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Sample records for obstetric health services

  1. [Enforceability of the right to health protection in obstetric services in Mexico].

    PubMed

    Meza, Alejandro; Mancinas, Sandra; Meneses, Sergio; Meléndez, David

    2015-05-01

    The inclusion of the framework of human rights in maternal health is mentioned more and more frequently as a feasible proposal to improve the care that women receive in obstetric health care services. Despite the fact Mexico has a solid regulatory framework for obstetric care, mechanisms of enforceability are essential to ensure that health-related human rights are upheld. In addition to being in place, enforceability mechanisms should be effective and accessible to people, particularly in obstetric care, where repeated human rights violations occur that endanger women's health and lives. The objective of this article is to specify the regulatory, legal, and extralegal elements that need to be considered in order to include maternal health in a set of enforceable human rights. PMID:26208208

  2. Assessment of Obstetric and Neonatal Health Services in Developing Country Health Facilities

    PubMed Central

    Manasyan, Albert; Saleem, Sarah; Koso-Thomas, Marion; Althabe, Fernando; Pasha, Omrana; Chomba, Elwyn; Goudar, Shivaprasad S.; Patel, Archana; Esamai, Fabian; Garces, Ana; Kodkany, Bhala; Belizan, Jose; McClure, Elizabeth M.; Derman, Richard J.; Hibberd, Patricia; Liechty, Edward A.; Hambidge, K. Michael; Carlo, Waldemar A.; Buekens, Pierre; Moore, Janet; Wright, Linda L.; Goldenberg, Robert L.

    2013-01-01

    Objective To describe the staffing and availability of medical equipment and medications and the performance of procedures at health facilities providing maternal and neonatal care at African, Asian, and Latin American sites participating in a multicenter trial to improve emergency obstetric/neonatal care in communities with high maternal and perinatal mortality. Study Design In 2009, prior to intervention, we surveyed 136 hospitals and 228 clinics in 7 sites in Africa, Asia, and Latin America regarding staffing, availability of equipment/ medications, and procedures including cesarean section. Results The coverage of physicians and nurses/midwives was poor in Africa and Latin America. In Africa, only 20% of hospitals had full-time physicians. Only 70% of hospitals in Africa and Asia had performed cesarean sections in the last 6 months. Oxygen was unavailable in 40% of African hospitals and 17% of Asian hospitals. Blood was unavailable in 80% of African and Asian hospitals. Conclusions Assuming that adequate facility services are necessary to improve pregnancy outcomes, it is not surprising that maternal and perinatal mortality rates in the areas surveyed are high. The data presented emphasize that to reduce mortality in these areas, resources that result in improved staffing and sufficient equipment, supplies, and medication, along with training, are required. PMID:23329566

  3. Implications of Comprehensive Mental Health Services Embedded in an Adolescent Obstetric Medical Home.

    PubMed

    Ashby, Bethany; Ranadive, Nikhil; Alaniz, Veronica; St John-Larkin, Celeste; Scott, Stephen

    2016-06-01

    Purpose Mental health issues in perinatal adolescents are well documented and studies have shown high rates of depressive disorders among this population. Treatment is challenging because pregnant adolescents are poorly adherent with mental health services. We describe a novel integrated mental health care program for pregnant and parenting adolescent mothers and their children. Methods The Colorado Adolescent Maternity Program (CAMP) is a comprehensive, multidisciplinary teen pregnancy and parenting medical home program serving an ethnically diverse and low socioeconomic status population in the Denver metro area. We describe the Healthy Expectations Adolescent Response Team (HEART), an embedded mental health care program focused on improving identification of mental health symptoms and increasing rates mental health treatment in adolescent mothers. Results From January 1, 2011-January 16 2014, 894 pregnant adolescents were enrolled in CAMP and 885 patients were screened for mental health issues. Prior to HEART's inception, 20 % of patients were identified as having mood symptoms in the postpartum period. Successful referrals to community mental health facilities occurred in only 5 % of identified patients. Following the creation of HEART, 41 % of patients were identified as needing mental health services. Nearly half of the identified patients (47 %) engaged in mental health treatment with the psychologist. Demographic factors including age, parity, ethnicity, and parent and partner involvement did not have a significant impact on treatment engagement. Trauma history was associated with lower treatment engagement. Conclusion Our findings suggest that an embedded mental health program in an adolescent obstetric and pediatric medical home is successful in improving identification and engagement in mental health treatment. Key components of the program include universal screening, intensive social work and case management involvement, and ready access to onsite

  4. Managing disruptive behaviors in the health care setting: focus on obstetrics services.

    PubMed

    Rosenstein, Alan H

    2011-03-01

    Disruptive behaviors can have a significant negative impact on staff relationships, communication flow, task responsibility, and team collaboration, all of which can adversely impact patient outcomes of care. Addressing disruptive behaviors in a positive manner by emphasizing the benefits of mutual understanding, shared goals and priorities, and adherence to accepted standards of care will enhance communication flow and improve the process and outcomes of care. This is particularly relevant in the obstetrics setting, where care is delivered over a continuum of time, with multiple different members of the health care team playing a vital role as the patient progresses from labor to delivery. Critical strategies for success include having strong organizational commitment and leadership support, raising provider insight and awareness, implementing appropriate policies and procedures, providing appropriate educational and training programs, and facilitating action-oriented interventional support. PMID:21183152

  5. Barriers to formal emergency obstetric care services' utilization.

    PubMed

    Essendi, Hildah; Mills, Samuel; Fotso, Jean-Christophe

    2011-06-01

    Access to appropriate health care including skilled birth attendance at delivery and timely referrals to emergency obstetric care services can greatly reduce maternal deaths and disabilities, yet women in sub-Saharan Africa continue to face limited access to skilled delivery services. This study relies on qualitative data collected from residents of two slums in Nairobi, Kenya in 2006 to investigate views surrounding barriers to the uptake of formal obstetric services. Data indicate that slum dwellers prefer formal to informal obstetric services. However, their efforts to utilize formal emergency obstetric care services are constrained by various factors including ineffective health decision making at the family level, inadequate transport facilities to formal care facilities and insecurity at night, high cost of health services, and inhospitable formal service providers and poorly equipped health facilities in the slums. As a result, a majority of slum dwellers opt for delivery services offered by traditional birth attendants (TBAs) who lack essential skills and equipment, thereby increasing the risk of death and disability. Based on these findings, we maintain that urban poor women face barriers to access of formal obstetric services at family, community, and health facility levels, and efforts to reduce maternal morbidity and mortality among the urban poor must tackle the barriers, which operate at these different levels to hinder women's access to formal obstetric care services. We recommend continuous community education on symptoms of complications related to pregnancy and timely referral. A focus on training of health personnel on "public relations" could also restore confidence in the health-care system with this populace. Further, we recommend improving the health facilities in the slums, improving the services provided by TBAs through capacity building as well as involving TBAs in referral processes to make access to services timely. Measures can also be

  6. Maternal health in resource-poor urban settings: how does women's autonomy influence the utilization of obstetric care services?

    PubMed Central

    Fotso, Jean-Christophe; Ezeh, Alex C; Essendi, Hildah

    2009-01-01

    Background Despite various international efforts initiated to improve maternal health, more than half a million women worldwide die each year as a result of complications arising from pregnancy and childbirth. This research was guided by the following questions: 1) How does women's autonomy influence the choice of place of delivery in resource-poor urban settings? 2) Does its effect vary by household wealth? and 3) To what extent does women's autonomy mediate the relationship between women's education and use of health facility for delivery? Methods The data used is from a maternal health study carried out in the slums of Nairobi, Kenya. A total of 1,927 women (out of 2,482) who had a pregnancy outcome in 2004–2005 were selected and interviewed. Seventeen variable items on autonomy were used to construct women's decision-making, freedom of movement, and overall autonomy. Further, all health facilities serving the study population were assessed with regard to the number, training and competency of obstetric staff; services offered; physical infrastructure; and availability, adequacy and functional status of supplies and other essential equipment for safe delivery, among others. A total of 25 facilities were surveyed. Results While household wealth, education and demographic and health covariates had strong relationships with place of delivery, the effects of women's overall autonomy, decision-making and freedom of movement were rather weak. Among middle to least poor households, all three measures of women's autonomy were associated with place of delivery, and in the expected direction; whereas among the poorest women, they were strong and counter-intuitive. Finally, the study showed that autonomy may not be a major mediator of the link between education and use of health services for delivery. Conclusion The paper argues in favor of broad actions to increase women's autonomy both as an end and as a means to facilitate improved reproductive health outcomes. It

  7. Rural-Urban Inequity in Unmet Obstetric Needs and Functionality of Emergency Obstetric Care Services in a Zambian District

    PubMed Central

    Ng’anjo Phiri, Selia; Fylkesnes, Knut; Moland, Karen Marie; Byskov, Jens; Kiserud, Torvid

    2016-01-01

    Background Zambia has a high maternal mortality ratio, 398/100,000 live births. Few pregnant women access emergency obstetric care services to handle complications at childbirth. We aimed to assess the deficit in life-saving obstetric services in the rural and urban areas of Kapiri Mposhi district. Method A cross-sectional survey was conducted in 2011 as part of the ‘Response to Accountable priority setting for Trust in health systems’ (REACT) project. Data on all childbirths that occurred in emergency obstetric care facilities in 2010 were obtained retrospectively. Sources of information included registers from maternity ward admission, delivery and operation theatre, and case records. Data included age, parity, mode of delivery, obstetric complications, and outcome of mother and the newborn. An approach using estimated major obstetric interventions expected but not done in health facilities was used to assess deficit of life-saving interventions in urban and rural areas. Results A total of 2114 urban and 1226 rural childbirths occurring in emergency obstetric care facilities (excluding abortions) were analysed. Facility childbirth constituted 81% of expected births in urban and 16% in rural areas. Based on the reference estimate that 1.4% of childbearing women were expected to need major obstetric intervention, unmet obstetric need was 77 of 106 women, thus 73% (95% CI 71–75%) in rural areas whereas urban areas had no deficit. Major obstetric interventions for absolute maternal indications were higher in urban 2.1% (95% CI 1.60–2.71%) than in rural areas 0.4% (95% CI 0.27–0.55%), with an urban to rural rate ratio of 5.5 (95% CI 3.55–8.76). Conclusions Women in rural areas had deficient obstetric care. The likelihood of under-going a life-saving intervention was 5.5 times higher for women in urban than rural areas. Targeting rural women with life-saving services could substantially reduce this inequity and preventable deaths. PMID:26824599

  8. Impact of Discontinued Obstetrical Services in Rural Missouri: 1990-2002

    ERIC Educational Resources Information Center

    Sontheimer, Dan; Halverson, Larry W.; Bell, Laird; Ellis, Mark; Bunting, Pamela Wilbanks

    2008-01-01

    Purpose: This study examines the potential relationship between loss of local obstetrical services and pregnancy outcomes. Methods: Missouri Hospital Association and Missouri Department of Health birth certificate records were used as sources of information. All member hospitals of the Missouri Hospital Association that were located in cities of…

  9. The relationship among cost, quality, and competition: an analysis of obstetrics services in Missouri hospitals.

    PubMed

    Skelton, A G

    1997-01-01

    An understanding of the relationship among cost, quality, and competition is vital to ongoing efforts of market-based health care reform. The objectives of this study were to introduce a distance-based operational definition of competition and to examine the relationships among competition, cost, and quality within the singular product and geographic market of obstetrics services at hospitals within the state of Missouri. Correlational results indicate that increased competition is related to both increases in quality of care and costs--the characteristics of a price-insensitive market. This has obvious implications on health policy debates focusing on enhancing market competition as an avenue for health care reform. PMID:9327357

  10. The critical role of supervision in retaining staff in obstetric services: a three country study.

    PubMed

    McAuliffe, Eilish; Daly, Michael; Kamwendo, Francis; Masanja, Honorati; Sidat, Mohsin; de Pinho, Helen

    2013-01-01

    Millennium Development Goal (MDG) 5 commits us to reducing maternal mortality rates by three quarters and MDG 4 commits us to reducing child mortality by two-thirds between 1990 and 2015. In order to reach these goals, greater access to basic emergency obstetric care (EmOC) as well as comprehensive EmOC which includes safe Caesarean section, is needed.. The limited capacity of health systems to meet demand for obstetric services has led several countries to utilize mid-level cadres as a substitute to more extensively trained and more internationally mobile healthcare workers. Although this does provide greater capacity for service delivery, concern about the performance and motivation of these workers is emerging. We propose that poor leadership characterized by inadequate and unstructured supervision underlies much of the dissatisfaction and turnover that has been shown to exist amongst these mid-level healthcare workers and indeed health workers more generally. To investigate this, we conducted a large-scale survey of 1,561 mid-level cadre healthcare workers (health workers trained for shorter periods to perform specific tasks e.g. clinical officers) delivering obstetric care in Malawi, Tanzania, and Mozambique. Participants indicated the primary supervision method used in their facility and we assessed their job satisfaction and intentions to leave their current workplace. In all three countries we found robust evidence indicating that a formal supervision process predicted high levels of job satisfaction and low intentions to leave. We find no evidence that facility level factors modify the link between supervisory methods and key outcomes. We interpret this evidence as strongly supporting the need to strengthen leadership and implement a framework and mechanism for systematic supportive supervision. This will promote better job satisfaction and improve the retention and performance of obstetric care workers, something which has the potential to improve

  11. The Critical Role of Supervision in Retaining Staff in Obstetric Services: A Three Country Study

    PubMed Central

    McAuliffe, Eilish; Daly, Michael; Kamwendo, Francis; Masanja, Honorati; Sidat, Mohsin; de Pinho, Helen

    2013-01-01

    Millennium Development Goal (MDG) 5 commits us to reducing maternal mortality rates by three quarters and MDG 4 commits us to reducing child mortality by two-thirds between 1990 and 2015. In order to reach these goals, greater access to basic emergency obstetric care (EmOC) as well as comprehensive EmOC which includes safe Caesarean section, is needed.. The limited capacity of health systems to meet demand for obstetric services has led several countries to utilize mid-level cadres as a substitute to more extensively trained and more internationally mobile healthcare workers. Although this does provide greater capacity for service delivery, concern about the performance and motivation of these workers is emerging. We propose that poor leadership characterized by inadequate and unstructured supervision underlies much of the dissatisfaction and turnover that has been shown to exist amongst these mid-level healthcare workers and indeed health workers more generally. To investigate this, we conducted a large-scale survey of 1,561 mid-level cadre healthcare workers (health workers trained for shorter periods to perform specific tasks e.g. clinical officers) delivering obstetric care in Malawi, Tanzania, and Mozambique. Participants indicated the primary supervision method used in their facility and we assessed their job satisfaction and intentions to leave their current workplace. In all three countries we found robust evidence indicating that a formal supervision process predicted high levels of job satisfaction and low intentions to leave. We find no evidence that facility level factors modify the link between supervisory methods and key outcomes. We interpret this evidence as strongly supporting the need to strengthen leadership and implement a framework and mechanism for systematic supportive supervision. This will promote better job satisfaction and improve the retention and performance of obstetric care workers, something which has the potential to improve

  12. How Has the Free Obstetric Care Policy Impacted Unmet Obstetric Need in a Rural Health District in Guinea?

    PubMed Central

    Delamou, Alexandre; Dubourg, Dominique; Beavogui, Abdoul Habib; Delvaux, Thérèse; Kolié, Jacques Seraphin; Barry, Thierno Hamidou; Camara, Bienvenu Salim; Edginton, Mary; Hinderaker, Sven; De Brouwere, Vincent

    2015-01-01

    Introduction In 2010, the Ministry of Health (MoH) of Guinea introduced a free emergency obstetric care policy in all the public health facilities of the country. This included antenatal checks, normal delivery and Caesarean section. Objective This study aims at assessing the changes in coverage of obstetric care according to the Unmet Obstetric Need concept before (2008) and after (2012) the implementation of the free emergency obstetric care policy in a rural health district in Guinea. Methods We carried out a descriptive cross-sectional study involving the retrospective review of routine programme data during the period April to June 2014. Results No statistical difference was observed in women’s sociodemographic characteristics and indications (absolute maternal indications versus non-absolute maternal indications) before and after the implementation of the policy. Compared to referrals from health centers of patients, direct admissions at hospital significantly increased from 49% to 66% between 2008 and 2012 (p = 0.001). In rural areas, this increase concerned all maternal complications regardless of their severity, while in urban areas it mainly affected very severe complications. Compared to 2008, there were significantly more Major Obstetric Interventions for Maternal Absolute Indications in 2012 (p<0.001). Maternal deaths decreased between 2008 and 2012 from 1.5% to 1.1% while neonatal death increased from 12% in 2008 to 15% in 2012. Conclusion The implementation of the free obstetric care policy led to a significant decrease in unmet obstetric need between 2008 and 2012 in the health district of Kissidougou. However, more research is needed to allow comparisons with other health districts in the country and to analyse the trends. PMID:26047472

  13. 21 CFR 884.4900 - Obstetric table and accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Obstetric table and accessories. 884.4900 Section 884.4900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Surgical Devices § 884.4900 Obstetric table and...

  14. 21 CFR 884.4900 - Obstetric table and accessories.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Obstetric table and accessories. 884.4900 Section 884.4900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological Surgical Devices § 884.4900 Obstetric table and...

  15. Global obstetric medicine: Collaborating towards global progress in maternal health

    PubMed Central

    Ateka-Barrutia, Oier; Rojas-Suarez, Jose Antonio; Wijeyaratne, Chandrika; Castillo, Eliana; Lombaard, Hennie; Magee, Laura A

    2015-01-01

    Globally, the nature of maternal mortality and morbidity is shifting from direct obstetric causes to an increasing proportion of indirect causes due to chronic conditions and ageing of the maternal population. Obstetric medicine can address an important gap in the care of women by broadening its scope to include colleagues, communities and countries that do not yet have established obstetric medicine training, education and resources. We present the concept of global obstetric medicine by highlighting three low- and middle-income country experiences as well as an example of successful collaboration. The article also discusses ideas and initiatives to build future partnerships within the global obstetric medicine community. PMID:27512469

  16. The traditional healer in obstetric care: A persistent wasted opportunity in maternal health.

    PubMed

    Aborigo, Raymond Akawire; Allotey, Pascale; Reidpath, Daniel D

    2015-05-01

    Traditional medical systems in low income countries remain the first line service of choice, particularly for rural communities. Although the role of traditional birth attendants (TBAs) is recognised in many primary health care systems in low income countries, other types of traditional practitioners have had less traction. We explored the role played by traditional healers in northern Ghana in managing pregnancy-related complications and examined their relevance to current initiatives to reduce maternal morbidity and mortality. A grounded theory qualitative approach was employed. Twenty focus group discussions were conducted with TBAs and 19 in-depth interviews with traditional healers with expertise in managing obstetric complications. Traditional healers are extensively consulted to manage obstetric complications within their communities. Their clientele includes families who for either reasons of access or traditional beliefs, will not use modern health care providers, or those who shop across multiple health systems. The traditional practitioners claim expertise in a range of complications that are related to witchcraft and other culturally defined syndromes; conditions for which modern health care providers are believed to lack expertise. Most healers expressed a willingness to work with the formal health services because they had unique knowledge, skills and the trust of the community. However this would require a stronger acknowledgement and integration within safe motherhood programs. PMID:25841096

  17. Governing the implementation of Emergency Obstetric Care: experiences of Rural District Health Managers, Tanzania

    PubMed Central

    2014-01-01

    Background Many health policies developed internationally often become adopted at the national level and are implemented locally at the district level. A decentralized district health system led by a district health management team becomes responsible for implementing such policies. This study aimed at exploring the experiences of a district health management team in implementing Emergency Obstetric Care (EmOC) related policies and identifying emerging governance aspects. Methods The study used a qualitative approach in which data was obtained from thirteen individual interviews and one focus group discussion (FGD). Interviews were conducted with members of the district health management team, district health service boards and NGO representatives. The FGD included key informants who were directly involved in the work of implementing EmOC services in the district. Documentary reviews and observation were done to supplement the data. All the materials were analysed using a qualitative content analysis approach. Results Implementation of EmOC was considered to be a process accompanied by achievements and challenges. Achievements included increased institutional delivery, increased number of ambulances, training service providers in emergency obstetric care and building a new rural health centre that provides comprehensive emergency obstetric care. These achievements were associated with good leadership skills of the team together with partnerships that existed between different actors such as the Non-Governmental Organization (NGO), development partners, local politicians and Traditional Birth Attendants (TBAs). Most challenges faced during the implementation of EmOC were related to governance issues at different levels and included delays in disbursement of funds from the central government, shortages of health workers, unclear mechanisms for accountability, lack of incentives to motivate overburdened staffs and lack of guidelines for partnership development

