortmans, Hein Van Poppel, Per J. Nilsson, Leticia De Mattos-Arruda, Alain Astier, Daniel Kelly, and Riccardo A. Audisio
- Subjects
Cancer Research ,Scrutiny ,Psychological intervention ,Health Services Accessibility ,03 medical and health sciences ,0302 clinical medicine ,Multidisciplinary approach ,Neoplasms ,Health care ,Humans ,Medicine ,030212 general & internal medicine ,Healthcare Disparities ,Reimbursement ,business.industry ,Therapies, Investigational ,Environmental resource management ,Information technology ,Public relations ,Europe ,Oncology ,030220 oncology & carcinogenesis ,Sustainability ,Position paper ,business ,Delivery of Health Care - Abstract
In recent decades cancer care has seen improvements in the speed and accuracy of diagnostic procedures; the effectiveness of surgery, radiation therapy and medical treatments; the power of information technology; and the development of multidisciplinary, specialist-led approaches to care. Such innovations are essential if we are to continue improving the lives of cancer patients across Europe despite financial pressures on our healthcare systems. Investment in innovation must be balanced with the need to ensure the sustainability of healthcare budgets, and all health professionals have a responsibility to help achieve this balance. It requires scrutiny of the way care is delivered; we must be ready to discontinue practices or interventions that are inefficient, and prioritise innovations that may deliver the best outcomes possible for patients within the limits of available resources. Decisions on innovations should take into account their long-term impact on patient outcomes and costs, not just their immediate costs. Adopting a culture of innovation requires a multidisciplinary team approach, with the patient at the centre and an integral part of the team. It must take a whole-system and whole-patient perspective on cancer care and be guided by high-quality real-world data, including outcomes relevant to the patient and actual costs of care; this accurately reflects the impact of any innovation in clinical practice. The European CanCer Organisation is committed to working with its member societies, patient organisations and the cancer community at large to find sustainable ways to identify and integrate the most meaningful innovations into all aspects of cancer care.
- Published
- 2017
39. White Paper for the WHO International Meeting of World Pharmacopoeias: Value of Pharmacopoeial Standards for Access to Quality Medicines.
- Subjects
- *
DRUGSTORES , *HEALTH services accessibility , *INTERPROFESSIONAL relations , *MEETINGS , *PATIENT safety , *PHARMACEUTICAL industry , *PHARMACY information services , *QUALITY assurance , *WORLD health , *COVID-19 pandemic - Abstract
The article discusses healthcare systems for the world, medicines play an important role in treating illness, preventing disease, and ultimately, saving lives. Topics include a broader sense, medicines have valuable to society as tools to protect the public health; and the quality of medicines has ensured by the control of many factors such as the quality of components.
- Published
- 2020
40. Lessons from evaluation of the NHS white paper Our Health, Our Care, Our Say
- Author
-
Helen Thorp, Ailsa M Cameron, Sarah Purdy, Stephen Peckham, Kate Stewart, Michael .W. Calnan, Chris Salisbury, and Rachel A Lart
- Subjects
Budgets ,Cost-Benefit Analysis ,Health Services Accessibility ,State Medicine ,Debate & Analysis ,White paper ,Nursing ,Health care ,Humans ,Medicine ,Healthcare Disparities ,Health policy ,HRHIS ,business.industry ,Health Policy ,Social Support ,International health ,Public relations ,Long-Term Care ,Health equity ,Long-term care ,England ,Health Care Reform ,Health care reform ,Patient Participation ,Family Practice ,business - Abstract
The NHS white paper Our Health, Our Care, Our Say was published by the previous UK Labour government in January 2006, describing a new strategic direction for health and social care in the community.1 This had four main goals: (a) better prevention and earlier intervention for improved health, independence, and wellbeing; (b) more choice and a stronger voice for individuals and communities; (c) tackling inequalities and improving access to services; and (d) more support for people with long-term needs. The context for these policy goals was the need, experienced by all developed countries, to remodel their healthcare systems to reflect the changing needs of their populations. In particular, the focus of health care is increasingly to support people to manage long-term health conditions at home and to reduce the number of admissions to hospital. Helping people to get more convenient and faster access to health care, providing them with more information to enable them to care for themselves, and integrating health and social care systems, are all strategies to meet this need. To achieve the policy goals, the white paper promoted a range of initiatives. The government produced a structured framework for ensuing implementation of these initiatives and tracking progress made towards the policy goals.2,3 A series of evaluations of the initiatives were commissioned, including formal programme evaluation, demonstration sites, pilot projects, and formative evaluation. This emphasis on evaluation reflected a commitment, which was increasingly evident from the late 1990s onward, to base policy on evidence about what works.4 What has been learned from this programme of evaluation about the extent to which these initiatives are achieving the policy goals of the white paper? We were commissioned by the Department of Health to review the evaluations of 10 initiatives that were specifically promoted by the …