  18. Obstetric care in a family health-oriented university associated neighborhood health center.

    PubMed

    Wingate, M B; Silber, T; McMillen, M; Zeccardi, J

    1976-04-01

    The structure, staffing, and planning methods of the obstetric component of a family-oriented University Hospital associated family health care facility are briefly described. The interviews and screening procedures are outlined necessary to develop a broad data base for total health care planning. The roles of the members of the multiprofessional team employed are described with particular emphasis on the use of a nurse midwife as the primary obstetric care professional. Management procedures are referred to as well as the educational component present within such a program. The program is evaluated in terms of clinical outcome, patient and professional acceptance, and cost. PMID:1263627

  19. The Impact of the West Africa Ebola Outbreak on Obstetric Health Care in Sierra Leone

    PubMed Central

    Brolin Ribacke, Kim J.; van Duinen, Alex J.; Nordenstedt, Helena; Höijer, Jonas; Molnes, Ragnhild; Froseth, Torunn Wigum; Koroma, AP; Darj, Elisabeth; Bolkan, Håkon Angel; Ekström, AnnaMia

    2016-01-01

    Background As Sierra Leone celebrates the end of the Ebola Virus Disease (EVD) outbreak, we can begin to fully grasp its impact on already weak health systems. The EVD outbreak in West Africa forced many hospitals to close down or reduce their activity, either to prevent nosocomial transmission or because of staff shortages. The aim of this study is to assess the potential impact of EVD on nationwide access to obstetric care in Sierra Leone. Methods and Findings Community health officers collected weekly data between January 2014—May 2015 on in-hospital deliveries and caesarean sections (C-sections) from all open facilities (public, private for-profit and private non-profit sectors) offering emergency obstetrics in Sierra Leone. This was compared to official data of EVD cases per district. Logistic and Poisson regression analyses were used to compute risk and rate estimates. Nationwide, the number of in-hospital deliveries and C-sections decreased by over 20% during the EVD outbreak. The decline occurred early on in the EVD outbreak and was mainly attributable to the closing of private not-for-profit hospitals rather than government facilities. Due to difficulties in collecting data in the midst of an epidemic, limitations of this study include some missing data points. Conclusions Both the number of in-hospital deliveries and C-sections substantially declined shortly after the onset of the EVD outbreak. Since access to emergency obstetric care, like C-sections, is associated with decreased maternal mortality, many women are likely to have died due to the reduced access to appropriate care during childbirth. Future research on indirect health effects of health system breakdown should ideally be nationwide and continue also into the recovery phase. It is also important to understand the mechanisms behind the deterioration so that important health services can be reestablished. PMID:26910462

  20. To the point: obstetrics and gynecology global health experiences for medical students.

    PubMed

    Hampton, Brittany S; Chuang, Alice W; Abbott, Jodi F; Buery-Joyner, Samantha D; Cullimore, Amie J; Dalrymple, John L; Forstein, David A; Hueppchen, Nancy A; Kaczmarczyk, Joseph M; Page-Ramsey, Sarah; Pradhan, Archana; Wolf, Abigail; Dugoff, Lorraine

    2014-07-01

    This article, from the To the Point series prepared by the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee, provides educators with an overview of considerations for obstetrics and gynecology global health experiences for the medical student. Options for integration of obstetrics and gynecology global health into undergraduate medical curricula are discussed. Specific considerations for global health clinical experiences for medical students, including choosing a clinical location, oversight and mentorship, goals and objectives, predeparture preparation, and evaluation, are reviewed. PMID:24334202

  1. Lifesaving emergency obstetric services are inadequate in south-west Ethiopia: a formidable challenge to reducing maternal mortality in Ethiopia

    PubMed Central

    2013-01-01

    Background Most maternal deaths take place during labour and within a few weeks after delivery. The availability and utilization of emergency obstetric care facilities is a key factor in reducing maternal mortality; however, there is limited evidence about how these institutions perform and how many people use emergency obstetric care facilities in rural Ethiopia. We aimed to assess the availability, quality, and utilization of emergency obstetric care services in the Gamo Gofa Zone of south-west Ethiopia. Methods We conducted a retrospective review of three hospitals and 63 health centres in Gamo Gofa. Using a retrospective review, we recorded obstetric services, documents, cards, and registration books of mothers treated and served in the Gamo Gofa Zone health facilities between July 2009 and June 2010. Results There were three basic and two comprehensive emergency obstetric care qualifying facilities for the 1,740,885 people living in Gamo Gofa. The proportion of births attended by skilled attendants in the health facilities was 6.6% of expected births, though the variation was large. Districts with a higher proportion of midwives per capita, hospitals and health centres capable of doing emergency caesarean sections had higher institutional delivery rates. There were 521 caesarean sections (0.8% of 64,413 expected deliveries and 12.3% of 4,231 facility deliveries). We recorded 79 (1.9%) maternal deaths out of 4,231 deliveries and pregnancy-related admissions at institutions, most often because of post-partum haemorrhage (42%), obstructed labour (15%) and puerperal sepsis (15%). Remote districts far from the capital of the Zone had a lower proportion of institutional deliveries (<2% of expected births compared to an overall average of 6.6%). Moreover, some remotely located institutions had very high maternal deaths (>4% of deliveries, much higher than the average 1.9%). Conclusion Based on a population of 1.7 million people, there should be 14 basic and four

  2. Perceived Health System Causes of Obstetric Fistula from Accounts of Affected Women in Rural Tanzania: A Qualitative Study.

    PubMed

    Mselle, Lilian T; Kohi, Thecla W

    2015-03-01

    Obstetric fistula is still a major problem in low income countries. While its main cause is untreated obstructed labour, misconceptions about it still persist. This study aimed at exploring and describing perceived health system causes of obstetric fistula from women affected by it in rural Tanzania. This exploratory qualitative study included twenty-eight women affected by obstetric fistula. Semi structured interviews and focus group discussions were held and thematic analysis used to analyse perceived health system causes of obstetric fistula from women's account. Perceived health system causes of obstetric fistula fundamentally reflected the poor quality of obstetric care women received at health care facilities relating to staff unaccountability, late referral, and torture by nurses. The women's perception emphasizes the importance of improving the quality of obstetric care provided by health care providers in health care facilities. PMID:26103702

  3. Primary care obstetrics and perinatal health in The Netherlands.

    PubMed

    Hingstman, L

    1994-01-01

    The Netherlands is the only industrialized country in which a large percentage of obstetric care takes place at home. Almost 31% of all deliveries are home confinements under supervision of a midwife or a general practitioner, and 84% of all postnatal care is given at home by maternity care assistants. To gain a better understanding of this unique situation, the structure of Dutch obstetric care is examined with special attention to the four pillars on which the system rests: the special protected position of the midwife, a generally accepted screening system for high-risk pregnancies, a well-organized maternity home care system, and the sociocultural environment in The Netherlands in which pregnancy and childbirth are considered normal physiological processes. Description of the obstetric system shows a degree of competition between the obstetricians, midwives, and general practitioners, in which the general practitioner has lost a considerable part of the "obstetric market." PMID:7830147

  4. Mental health screening among newly arrived refugees seeking routine obstetric and gynecologic care.

    PubMed

    Johnson-Agbakwu, Crista E; Allen, Jennifer; Nizigiyimana, Jeanne F; Ramirez, Glenda; Hollifield, Michael

    2014-11-01

    Posttraumatic stress disorder (PTSD), anxiety, and depression are common mental health disorders in the refugee population. High rates of violence, trauma, and PTSD among refugee women remain unaddressed. The process of implementing a mental health screening tool among multiethnic, newly arrived refugee women receiving routine obstetric and gynecologic care in a dedicated refugee women's health clinic is described. The Refugee Health Screener-15 (RHS-15) is a culturally responsive, efficient, validated screening instrument that detects symptoms of emotional distress across diverse refugee populations and languages. An interdisciplinary community partnership was established with a local behavioral health services agency to facilitate the referral of women scoring positive on the RHS-15. Staff and provider training sessions, as well as the incorporation of bicultural, multilingual cultural health navigators, greatly facilitated linguistically appropriate care coordination for refugee women in a culturally sensitive manner. Twenty-six (23.2%) of the 112 women who completed the RHS-15 scored positive, of which 14 (53.8%) were Iraqi, 1 (3.8%) was Burmese, and 3 (11.5%) were Somali. Among these 26 women, 8 (30.8%) are actively receiving mental health services and 5 (19.2%) have appointments scheduled. However, 13 (50%) are not enrolled in mental health care because of either declining services (46.2%) or a lack of insurance (53.8%). Screening for mental disorders among refugee women will promote greater awareness and identify those individuals who would benefit from further mental health evaluation and treatment. Sustainable interdisciplinary models of care are necessary to promote health education, dispel myths, and reduce the stigma of mental health. PMID:25383999

  5. Mental Health Screening Among Newly-Arrived Refugees Seeking Routine Obstetric and Gynecologic Care

    PubMed Central

    Johnson-Agbakwu, Crista E.; Allen, Jennifer; Nizigiyimana, Jeanne F.; Ramirez, Glenda; Hollifield, Michael

    2014-01-01

    Posttraumatic stress disorder (PTSD), anxiety, and depression are the most common mental health disorders in the refugee population. High rates of violence, trauma, and PTSD among refugee women remain unaddressed. The process of implementing a mental health screening tool among multi-ethnic, newly-arrived refugee women receiving routine obstetric and gynecologic care in a dedicated refugee women’s health clinic is described. The Refugee Health Screener-15 (RHS-15) is a culturally-responsive, efficient, validated screening instrument that detects symptoms of emotional distress across diverse refugee populations and languages. An interdisciplinary community partnership was established with a local behavioral health services agency to facilitate the referral of women scoring positive on the RHS-15. Staff and provider training sessions, as well as the incorporation of bi-cultural, multi-lingual Cultural Health Navigators, greatly facilitated linguistically-appropriate care coordination for refugee women in a culturally sensitive manner. Twenty-six (23.2%) of the 112 women who completed the RHS-15 scored positive; of which 14 (53.8%) were Iraqi, one (3.8%) was Burmese, and three (11.5%) were Somali. Among these 26 women, eight (30.8%) are actively receiving mental health services, and five (19.2%) have appointments scheduled. However 13 (50%) are not enrolled in mental health care due to either declining services (46.2%), or a lack of insurance (53.8%). Screening for mental disorders among refugee women will promote greater awareness and identify those individuals who would benefit from further mental health evaluation and treatment. Sustainable interdisciplinary models of care are necessary to promote health education, dispel myths and reduce the stigma of mental health. PMID:25383999

  6. Provision of critical care services for the obstetric population.

    PubMed

    Sultan, P; Arulkumaran, N; Rhodes, A

    2013-12-01

    Management of the peripartum patient is a challenging aspect of critical care that requires consideration of both the physiological changes associated with pregnancy as well as the well-being of the foetus. In the UK, for every maternal death, approximately 118 near-miss events or severe acute maternal morbidities (SAMMs) occur. While a dedicated anaesthetic cover is usually provided on larger labour wards in the UK and US, a close communication with intensive care and other medical specialties must still be maintained. Medical outreach teams and early warning scores may help facilitate the early identification of clinical deterioration and prompt treatment. Ultimately level of care is allocated according to the clinical need, not the location, which may be a designated room, a normal labour room or a recovery area. Specialist obstetric units that provide high-dependency care facilities show lower rates of maternal transfer to critical care units and improved continuity of care before and after labour. The benefits of obstetric high-dependency units (HDUs) are likely to be determined by a number of logistic aspects of the hospital organisation, including hospital size and available resources. There remains a striking contrast in the burden of maternal mortality and morbidity and intensive care unit (ICU) resources between high- and low-income countries. The countries with the highest maternal mortality rates have the lowest number of ICU beds per capita. In under-resourced countries, patients admitted to ICUs tend to have higher illness severity scores, suggesting delayed admission to the ICU. The appropriate training of midwives is essential for successful HDUs located within labour wards. PMID:23972289

  7. An assessment of priority setting process and its implication on availability of emergency obstetric care services in Malindi District, Kenya

    PubMed Central

    Nyandieka, Lilian Nyamusi; Kombe, Yeri; Ng'ang'a, Zipporah; Byskov, Jens; Njeru, Mercy Karimi

    2015-01-01

    Introduction In spite of the critical role of Emergency Obstetric Care in treating complications arising from pregnancy and childbirth, very few facilities are equipped in Kenya to offer this service. In Malindi, availability of EmOC services does not meet the UN recommended levels of at least one comprehensive and four basic EmOC facilities per 500,000 populations. This study was conducted to assess priority setting process and its implication on availability, access and use of EmOC services at the district level. Methods A qualitative study was conducted both at health facility and community levels. Triangulation of data sources and methods was employed, where document reviews, in-depth interviews and focus group discussions were conducted with health personnel, facility committee members, stakeholders who offer and/ or support maternal health services and programmes; and the community members as end users. Data was thematically analysed. Results Limitations in the extent to which priorities in regard to maternal health services can be set at the district level were observed. The priority setting process was greatly restricted by guidelines and limited resources from the national level. Relevant stakeholders including community members are not involved in the priority setting process, thereby denying them the opportunity to contribute in the process. Conclusion The findings illuminate that consideration of all local plans in national planning and budgeting as well as the involvement of all relevant stakeholders in the priority setting exercise is essential in order to achieve a consensus on the provision of emergency obstetric care services among other health service priorities. PMID:26889337

  8. 21 CFR 884.5100 - Obstetric anesthesia set.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric anesthesia set. 884.5100 Section 884.5100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... § 884.5100 Obstetric anesthesia set. (a) Identification. An obstetric anesthesia set is an assembly...

  9. 21 CFR 884.4900 - Obstetric table and accessories.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Obstetric table and accessories. 884.4900 Section 884.4900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological...

  10. 21 CFR 884.4900 - Obstetric table and accessories.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric table and accessories. 884.4900 Section 884.4900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological...

  11. 21 CFR 884.4900 - Obstetric table and accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Obstetric table and accessories. 884.4900 Section 884.4900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES OBSTETRICAL AND GYNECOLOGICAL DEVICES Obstetrical and Gynecological...

  12. Obstetric services in the UK: what we need now.

    PubMed

    Setna, Zeryab; Tuffnell, Derek

    2008-02-01

    Pregnancy and childbirth should be a safe and memorable experience for both women and their partners. This article discusses the current position of maternity services, their strengths and limitations, and suggests future directions required to improve these services further. PMID:18386729

  13. Bridging the Gaps in Obstetric Care: Perspectives of Service Delivery Providers on Challenges and Core Components of Care in Rural Georgia.

    PubMed

    Pinto, Meredith; Rochat, Roger; Hennink, Monique; Zertuche, Adrienne D; Spelke, Bridget

    2016-07-01

    Objectives In 2011, a workforce assessment conducted by the Georgia Maternal and Infant Health Research Group found that 52 % of Primary Care Service Areas outside metropolitan Atlanta, Georgia, had an overburdened or complete lack of obstetric care services. In response to that finding, this study's aim was twofold: to describe challenges faced by providers who currently deliver or formerly delivered obstetric care in these areas, and to identify essential core components that can be integrated into alternative models of care in order to alleviate the burden placed on the remaining obstetric providers. Methods We conducted 46 qualitative in-depth interviews with obstetricians, maternal-fetal medicine specialists, certified nurse midwives, and maternal and infant health leaders in Georgia. Interviews were digitally recorded, transcribed verbatim, uploaded into MAXQDA software, and analyzed using a Grounded Theory Approach. Results Providers faced significant financial barriers in service delivery, including low Medicaid reimbursement, high proportions of self-pay patients, and high cost of medical malpractice insurance. Further challenges in provision of obstetric care in this region were related to patient's late initiation of prenatal care and lacking collaboration between obstetric providers. Essential components of effective models of care included continuity, efficient use of resources, and risk-appropriate services. Conclusion Our analysis revealed core components of improved models of care that are more cost effective and would expand coverage. These components include closer collaboration among stakeholder populations, decentralization of services with effective use of each type of clinical provider, improved continuity of care, and system-wide changes to increase Medicaid benefits. PMID:27090413

  14. Availability and Distribution of Emergency Obstetric Care Services in Karnataka State, South India: Access and Equity Considerations

    PubMed Central

    Mony, Prem K.; Krishnamurthy, Jayanna; Thomas, Annamma; Sankar, Kiruba; Ramesh, B. M.; Moses, Stephen; Blanchard, James; Avery, Lisa

    2013-01-01

    Background As part of efforts to reduce maternal deaths in Karnataka state, India, there has been a concerted effort to increase institutional deliveries. However, little is known about the quality of care in these healthcare facilities. We investigated the availability and distribution of emergency obstetric care (EmOC) services in eight northern districts of Karnataka state in south India. Methods & Findings We undertook a cross-sectional study of 444 government and 422 private health facilities, functional 24-hours-a-day 7-days-a-week. EmOC availability and distribution were evaluated for 8 districts and 42 taluks (sub-districts) during the year 2010, based on a combination of self-reporting, record review and direct observation. Overall, the availability of EmOC services at the sub-state level [EmOC = 5.9/500,000; comprehensive EmOC (CEmOC) = 4.5/500,000 and basic EmOC (BEmOC) = 1.4/500,000] was seen to meet the benchmark. These services however were largely located in the private sector (90% of CEmOC and 70% of BemOC facilities). Thirty six percent of private facilities and six percent of government facilities were EmOC centres. Although half of eight districts had a sufficient number of EmOC facilities and all eight districts had a sufficient number of CEmOC facilities, only two-fifths of the 42 taluks had a sufficient number of EmOC facilities. With the private facilities being largely located in select towns only, the ‘non-headquarter’ taluks and ‘backward’ taluks suffered from a marked lack of coverage of these services. Spatial mapping further helped identify the clustering of a large number of contiguous taluks without adequate government EmOC facilities in northeastern Karnataka. Conclusions In conclusion, disaggregating information on emergency obstetric care service availability at district and subdistrict levels is critical for health policy and planning in the Indian setting. Reducing maternal deaths will require greater

  15. Estimating Health Services Requirements

    NASA Technical Reports Server (NTRS)

    Alexander, H. M.

    1985-01-01

    In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.

  16. Customer satisfaction in medical service encounters -- a comparison between obstetrics and gynecology patients and general medical patients.

    PubMed

    Chang, Ching-Sheng; Weng, Hui-Ching; Chang, Hsin-Hsin; Hsu, Tsuen-Ho

    2006-03-01

    This study is concerned with the "service encounter", and seeks to describe, by use of the Service Encounter Evaluation Model, how the processes involved in the service encounter affect customer satisfaction. Its findings have implications for management practice and research directions, and recommendations are made. With the implementation of a national health insurance scheme, an ever-prospering economy and continually improving educational levels in Taiwan, demand among citizens for good health and medical care is ever increasing. Obstetrics and gynecology patients often differ greatly from general patients, in terms of their moods and emotions. This research involved an empirical study, whose subjects were 590 customers of general clinics and 339 customers of gynecology clinics, in various medical centers in southern Taiwan. By factor analysis, the study established four influencing factors, which were "Medical professionals", "Nursing professionals", "Service personnel" and "Space and facilities". Using the Linear Structural Relation Model (LISREL), it found that medical professionals, nursing professionals, service personnel and space and facilities were effective predictors of medical treatment satisfaction. We also found that the greatest positive impact on overall medical treatment satisfaction resulted from rises in satisfaction with medical professionals, but that the least impact was achieved in relation to service personnel in the general and gynecology clinics. PMID:16547902

  17. A mother–baby psychiatric day hospital: History, rationale, and why perinatal mental health is important for obstetric medicine

    PubMed Central

    Howard, Margaret M

    2014-01-01

    Background Women frequently experience depression, anxiety, or other mental health concerns during pregnancy and postpartum, impacting her and her infant’s health. Patients who require management of medical conditions during the perinatal period are even more likely to experience depression and anxiety compared to those without comorbid medical issues. Despite the availability of effective treatments, perinatal mental health utilization rates are strikingly low. Methods To address common treatment barriers, we developed a specialized mother–baby day hospital for women with psychiatric distress during the peripartum. In this report, we summarize findings from 800 patient satisfaction surveys collected from women treated at the program between 2007 and 2012. Results Findings suggest that women are highly satisfied with the treatment received, often noting that the inclusion of the baby in their treatment is a highly valued feature of care. Conclusion The relevance of perinatal mental health services for patients who are followed by obstetrical medicine specialists is discussed.