- Published
- 2011
41. Developing an integrated emergency medical services in a low-income country like Nepal: a concept paper.
- Author
-
Bhandari, Deepak and Yadav, Nabin Krishna
- Subjects
- *
EMERGENCY medical services , *HEALTH services accessibility , *HEALTH status indicators , *INCOME , *INTEGRATED health care delivery , *INTERPROFESSIONAL relations , *MEDICAL care costs , *POVERTY , *GOVERNMENT aid - Abstract
Background: The main aim of emergency medical services (EMS) should be to provide universal emergency medical care which is EMS system available to all those who need it. Most of the developed countries have an integrated EMS system that is accessible by a single dial number in the whole country. Nepal does not have a proper EMS system. We conducted a literature review regarding methods of developing an integrated EMS system in Nepal. Result: The fragmented system, high demand–low supply, inequity with the service, and inadequately trained responders are major problems associated with EMS in Nepal. Nepal too should develop an integrated single dial number EMS system to meet the current demand of EMS. Having a paramedic in ambulances as the first responders will prevent chaos and save critical time. Funding models have to be considered while developing an EMS considering the capital as well as operational cost. Conclusion: Nepal can develop a public private partnership model of EMS where capital cost is provided by the government and operational cost by other methods. Community-based insurance system looks more feasible in a country like Nepal for generating operational cost. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
42. A community engaged primary healthcare strategy to address rural school student inequities: a descriptive paper.
- Author
-
Jones, Debra, Ballard, Jacqueline, Dyson, Robert, Macbeth, Peter, Lyle, David, Sunny, Palatty, Thomas, Anu, and Sharma, Indira
- Subjects
- *
COMMUNITY health nursing , *HEALTH services accessibility , *HEALTH status indicators , *HIGH school students , *INTERPROFESSIONAL relations , *LABOR supply , *NURSING services , *PRIMARY health care , *RESEARCH funding , *RURAL conditions , *STRATEGIC planning , *SOCIOECONOMIC factors , *EDUCATIONAL attainment - Abstract
Aim: This descriptive paper aims to describe the design and implementation of a community engaged primary healthcare strategy in rural Australia, the Primary Healthcare Registered Nurse: Schools-Based strategy. This strategy seeks to address the health, education and social inequities confronting children and adolescents through community engaged service provision and nursing practice. Background: There have been increasing calls for primary healthcare approaches to address rural health inequities, including contextualised healthcare, enhanced healthcare access, community engagement in needs and solutions identification and local-level collaborations. However, rural healthcare can be poorly aligned to community contexts and needs and be firmly entrenched in health systems, marginalising community participation. Methods: This strategy has been designed to enhance nursing service and practice responsiveness to the rural context, primary healthcare principles, and community experiences and expectations of healthcare. The strategy is underpinned by a cross-sector collaboration between a local health district, school education and a university department of rural health. A research framework is being developed to explore strategy impacts for service recipients, cross-sector systems, and the establishment and maintenance of a primary healthcare nursing workforce. Findings: Although in the early stages of implementation, key learnings have been acquired and strategic, relationship, resource and workforce gains achieved. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
43. Rural Health Scenario – Role of family medicine: Academy of Family Physicians of India Position Paper.
- Author
-
Kumar, Pratyush and Kumar, Raman
- Subjects
- *
FAMILY medicine , *FAMILY roles , *RURAL health , *MEDICAL personnel , *PHYSICIANS , *HEALTH services accessibility - Abstract
Half the world’s people currently live in rural and remote areas. About 70% of the world’s 1.4 billion people who are extremely poor live in rural areas. The problem is that the majority of healthcare providers prefer to serve in urban areas. Only a comprehensive and systematic approach can address these inequities. India, the largest democratic republic in the world, possesses 2.4% of the world’s land area and supports 16% of the world’s population. According to census 2011, 68.84% of population resides in rural areas. Nearly 86% of all the medical visits in India are made by rural inhabitants with a majority still traveling more than 100 km to avail healthcare facility, of which 70%–80% is born out of pocket landing them in poverty. A country’s approach must systematically and simultaneously address legal coverage and rights, health worker shortages, extension of healthcare protection, and quality of care. Only then can equitable access for all be fully achieved. Those living in rural areas have access to health protection and services that meet the criteria of availability, affordability, accessibility, acceptability, and quality. Family medicine as a broad specialty has its role from womb till tomb. Family medicine is defined as a specialty of medicine which is concerned with providing comprehensive care to individuals and families by integrating biomedical, behavioral, and social sciences. As an academic discipline, it includes comprehensive healthcare services, education, and research. A family doctor provides primary and continuing care to the entire family within the communities; addresses physical, psychological, and social problems; and coordinates comprehensive healthcare services with other specialists, as needed. The practitioners in family medicine can play an important role in providing healthcare services to the suffering humanity. The general practitioner’s responsibility in Medicare includes management of emergencies, treatment of problems relating to various medical and surgical specialties, care of entire family in its environment, appropriate referrals, and follow-up. He or she is the first-level contact for the patients and his or her family. Family medicine is the ideal solution to growing rural healthcare challenges. This article is a formal position paper of the Academy of Family Physicians of India. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
44. Blood diseases in Africa: Redressing unjust disparities is an urgent unmet need.
- Author
-
Makani J, Cavazzana M, Gupta K, Nnodu O, Odame I, Tshilolo L, Ware R, and Luzzatto L
- Subjects
- Humans, Health Services Needs and Demand, Africa epidemiology, Health Services Accessibility, Hematologic Diseases
- Published
- 2022
- Full Text
- View/download PDF
45. Black Canadians' Exposure to Everyday Racism: Implications for Health System Access and Health Promotion among Urban Black Communities.
- Author
-
Husbands W, Lawson DO, Etowa EB, Mbuagbaw L, Baidoobonso S, Tharao W, Yaya S, Nelson LE, Aden M, and Etowa J
- Subjects
- Female, Humans, Black People, Canada, HIV Infections prevention & control, Male, Adolescent, Adult, Middle Aged, Social Determinants of Health, Health Promotion, Racism, Health Services Accessibility, Healthcare Disparities
- Abstract
This study explores the social determinants of Black Canadians' exposure to everyday racism, its relationship to health system access, and implications for health promotion. We used data from the A/C Study survey on HIV transmission and prevention among Black Canadians. We implemented the survey (N = 1360) in 2018-2019 in Toronto and Ottawa-two large cities that together account for 42% of Canada's Black population-among self-identified Black residents aged 15-64 years, who were born in sub-Sahara Africa or the Caribbean or had a parent who was born in those regions. Participants reported racist encounters in the preceding 12 months using the Everyday Discrimination Scale. We assessed the socio-demographic correlates of racist experiences and the impact of racism on health system access using multivariable generalised linear models. Sixty percent of participants reported experiencing racism in the preceding 12 months. Based on the adjusted odds ratios, participants were more likely to experience racism if they were older, employed, Canadian-born, had higher levels of education, self-identified as LGBTQ + and reported generally moderate access to basic needs and adequate housing; and less likely to experience racism if they lived in Ottawa, self-identified as female or reported higher levels of social capital. Visiting a healthcare provider or facility, and difficulty accessing healthcare were associated with racist experiences. Racist experiences diminished the likelihood of being tested for HIV. Racist experiences were widespread, especially among those with higher levels of social wellbeing or greater exposure to Canadian institutions. Study participants also associated racist experiences with the healthcare system., (© 2022. The New York Academy of Medicine.)