  18. Utilization of Emergency Service of Obstetrics and Gynecology: A Cross-Sectional Analysis of a Training Hospital

    PubMed Central

    Aksoy, Huseyin; Aksoy, Ulku; Ozturk, Mustafa; Ozyurt, Sezin; Acmaz, Gokhan; Karadag, Ozge Idem; Yucel, Burak; Aydin, Turgut

    2015-01-01

    Background Overutilization and inappropriate use of emergency departments (EDs) by patients with non-urgent health problems has become a major concern worldwide. This study aims to describe the characteristics of obstetric and gynecologic patients admitted to the Department of Emergency Obstetric and Gynecology. Methods A retrospective and cross-sectional study was designed at our Emergency Service of Obstetrics and Gynecology of Kayseri Education and Research Hospital of Medicine between January 1 and December 31, 2013. A total of 30,853 patients applying to emergency service were retrospectively analyzed from the admission charts, patient files and hospital automation system. Patients were assessed in terms of demographic features, presentation times, complaints, admission type (with own facilities, with consultation or with ambulance), diagnoses (urgent or non-ergent), discharge rates, clinical admission, rejection rate of examination, and rejection rate of hospitalization. Results A total of 30,853 patients were analyzed retrospectively. The mean age of patients was 27.69 ± 8.44 years; 51% of patients were between 20 and 29 years old. The categories of patients in urgent and non-urgent were 69% and 31% respectively. Most common presentation time period was between 19:00 and 21:00. Labor pain, pain and bleeding during pregnency, routine antenatal control, pelvic pain and menstrual irregularity were the most common complaints. Labor pain with the rate of 21% was the most common cause of ED admission. All patients who presented with labor pain were hospitalized. Patients hospitalized for labor constituted 56% of all hospitalized patients. Among patients, 62% were treated on an outpatient basis and 38% were hospitalized. Of patients, 3.54% refused to hospitalization. The cases using the ambulance to admission constituted 1.07% of all ED patients. Of these patients who have used ambulance 3.65% refused to the patient examination. Conclusions To improve the

  19. Essential basic and emergency obstetric and newborn care: from education and training to service delivery and quality of care.

    PubMed

    Otolorin, Emmanuel; Gomez, Patricia; Currie, Sheena; Thapa, Kusum; Dao, Blami

    2015-06-01

    Approximately 15% of expected births worldwide will result in life-threatening complications during pregnancy, delivery, or the postpartum period. Providers skilled in emergency obstetric and newborn care (EmONC) services are essential, particularly in countries with a high burden of maternal and newborn mortality. Jhpiego and its consortia partners have implemented three global programs to build provider capacity to provide comprehensive EmONC services to women and newborns in these resource-poor settings. Providers have been educated to deliver high-impact maternal and newborn health interventions, such as prevention and treatment of postpartum hemorrhage and pre-eclampsia/eclampsia and management of birth asphyxia, within the broader context of quality health services. This article describes Jhpiego's programming efforts within the framework of the basic and expanded signal functions that serve as indicators of high-quality basic and emergency care services. Lessons learned include the importance of health facility strengthening, competency-based provider education, global leadership, and strong government ownership and coordination as essential precursors to scale-up of high impact evidence-based maternal and newborn interventions in low-resource settings. PMID:26115858

  20. Obstetric Provider Maldistribution: Georgia, USA, 2011.

    PubMed

    Spelke, Bridget; Zertuche, Adrienne D; Rochat, Roger

    2016-07-01

    Objectives In 2010, Georgia had the nation's highest maternal mortality rate, sixteenth highest infant mortality rate, and a waning obstetrician/gynecologist (ob/gyn) workforce. Statewide ob/gyn workforce data, however, masked obstetric-specific care shortages and regional variation in obstetric services. The Georgia Maternal and Infant Health Research Group thereby assessed each Georgia region's obstetric provider workforce to identify service-deficient areas. Methods We identified 63 birthing facilities in the 82 Primary Care Service Areas (PCSAs) outside metropolitan Atlanta and interviewed nurse managers and others to assess the age, sex, and expected departure year of each delivering professional. Using accepted annual delivery rates of 155 per obstetrician (OB), 100 per certified nurse midwife (CNM), and 70 per family medicine physician (FP) we converted obstetric providers into "OB equivalents" to standardize obstetric services available in any given area. Using facility births and computed OB equivalents (contemporary and 2020 estimates), we calculated current and projected average annual births per provider (AABP) for each PCSA, categorizing its obstetric provider workforce as "adequate" (AABP < 144), "at risk" (144 ≤ AABP ≤ 166), or "deficient" (AABP > 166). We mapped results using ArcGIS. Results Of 82 surveyed PCSAs, 52 % (43) were deficient in obstetric care; 16 % (13) had a shortage and 37 % (30) lacked obstetric providers entirely. There were no delivering FPs in 89 % (73) of PCSAs and no CNMs in 70 % (56). If Georgia fails to recruit delivering providers, 72 % (58/77) of PCSAs will have deficient or no obstetric care by 2020. Conclusions Obstetric provider shortages in Georgia hinder access to prenatal and delivery services. Care-deficient areas will expand if recruitment and retention of delivering professionals does not improve. PMID:27084367

  1. Implementation of an obstetric cell salvage service in a tertiary women’s hospital

    PubMed Central

    Lew, Eileen; Tagore, Shephali

    2015-01-01

    INTRODUCTION Intraoperative cell salvage (ICS) is an important aspect of patient blood management programmes. An ICS service was introduced at KK Women’s and Children’s Hospital, Singapore, from 2 May 2011 to 30 April 2013 to aid in the management of massive obstetric haemorrhage. METHODS With support from the Ministry of Health’s Healthcare Quality Improvement and Innovation Fund, a workgroup comprising obstetricians, anaesthetists and nursing staff was formed to develop training requirements, clinical guidelines and protocols for implementing ICS using the Haemonetics Cell Saver 5. Pregnant women with an anticipated blood loss of > 1,000 mL during Caesarean delivery, a baseline haemoglobin level of < 10 g/dL, rare blood types and who had refused donor blood were recruited to the service after obtaining informed consent. RESULTS A total of 11 women were recruited to the ICS service; the primary indications were placenta praevia and placenta accreta. Median blood loss in these 11 patients was 1,500 (range 400–3,000) mL. In four patients, adequate autologous blood was collected to initiate processing and salvaged, processed blood was successfully reinfused (mean 381.3 [range 223.0–700.0] mL). Median blood loss among these four patients was 2,000 (range 2,000–3,000) mL. No adverse event occurred following autologous transfusion. Mean immediate postoperative haemoglobin level was 8.0 (range 7.1–9.4) g/dL. CONCLUSION The implementation of an obstetric ICS service in our institution was successful. Future studies should seek to address the cost-effectiveness of ICS in reducing allogeneic blood utilisation. PMID:26311910

  2. Trade in health services.

    PubMed Central

    Chanda, Rupa

    2002-01-01

    In light of the increasing globalization of the health sector, this article examines ways in which health services can be traded, using the mode-wise characterization of trade defined in the General Agreement on Trade in Services. The trade modes include cross- border delivery of health services via physical and electronic means, and cross-border movement of consumers, professionals, and capital. An examination of the positive and negative implications of trade in health services for equity, efficiency, quality, and access to health care indicates that health services trade has brought mixed benefits and that there is a clear role for policy measures to mitigate the adverse consequences and facilitate the gains. Some policy measures and priority areas for action are outlined, including steps to address the "brain drain"; increasing investment in the health sector and prioritizing this investment better; and promoting linkages between private and public health care services to ensure equity. Data collection, measures, and studies on health services trade all need to be improved, to assess better the magnitude and potential implications of this trade. In this context, the potential costs and benefits of trade in health services are shaped by the underlying structural conditions and existing regulatory, policy, and infrastructure in the health sector. Thus, appropriate policies and safeguard measures are required to take advantage of globalization in health services. PMID:11953795

  3. Barriers to Emergency Obstetric Care Services in Perinatal Deaths in Rural Gambia: A Qualitative In-Depth Interview Study

    PubMed Central

    Jammeh, Abdou; Sundby, Johanne; Vangen, Siri

    2011-01-01

    Objective. The Gambia has one of the world's highest perinatal mortality rates. We explored barriers of timely access to emergency obstetric care services resulting in perinatal deaths and in survivors of severe obstetric complications in rural Gambia. Method. We applied the “three delays” model as a framework for assessing contributing factors to perinatal deaths and obstetric complications. Qualitative in-depth interviews were conducted with 20 survivors of severe obstetric complications at home settings within three to four weeks after hospital discharge. Family members and traditional birth attendants were also interviewed. The interviews were translated into English and transcribed verbatim. We used content analysis to identify barriers of care. Results. Transport/cost-related delays are the major contributors of perinatal deaths in this study. A delay in recognising danger signs of pregnancy/labour or decision to seek care outside the home was the second important contributor of perinatal deaths. Decision to seek care may be timely, but impaired access precluded utilization of EmOC services. Obtaining blood for transfusion was also identified as a deterrent to appropriate care. Conclusion. Delays in accessing EmOC are critical in perinatal deaths. Thus, timely availability of emergency transport services and prompt decision-making are warranted for improved perinatal outcomes in rural Gambia. PMID:21766039

  4. Annual report of the Women's Health Care Committee, Japan Society of Obstetrics and Gynecology, 2015.

    PubMed

    Wakatsuki, Akihiko; Takamatsu, Kiyoshi

    2016-02-01

    The activity of the Women's Health Care Committee over a two year period up to June 2015 focused upon: (i) management of breast diseases in obstetrics and gynecology; (ii) investigation of lifestyle-related disease and bone mineral density after gynecologic cancer therapy; (iii) postoperative women's health care; (iv) current surgical treatment for pelvic organ prolapse among gynecologists in Japan; (v) cesarean indication for pregnant women with active/inactive genital viral lesions; (vi) health care of young female athletes concerned about menstrual cycle abnormalities, stress fractures and premenstrual syndrome/premenstrual dysphoric disorder; (vii) a training program for women's health care advisers; and (viii) a new edition of the oral contraceptive and low-dose estrogen-progestogen guideline. Detailed activities of the eight subcommittees are described in the text. PMID:26694692

  5. Zika Virus and Pregnancy: What Obstetric Health Care Providers Need to Know.

    PubMed

    Meaney-Delman, Dana; Rasmussen, Sonja A; Staples, J Erin; Oduyebo, Titilope; Ellington, Sascha R; Petersen, Emily E; Fischer, Marc; Jamieson, Denise J

    2016-04-01

    Zika virus is a flavivirus transmitted by Aedes (Stegomyia) species of mosquitoes. In May 2015, the World Health Organization confirmed the first local transmission of Zika virus in the Americas in Brazil. The virus has spread rapidly to other countries in the Americas; as of January 29, 2016, local transmission has been detected in at least 22 countries or territories, including the Commonwealth of Puerto Rico and the U.S. Virgin Islands. Zika virus can infect pregnant women in all three trimesters. Although pregnant women do not appear to be more susceptible to or more severely affected by Zika virus infection, maternal-fetal transmission has been documented. Several pieces of evidence suggest that maternal Zika virus infection is associated with adverse neonatal outcomes, most notably microcephaly. Because of the number of countries and territories with local Zika virus transmission, it is likely that obstetric health care providers will care for pregnant women who live in or have traveled to an area of local Zika virus transmission. We review information on Zika virus, its clinical presentation, modes of transmission, laboratory testing, effects during pregnancy, and methods of prevention to assist obstetric health care providers in caring for pregnant women considering travel or with a history of travel to areas with ongoing Zika virus transmission and pregnant women residing in areas with ongoing Zika virus transmission. PMID:26889662

  6. College Health: Health Services and Common Health Problems

    MedlinePlus

    ... Conditions Nutrition & Fitness Emotional Health College Health: Health Services and Common Health Problems Posted under Health Guides . ... March 2015. +Related Content What are student health services? The student health services (sometimes called the student ...

  7. Selected Health Service Occupations.

    ERIC Educational Resources Information Center

    Coleman, Arthur D.

    Prepared by an occupational analyst of the Utah Department of Employment Security, this manual provides job guides for 39 health service occupations concerned mainly with doctors, nurses, and related hospital-medical-health consultants and services. Classified according to "The Dictionary of Occupational Titles," each occupational description…

  8. The Role of Obstetric Knowledge in Utilization of Delivery Service in Nepal

    ERIC Educational Resources Information Center

    Karkee, Rajendra; Baral, Om Bahadur; Khanal, Vishnu; Lee, Andy H.

    2014-01-01

    Birth Preparedness and Complication Readiness (BP/CR) program has been promoted in Nepal to equip pregnant women with obstetric knowledge so as to motivate them to seek professional care. Using a prospective design of 701 pregnant women of more than 5 months gestation in a central hills district of Nepal, we evaluated if having obstetric knowledge…

  9. The FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health.

    PubMed

    Taylor, David J; Vander Plaetse, Bart

    2014-10-01

    The FIGO Leadership in Obstetrics and Gynecology for Impact and Change (LOGIC) Initiative in Maternal and Newborn Health developed the organizational capacity of national professional organizations of obstetrics and gynecology in eight African and Asian countries. The initiative was funded by a grant from the Bill and Melinda Gates Foundation and had three key objectives. These goals were to support the eight FIGO member associations to strengthen their capacity to work effectively; to influence national policies on maternal and newborn health; and to work toward improving clinical practice in this area. The current supplement presents evidence that the focus and effectiveness of a national obstetric and gynecologic association-as well as its influence on major public health issues (such as United Nations Millennium Development Goals 4 and 5)-can be substantially broadened and enhanced by the provision of external support. PMID:25115412

  10. Development of an intervention to improve mental health for obstetric fistula patients in Tanzania

    PubMed Central

    Watt, Melissa H.; Wilson, Sarah M.; Sikkema, Kathleen J.; Velloza, Jennifer; Mosha, Mary V.; Masenga, Gileard G.; Bangser, Margaret; Browning, Andrew; Nyindo, Pilli M.

    2015-01-01

    Obstetric fistula is a debilitating childbirth injury that has been associated with high rates of psychological distress. Global efforts have helped to link women to surgical repair, but thus far no evidence-based interventions exist to address the psychological needs of these women during the hospital stay. In this paper, we describe the development of a psychological intervention for women in Tanzania who are receiving surgical care for an obstetric fistula. The intervention was developed based on theories of cognitive behavioral therapy and coping models. Content and delivery were informed by qualitative data collection with a range of stakeholders including women with fistula, and input from a study advisory board. The resulting intervention was six individual sessions, delivered by a trained community health nurse. The session topics were: 1) recounting the fistula story; 2) creating a new story about the fistula; 3) loss, grief and shame; 4) specific strategies for coping; 5) social relationships; and 6) planning for the future. A trial run of the intervention revealed that the intervention could be delivered with fidelity and was acceptable to patients. A future randomized control trial will evaluate the efficacy of this intervention to address the mental health symptoms of this population. PMID:25710896

  11. Rating maternal and neonatal health services in developing countries.

    PubMed Central

    Bulatao, Rodolfo A.; Ross, John A.

    2002-01-01

    OBJECTIVE: To assess maternal and neonatal health services in 49 developing countries. METHODS: The services were rated on a scale of 0 to 100 by 10 - 25 experts in each country. The ratings covered emergency and routine services, including family planning, at health centres and district hospitals, access to these services for both rural and urban women, the likelihood that women would receive particular forms of antenatal and delivery care, and supporting elements of programmes such as policy, resources, monitoring, health promotion and training. FINDINGS: The average rating was only 56, but countries varied widely, especially in access to services in rural areas. Comparatively good ratings were reported for immunization services, aspects of antenatal care and counselling on breast feeding. Ratings were particularly weak for emergency obstetric care in rural areas, safe abortion and HIV counselling. CONCLUSION: Maternal health programme effort in developing countries is seriously deficient, particularly in rural areas. Rural women are disadvantaged in many respects, but especially regarding the treatment of emergency obstetric conditions. Both rural and urban women receive inadequate HIV counselling and testing and have quite limited access to safe abortion. Improving services requires moving beyond policy reform to strengthening implementation of services and to better staff training and health promotion. Increased financing is only part of the solution. PMID:12378290

  12. Consumer Health: Products and Services.

    ERIC Educational Resources Information Center

    Haag, Jessie Helen

    This book presents a general overview of consumer health, its products and services. Consumer health is defined as those topics dealing with a wise selection of health products and services, agencies concerned with the control of these products and services, evaluation of quackery and health misconceptions, health careers, and health insurance.…

  13. Availability of drugs and medical supplies for emergency obstetric care: experience of health facility managers in a rural District of Tanzania

    PubMed Central

    2014-01-01

    Background Provision of quality emergency obstetric care relies upon the presence of skilled health attendants working in an environment where drugs and medical supplies are available when needed and in adequate quantity and of assured quality. This study aimed to describe the experience of rural health facility managers in ensuring the timely availability of drugs and medical supplies for emergency obstetric care (EmOC). Methods In-depth interviews were conducted with a total of 17 health facility managers: 14 from dispensaries and three from health centers. Two members of the Council Health Management Team and one member of the Council Health Service Board were also interviewed. A survey of health facilities was conducted to supplement the data. All the materials were analysed using a qualitative thematic analysis approach. Results Participants reported on the unreliability of obtaining drugs and medical supplies for EmOC; this was supported by the absence of essential items observed during the facility survey. The unreliability of obtaining drugs and medical supplies was reported to result in the provision of untimely and suboptimal EmOC services. An insufficient budget for drugs from central government, lack of accountability within the supply system and a bureaucratic process of accessing the locally mobilized drug fund were reported to contribute to the current situation. Conclusion The unreliability of obtaining drugs and medical supplies compromises the timely provision of quality EmOC. Multiple approaches should be used to address challenges within the health system that prevent access to essential drugs and supplies for maternal health. There should be a special focus on improving the governance of the drug delivery system so that it promotes the accountability of key players, transparency in the handling of information and drug funds, and the participation of key stakeholders in decision making over the allocation of locally collected drug funds. PMID

  14. Provider-Initiated Late Preterm Births in Brazil: Differences between Public and Private Health Services

    PubMed Central

    Leal, Maria do Carmo; Esteves-Pereira, Ana Paula; Nakamura-Pereira, Marcos; Torres, Jacqueline Alves; Domingues, Rosa Maria Soares Madeira; Dias, Marcos Augusto Bastos; Moreira, Maria Elizabeth; Theme-Filha, Mariza; da Gama, Silvana Granado Nogueira

    2016-01-01

    Background A large proportion of the rise in prematurity worldwide is owing to late preterm births, which may be due to the expansion of obstetric interventions, especially pre-labour caesarean section. Late preterm births pose similar risks to overall prematurity, making this trend a concern. In this study, we describe factors associated with provider-initiated late preterm birth and verify differences in provider-initiated late preterm birth rates between public and private health services according to obstetric risk. Methods This is a sub-analysis of a national population-based survey of postpartum women entitled “Birth in Brazil”, performed between 2011 and 2012. We included 23,472 singleton live births. We performed non-conditional multiple logistic regressions assessing associated factors and analysing differences between public and private health services. Results Provider-initiated births accounted for 38% of late preterm births; 32% in public health services and 61% in private health services. They were associated with previous preterm birth(s) and maternal pathologies for women receiving both public and private services and with maternal age ≥35 years for women receiving public services. Women receiving private health services had higher rates of provider-initiated late preterm birth (rate of 4.8%) when compared to the ones receiving public services (rate of 2.4%), regardless of obstetric risk–adjusted OR of 2.3 (CI 1.5–3.6) for women of low obstetric risk and adjusted OR of 1.6 (CI 1.1–2.3) for women of high obstetric risk. Conclusion The high rates of provider-initiated late preterm birth suggests a considerable potential for reduction, as such prematurity can be avoided, especially in women of low obstetric risk. To promote healthy births, we advise introducing policies with incentives for the adoption of new models of birth care. PMID:27196102

  15. Use of an Information Retrieval Service in an Obstetrics/Gynecology Residency Program.

    ERIC Educational Resources Information Center

    And Others; Gunning, John E.