- Published
- 2022
- Full Text
- View/download PDF
46. The global challenges and opportunities in the practice of rheumatology: white paper by the World Forum on Rheumatic and Musculoskeletal Diseases
- Author
-
Joseph Flood, Yousef Al Weshahi, Tore K Kvien, Jamal Al Saleh, Femi Adelowo, Gerd-Rüdiger Burmester, Heather McDonald-Blumer, Lyn March, Mustafa Al Maini, Maurizio Cutolo, Kevin D. Pile, Carlos Pineda, and Carter Thorne
- Subjects
medicine.medical_specialty ,Population ageing ,Biomedical Research ,business.industry ,Public health ,Alternative medicine ,Developing country ,General Medicine ,Global Health ,Health Services Accessibility ,White paper ,Rheumatology ,Family medicine ,Scale (social sciences) ,Rheumatic Diseases ,Health care ,Physical therapy ,Global health ,Prevalence ,Medicine ,Humans ,Musculoskeletal Diseases ,business - Abstract
Rheumatic and musculoskeletal diseases (RMDs) represent a multitude of degenerative, inflammatory and auto-immune conditions affecting millions of people worldwide. Persons with these diseases may potentially experience severe chronic pain, joint damage, increasing disability and even death. With an increasingly ageing population, the prevalence and burden of RMDs are predicted to increase, placing greater demands on the global practice of rheumatology and related healthcare budgets. Effective treatment of RMDs currently faces a number of challenges in both the developed and developing world, and individual countries may face more specific local challenges. However, limited understanding of the burden of RMDs amongst public health professionals and policy-makers means that these diseases are often not considered a public health priority. The objective of this review is to increase awareness of the RMDs and to identify opportunities to address RMD challenges on both a local and global scale. On 26 September 2014, rheumatology experts from five different continents met at the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD) to discuss and identify some key challenges for the RMDs community today. The outcomes are presented in this review, focusing on access to rheumatology services, diagnostics and therapies, rheumatology education and training and on clinical trials, as well as investigator-initiated and epidemiological research. The long-term vision of the WFRMD is to increase perception of the RMDs as a major burden to society and to explore potential opportunities to improve global and local RMD care.
- Published
- 2014
47. Assistive technology policy : a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit
- Author
-
Malcolm MacLachlan, David Banes, Diane Bell, Johan Borg, Brian Donnelly, Michael Fembek, Ritu Ghosh, Rosemary Joan Gowran, Emma Hannay, Diana Hiscock, Evert-Jan Hoogerwerf, Tracey Howe, Friedbert Kohler, Natasha Layton, Siobhán Long, Hasheem Mannan, Gubela Mji, Thomas Odera Ongolo, Katherine Perry, Cecilia Pettersson, Jessica Power, Vinicius Delgado Ramos, Lenka Slepičková, Emma M. Smith, Kiu Tay-Teo, Priscille Geiser, and Hilary Hooks
- Subjects
Aging ,030506 rehabilitation ,Orthopedic Equipment ,Health Policy ,Rehabilitation ,Biomedical Engineering ,Physical Therapy, Sports Therapy and Rehabilitation ,Public Health, Global Health, Social Medicine and Epidemiology ,Global Health ,Self-Help Devices ,Health Services Accessibility ,03 medical and health sciences ,Speech and Hearing ,Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi ,0302 clinical medicine ,Humans ,Disabled Persons ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Power, Psychological ,Policy Making ,0305 other medical science ,Developing Countries ,Needs Assessment ,Quality of Health Care - Abstract
Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization's Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable. Implications for Rehabilitation The development of policy in the area of asssitive technology is important to provide an overarching vision and outline resourcing priorities. This paper identifies some of the key themes that should be addressed when developing or revising assistive technology policy. Each country should establish a National Assistive Technology policy and develop a theory of change for its implementation.