    1980-01-01

    A program that uses the clinical librarian as a member of the patient care team has been developed by an obstetrics and gynecology department of a university medical center to keep faculty and hospital house staff knowledgeable about current developments and research. Program objectives, methodology, costs, evaluation, and information utilization…

  16. Antenatal and obstetric care in Afghanistan – a qualitative study among health care receivers and health care providers

    PubMed Central

    2013-01-01

    Background Despite attempts from the government to improve ante- and perinatal care, Afghanistan has once again been labeled “the worst country in which to be a mom” in Save the Children’s World’s Mothers’ Report. This study investigated how pregnant women and health care providers experience the existing antenatal and obstetric health care situation in Afghanistan. Methods Data were obtained through one-to-one semi-structured interviews of 27 individuals, including 12 women who were pregnant or had recently given birth, seven doctors, five midwives, and three traditional birth attendants. The interviews were carried out in Kabul and the village of Ramak in Ghazni Province. Interviews were taped, transcribed, and analyzed according to the principles of Giorgi’s phenomenological analysis. Results Antenatal care was reported to be underused, even when available. Several obstacles were identified, including a lack of knowledge regarding the importance of antenatal care among the women and their families, financial difficulties, and transportation problems. The women also reported significant dissatisfaction with the attitudes and behavior of health personnel, which included instances of verbal and physical abuse. According to the health professionals, poor working conditions, low salaries, and high stress levels contributed to this matter. Personal contacts inside the hospital were considered necessary for receiving high quality care, and bribery was customary. Despite these serious concerns, the women expressed gratitude for having even limited access to health care, especially treatment provided by a female doctor. Health professionals were proud of their work and enjoyed the opportunity to help their community. Conclusion This study identified several obstacles which must be addressed to improve reproductive health in Afghanistan. There was limited understanding of the importance of antenatal care and a lack of family support. Financial and

  17. Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States

    PubMed Central

    Jamieson, Denise J.; Kpaduwa, Julius; Schrier, Sarah; Kim, Moon; Green, Nicole M.; Ströher, Ute; Muehlenbachs, Atis; Bell, Michael; Rollin, Pierre E.; Mascola, Laurene

    2016-01-01

    Many of the survivors of the 2014–2015 epidemic of Ebola virus disease (EVD) in West Africa were women of childbearing age. Limited clinical and laboratory data exist that describe these women’s pregnancies and outcomes. We report the case of an EVD survivor who became pregnant and delivered her child in the United States, and we discuss implications of this case for infection control practices in obstetric services. Hospitals in the United States must be prepared to care for EVD survivors. PMID:27191253

  18. Pregnancy, Labor, and Delivery after Ebola Virus Disease and Implications for Infection Control in Obstetric Services, United States.

    PubMed

    Kamali, Amanda; Jamieson, Denise J; Kpaduwa, Julius; Schrier, Sarah; Kim, Moon; Green, Nicole M; Ströher, Ute; Muehlenbachs, Atis; Bell, Michael; Rollin, Pierre E; Mascola, Laurene

    2016-07-01

    Many of the survivors of the 2014-2015 epidemic of Ebola virus disease (EVD) in western Africa were women of childbearing age. Limited clinical and laboratory data exist that describe these women's pregnancies and outcomes. We report the case of an EVD survivor who became pregnant and delivered her child in the United States, and we discuss implications of this case for infection control practices in obstetric services. Hospitals in the United States must be prepared to care for EVD survivors. PMID:27191253

  19. Making It Happen: Training health-care providers in emergency obstetric and newborn care.

    PubMed

    Ameh, Charles A; van den Broek, Nynke

    2015-11-01

    An estimated 289,000 maternal deaths, 2.6 million stillbirths and 2.4 million newborn deaths occur globally each year, with the majority occurring around the time of childbirth. The medical and surgical interventions to prevent this loss of life are known, and most maternal and newborn deaths are in principle preventable. There is a need to build the capacity of health-care providers to recognize and manage complications during pregnancy, childbirth and the post-partum period. Skills-and-drills competency-based training in skilled birth attendance, emergency obstetric care and early newborn care (EmONC) is an approach that is successful in improving knowledge and skills. There is emerging evidence of this resulting in improved availability and quality of care. To evaluate the effectiveness of EmONC training, operational research using an adapted Kirkpatrick framework and a theory of change approach is needed. The Making It Happen programme is an example of this. PMID:25911056

  20. Family planning, obstetrical and gynecological health care provision in the Soviet Far East.

    PubMed

    Thomsen, R J

    1992-01-01

    The Soviet model for both obstetrical and gynecological care and family planning provision seems entrenched in the Soviet Far East as found during a July 1991 visit to the Magadan and Chukotka Regions. Modern birth control is minimally practiced, but does include use of the older Soviet Loop intrauterine contraceptive device (IUD), recent introduction of the new Soviet Copper-T IUD and sporadic availability of condoms and foreign made birth control pills. Without male or female surgical sterilizations being performed, the consequence is that the major form of family planning is first trimester abortion. During this visit, I introduced the use of the NORPLANT Subdermal Contraceptive System and the Copper-T380A IUD to physicians at Anadry and Pevek regional hospitals. Gynecological surgery was also performed and fairly typical ob-gyn care units were toured. Ob-Gyn physicians in the Soviet Far East were found to be highly motivated. They look to the West for help in upgrading family planning and ob-gyn health care in the face of severe shortages after a half decade of perestroika. PMID:1605341

  1. Health Occupations Education. Health Services Careers.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    Twenty-four units on health service careers are presented in this teacher's guide. The units are organized into four sections as follow: Section A--Orientation (health careers, career success, Health Occupations Students of America); Section B--Health and First Aid (personal health, community health, and first aid); Section C--Body Structure and…

  2. Has Chiranjeevi Yojana changed the geographic availability of free comprehensive emergency obstetric care services in Gujarat, India?

    PubMed Central

    Vora, Kranti Suresh; Yasobant, Sandul; Patel, Amit; Upadhyay, Ashish; Mavalankar, Dileep V.

    2015-01-01

    Background The high rate of maternal mortality in India is of grave concern. Poor rural Indian women are most vulnerable to preventable maternal deaths primarily because they have limited availability of affordable emergency obstetric care (EmOC) within reasonable geographic proximity. Scarcity of obstetricians in the public sector combined with financial barriers to accessing private sector obstetrician services preclude this underserved population from availing lifesaving functions of comprehensive EmOC such as C-section. In order to overcome this limitation, Government of Gujarat initiated a unique public–private partnership program called Chiranjeevi Yojana (CY) in 2005. The program envisaged leveraging private sector providers to increase availability and thereby accessibility of EmOC care for vulnerable sections of society. Under CY, private sector providers render obstetric care services to poor women at no cost to patients. This paper examines the CY's effectiveness in improving availability of CEmOC services between 2006 and 2012 in three districts of Gujarat, India. Methods Primary data on facility locations, EmOC functionality, and obstetric bed availability were collected in the years 2012 and 2013 in three study districts. Secondary data from Census 2001 and 2011 were used along with required geographic information from Topo sheets and Google Earth maps. ArcGIS version 10 was used to analyze the availability of services using two-step floating catchment area (2SFCA) method. Results Our analysis suggests that the availability of CEmOC services within reasonable travel distance has greatly improved in all three study districts as a result of CY. We also show that the declining participation of the private sector did not result in an increase in distance to the nearest facility, but the extent of availability of providers for several villages was reduced. Spatial and temporal analyses in this paper provide a comprehensive understanding of trends in the

  3. Referrals between Public Sector Health Institutions for Women with Obstetric High Risk, Complications, or Emergencies in India - A Systematic Review.

    PubMed

    Singh, Samiksha; Doyle, Pat; Campbell, Oona M; Mathew, Manu; Murthy, G V S

    2016-01-01

    Emergency obstetric care (EmOC) within primary health care systems requires a linked referral system to be effective in reducing maternal death. This systematic review aimed to summarize evidence on the proportion of referrals between institutions during pregnancy and delivery, and the factors affecting referrals, in India. We searched 6 electronic databases, reviewed four regional databases and repositories, and relevant program reports from India published between 1994 and 2013. All types of study or reports (except editorials, comments and letters) which reported on institution-referrals (out-referral or in-referral) for obstetric care were included. Results were synthesized on the proportion and the reasons for referral, and factors affecting referrals. Of the 11,346 articles identified by the search, we included 232 articles in the full text review and extracted data from 16 studies that met our inclusion criteria Of the 16, one was RCT, seven intervention cohort (without controls), six cross-sectional, and three qualitative studies. Bias and quality of studies were reported. Between 25% and 52% of all pregnancies were referred from Sub-centres for antenatal high-risk, 14% to 36% from nurse run delivery or basic EmOC centres for complications or emergencies, and 2 to 7% were referred from doctor run basic EmOC centres for specialist care at comprehensive EmOC centres. Problems identified with referrals from peripheral health centres included low skills and confidence of staff, reluctance to induce labour, confusion over the clinical criteria for referral, non-uniform standards of care at referral institutions, a tendency to by-pass middle level institutions, a lack of referral communication and supervision, and poor compliance. The high proportion of referrals from peripheral health centers reflects the lack of appropriate clinical guidelines, processes, and skills for obstetric care and referral in India. This, combined with inadequate referral communication

  4. What Obstetric Health Care Providers Need to Know About Measles and Pregnancy

    PubMed Central

    Rasmussen, Sonja A.; Jamieson, Denise J.

    2015-01-01

    From January 1 to April 3, 2015, 159 people from 18 states and the District of Columbia were reported as having measles. Most cases are part of an outbreak linked to a California amusement park. Because measles was eliminated in the United States in 2000, most U.S. clinicians are unfamiliar with the condition. We reviewed information on the current outbreak, measles manifestations, diagnostic methods, treatment, and infection-control recommendations. To identify information on measles and pregnancy, we reviewed reports with 20 or more measles cases during pregnancy that included data on effects on pregnant women or pregnancy outcomes. These reports were identified through MEDLINE from inception through February 2015 using the following strategy: (((pregnan*) AND measles) AND English[Language]) NOT review[Publication Type]. Reference lists also were reviewed to identify additional articles. Pregnant women infected with measles are more likely to be hospitalized, develop pneumonia, and die than nonpregnant women. Adverse pregnancy outcomes, including pregnancy loss, preterm birth, and low birth weight, are associated with maternal measles; however, the risk of congenital defects does not appear to be increased. No antiviral therapy is available; treatment is supportive. Early identification of possible cases is needed so that appropriate infection control can be instituted promptly. The recent measles outbreak highlights the role that obstetric health care providers play in vaccine-preventable illnesses; obstetrician–gynecologists should ensure that patients are up to date on all vaccines, including measles-containing vaccines, and should recommend and ideally offer a measles-containing vaccine to women without evidence of measles immunity before or after pregnancy. PMID:25899422

  5. Incorporating immunizations into routine obstetric care to facilitate Health Care Practitioners in implementing maternal immunization recommendations

    PubMed Central

    Webb, Heather; Street, Jackie; Marshall, Helen

    2014-01-01

    Immunization against pertussis, influenza, and rubella reduces morbidity and mortality in pregnant women and their offspring. Health care professionals (HCPs) caring for women perinatally are uniquely placed to reduce maternal vaccine preventable diseases (VPDs). Despite guidelines recommending immunization during the perinatal period, maternal vaccine uptake remains low. This qualitative study explored the role of obstetricians, general practitioners, and midwives in maternal vaccine uptake. Semi-structured interviews (n = 15) were conducted with perinatal HCPs at a tertiary maternity hospital in South Australia. HCPs were asked to reflect on their knowledge, beliefs, and practice relating to immunization advice and vaccine provision. Interviews were transcribed and coded using thematic analysis. Data collection and analysis was an iterative process, with collection ceasing with theoretical saturation. Participants unanimously supported maternal vaccination as an effective way of reducing risk of disease in this vulnerable population, however only rubella immunity detection and immunization is embedded in routine care. Among these professionals, delegation of responsibility for maternal immunization was unclear and knowledge about maternal immunization was variable. Influenza and pertussis vaccine prevention measures were not included in standard pregnancy record documentation, information provision to patients was “ad hoc” and vaccinations not offered on-site. The key finding was that the incorporation of maternal vaccinations into standard care through a structured process is an important facilitator for immunization uptake. Incorporating vaccine preventable disease management measures into routine obstetric care including incorporation into the Pregnancy Record would facilitate HCPs in implementing recommendations. Rubella prevention provides a useful “template” for other vaccines. PMID:24509790

  6. The MOM Project: delivering maternal health services among internally displaced populations in eastern Burma.

    PubMed

    Mullany, Luke C; Lee, Catherine I; Paw, Palae; Shwe Oo, Eh Kalu; Maung, Cynthia; Kuiper, Heather; Masenior, Nicole; Mansenior, Nicole; Beyrer, Chris; Lee, Thomas J

    2008-05-01

    Alternative strategies to increase access to reproductive health services among internally displaced populations are urgently needed. In eastern Burma, continuing conflict and lack of functioning health systems render the emphasis on facility-based delivery with skilled attendants unfeasible. Along the Thailand-Burma border, local organisations have implemented an innovative pilot, the Mobile Obstetric Maternal Health Workers (MOM) Project, establishing a three-tiered collaborative network of community-based reproductive health workers. Health workers from local organisations received practical training in basic emergency obstetric care plus blood transfusion, antenatal care and family planning at a central facility. After returning to their target communities inside Burma, these first-tier maternal health workers trained a second tier of local health workers and a third tier of traditional birth attendants (TBAs) to provide a limited subset of these interventions, depending on their level of training. In this ongoing project, close communication between health workers and TBAs promotes acceptance and coverage of maternity services throughout the community. We describe the rationale, design and implementation of the project and a parallel monitoring plan for evaluation of the project. This innovative obstetric health care delivery strategy may serve as a model for the delivery of other essential health services in this population and for increasing access to care in other conflict settings. PMID:18513606

  7. Health care's service fanatics.

    PubMed

    Merlino, James I; Raman, Ananth

    2013-05-01

    The Cleveland Clinic has long had a reputation for medical excellence. But in 2009 the CEO acknowledged that patients did not think much of their experience there and decided to act. Since then the Clinic has leaped to the top tier of patient-satisfaction surveys, and it now draws hospital executives from around the world who want to study its practices. The Clinic's journey also holds Lessons for organizations outside health care that must suddenly compete by creating a superior customer experience. The authors, one of whom was critical to steering the hospital's transformation, detail the processes that allowed the Clinic to excel at patient satisfaction without jeopardizing its traditional strengths. Hospital leaders: Publicized the problem internally. Seeing the hospital's dismal service scores shocked employees into recognizing that serious flaws existed. Worked to understand patients' needs. Management commissioned studies to get at the root causes of dissatisfaction. Made everyone a caregiver. An enterprisewide program trained everyone, from physicians to janitors, to put the patient first. Increased employee engagement. The Clinic instituted a "caregiver celebration" program and redoubled other motivational efforts. Established new processes. For example, any patient, for any reason, can now make a same-day appointment with a single call. Set patients' expectations. Printed and online materials educate patients about their stays--before they're admitted. Operating a truly patient-centered organization, the authors conclude, isn't a program; it's a way of life. PMID:23898737

  8. [Coverage of health services].

    PubMed

    Martínez-Narváez, G

    1992-01-01

    In this paper the concepts and criteria related to health coverage are discussed in the context of the organization of national health systems. The main international agreements based on WHO/PAHO proposals are also described. The relationship between primary health care and health coverage is analyzed and the evolution of the programs for the extension of health coverage in Mexico are discussed, with emphasis on the problems of overlap and definition of the universe in the several institutions of the health sector. Finally, the author reviews the problems to measure coverage in order to guarantee social and operative efficiency of the Mexican health system. PMID:1411776

  9. The emergence of a global right to health norm – the unresolved case of universal access to quality emergency obstetric care

    PubMed Central

    2014-01-01

    Background The global response to HIV suggests the potential of an emergent global right to health norm, embracing shared global responsibility for health, to assist policy communities in framing the obligations of the domestic state and the international community. Our research explores the extent to which this global right to health norm has influenced the global policy process around maternal health rights, with a focus on universal access to emergency obstetric care. Methods In examining the extent to which arguments stemming from a global right to health norm have been successful in advancing international policy on universal access to emergency obstetric care, we looked at the period from 1985 to 2013 period. We adopted a qualitative case study approach applying a process-tracing methodology using multiple data sources, including an extensive literature review and limited key informant interviews to analyse the international policy agenda setting process surrounding maternal health rights, focusing on emergency obstetric care. We applied John Kingdon's public policy agenda setting streams model to analyse our data. Results Kingdon’s model suggests that to succeed as a mobilising norm, the right to health could work if it can help bring the problem, policy and political streams together, as it did with access to AIDS treatment. Our analysis suggests that despite a normative grounding in the right to health, prioritisation of the specific maternal health entitlements remains fragmented. Conclusions Despite United Nations recognition of maternal mortality as a human rights issue, the relevant policy communities have not yet managed to shift the policy agenda to prioritise the global right to health norm of shared responsibility for realising access to emergency obstetric care. The experience of HIV advocates in pushing for global solutions based on right to health principles, including participation, solidarity and accountability; suggest potential avenues for

  10. International Federation of Gynecology and Obstetrics opinion on reproductive health impacts of exposure to toxic environmental chemicals.

    PubMed

    Di Renzo, Gian Carlo; Conry, Jeanne A; Blake, Jennifer; DeFrancesco, Mark S; DeNicola, Nathaniel; Martin, James N; McCue, Kelly A; Richmond, David; Shah, Abid; Sutton, Patrice; Woodruff, Tracey J; van der Poel, Sheryl Ziemin; Giudice, Linda C

    2015-12-01

    Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and related health outcomes are inequitably distributed within and between countries; universally, the consequences of exposure are disproportionately borne by people with low incomes. Discrimination, other social factors, economic factors, and occupation impact risk of exposure and harm. Documented links between prenatal exposure to environmental chemicals and adverse health outcomes span the life course and include impacts on fertility and pregnancy, neurodevelopment, and cancer. The global health and economic burden related to toxic environmental chemicals is in excess of millions of deaths and billions of dollars every year. On the basis of accumulating robust evidence of exposures and adverse health impacts related to toxic environmental chemicals, the International Federation of Gynecology and Obstetrics (FIGO) joins other leading reproductive health professional societies in calling for timely action to prevent harm. FIGO recommends that reproductive and other health professionals advocate for policies to prevent exposure to toxic environmental chemicals, work to ensure a healthy food system for all, make environmental health part of health care, and champion environmental justice. PMID:26433469

  11. School Health Services.

    ERIC Educational Resources Information Center

    Wilson, Charles C., Ed.

    A comprehensive guide for health procedures in small and large school systems, this volume emphasizes the need for coordination of school efforts with those of parents, departments of health, private practitioners of medicine and dentistry, and community health agencies. Particular attention is given to the role of the teacher in school health…

  12. Guidelines for School Health Services.

    ERIC Educational Resources Information Center

    Dougherty, Sarah; And Others

    This publication was designed to assist chief school administrators, school nurses, school physicians, staff, and other school health personnel in developing, implementing, and evaluating sound school health programs for New Jersey public school students. Section I delineates responsibility for school health services, discussing the role of…

  13. Obstetric complications and mother’s age at delivery are predictors of eating disorder symptoms among Health Science college students

    PubMed Central

    Lofrano-Prado, Mara Cristina; do Prado, Wagner Luiz; de Barros, Mauro Virgilio Gomes; Tenório, Thiago Ricardo dos Santos; de Souza, Sandra Lopes

    2015-01-01

    ABSTRACT Objective To identify the association between perinatal/neonatal factors and symptoms of eating disorders among college students. Methods Four hundred and eight college students (283 women), aged 18 to 23 years old, enrolled in the first semester of a Bachelor of Health Science degree program were included in the sample. Eating disorder symptoms and body image dissatisfaction were assessed with the Eating Attitudes Test and Bulimic Investigatory Test of Edinburgh. Information regarding birth weight, breastfeeding, obstetric complications, mother’s age at delivery, type of delivery, and birth order were self-reported by the volunteers after consulting their parents. Association between perinatal and neonatal factors and symptoms of anorexia nervosa and bulimia nervosa were assessed by binary logistic regression adjusted for sex, age, and body mass index. Results The likelihood of presenting with symptoms of anorexia nervosa was 0.5 time lower for those students born from the oldest mothers (odds ratio – OR=0.37; 95% confidence interval – 95%CI: 0.17-0.83). Relative to bulimia nervosa, the risk was higher among students who reported obstetric complications (OR=2.62; 95%CI: 1.03-6.67). Conclusion We observed the association between perinatal and neonatal factors with symptoms of eating disorders in college students. PMID:26676267

  14. Prevention in Obstetrics.

    ERIC Educational Resources Information Center

    Children in the Tropics, 1984

    1984-01-01

    The aim of this issue of "Children in the Tropics" is to describe work that may be done by a motivated health team having only the strict minimum of material resources. While not a handbook of obstetrics, this text serves as a reminder of basic information and procedures workers must be able to perform. Following a review of the educational and…

  15. Mobile Health (mHealth) Services and Online Health Educators

    PubMed Central

    Anshari, Muhammad; Almunawar, Mohammad Nabil

    2016-01-01

    Mobile technology enables health-care organizations to extend health-care services by providing a suitable environment to achieve mobile health (mHealth) goals, making some health-care services accessible anywhere and anytime. Introducing mHealth could change the business processes in delivering services to patients. mHealth could empower patients as it becomes necessary for them to become involved in the health-care processes related to them. This includes the ability for patients to manage their personal information and interact with health-care staff as well as among patients themselves. The study proposes a new position to supervise mHealth services: the online health educator (OHE). The OHE should be occupied by special health-care staffs who are trained in managing online services. A survey was conducted in Brunei and Indonesia to discover the roles of OHE in managing mHealth services, followed by a focus group discussion with participants who interacted with OHE in a real online health scenario. Data analysis showed that OHE could improve patients’ confidence and satisfaction in health-care services. PMID:27257387

  16. Health Services and Collective Bargaining

    ERIC Educational Resources Information Center

    Torrence, William D.

    1974-01-01

    A rationale is suggested for designing and developing education and training programs in labor relations for hospital managements. Also, federal work stoppage data are identified as they relate to medical and other health services. (AG)

  17. 21 CFR 884.4500 - Obstetric fetal destructive instrument.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Obstetric fetal destructive instrument. 884.4500 Section 884.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... dead or anomalous (abnormal) fetus. This generic type of device includes the cleidoclast,...

  18. 21 CFR 884.4500 - Obstetric fetal destructive instrument.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Obstetric fetal destructive instrument. 884.4500 Section 884.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... dead or anomalous (abnormal) fetus. This generic type of device includes the cleidoclast,...

  19. 21 CFR 884.4500 - Obstetric fetal destructive instrument.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Obstetric fetal destructive instrument. 884.4500 Section 884.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... dead or anomalous (abnormal) fetus. This generic type of device includes the cleidoclast,...

  20. 21 CFR 884.4500 - Obstetric fetal destructive instrument.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Obstetric fetal destructive instrument. 884.4500 Section 884.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... dead or anomalous (abnormal) fetus. This generic type of device includes the cleidoclast,...

  1. 21 CFR 884.4500 - Obstetric fetal destructive instrument.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Obstetric fetal destructive instrument. 884.4500 Section 884.4500 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... dead or anomalous (abnormal) fetus. This generic type of device includes the cleidoclast,...

  2. Obstetrical Forceps

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Marshall inventors Seth Lawson and Stanley Smeltzer display a pair of obstetrical forceps they designed. The forceps, made from composite space-age materials, measure the force applied during instrument-assisted delivery. The new forceps will help medical students get a feel for instrument-assisted deliveries before entering practice.

  3. 'Halfway people': refugee views of reproductive health services.

    PubMed

    Whelan, A; Blogg, J

    2007-01-01

    The objective of this study was to identify factors that facilitate or hinder access to, use of, and satisfaction with reproductive health services in refugee settings, from the perspective of beneficiaries. Rapid appraisal methods included 46 focus group discussions and interviews with over 800 refugees, audits of 14 health facilities, referral hospital reviews, exit interviews with clients, and interviews with health workers. The study was conducted between February and April 2004 in 11 sites in Uganda, Republic of Congo, and Yemen. Reproductive health was clearly on the policy agenda in all countries with stable refugee sites, but problems with implementation and resources were identified. The quality of services was variable, with high staff turnover in some areas affecting relationships with refugee clients. Referral hospitals in host countries were not all equipped to deal with obstetric and other emergencies of either local or refugee populations, including deficiencies in safe blood supplies and antibiotics. Diagnosis and treatment of STIs and HIV/AIDS was frequently inadequate. Gender based violence was the least well addressed aspect of reproductive health. Interest and knowledge about family planning was high, but acceptance was low. It was concluded that progress has been made in reproductive health services for refugees since 1994, however, urgent advocacy and action is required to sustain and improve the situation. Local implementing partners need more support and supervision to develop appropriate service models and to maintain an acceptable standard of care. PMID:19283634

  4. Health services in Indonesia.

    PubMed

    Kosen, S; Gunawan, S

    In Indonesia, rapid economic development has led to a reduction in poverty among the 195 million inhabitants. While population increased more than 50% from 1971 to 1990, the annual growth rate, crude birth rate, and total fertility rates have declined rapidly. Life expectancy has increased from 45.7 years in 1971 to 62.7 in 1994 as crude death rates and infant and child mortality rates have declined. Causes of death have shifted from infectious to chronic diseases, but in 1992 major causes of death in children under 5 years old were preventable, and the maternal mortality rate was 425/100,000. Policies which guide the development of health care call for improvements in quality of life, adherence to humanitarian principles, use of scientifically approved traditional medicine, and provision of public health through a three-tiered system. Health care is financed by the government and the community, and managed care has been encouraged. Foreign aid has bolstered development in the health sector. Adequate sanitation has been achieved for 35% of the population, and 65% of urban and 35% of rural residents have reasonable access to clean water. Improvements in health indicators include 55% contraceptive prevalence, reduction in prevalence of anemia during pregnancy, 55.8% of pregnant women receiving prenatal care, a decrease in protein-energy malnutrition among children under five, and high vaccination coverage. Remaining public health problems include malaria, tuberculosis, dengue hemorrhagic fever, an increase in HIV/AIDS, iodine-deficiency, an increasing number of traffic fatalities, and an increasing number of smokers. New health policies have been instituted to meet these challenges as Indonesia's need for a productive and competitive labor force increases. PMID:8985447

  5. Heterogeneous Impact of the “Seguro Popular” Program on the Utilization of Obstetrical Services in Mexico, 2001–2006: A Multinomial Probit Model with a Discrete Endogenous Variable

    PubMed Central

    Sosa-Rubi, Sandra G.; Galárraga, Omar

    2009-01-01

    Objective We evaluated the impact of Seguro Popular (SP), a program introduced in 2001 in Mexico primarily to finance health care for the poor. We focused on the effect of household enrollment in SP on pregnant women’s access to obstetrical services, an important outcome measure of both maternal and infant health. Data We relied upon data from the cross-sectional 2006 National Health and Nutrition Survey (ENSANUT) in Mexico. We analyzed the responses of 3,890 women who delivered babies during 2001–2006 and whose households lacked employer-based health care coverage. Methods We formulated a multinomial probit model that distinguished between three mutually exclusive sites for delivering a baby: a health unit specifically accredited by SP; a non-SP-accredited clinic run by the Department of Health (Secretaría de Salud, or SSA); and private obstetrical care. Our model accounted for the endogeneity of the household’s binary decision to enroll in the SP program. Results Women in households that participated in the SP program had a much stronger preference for having a baby in a SP-sponsored unit rather than paying out of pocket for a private delivery. At the same time, participation in SP was associated with a stronger preference for delivering in the private sector rather than at a state-run SSA clinic. On balance, the Seguro Popular program reduced pregnant women’s attendance at an SSA clinic much more than it reduced the probability of delivering a baby in the private sector. The quantitative impact of the SP program varied with the woman’s education and health, as well as the assets and location (rural versus urban) of the household. Conclusions The SP program had a robust, significantly positive impact on access to obstetrical services. Our finding that women enrolled in SP switched from non-SP state-run facilities, rather than from out-of-pocket private services, is important for public policy and requires further exploration. PMID:18824268

  6. Obstetric Care and Method of Delivery in Mexico: Results from the 2012 National Health and Nutrition Survey

    PubMed Central

    Heredia-Pi, Ileana; Servan-Mori, Edson E.; Wirtz, Veronika J.; Avila-Burgos, Leticia; Lozano, Rafael

    2014-01-01

    Objective To identify the current clinical, socio-demographic and obstetric factors associated with the various types of delivery strategies in Mexico. Materials and Methods This is a cross-sectional study based on the 2012 National Health and Nutrition Survey (ENSANUT) of 6,736 women aged 12 to 49 years. Delivery types discussed in this paper include vaginal delivery, emergency cesarean section and planned cesarean section. Using bivariate analyses, sub-population group differences were identified. Logistic regression models were applied, including both binary and multinomial outcome variables from the survey. The logistic regression results identify those covariates associated with the type of delivery. Results 53.1% of institutional births in the period 2006 through 2012 were vaginal deliveries, 46.9% were either a planned or emergency cesarean sections. The highest rates of this procedure were among women who reported a complication during delivery (OR: 4.21; 95%CI: 3.66–4.84), between the ages of 35 and 49 at the time of their last child birth (OR: 2.54; 95%CI: 2.02–3.20) and women receiving care through private healthcare providers during delivery (OR: 2.36; 95%CI: 1.84–3.03). Conclusions The existence of different socio-demographic and obstetric profiles among women who receive care for vaginal or cesarean delivery, are supported by the findings of the present study. The frequency of vaginal delivery is higher in indigenous women, when the care provider is public and, in women with two or more children at time of the most recent child birth. Planned cesarean deliveries are positively associated with years of schooling, a higher socioeconomic level, and higher age. The occurrence of emergency cesarean sections is elevated in women with a diagnosis of a health issue during pregnancy or delivery, and it is reduced in highly marginalized settings. PMID:25101781

  7. Electronic Health Services

    PubMed Central

    Khalil, Mounir M; Jones, Ray

    2007-01-01

    Information and communication technologies have made dramatic changes in our lives. Healthcare communities also made use of these technologies. Using computerized medical knowledge, electronic patients’ information and telecommunications a lot of applications are now established throughout the world. These include better ways of information management, remote education, telemedicine and public services. Yet, a lot of people don't know about these technologies and their applications. Understanding the concepts and ideologies behind these terms, knowing how they will be implemented, what is it like to use them and what benefit will be gained, are basic knowledge steps approaching these technologies. Difficulties using these services, especially in developing countries should not be neglected or underestimated. PMID:21503245

  8. [Constructing knowledge about solid waste in health services in the education of health professionals].

    PubMed

    Corrêa, Luciara Bilhalva; Lunardi, Valéria Lerch; Santos, Silvana Sidney Costa

    2008-12-01

    The need to implement policies to manage solid residues in health services (SRHS) in different health institutions is unquestionable, considering the risks they pose to public health and the environmental degradation caused by them. In order to find out how knowledge about SRHS has been constructed in the education of the health professional, data were collected with semistructured interviews with students, professors and coordinators in four schools (Nursing and Obstetrics, Odontology, Veterinary Sciences, and Medicine) at a Higher Education Institution located in the south of Brazil. The data content and document analysis identified based on the Complexity Theory ideas, show the need for a teaching reform which should include new concepts, such as integrality, articulation, dialog, and problematization, in the Teaching Projects developed by those courses, so that future health professionals can construct their knowledge about solid residues with responsibility and commitment. PMID:19320342

  9. 34 CFR 303.16 - Health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 34 Education 2 2012-07-01 2012-07-01 false Health services. 303.16 Section 303.16 Education... DISABILITIES General Definitions Used in This Part § 303.16 Health services. (a) Health services mean services..., the changing of dressings or colostomy collection bags, and other health services; and...

  10. 34 CFR 303.16 - Health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 34 Education 2 2013-07-01 2013-07-01 false Health services. 303.16 Section 303.16 Education... DISABILITIES General Definitions Used in This Part § 303.16 Health services. (a) Health services mean services..., the changing of dressings or colostomy collection bags, and other health services; and...

  11. 34 CFR 303.16 - Health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 34 Education 2 2014-07-01 2013-07-01 true Health services. 303.16 Section 303.16 Education... DISABILITIES General Definitions Used in This Part § 303.16 Health services. (a) Health services mean services..., the changing of dressings or colostomy collection bags, and other health services; and...

  12. Integrating mental health services into primary HIV care for women: the Whole Life project.

    PubMed Central

    Dodds, Sally; Nuehring, Elane M.; Blaney, Nancy T.; Blakley, Theresa; Lizzotte, Jean-Marie; Lopez, Myriam; Potter, JoNell E.; O'Sullivan, Mary J.

    2004-01-01

    The high rate of mental health problems in HIV-infected women jeopardizes the health of this vulnerable population, and constitutes a mandate for integrating mental health services into HIV primary care. The Whole Life project-a collaboration of the departments of Psychiatry and Obstetrics/Gynecology at the University of Miami School of Medicine-successfully integrated mental health services into primary HIV care for women. This article describes the conceptual framework of the integration, implementation strategies, effects of the service integration, and lessons learned. Funded by the Health Resources and Services Administration (HRSA) as a Special Program of National Significance (SPNS), Whole Life efforts have been sustained beyond the demonstration funding period as a result of the changes brought about in organizational structures, service delivery, and the providers' conceptualization of health for HIV-infected women. PMID:15147649

  13. Knowledge about Danger Signs of Obstetric Complications and Associated Factors among Postnatal Mothers of Mechekel District Health Centers, East Gojjam Zone, Northwest Ethiopia, 2014

    PubMed Central

    Amenu, Gedefa; Mulaw, Zerfu; Seyoum, Tewodros; Bayu, Hinsermu

    2016-01-01

    Background. Developing countries like Ethiopia contributed highest level of maternal mortality due to obstetric complications. Women awareness of obstetric danger sign to recognize complications to seek medical care early is the first intervention in an effort to decrease maternal death. Objective. To assess knowledge about danger signs of obstetric complications and associated factors among postnatal mothers at Mechekel district health centers, East Gojjam zone, Northwest Ethiopia, 2014. Methods. An institution based cross-sectional study was conducted from August to October, 2014, in Mechekel district health centers. Systematic random sampling was used to select four hundred eleven study participants. A pretested structured questionnaire was used to collect data. Data were entered to Epi Info version 3.5.3 and exported to SPSS 20.0 for further analysis. Descriptive and summary statistics were done. Logistic regression analyses were used to see the association of different variables. Odds ratios and 95% confidence interval were computed to determine the presence and strength of association. Results. According to this study, 55.1% participants were knowledgeable about danger signs of obstetric complications. Maternal and husband educational level ((AOR = 1.977, 95% CI: 1.052, 3.716) and (AOR = 3.163, 95% CI: 1.860, 5.3770), resp.), family monthly income ≥ 1500 (AOR = 2.954, 95% CI: 1.289, 6.770), being multipara (AOR = 7.463, 95% CI: 1.301, 12.800), ANC follow-up during last pregnancy (AOR = 2.184, 95% CI: 1.137, 4.196), and place of last delivery (AOR = 1.955, 95% CI: 1.214, 3.150) were variables found to be significantly associated with women's knowledge on danger signs of obstetric complications. Conclusion. Significant proportion of respondents were not knowledgeable about obstetric danger signs and factors like educational status, place of last delivery, and antenatal follow-up were found to be associated. PMID:27375920

  14. [Mental health services in Australia].

    PubMed

    Kisely, Steve; Lesage, Alain

    2014-01-01

    Canada is 1.5 times the size of Australia. Australia's population of 20 million is located principally on the east coast. Like Canada, the Australia has a federal system of Government with 5 States and two territories. Each State and territory has its own legislation on mental health. The federal (Commonwealth) Government is responsible for health care planning. In addition, the federal Government subsidizes an insurance program (Medicare) that covers visits to specialists and family physicians, while provincial governments are involved in the provision of hospital care and community mental health services. The Commonwealth government also subsidises the cost of medication through the Pharmaceutical Benefits Scheme. These funds are supplemented by private health insurance. Mental health costs account for 6.5 per cent of all health care costs. Primary care treats the majority of common psychological disorders such as anxiety or depression, while specialist mental health services concentrate on those with severe mental illness. There have been 4 national mental health plans since 1992 with the long term aims of promoting mental health, increasing the quality and responsiveness of services, and creating a consistent approach to mental health service system reform among Australian states and territories. These systematic cycles of planning have first allowed a shift from psychiatric hospitals to community services, from reliance on psychiatric hospitals as pivotal to psychiatric care system. Community care budgets have increased, but overall have decreased with money not following patients; but recent deployment of federally funded through Medicare access to psychotherapy by psychologists for common mental disorders in primary care have increased overall budget. Concerns remain that shift to youth first onset psychosis clinics may come from older long-term psychotic patients, a form of discrimination whilst evidence amount of excess mortality by cardio

  15. Federal health services grants, 1985.

    PubMed

    Zwick, D I

    1986-01-01

    Federal health services grants amounted to about $1.8 billion in fiscal year 1985. The total amount was about $100 million less, about 6 percent, than in 1980. Reductions in the health planning program accounted for most of the decline in absolute dollars. The four formula grants to State agencies amounted to about $1.0 billion in 1985, about 60 percent of the total. The largest formula grants were for maternal and child health services and for alcohol, drug abuse, and mental health services. Project grants to selected State and local agencies amounted to about $.8 billion. There was 12 such grants in 1985 (compared with 34 in 1980). The largest, for community health services, equaled almost half the total. In real, inflation-adjusted dollars, the decline in Federal funds for these programs exceeded a third during the 5-year period. The overall dollar total in real terms in 1985 approximated the 1970 level. The ratio of formula grants to project grants in 1985 was similar to that in 1965. Studies of the impact of changes in Federal grants have found that while the development of health programs has been seriously constrained in most cases, their nature has not been substantially altered. In some cases broader program approaches and allocations have been favored. Established modes of operations and administration have generally been strengthened. Some efficiencies but few savings in administration have been identified. Replacement of reduced Federal funding by the States has been modest but has increased over time, especially for direct service activities. These changes reflect the important influence of professionalism in the health fields and the varying strengths of political interest and influence among program supporters. The long-term impact on program innovation is not yet clear. PMID:3094081

  16. Medical Student Mental Health Services

    PubMed Central

    Roman, Brenda

    2009-01-01

    Medical school is a stressful and challenging time in the academic career of physicians. Because of the psychological pressure inherent to this process, all medical schools should have easily accessible medical student mental health services. Some schools of medicine provide these services through departments of psychiatry or other associated training programs. Since this stressful lifestyle often continues through residency training and life as a physician, this is a critical period in which to develop and utilize functional and effective coping strategies. When psychiatrists provide the mental health treatment to medical students, it is important to consider transference and countertransference issues, over intellectualization, and instances of strong idealization and identification. PMID:19724734

  17. Gender-planned health services.

    PubMed

    Raikes, A; Shoo, R; Brabin, L

    1992-08-01

    Gender-planned health services are planned on the basis that women and men play different roles in society and have different medical needs. The feminist movement has provided a broad charter of rights for women, reflecting women's needs, but these have yet to be translated into operational programmes. National programmes for women would allow co-ordination of broad-based programmes to improve women's health and social position. To change social norms discriminating against women will require changing male attitudes. Health programmes for males have received little attention, except from family planning organizations, although in most countries, males have a high rate of accidents, infections and parasitic disease. Controlled studies are required to evaluate the benefits of gender-planned health services. PMID:1489242

  18. Competence of health workers in emergency obstetric care: an assessment using clinical vignettes in Brong Ahafo region, Ghana

    PubMed Central

    Lohela, Terhi Johanna; Nesbitt, Robin Clark; Manu, Alexander; Vesel, Linda; Okyere, Eunice; Kirkwood, Betty; Gabrysch, Sabine

    2016-01-01

    Objectives To assess health worker competence in emergency obstetric care using clinical vignettes, to link competence to availability of infrastructure in facilities, and to average annual delivery workload in facilities. Design Cross-sectional Health Facility Assessment linked to population-based surveillance data. Setting 7 districts in Brong Ahafo region, Ghana. Participants Most experienced delivery care providers in all 64 delivery facilities in the 7 districts. Primary outcome measures Health worker competence in clinical vignette actions by cadre of delivery care provider and by type of facility. Competence was also compared with availability of relevant drugs and equipment, and to average annual workload per skilled birth attendant. Results Vignette scores were moderate overall, and differed significantly by respondent cadre ranging from a median of 70% correct among doctors, via 55% among midwives, to 25% among other cadres such as health assistants and health extension workers (p<0.001). Competence varied significantly by facility type: hospital respondents, who were mainly doctors and midwives, achieved highest scores (70% correct) and clinic respondents scored lowest (45% correct). There was a lack of inexpensive key drugs and equipment to carry out vignette actions, and more often, lack of competence to use available items in clinical situations. The average annual workload was very unevenly distributed among facilities, ranging from 0 to 184 deliveries per skilled birth attendant, with higher workload associated with higher vignette scores. Conclusions Lack of competence might limit clinical practice even more than lack of relevant drugs and equipment. Cadres other than midwives and doctors might not be able to diagnose and manage delivery complications. Checking clinical competence through vignettes in addition to checklist items could contribute to a more comprehensive approach to evaluate quality of care. Trial registration number NCT00623337