- Published
- 2018
48. Improving access in rheumatology: Evaluating the validity of a paper triage process involving an advanced practice physiotherapist through a retrospective chart review
- Author
-
Aviva Lichtenstein MScPT, Brad McArthur MScPT, Kristin E. Musselman Pt, Cassie Bender MScPT, Chandra Farrer Pt, Kristin Bignell MScPT, and MHSc Theresa Kay Pt
- Subjects
Adult ,Male ,Canada ,medicine.medical_specialty ,Process (engineering) ,Decision Making ,Physical Therapy, Sports Therapy and Rehabilitation ,Sensitivity and Specificity ,Severity of Illness Index ,Health Services Accessibility ,Appointments and Schedules ,Rheumatic Diseases ,Chart review ,Internal medicine ,medicine ,Humans ,Referral and Consultation ,Aged ,Retrospective Studies ,business.industry ,Middle Aged ,medicine.disease ,Triage ,Rheumatology ,Physical Therapists ,Female ,Medical emergency ,Rheumatologists ,business - Abstract
Objectives: This study evaluated a standardized paper triage process conducted by an advanced practice physiotherapist (APP) at a rheumatology center. The aims were to (1) determine the concordance between paper triage priority assignment and the rheumatologist’s diagnosis; (2) determine the sensitivity and specificity of the paper triage process; and (3) assess reasons for incorrect priority ranking. Methods: Referrals were triaged by a formally trained APP into one of the three priorities, guided by a priority referral tool. A retrospective review of 192 charts was performed. Raw proportion of agreement between paper triage and rheumatologist’s diagnosis was supplemented by a prevalence-adjusted bias-adjusted kappa (PABAK). Priority categories were collapsed to calculate sensitivity and specificity. For discordant cases, additional information was collected from the referral and chart to identify potential features leading to discrepancy. Results: Overall agreement was 76%. The PABAK was 0.80 [95% confidence interval 0.70–0.90]. Sensitivity ranged 0.64–0.92 and specificity ranged 0.81–0.94, depending on the priority category. Forty-six cases were discordant, with the APP choosing a higher priority in 37 cases. An incorrect diagnosis from the family physician with no supporting information for the paper triage led to discordance in 16 cases. Conclusion: A standardized paper triage process conducted by an APP showed substantial concordance, sensitivity, and specificity.
- Published
- 2018
- Full Text
- View/download PDF
49. Digital health solutions to improve health care: a call for papers.
- Author
-
Divya Lakhotia, Rapeepong Suphanchaimat, Walaiporn Patcharanarumol, Labrique, Alain, and Viroj Tangcharoensathien
- Subjects
- *
PREVENTION of communicable diseases , *HEALTH services accessibility , *COMMUNICABLE diseases , *MIDDLE-income countries , *LIFE expectancy , *STAKEHOLDER analysis , *DIGITAL technology , *DIGITAL health , *MEDICAL care , *LABOR supply , *QUALITY assurance , *LOW-income countries , *HEALTH equity , *COVID-19 pandemic , *TELEMEDICINE , *HEALTH self-care - Abstract
The article discusses the role of digital health solutions in strengthening health systems and improving health care services. Topics discussed include the global challenge of health inequities with billions of people facing preventable diseases and premature deaths due to the lack of health care access, the interoperability of existing health data which is needed to implement digital solutions, and the periodical's calls for papers about digital health solutions.
- Published
- 2024
- Full Text
- View/download PDF
50. HIV Pre-Exposure Prophylaxis Medication for Adolescents and Young Adults: A Position Paper of the Society for Adolescent Health and Medicine
- Author
-
Adam Leonard
- Subjects
Adult ,Male ,030505 public health ,Adolescent ,Anti-HIV Agents ,Public Health, Environmental and Occupational Health ,Adolescent Health ,HIV Infections ,Health Services Accessibility ,Medication Adherence ,03 medical and health sciences ,Psychiatry and Mental health ,Sexual and Gender Minorities ,Young Adult ,0302 clinical medicine ,Pediatrics, Perinatology and Child Health ,Emtricitabine ,Humans ,Female ,Pre-Exposure Prophylaxis ,030212 general & internal medicine ,0305 other medical science ,Tenofovir - Abstract
Pre-exposure prophylaxis (PrEP) is a biomedical prevention intervention that has demonstrated high efficacy in reducing human immunodeficiency virus (HIV) transmission. While an increasing number of jurisdictions have endorsed the use of emtricitabine/tenofovir disoproxil fumarate (FTC/TDF) for PrEP, access to PrEP varies widely. Adolescents and young adults (AYAs), especially those at high risk of HIV acquisition, such as young gay, bisexual, and other men having sex with men (YGBMSM) and individuals living in countries where HIV is endemic, face multiple barriers that limit their access to PrEP. This position paper provides context and recommendations for the promotion and use of PrEP among AYAs.
- Published
- 2018
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.