  19. Risk of psychological distress following severe obstetric complications in Benin: the role of economics, physical health and spousal abuse

    PubMed Central

    Fottrell, Edward; Kanhonou, Lydie; Goufodji, Sourou; Béhague, Dominique P.; Marshall, Tom; Patel, Vikram; Filippi, Véronique

    2010-01-01

    Background Little is known about the impact of life-threatening obstetric complications (‘near miss’) on women’s mental health in low- and middle-income countries. Aims To examine the relationships between near miss and postpartum psychological distress in the Republic of Benin. Method One-year prospective cohort using epidemiological and ethnographic techniques in a population of women delivering at health facilities. Results In total 694 women contributed to the study. Except when associated with perinatal death, near-miss events were not associated with greater risk of psychological distress in the 12 months postpartum compared with uncomplicated childbirth. Much of the direct effect of near miss with perinatal death on increased risk of psychological distress was shown to be mediated through wider consequences of traumatic childbirth. Conclusions A live baby protects near-miss women from increased vulnerability by giving a positive element in their lives that helps them cope and reduces their risk of psychological distress. Near-miss women with perinatal death should be targeted early postpartum to prevent or treat the development of depressive symptoms. PMID:20044654

  20. Developing core sets for patients with obstetric brachial plexus injury based on the International Classification of Functioning, Disability and Health

    PubMed Central

    Duijnisveld, B. J.; Saraç, Ç.; Malessy, M. J. A.; Vliet Vlieland, T. P. M.; Nelissen, R. G. H. H.; Brachial Plexus Advisory Board, The ICF

    2013-01-01

    Background Symptoms of obstetric brachial plexus injury (OBPI) vary widely over the course of time and from individual to individual and can include various degrees of denervation, muscle weakness, contractures, bone deformities and functional limitations. To date, no universally accepted overall framework is available to assess the outcome of patients with OBPI. The objective of this paper is to outline the proposed process for the development of International Classification of Functioning, Disability and Health (ICF) Core Sets for patients with an OBPI. Methods The first step is to conduct four preparatory studies to identify ICF categories important for OBPI: a) a systematic literature review to identify outcome measures, b) a qualitative study using focus groups, c) an expert survey and d) a cross-sectional, multicentre study. A first version of ICF Core Sets will be defined at a consensus conference, which will integrate the evidence from the preparatory studies. In a second step, field-testing among patients will validate this first version of Core Sets for OBPI. Discussion The proposed method to develop ICF Core Sets for OBPI yields a practical tool for multiple purposes: for clinicians to systematically assess and evaluate the individual’s functioning, for researchers to design and compare studies, and for patients to get more insight into their health problems and their management. PMID:23836476

  1. [Smart cards in health services].

    PubMed

    Rienhoff, O

    2001-10-01

    Since the early 1980-ties it has been tried to utilise smart cards in health care. All industrialised countries participated in those efforts. The most sustainable analyses took place in Europe--specifically in the United Kingdom, France, and Germany. The first systems installed (the service access cards in F and G, the Health Professional Card in F) are already conceptionally outdated today. The senior understanding of the great importance of smart cards for security of electronic communication in health care does contrast to a hesitating behaviour of the key players in health care and health politics in Germany. There are clear hints that this may relate to the low informatics knowledge of current senior management. PMID:11688229

  2. Birth of a health service.

    PubMed

    Anderson, G

    On April 18th, independent Zimbabwe celebrated its 3rd birthday. In 1980, within days after taking power, Robert Mugabe's government announced that health care was to be free to everyone earning less then Z150 (60 British pounds) a month--the vast majority of the population. Although the free services are a good public relations policy, more important was the decision to expand the health services at grassroots level and to shift emphasis from an urban based curative system to rural based preventive care. Zimbabwe desperately needs doctors. According to the World Health Organization (WHO), the country has some 1400 registered doctors, roughly 1 for every 6000 people. Yet, of the 1400, under 300 work in the government health services and many of those are based in Harare, the capital. Of Zimbabwe's 28 district hospitals, only 14 have a full-time doctor. In some rural areas, there is 1 doctor/100,000 or more people. The nature of the country's health problems, coupled with the government's severe shortage of cash, shows why nursing is so crucial to Zimbabwe's development. If the rural communities, which make up 85% of the population, were to have easy access to a qualified nurse, or even a nursing assistant, the quality of life would double. The only thing that is more important is a clean water supply. Possibly the most important role for nurses in Zimbabwe is that of education. Nurses can spread awareness of basic hygiene, raise the skill of local people in dealing with minor health problems independently, carry out immunization programs, offer contraceptive advice, give guidance on breastfeeding and infant nutrition, and work with practitioners of traditional African medicines to make sure they possess basic scientific knowledge. Rebuilding after the war was not a major problem for the Mugabe health ministry, for in many areas there was simply nothing to rebuild. There were never any health services. A far greater problem has been the top heavy structure of the

  3. Developing School Health Services in Massachusetts: A Public Health Model

    ERIC Educational Resources Information Center

    Sheetz, Anne H.

    2003-01-01

    In 1993 the Massachusetts Department of Public Health (MDPH) began defining essential components of school health service programs, consistent with the public health model. The MDPH designed and funded the Enhanced School Health Service Programs to develop 4 core components of local school health services: (a) strengthening the administrative…

  4. Abortion health services in Canada

    PubMed Central

    Norman, Wendy V.; Guilbert, Edith R.; Okpaleke, Christopher; Hayden, Althea S.; Steven Lichtenberg, E.; Paul, Maureen; White, Katharine O’Connell; Jones, Heidi E.

    2016-01-01

    Abstract Objective To determine the location of Canadian abortion services relative to where reproductive-age women reside, and the characteristics of abortion facilities and providers. Design An international survey was adapted for Canadian relevance. Public sources and professional networks were used to identify facilities. The bilingual survey was distributed by mail and e-mail from July to November 2013. Setting Canada. Participants A total of 94 abortion facilities were identified. Main outcome measures The number and location of services were compared with the distribution of reproductive-age women by location of residence. Results We identified 94 Canadian facilities providing abortion in 2012, with 48.9% in Quebec. The response rate was 83.0% (78 of 94). Facilities in every jurisdiction with services responded. In Quebec and British Columbia abortion services are nearly equally present in large urban centres and rural locations throughout the provinces; in other Canadian provinces services are chiefly located in large urban areas. No abortion services were identified in Prince Edward Island. Respondents reported provision of 75 650 abortions in 2012 (including 4.0% by medical abortion). Canadian facilities reported minimal or no harassment, in stark contrast to American facilities that responded to the same survey. Conclusion Access to abortion services varies by region across Canada. Services are not equitably distributed in relation to the regions where reproductive-age women reside. British Columbia and Quebec have demonstrated effective strategies to address disparities. Health policy and service improvements have the potential to address current abortion access inequity in Canada. These measures include improved access to mifepristone for medical abortion; provincial policies to support abortion services; routine abortion training within family medicine residency programs; and increasing the scope of practice for nurses and midwives to include abortion

  5. Termination of pregnancy as emergency obstetric care: the interpretation of Catholic health policy and the consequences for pregnant women: an analysis of the death of Savita Halappanavar in Ireland and similar cases.

    PubMed

    Berer, Marge

    2013-05-01

    Issues arising from the death of Savita Halappanavar in Ireland in October 2012 include the question of whether it is unethical to refuse to terminate a non-viable pregnancy when the woman's life may be at risk. In Catholic maternity services, this decision intersects with health professionals' interpretation of Catholic health policy on treatment of miscarriage as well as the law on abortion. This paper explores how these issues came together around Savita's death and the consequences for pregnant women and maternity services worldwide. It discusses cases not only in Ireland but also the Americas. Many of the events presented are recent, and most of the sources are media and individual reports. However, there is a very worrying common thread across countries and continents. If further research unearths more cases like Savita's, any Catholic health professionals and/or hospitals refusing to terminate a pregnancy as emergency obstetric care should be stripped of their right to provide maternity services. In some countries these are the main or only existing maternity services. Even so, governments should refuse to fund these services, and either replace them with non-religious services or require that non-religious staff are available at all times specifically to take charge of such cases to prevent unnecessary deaths. At issue is whether a woman's life comes first or not at all. PMID:23684182

  6. 34 CFR 303.13 - Health services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Health services. 303.13 Section 303.13 Education... DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.13 Health services. (a) As used in this part, health services means services necessary to enable a child to benefit from the...

  7. 34 CFR 303.13 - Health services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 34 Education 2 2011-07-01 2010-07-01 true Health services. 303.13 Section 303.13 Education... DISABILITIES General Purpose, Eligibility, and Other General Provisions § 303.13 Health services. (a) As used in this part, health services means services necessary to enable a child to benefit from the...

  8. Women's Health Care Teams and the Future of Obstetrics and Gynecology.

    PubMed

    Hollier, Lisa M; Promecene, Pamela A; Owens, Michelle Y; Hampton, Moss; Gala, Rajiv; Kulbida, Nicholas; Tomich, Paul; Gregg, Laurie; Rothenberg, Jeffrey; Phelan, Sharon T; Jennings, John C

    2015-12-01

    Health care delivery is in a stage of transformation and a meaningful change in provision of care must also be accompanied by changes in the educational process of health care professionals. This article lays out a roadmap to better prepare obstetrician-gynecologists (ob-gyns) to succeed in interdisciplinary women's health care teams. Just as our current educational programs emphasize the development of competent surgical skills, our future programs must encourage and support the development of communication, teamwork, and leadership skills for ob-gyns. Formal integration of these fundamentals at all levels of the health care training continuum will create an educational system designed to equip all practitioners with a basic level of knowledge and provide opportunities to acquire additional knowledge and skills as needs and interest dictate. Integral to the implementation will be the evaluation of the effects of the contributions of interprofessional education on patient, practice, and health system outcomes. Successful demonstration of value will lead to the sustainability of the educational programs through recognition by physicians, health care teams, academia, health care systems, and payers. PMID:26551185

  9. Understanding motivators and barriers of hospital-based obstetric and pediatric health care worker influenza vaccination programs in Australia.

    PubMed

    Tuckerman, Jane L; Shrestha, Lexa; Collins, Joanne E; Marshall, Helen S

    2016-07-01

    Understanding motivators and barriers of health care worker (HCW) vaccination programs is important for determining strategies to improve uptake. The aim of this study was to explore key drivers and HCW decision making related to recommended vaccines and seasonal influenza vaccination programs. We used a qualitative approach with semi-structured one-to-one interviews with 22 HCWs working at a tertiary pediatric and obstetric hospital in South Australia. A thematic analysis and coding were used to examine data. Key motivators that emerged included: sense of responsibility, convenience and ease of access, rotating trolleys, the influenza vaccine being free, basic knowledge about influenza and influenza vaccination, peer pressure, personal values and family culture, as well as the culture of support for the program. Personal decisions were the major barrier to HCWs receiving the influenza vaccine which were predominantly self-protection related or due to previous experience or fear of adverse reactions. Other barriers that emerged were misconceptions about the influenza vaccine, needle phobia and privacy concerns. This study identified both attitudinal and structural barriers that could be addressed to improve uptake of the seasonal influenza vaccine. PMID:27245460

  10. Referrals between Public Sector Health Institutions for Women with Obstetric High Risk, Complications, or Emergencies in India – A Systematic Review

    PubMed Central

    Singh, Samiksha; Doyle, Pat; Campbell, Oona M.; Mathew, Manu; Murthy, G. V. S.

    2016-01-01

    Emergency obstetric care (EmOC) within primary health care systems requires a linked referral system to be effective in reducing maternal death. This systematic review aimed to summarize evidence on the proportion of referrals between institutions during pregnancy and delivery, and the factors affecting referrals, in India. We searched 6 electronic databases, reviewed four regional databases and repositories, and relevant program reports from India published between 1994 and 2013. All types of study or reports (except editorials, comments and letters) which reported on institution-referrals (out-referral or in-referral) for obstetric care were included. Results were synthesized on the proportion and the reasons for referral, and factors affecting referrals. Of the 11,346 articles identified by the search, we included 232 articles in the full text review and extracted data from 16 studies that met our inclusion criteria Of the 16, one was RCT, seven intervention cohort (without controls), six cross-sectional, and three qualitative studies. Bias and quality of studies were reported. Between 25% and 52% of all pregnancies were referred from Sub-centres for antenatal high-risk, 14% to 36% from nurse run delivery or basic EmOC centres for complications or emergencies, and 2 to 7% were referred from doctor run basic EmOC centres for specialist care at comprehensive EmOC centres. Problems identified with referrals from peripheral health centres included low skills and confidence of staff, reluctance to induce labour, confusion over the clinical criteria for referral, non-uniform standards of care at referral institutions, a tendency to by-pass middle level institutions, a lack of referral communication and supervision, and poor compliance. The high proportion of referrals from peripheral health centers reflects the lack of appropriate clinical guidelines, processes, and skills for obstetric care and referral in India. This, combined with inadequate referral communication

  11. Postemergency health services for refugee and host populations in Uganda, 1999-2002.

    PubMed

    Orach, Christopher Garimoi; De Brouwere, Vincent

    Since 1990, Uganda has hosted an estimated 200?000 refugees in postemergency settlements interspersed within host communities. We investigated the extent to which obstetric needs were met in the refugee and host populations during 1999-2002. Between September and December, 2000, we retrospectively collected data from 1999 and 2000 on major obstetric interventions for absolute maternal indications from all five hospitals in Arua, Adjumani, and Moyo districts, Uganda. The same data were collected prospectively for 2001. We did community-based maternal mortality surveys on refugee and host populations in Adjumani district in 2002. Rates of major obstetric interventions were significantly higher for refugees than for the host population who live in the same rural areas as refugees (1.01% [95% CI 0.77-1.25] vs 0.45% [0.38-0.52]; p<0.0001). Rates of major obstetric interventions were also significantly higher for refugees than for the host population who live in rural areas without refugees (1.01% [0.77-1.25] vs 0.40% [0.36-0.44]; p<0.0001). Maternal mortality was 2.5 times higher in the host population than in refugees in the Adjumani district (322 per 100000 births [247-396] vs 130 [81-179]. Refugees had better access to health services than did the rural host population in the northern Ugandan communities that we surveyed. PMID:15313362

  12. [Vulnerability and National Health Service].

    PubMed

    Lima, Cristina

    2006-01-01

    Safegarding health has been an objective of every learned civilization, ancient and modern. In modern times, at least in the western world, the increase in longevity associated with social isolation has created further vu1nerability for the older individua1. Today, healthcare is a social burden of extremely high cost. Among us this service is provided by the National Health Service in accordance to the Constituição da República Portuguesa (Constitution of the Portuguese Republic). Despite the constitutional guarantees of equa1ity in health there are obvious discrepancies in access to health care and the conditions that promote health such as education and wealth. In a poor country, even with limited resources, inequa1ity can be minimized via policies and practical measures founded in equa1ity and social responsibility, not only the principles of economic efficiency. Only in this way can we guarantee equa1 access to health and the distribution of available resources in accordance to health care necessities. Yet, the investment in high technology among us seems out of fase with the investment in the area concerning functional recovery from high morta1ity illness, such as stroke. In Portugal the problem is extremely bad. Life expectancy has been extended but qua1ity of life is still very low. Victims of the social order, the elderly live alone without family who can care for them; on the other hand, the lack of investment in recovery and social integration of individua1s with disabling scars, Turns the ends of their life's into a nightmare for themselves and their kin. It follows stating the necessity to analyse and define the criteria to be used when allocating resources in order to guarantee equality in health and relief from suffering and also to stop discrimination of vu1nerable populations in access to healthcare. Whatever the criteria, it must be pre-defined and its principles widely discussed, reiterating, only that longevity cannot be an acceptable criteria

  13. Department of Health and Human Services

    MedlinePlus

    ... content HHS .gov Search U.S. Department of Health & Human Services Search Close A-Z Index About HHS ... Start Standards The U.S. Department of Health and Human Services announced new standards to further strengthen the ...

  14. Safety Assurance in Obstetrical Ultrasound

    PubMed Central

    Miller, Douglas L

    2008-01-01

    Safety assurance for diagnostic ultrasound in obstetrics began with a tacit assumption of safety allowed by a federal law enacted in 1976 for then-existing medical ultrasound equipment. The implementation of the 510(k) pre-market approval process for diagnostic ultrasound resulted in the establishment of guideline upper limits for several examination categories in 1985. The obstetrical category has undergone substantial evolution from initial limits (I. e., 46 mW/cm2 spatial peak temporal average (SPTA) intensity) set in 1985. Thermal and mechanical exposure indices, which are displayed on-screen according to an Output Display Standard (ODS), were developed for safety assurance with relaxed upper limits. In 1992, with the adoption of the ODS, the allowable output for obstetrical ultrasound was increased both in terms of the average exposure (e. g. to a possible 720 mW/cm2 SPTA intensity) and of the peak exposure (via the Mechanical Index). There has been little or no subsequent research with the modern obstetrical ultrasound machines to systematically assess potential risks to the fetus using either relevant animal models of obstetrical exposure or human epidemiology studies. The assurance of safety for obstetrical ultrasound therefore is supported by three ongoing means: (I) review of a substantial but uncoordinated bioeffect research literature, (ii) the theoretical evaluation of diagnostic ultrasound exposure in terms of thermal and nonthermal mechanisms for bioeffects, and (iii) the skill and knowledge of professional sonographers. At this time, there is no specific reason to suspect that there is any significant health risk to the fetus or mother from exposure to diagnostic ultrasound in obstetrics. This assurance of safety supports the prudent use of diagnostic ultrasound in obstetrics by trained professionals for any medically indicated examination. PMID:18450141

  15. Safety assurance in obstetrical ultrasound.

    PubMed

    Miller, Douglas L

    2008-04-01

    Safety assurance for diagnostic ultrasound in obstetrics began with a tacit assumption of safety allowed by a federal law enacted in 1976 for then-existing medical ultrasound equipment. The implementation of the 510(k) pre-market-approval process for diagnostic ultrasound resulted in the establishment of guideline upper limits for several examination categories in 1985. The obstetrical category has undergone substantial evolution from initial limits (ie, 46 mW/cm2 spatial peak temporal average [SPTA] intensity) set in 1985. Thermal and mechanical exposure indices, which are displayed onscreen according to an Output Display Standard, were developed for safety assurance with relaxed upper limits. In 1992, with the adoption of the Output Display Standard, the allowable output for obstetrical ultrasound was increased in terms of both the average exposure (eg, to a possible 720 mW/cm2 SPTA intensity) and the peak exposure (via the Mechanical Index). There has been little or no subsequent research with the modern obstetrical ultrasound machines to systematically assess potential risks to the fetus using either relevant animal models of obstetrical exposure or human epidemiology studies. The assurance of safety for obstetrical ultrasound therefore is supported by three ongoing means: (1) review of a substantial but uncoordinated bioeffect research literature; (2) the theoretical evaluation of diagnostic ultrasound exposure in terms of thermal and nonthermal mechanisms for bioeffects; and (3) the skill and knowledge of professional sonographers. At this time, there is no specific reason to suspect that there is any significant health risk to the fetus or mother from exposure to diagnostic ultrasound in obstetrics. This assurance of safety supports the prudent use of diagnostic ultrasound in obstetrics by trained professionals for any medically indicated examination. PMID:18450141

  16. 42 CFR 136.24 - Authorization for contract health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Authorization for contract health services. 136.24 Section 136.24 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Contract Health Services §...

  17. Emergency preparedness in obstetrics.

    PubMed

    Haeri, Sina; Marcozzi, David

    2015-04-01

    During and after disasters, focus is directed toward meeting the immediate needs of the general population. As a result, the routine health care and the special needs of some vulnerable populations such as pregnant and postpartum women may be overlooked within a resource-limited setting. In the event of hazards such as natural disasters, manmade disasters, and terrorism, knowledge of emergency preparedness strategies is imperative for the pregnant woman and her family, obstetric providers, and hospitals. Individualized plans for the pregnant woman and her family should include knowledge of shelter in place, birth at home, and evacuation. Obstetric providers need to have a personal disaster plan in place that accounts for work responsibilities in case of an emergency and business continuity strategies to continue to provide care to their communities. Hospitals should have a comprehensive emergency preparedness program utilizing an "all hazards" approach to meet the needs of pregnant and postpartum women and other vulnerable populations during disasters. With lessons learned in recent tragedies such as Hurricane Katrina in mind, we hope this review will stimulate emergency preparedness discussions and actions among obstetric providers and attenuate adverse outcomes related to catastrophes in the future. PMID:25751222

  18. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 1 2012-10-01 2012-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  19. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 1 2011-10-01 2011-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  20. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  1. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  2. 45 CFR 96.45 - Preventive health and health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health...

  3. Student Health Services at Orchard Ridge.

    ERIC Educational Resources Information Center

    Nichols, Don D.

    This paper provides a synoptic review of student health services at the community college level while giving a more detailed description of the nature of health services at Orchard Ridge, a campus of Oakland Community College. The present College Health Service program provides for a part-time (24 hrs./wk.) nurse at Orchard Ridge. A variety of…

  4. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    PubMed Central

    2012-01-01

    Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5%) of sub-counties, 21/42 (50.0%) parishes and 32/212 (15.1%) villages (clusters), were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization) while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies) included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54) and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14). Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community sensitization by empowered

  5. Malpractice Burden, Rural Location, and Discontinuation of Obstetric Care: A Study of Obstetric Providers in Michigan

    PubMed Central

    Xu, Xiao; Siefert, Kristine A.; Jacobson, Peter D.; Lori, Jody R.; Gueorguieva, Iana; Ransom, Scott B.

    2011-01-01

    Context It has long been a concern that professional liability problems disproportionately affect the delivery of obstetrical services to women living in rural areas. Michigan, a state with a large number of rural communities, is considered to be at risk for a medical liability crisis. Purpose This study examined whether higher malpractice burden on obstetric providers was associated with an increased likelihood of discontinuing obstetric care and whether there were rural-urban differences in the relationship. Methods Data on 500 obstetrician-gynecologists and family physicians who had provided obstetric care at some point in their career (either currently or previously) were obtained from a statewide survey in Michigan. Statistical tests and multivariate regression analyses were performed to examine the interrelationship among malpractice burden, rural location, and discontinuation of obstetric care. Findings After adjusting for other factors that might influence a physician’s decision about whether to stop obstetric care, our results showed no significant impact of malpractice burden on physicians’ likelihood to discontinue obstetric care. Rural-urban location of the practice did not modify the nature of this relationship. However, family physicians in rural Michigan had a nearly four fold higher likelihood of withdrawing obstetric care when compared to urban family physicians. Conclusions The higher likelihood of rural family physicians to discontinue obstetric care should be carefully weighed in future interventions to preserve obstetric care supply. More research is needed to better understand the practice environment of rural family physicians and the reasons for their withdrawal from obstetric care. PMID:19166559

  6. Global Health Opportunities in Obstetrics and Gynecology Training: Examining Engagement Through an Ethical Lens.

    PubMed

    Zaidi, Mohammad Y; Haddad, Lisa; Lathrop, Eva

    2015-12-01

    This study aims to describe global health training (GHT) programs through the ethical lens suggested by the Working Group on Ethics Guidelines for Global Health Training (WEIGHT). A total of 35 GHT programs were identified, and general information was obtained online. Semi-structured telephone interviews of key members of 19 programs were then conducted and transcribed. The interview guide was constructed using WEIGHT recommendations. Transcript data were grouped according to domains: reciprocity, trainee selection and preparedness, needs assessments, and ethical questions. Many programs expressed difficulty in building reciprocal relationships due to imbalanced power structures. Eleven programs reported no formal application process for selecting trainees. Twelve (63%) programs reported only a single day of preparation. Nine (47%) programs did not conduct a formalized needs assessment of partner sites. Ethical considerations varied from concerns for safety to inadequate training for residents. This study reveals the limited preparedness curricula and lack of formalized needs assessments among several programs. Although many programs make an effort to build reciprocal exchanges with host partners, experiences for foreign trainees within the United States are limited, and U.S. residents are often tasked with duties above their training level abroad. This study demonstrates the need to restructure how GHT programs are formed and operated. PMID:26324736

  7. [Health services research--from the Health Research Council's perspective].

    PubMed

    Adler, Guido

    2006-01-01

    As early as 1994, the Health Research Council of the Federal Ministry of Education and Research started activities to outline a strategic concept for health services research in Germany. The Health Research Council set the stage for the initiation of a common funding program on health services research of the statutory health insurance funds, the Federal Ministry for Education and Research and the Federal Ministry of Health. This funding program has provided an important stimulus to health services research in Germany. Moreover, it has promoted the involvement and responsibility of the statutory health insurance funds in health services research. In future the funding program will be continued and additionally involve pension insurance funds as well as private health insurance funds. In addition to this special funding program there is a need for a coordinated approach to the further development of health services research in Germany--a common task for both research and funding organizations in health research. PMID:17175754

  8. Health Service Delivery in Developing Countries

    ERIC Educational Resources Information Center

    Benyoussef, Amor

    1977-01-01

    Reviews recent work dealing with methodological and technical issues in health and development; presents examples of the application of social sciences, including health demography and economics, in questions of health services delivery; and analyzes delivery of health services to rural and nomadic populations in Africa, Asia, and Latin America.…

  9. Guidelines for Health Services for Migrant Students.

    ERIC Educational Resources Information Center

    Strazicich, Mirko, Ed.

    This publication provides a standard by which California migrant education health staff can plan, implement, and evaluate a health program for students in grades K-12. Following sections which describe current state legislation, the need for health services, and California's objectives and activities regarding health services for migrant students…

  10. Health Services Manual. Hicksville Public Schools.

    ERIC Educational Resources Information Center

    1987

    This procedure manual describes the uniform procedures used by the Hicksville, New York School District's Health Services Program. Its objectives are to establish a uniform set of health services guidelines and procedures, to update all health forms, to maintain an awareness of the current changes in health laws that govern school districts, and…

  11. [Patient-Proposed Health Services].

    PubMed

    Fujiwara, Yasuhiro

    2016-06-01

    The Patient-Proposed Health Services(PPHS)was launched in April 2016. PPHS was proposed by the Council for Regulatory Reform, which was established in January 2013 under the Second Abe Administration. After discussion within the council, PPHS was published in the Japan Revitalization Strategy(2014 revised edition), which was endorsed by the Cabinet on June 24, 2014. PPHS was proposed therein as a new mechanism within the mixed billing system to apply for a combination of treatment not covered by the public health insurance with treatment covered by the insurance. Subsequently, PPHS was submitted for diet deliberations in April and May 2015 and inserted into article 63 of the health insurance act in accordance with "a law for making partial amendments to the National Health Insurance Act, etc., in order to create a sustainable medical insurance system", which was promulgated on May 29, 2015. In this paper I will review the background of the birth of PPHS and discuss its overview. PMID:27306801

  12. Health services in urban India.

    PubMed

    Mittal, S K; Ramji, S

    1989-01-01

    At the time of independence 340 million lived in urban areas in India, and currently 200 million of an estimated population of 800 million live in 3000 cities and towns with inhabitants over 10.000. There are 90.000 government-employed doctors in urban areas: 1 doctor per 2200 residents. Another 180.000 are practicing in such areas providing a ratio of 1 doctor for every 800 urban people. In Delhi in 1986 there were 63 allopathic hospitals with 15.000 beds and 561 dispensaries. Government employees receive preferential treatment, while the public waits long hours. In frustration the poor often turn to private practitioners even if their qualifications are dubious. Despite 35 years of socialistic planning, only 10-15% of children living in a Delhi colony received adequate vaccination. To rectify this inequality a system is recommended guaranteeing public access to dispensaries on the same fee-basis as that accorded to government employees. A health card could prevent misuse, and it would ensure optimal utilization of existing health facilities. Future development of 50-100 bed hospitals within 2-3 km of clients' homes and the attachment of 5-10 of them to a large hospital or medical school is proposed. A central health board could oversee and coordinate area-based health services. PMID:2638675

  13. 42 CFR 136a.13 - Authorization for contract health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Authorization for contract health services. 136a.13 Section 136a.13 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who...

  14. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 1 2014-10-01 2014-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  15. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 1 2011-10-01 2011-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  16. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 1 2013-10-01 2013-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  17. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  18. 42 CFR 136a.15 - Health Service Delivery Areas.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 1 2012-10-01 2012-10-01 false Health Service Delivery Areas. 136a.15 Section 136a.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH What Services Are Available and Who Is Eligible...

  19. Mental Health Service Delivery Systems and Perceived Qualifications of Mental Health Service Providers in School Settings

    ERIC Educational Resources Information Center

    Dixon, Decia Nicole

    2009-01-01

    Latest research on the mental health status of children indicates that schools are key providers of mental health services (U.S. Department of Health and Human Services, 2003). The push for school mental health services has only increased as stakeholders have begun to recognize the significance of sound mental health as an essential part of…

  20. The Current Status and Future of Academic Obstetrics.

    ERIC Educational Resources Information Center

    Bowers, John Z., Ed.; Purcell, Elizabeth F., Ed.

    The state of research in academic obstetrics and its relationship to research in other academic disciplines was addressed in a 1979 conference. Participants included representatives of academic obstetrics, academic pediatrics, and public health. After an introductory discussion by Howard C. Taylor, Jr. on changes in obstetrics in the last 25…

  1. Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services.

    PubMed

    Guerrero, Erick G; Andrews, Christina; Harris, Lesley; Padwa, Howard; Kong, Yinfei; M S W, Karissa Fenwick

    2016-01-01

    In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform. PMID:26350114

  2. Regional health library service in northern Ireland.

    PubMed

    Crawford, D S

    1990-10-01

    The regional medical library service provided to physicians, hospitals, nurses, social workers, and health care administrators throughout Northern Ireland by the Queen's University of Belfast is described. A brief outline of the National Health Service in the United Kingdom is given, and the library service is described in terms of collections, cataloging, interlibrary loan, and reference. PMID:2224299

  3. Regional health library service in northern Ireland.

    PubMed Central

    Crawford, D S

    1990-01-01

    The regional medical library service provided to physicians, hospitals, nurses, social workers, and health care administrators throughout Northern Ireland by the Queen's University of Belfast is described. A brief outline of the National Health Service in the United Kingdom is given, and the library service is described in terms of collections, cataloging, interlibrary loan, and reference. PMID:2224299

  4. Hispanics and Culturally Sensitive Mental Health Services.

    ERIC Educational Resources Information Center

    Hispanic Research Center Research Bulletin, 1985

    1985-01-01

    The objective of improving mental health care for Hispanics has been reviewed, most often, as dependent upon the provision of culturally sensitive mental health services. "Cultural sensitivity," however, is an imprecise term, especially when efforts are made to put it into operation when providing mental health services to Hispanic clients.…

  5. Children's Health Services Manual. Revised Edition.

    ERIC Educational Resources Information Center

    South Carolina State Dept. of Health and Environmental Control, Columbia.

    This manual for South Carolina's child health personnel covers program planning, evaluation, monitoring, and administration, and provides standards, procedures, policies, and regulations concerning health services for children in the state. An initial section on children's health services covers eligibility; the Women, Infants and Children…

  6. Health Services Assistant. Revised. Instructor Guide.

    ERIC Educational Resources Information Center

    Missouri Univ., Columbia. Instructional Materials Lab.

    This color-coded curriculum guide was developed to help health services educators prepare students for health services occupations. The curriculum is organized in 20 units that cover the following topics: interpersonal relationships and the health care team; communication and observation skills; safety considerations; microbiology; the body as a…

  7. Preventive Health Services Utilization Among Korean Americans.

    PubMed

    Kim, Kyeongmo; Casado, Banghwa Lee

    2016-01-01

    This study examined the use of preventive health services among Korean American adults. Data were drawn from a cross-sectional survey of 212 Korean Americans in the Chicago, Illinois, metropolitan area. Guided by the Andersen's behavioral model, the authors examined whether predisposing (age, gender, marital status, household size, education), enabling (income, health insurance, English proficiency, citizenship, social network), and need (health status) factors are predictive of Korean Americans' preventive health services utilization. A binomial logistic regression showed that younger age, male, noncitizen, low income, no insurance, a larger family network, and better perceived health were associated with decreased odds of using preventive health services. PMID:27171558

  8. Psychotherapy services outside the National Health Service.

    PubMed

    Kroll, U

    1976-02-01

    With the help of an Upjohn Travelling Fellowship, I visited 15 units providing services for people under stress. There were nine residential units and six non-residential units, all were Christian charitable organisations and in all there was close co-operation with the medical profession.All these organisations accept referrals from general practitioners and deserve to be more widely known. PMID:1255548

  9. Health services research: why and how?

    PubMed

    Hjort, P F

    1976-01-01

    It is useful to divide medical research into three areas: biomedical, clinical, and health services research. The areas partly overlap, and health services research is also related to social services research. Research is carried out to solve problems and is an instrument for change. Health services research has developed over the last ten years in response to increasing problems in many health services. Superficially, these problems are caused by insufficient resources, but no service can hope to pay its way out of them. Some may be fairly accurately investigated, like need, demand, and utilization of care. Others are more complicated, e.g. evaluation of care, defining standards, and cost--benefit analyses. A few deal with fundamental values, like quality of life and responsibility of individuals and societies. So far, health services research has led to greater emphasis on primary care, but it is fair to say that it has not managed to infiltrate the service and influence people's attitudes and ambitions. In the future, one must bring health services research inside the service and involve the professionals more deeply. One must support prevention studies, attack the ethical and clinical problems related to quality of life, study the potential of non-professional support in the community, and promote rational attitudes among professions, patients, people and politicians. The task is never-ending and health services research, therefore, must be part of the programme of all medical schools. PMID:829768

  10. The promotion of private health insurance and its implications for the social organisation of healthcare: a case study of private sector obstetric practice in Chile.

    PubMed

    Murray, Susan F; Elston, Mary Ann

    2005-09-01

    This paper examines some of the implications of the process of privatisation of a national healthcare system for the delivery, organisation and, ultimately, the outcome of services. Through a case study of obstetric care in Chile, we illuminate the relationships between the macro-level of political decisions, the meso-level of the organisations through which government reforms were enacted, and the micro-level of clinical practice. We show that, for a significant proportion of Chilean women seeking maternity care, privatisation has led to expanded access and to ostensibly highly-personalised relationships with specialists. However, because of the fragmentation of maternity services, the altered work patterns for obstetricians occasioned by changes in healthcare financing and the relatively weak market position of most obstetricians, this personalised care is dependent on highly technologised obstetric practices. By examining the specific organisational arrangements under which private maternity care is conducted in Chile we shed light on the connection between privately-funded maternity care and high caesarean section rates in this setting. PMID:16283895

  11. Health Services and Women's Oral Health.

    ERIC Educational Resources Information Center

    O'Mullane, Denis; And Others

    1993-01-01

    Data on the relative levels of men's and women's dental health are scarce, but the available data do indicate differences in tooth loss and health-related behavior patterns. Better methods for recording and reporting this information are recommended. (MSE)

  12. [Maternal and infant health services and the public health clinic].

    PubMed

    Urasaki, S

    1986-11-01

    The public health clinic under the jurisdiction of prefectural government should continue to play a major role in maternal-child health services. Ministry of Health's revision plan for Maternal-child Health Law, according to which maternal-child health services are to be transferred totally to municipal (city-town-village) government, is strongly opposed by public health nurses and others. The plan goes against the current movement and effort to revitalize public health clinics, where more 50% of services rendered are maternal-child health related. Secondly, municipal health centers would have much more difficulty providing quality services than prefectural public health clinics which receive annual federal aid for their operation. Federal funding for maternal-child health care, regardless of jurisdictions, is currently 1/3 of standard unit cost. Extreme financial strain on municipal governments would result in regional differences in the quality of services and/or eventual financial burden on the patients. While the national government is trying to emphasize administrative aspects of the public health clinic, it is ordinary citizens' day to day health problems that people expect the clinic to deal with, individually, via check-ups, health counseling, home visits, public health education and telephone health hot line. PMID:3642046

  13. Indian Health Trends and Services, 1974 Edition.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Washington, DC. Div. of Indian Health.

    The American Indian Health Service (AIHS), subsidiary of the Department of Health, Education, and Welfare, is dedicated to elevating the health status of Indian and Alaskan Native peoples by: developing modern health facilities; encouraging Indian acquaintance with and participation in existing programs; being responsive to the concept of…

  14. Using Web-Based Questionnaires and Obstetric Records to Assess General Health Characteristics Among Pregnant Women: A Validation Study

    PubMed Central

    Schouten, Naomi PE; Merkus, Peter JFM; Verhaak, Chris M; Roeleveld, Nel; Roukema, Jolt

    2015-01-01

    Background Self-reported medical history information is included in many studies. However, data on the validity of Web-based questionnaires assessing medical history are scarce. If proven to be valid, Web-based questionnaires may provide researchers with an efficient means to collect data on this parameter in large populations. Objective The aim of this study was to assess the validity of a Web-based questionnaire on chronic medical conditions, allergies, and blood pressure readings against obstetric records and data from general practitioners. Methods Self-reported questionnaire data were compared with obstetric records for 519 pregnant women participating in the Dutch PRegnancy and Infant DEvelopment (PRIDE) Study from July 2011 through November 2012. These women completed Web-based questionnaires around their first prenatal care visit and in gestational weeks 17 and 34. We calculated kappa statistics (κ) and the observed proportions of positive and negative agreement between the baseline questionnaire and obstetric records for chronic conditions and allergies. In case of inconsistencies between these 2 data sources, medical records from the woman’s general practitioner were consulted as the reference standard. For systolic and diastolic blood pressure, intraclass correlation coefficients (ICCs) were calculated for multiple data points. Results Agreement between the baseline questionnaire and the obstetric record was substantial (κ=.61) for any chronic condition and moderate for any allergy (κ=.51). For specific conditions, we found high observed proportions of negative agreement (range 0.88-1.00) and on average moderate observed proportions of positive agreement with a wide range (range 0.19-0.90). Using the reference standard, the sensitivity of the Web-based questionnaire for chronic conditions and allergies was comparable to or even better than the sensitivity of the obstetric records, in particular for migraine (0.90 vs 0.40, P=.02), asthma (0.86 vs 0

  15. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2014-10-01 2014-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  16. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2013-10-01 2013-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  17. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2012-10-01 2012-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  18. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Health, and the Substance Abuse and Mental Health Services Administration, and the offices of the... 42 Public Health 1 2011-10-01 2011-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  19. 42 CFR 93.220 - Public Health Service or PHS.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES PUBLIC HEALTH SERVICE POLICIES...

  20. Safer maternal health in rural Uttar Pradesh: do primary health services contribute?

    PubMed

    RamaRao, S; Caleb, L; Khan, M E; Townsend, J W

    2001-09-01

    India accounts for about one-quarter of maternal deaths world wide, with the most recent statistics showing an average maternal mortality ratio of 407 per 100 000 live births at the national level. The government had hoped to reduce maternal mortality to 200 by 2000, but it is clear that this was not achieved. This paper explores the reasons why the most populous state of Uttar Pradesh continues to have one of the highest reported maternal mortality ratios in India. Data from two districts of Uttar Pradesh on mother and child health-care utilization and the readiness of the public sector to provide antenatal and emergency obstetric services are used to illustrate the reasons why maternal mortality has not declined. While blueprints for safe motherhood programmes exist, the equipment and technical competence to provide services is weak at the present moment. Reductions in maternal mortality would require interventions to improve service delivery as well as community mobilization to improve utilization of services, especially in life-threatening situations. PMID:11527866

  1. School Mental Health Resources and Adolescent Mental Health Service Use

    PubMed Central

    Green, Jennifer Greif; McLaughlin, Katie A.; Alegría, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A,; Kessler, Ronald C.

    2014-01-01

    Objective Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to increase service use. This paper examines associations of school resources with past-year mental health service use among students with 12-month DSM-IV mental disorders. Method Data come from the U.S. National Comorbidity Survey Adolescent Supplement (NCS-A), a national survey of adolescent mental health that included 4,445 adolescent-parent pairs in 227 schools in which principals and mental health coordinators completed surveys about school resources-policies for addressing student emotional problems. Adolescents and parents completed the Composite International Diagnostic Interview and reported mental health service use across multiple sectors. Multilevel multivariate regression was used to examine associations of school mental health resources and individual-level service use. Results Roughly half (45.3%) of adolescents with a 12-month DSM-IV disorder received past-year mental health services. Substantial variation existed in school resources. Increased school engagement in early identification was significantly associated with mental health service use for adolescents with mild/moderate mental and behavior disorders. The ratio of students-to-mental health providers was not associated with overall service use, but was associated with sector of service use. Conclusions School mental health resources, particularly those related to early identification, may facilitate mental health service use and influence sector of service use for youths with DSM disorders. PMID:23622851

  2. Funding Early Childhood Mental Health Services & Supports.

    ERIC Educational Resources Information Center

    Wishmann, Amy; Kates, Donald; Kaufmann, Roxane

    This paper is the first of a two-part series on financing early childhood mental health services. It discusses the need for a systemic approach to financing early childhood mental health services and supports and presents a matrix to assist states and communities in the design of comprehensive financing systems. The vertical axis of the matrix…

  3. Acceptance of Swedish e-health services

    PubMed Central

    Jung, Mary-Louise; Loria, Karla

    2010-01-01

    Objective: To investigate older people’s acceptance of e-health services, in order to identify determinants of, and barriers to, their intention to use e-health. Method: Based on one of the best-established models of technology acceptance, Technology Acceptance Model (TAM), in-depth exploratory interviews with twelve individuals over 45 years of age and of varying backgrounds are conducted. Results: This investigation could find support for the importance of usefulness and perceived ease of use of the e-health service offered as the main determinants of people’s intention to use the service. Additional factors critical to the acceptance of e-health are identified, such as the importance of the compatibility of the services with citizens’ needs and trust in the service provider. Most interviewees expressed positive attitudes towards using e-health and find these services useful, convenient, and easy to use. Conclusion: E-health services are perceived as a good complement to traditional health care service delivery, even among older people. These people, however, need to become aware of the e-health alternatives that are offered to them and the benefits they provide. PMID:21289860

  4. Communication Access to Health and Social Services

    ERIC Educational Resources Information Center

    Parr, Susie; Pound, Carole; Hewitt, Alan

    2006-01-01

    This article describes the efforts of a group of people in the United Kingdom at Connect-the communication disability network-to make health and social services more communicatively accessible to people with aphasia. The project involved listening to people with aphasia talk about their experiences with health and social care services and working…

  5. Private equity investment in health care services.

    PubMed

    Robbins, Catherine J; Rudsenske, Todd; Vaughan, James S

    2008-01-01

    Sophisticated private equity investors in health services provide venture capital for early-stage companies, growth capital for mid-stage companies, and equity capital for buyouts of mid-stage and mature companies. They pursue opportunities in provider sectors that are large and have a stable reimbursement environment, such as acute care services; sectors with room to execute consolidation strategies, such as labs; alternative-site sectors, such as "storefront" medicine; and clinical services, such as behavioral health, that are subject to profitably increasing quality and lowering costs. The innovations created through private equity investments could challenge established health services organizations. PMID:18780929

  6. Health and health services in Central America.

    PubMed

    Garfield, R M; Rodriguez, P F

    1985-08-16

    Despite rapid economic growth since World War II, health conditions improved only slowly in most of Central America. This is a result of poor medical, social, and economic infrastructure, income maldistribution, and the poor utilization of health investments. The economic crisis of the 1980s and civil strife have further endangered health in the region. Life expectancy has fallen among men in El Salvador and civil strife has become the most common cause of death in Guatemala, Nicaragua, and El Salvador. Large-scale US assistance has done little to improve conditions, and refugees continue to pour into North America. It is estimated that there are more than a million refugees within Central America, while a million have fled to the United States. Costa Rica and Nicaragua are partial exceptions to this dismal health picture. An effective approach to the many health problems in Central America will require joint planning and cooperation among all countries in the region. PMID:4021026

  7. Local Government Health Services in Interwar England:

    PubMed Central

    Gorsky, Martin

    2011-01-01

    Summary This article provides a critical discussion of recent work on local government health care and health services in interwar England. A literature review examines case study approaches and comparative quantitative surveys, highlighting conventional and revisionist interpretations. Noting the differing selection criteria evident in some works, it argues that studies based upon a limited number of personal health services provide an insufficient basis for assessing local health activity and policy. There follows a regional study demonstrating various discrepancies between health financing data in local sources and those in nationally collated returns. These in turn give rise to various problems of assessment and interpretation in works relying on the latter, particularly with respect to services for schoolchildren and long-stay patients. The case study points to the importance of integrating poor law medical services in evaluations, and of learning more about the role of government subsidy in supporting expanding services. PMID:22080797

  8. Designing online health services for patients.

    PubMed

    Crotty, Bradley H; Slack, Warner V

    2016-01-01

    Patients are increasingly interacting with their healthcare system through online health services, such as patient portals and telehealth programs. Recently, Shabrabani and Mizrachi provided data outlining factors that are most important for users or potential users of these online services. The authors conclude convincingly that while online health services have great potential to be helpful to their users, they could be better designed. As patients and their families play an increasingly active role in their health care, online health services should be made easier for them to use and better suited to their health-related needs. Further, the online services should be more welcoming to people of all literacy levels and from all socioeconomic backgrounds. PMID:27307985

  9. Youth reproductive health services in Bulawayo, Zimbabwe.

    PubMed

    Mashamba, Alethea; Robson, Elsbeth

    2002-12-01

    This study examines young people's access to reproductive healthcare services via an urban youth advisory centre in Bulawayo, Zimbabwe. The aim is to explain why teenagers do not always use existing health services. Data from exit questionnaires with users and focus groups with non-users are analysed to evaluate service accessibility. Analysis suggests that even where clinics are spatially accessible, barriers to access include temporal factors, lack of factual knowledge and stigmatisation. The paper concludes that spatial accessibility is not the only factor necessary to ensure equal access to health services. Recommendations are made towards tackling young people's unmet needs for reproductive healthcare services. PMID:12399216

  10. Mental health services in the Solomon Islands.

    PubMed

    Orotaloa, Paul; Blignault, Ilse

    2012-06-01

    The Solomon Islands comprise an archipelago of nearly 1,000 islands and coral atolls and have an estimated population of 549,574 people. Formal mental health services date back to 1950 when an asylum was established. Since then the process of mental health service development has been largely one of incremental change, with a major boost to community services in the last two decades. During the 1990s a mental health outpatient clinic was established in Honiara, together with attempts to recruit nursing staff as psychiatric coordinators in the provinces. In 1996, the Ministry commenced sending registered nurses for psychiatric training in Papua New Guinea. By 2010, there were 13 psychiatric nurses and one psychiatrist, with a second psychiatrist in training. A National Mental Health Policy was drafted in 2009 but is yet to be endorsed by Cabinet. A significant portion of the population still turns to traditional healers or church leaders for purposes of healing, seeking help from Western medicine only after all other alternatives in the community have been exhausted. There is still a long way to go before mental health services are available, affordable and accessible to the whole population, including people living in geographically remote areas. Realization of this vision requires increased resourcing for mental health services; improved communication and collaboration between the centrally-based, national mental health services and the provincial health services; and closer, ongoing relationships between all stakeholders and partners, both locally and internationally. PMID:26767360

  11. Mental Health Care in a High School Based Health Service.

    ERIC Educational Resources Information Center

    Jepson, Lisa; Juszczak, Linda; Fisher, Martin

    1998-01-01

    Describes the mental-health and medical services provided at a high-school-based service center. Five years after the center's inception mental health visits had quadrupled. One third of students utilizing the center reported substance abuse within their family. Other reasons for center use included pregnancy, suicidal ideation, obesity,…

  12. Health Services for Migrant Children.

    ERIC Educational Resources Information Center

    Bove, Beverly A.

    Intended as a resource for administrators, teachers, nurses, paraprofessionals, health coordinators, and community action personnel who are interested in meeting the health needs of migrant children, this handbook offers suggestions for organizing community resources in providing health care to migrant children. Poor nutrition, the lack of dental…

  13. Availability and Continuity of Care for Maternal Health Services in the Primary Health Centres in Nnewi, Nigeria (January - March 2010)

    PubMed Central

    Nnebue, Chinomnso C.; Ebenebe, Uzo E.; Duru, Chukwuma B.; Egenti, Nonye B.; Emelumadu, Obiageli F.; Ibeh, Christian C.

    2016-01-01

    Background: In some primary health care settings, even where the health services are not available, provisions are not made to ensure continuity of care. This study aimed to determine the availability and level of continuity of care for maternal health services in the primary health centers (PHCs) in Nnewi, Nigeria. Methods: This was a cross-sectional survey. Using multistage sampling technique, 280 women utilizing maternal health services from four randomly selected public PHCs in Nnewi, Nigeria were chosen for the study. Data collection employed a mix of quantitative and qualitative methods. Results: The mean ± standard deviation for age of the respondents was 29.2 ± 5.9 years. The facilities studied provided out-patient services, but the only in-patient services provided was for women who delivered or those in labor. None of the facilities is equipped to provide even basic essential obstetric care services. None had standardized a protocol for referring clients, referral forms, a transport system, or a community loan scheme in place. Forty-four (15.7%) women were referred for care outside of the PHCs for the following reasons: Lack of drugs and supplies (9.1%); lack of equipment (90.9%), lack of skilled personnel (45.5%) among others. Conclusions: This study showed that despite the unavailability of some services, appropriate strategies were not in place to ensure the coherent pattern of services within and between the PHCs and other levels of care. Delivery to the clients of comprehensive and integrated maternal health services, and efficient referral systems are thus recommended. PMID:27076882

  14. Health services accessibility among Spanish elderly.

    PubMed

    Fernández-Mayoralas, G; Rodríguez, V; Rojo, F

    2000-01-01

    The paper aims to identify the variables that best explain the use of health services by people aged 65 and over in Spain. The data comes from the 1993 Spanish National Health Survey (ENSE 93). The conceptual framework is the model proposed by Andersen, who suggests that utilisation is a function of predisposition to use the services, the ability to use them and of need. A bivariate and multivariate analysis (SPSS-X Discriminant Procedure) is conducted to define the predictors that best discriminate users and non-users. The use of each health service is explained by a different set of variables. The need variables play a more important role in predicting the use of non-discretionary services that are more closely related to healing processes (medical consultations, emergencies and hospitalisation). The predisposing and enabling variables are more relevant in explaining the use of dental services, indicating a certain degree of inequity of these discretionary services. PMID:10622691

  15. Court-ordered obstetrical interventions.

    PubMed

    Kolder, V E; Gallagher, J; Parsons, M T

    1987-05-01

    In a national survey, we investigated the scope and circumstances of court-ordered obstetrical procedures in cases in which the women had refused therapy deemed necessary for the fetus. We also solicited the opinions of leading obstetricians regarding such cases. Court orders have been obtained for cesarean sections in 11 states, for hospital detentions in 2 states, and for intrauterine transfusions in 1 state. Among 21 cases in which court orders were sought, the orders were obtained in 86 percent; in 88 percent of those cases, the orders were received within six hours. Eighty-one percent of the women involved were black, Asian, or Hispanic, 44 percent were unmarried, and 24 percent did not speak English as their primary language. All the women were treated in a teaching-hospital clinic or were receiving public assistance. No important maternal morbidity or mortality was reported. Forty-six percent of the heads of fellowship programs in maternal-fetal medicine thought that women who refused medical advice and thereby endangered the life of the fetus should be detained. Forty-seven percent supported court orders for procedures such as intrauterine transfusions. We conclude from these data that court-ordered obstetrical procedures represent an important and growing problem that evokes sharply divided responses from faculty members in obstetrics. Such procedures are based on dubious legal grounds, and they may have far-reaching implications for obstetrical practice and maternal and infant health. PMID:3574370

  16. Health Services, Student Services Department: Program Evaluation. 1990-91.

    ERIC Educational Resources Information Center

    Jeschke, Thomas; And Others

    This document evaluates the Des Moines Public Schools health services and education program, which utilizes the professional expertise of school nurses throughout the district. The program promotes success in the learning process for students (including those with complex health care needs, conditions, and disabilities), employees, and the…

  17. Obstetric antiphospholipid syndrome.

    PubMed

    Esteve-Valverde, E; Ferrer-Oliveras, R; Alijotas-Reig, J

    2016-04-01

    Obstetric antiphospholipid syndrome is an acquired autoimmune disorder that is associated with various obstetric complications and, in the absence of prior history of thrombosis, with the presence of antiphospholipid antibodies directed against other phospholipids, proteins called cofactors or PL-cofactor complexes. Although the obstetric complications have been related to the procoagulant properties of antiphospholipid antibodies, pathological studies of human placenta have shown the proinflammatory capacity of antiphospholipid antibodies via the complement system and proinflammatory cytokines. There is no general agreement on which antiphospholipid antibodies profile (laboratory) confers the greatest obstetric risk, but the best candidates are categories I and IIa. Combined treatment with low doses of aspirin and heparin achieves good obstetric and maternal outcomes. In this study, we also review the therapeutic possibilities in refractory cases, although the likelihood of progressing to other autoimmune diseases is low. We briefly comment on incomplete obstetric antiphospholipid syndrome, also known as antiphospholipid antibody-mediated pregnancy morbidity syndrome. PMID:26603476

  18. Intelligent Healthcare Service Using Health Lifelog Analysis.

    PubMed

    Choi, Junho; Choi, Chang; Ko, Hoon; Kim, Pankoo

    2016-08-01

    Recently, there have been many studies of health services combined with smart devices, gathering a user' health lifelog and managing his or her health for the improvement of the quality of his or her life, using various sensors. However, previous works have problems in the extraction of patterns in person's complex health lifelog, the analysis of complex relations among those patterns, the extension of them to related services, and reuse of lifelog patterns. The healthcare lifelogs should search efficiently data necessary for users from big data because those gather real-time data of various types of data. The healthcare lifelogs should search efficiently data necessary for users from big data because those gather real-time data of various types of data. In this paper, we propose the intelligent healthcare service for reasoning personal health state with data extraction, pattern analysis, health life ontology modeling using health lifelog analysis based on smart devices. The proposed health information service provided more and more appropriate service with users if more reasoning rules related to more and various healthcare lifelog information gathering are included in the service. PMID:27352004

  19. [Main trends in restructuring of maternal and child health services].

    PubMed

    Baranov, A A

    1988-01-01

    Russia's success in the 1990s with the perestroika programs aimed at benefitting public health depends to a large degree upon constructive solutions to the many existing problems with maternity and pediatric health services. In a resolution by the Central Committee of the CPSU the necessity for increased prophylaxis is emphasized. Leading a healthy life is considered most important, since half of all factors influencing the health status of the population depends on it. Most pediatrists and medical assistants, however, are either undisposed or lack the skills to educate children, adolescents and parents in personal hygiene. The fight against controllable infections, whose frequency in the USSR is one of the highest among developed nations due to a low level of or even falsified immunizations, is to be stepped up. In order to combat childhood diseases, infant mortality, and invalidity, the quality of clinical examinations of pregnant women and newborn babies must be enhanced through implementing prenatal diagnostics, mass screenings of the newborn, ultrasound diagnostics, chorionic biopsies, and genetic medical consultations for families with a history of perinatal and infant mortality. Prophylaxis of intrauterine fetal infections is planned in 20-25 regional diagnostic centers. The need for decentralization, regionalization, and demographic distribution analyses is stressed. Regional centers are to upgrade skills of doctors, medical workers, and administrators, that to a large degree are lacking in adequate education. A centralized fund has been created by the Soviet Health Ministry, earmarked for concrete scientific projects instead of blanket financing of medical institutions, who, in addition, by 1989 will start being financially self-supporting. Expert councils for obstetrics, gynecology, and pediatrics are to be created in order to increase efficiency and applying results of scientific research. PMID:3200638

  20. Office for prevention and health services assessment

    NASA Astrophysics Data System (ADS)

    Wright, James A.

    1994-12-01

    The Air Force Surgeon General has established the Office for Prevention and Health Care ASsessment (OPHSA) to become the center of excellence for preventive services and health care assessment in the U.S. Air Force and the Department of Defense. OPHSA using the principles of total quality management and integrated teams will evaluate, compare, and modify preventive services delivery guidelines to preserve the fighting force by preventing illness and injuries in military populations. OPHSA will evaluate and formulate health care delivery guidelines to improve health care access and delivery to military patient populations. OPHSA will develop data to determine the health status and health needs to beneficiary populations so medical managers can deliver medical care in the most cost effective manner. OPHSA is located at Brooks Air Force Base in San Antonio, Texas. OPHSA will have thirty seven active duty military, civil service, and contract employees and should be fully functional by the end of 1995.

  1. Health Behavior, Health Education, Health Service Utilization and Compliance with Health Regimes: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Toledo, J. R.; Hughes, Howard

    This bibliography includes references from major articles, Index Medicus (1972- 1977), and Psychological Abstracts (1967-1977). The material is arranged under four major headings--health behavior, health education, health services utilization, and compliance with health regimes. It will be of interest to persons working in medical settings and…

  2. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  3. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  4. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  5. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  6. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  7. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  8. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  9. 42 CFR 440.70 - Home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Home health services. 440.70 Section 440.70 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services....

  10. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  11. 42 CFR 441.15 - Home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Home health services. 441.15 Section 441.15 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this...

  12. Health Extension Workers' and Mothers' Attitudes to Maternal Health Service Utilization and Acceptance in Adwa Woreda, Tigray Region, Ethiopia

    PubMed Central

    Jackson, Ruth; Tesfay, Fisaha Haile; Godefay, Hagos; Gebrehiwot, Tesfay Gebregzabher

    2016-01-01

    Background The maternal health system in Ethiopia links health posts in rural communities (kebeles) with district (woreda) health centres, and health centres with primary hospitals. At each health post two Health Extension Workers (HEWs) assist women with birth preparedness, complication readiness, and mobilize communities to facilitate timely referral to mid-level service providers. This study explored HEWs’ and mother’s attitudes to maternal health services in Adwa Woreda, Tigray Region. Methods In this qualitative study, we trained 16 HEWs to interview 45 women to gain a better understanding of the social context of maternal health related behaviours. Themes included barriers to health services; women’s social status and mobility; and women’s perceptions of skilled birth attendant’s care. All data were analyzed thematically. Findings There have been substantial efforts to improve maternal health and reduce maternal mortality in Adwa Woreda. Women identified barriers to healthcare including distance and lack of transportation due to geographical factors; the absence of many husbands due to off-woreda farming; traditional factors such as zwar (some pregnant women are afraid of meeting other pregnant women), and discouragement from mothers and mothers-in-law who delivered their children at home. Some women experienced disrespectful care at the hospital. Facilitators to skilled birth attendance included: identification of pregnant women through Women’s Development Groups (WDGs), and referral by ambulance to health facilities either before a woman’s Expected Due Date (EDD) or if labour started at home. Conclusion With the support of WDGs, HEWs have increased the rate of skilled birth attendance by calling ambulances to transfer women to health centres either before their EDD or when labour starts at home. These findings add to the growing body of evidence that health workers at the community level can work with women’s groups to improve maternal

  13. Pakistan: the Faisalabad Obstetric Flying Squad.

    PubMed

    Andina, M M; Fikree, F F

    1995-01-01

    The Faisalabad Obstetric Flying Squad was established in 1988 and provides access to emergency obstetric services for the poor women of Faisalabad. The service is highly appreciated by both women and participating dais. The latter receive training from the Mother and Child Welfare Association of Faisalabad and form an integral part of the obstetric care team. While problems in accessing communication facilities exist, the project has made a lasting impact on the provision of emergency obstetric services in the city. Improved recording and reporting mechanisms would permit a more precise assessment of the impact of the service on the reduction of maternal morbidity and mortality. It would also permit an assessment of the operating costs of the service. One of the reasons the service functions effectively is that it is fully integrated into the general operations of the Allied Hospital. If similar institutional mechanisms can be established there is good reason to think that the Faisalabad Obstetric Flying Squad could be replicated in other developing country settings. PMID:7571713

  14. School Health Services Guidelines, Revised.

    ERIC Educational Resources Information Center

    Haufler, Lillian H.

    This manual is intended to serve as a guideline for school administrators and personnel who are concerned with the health education of school age children. Because of the different and complicated health problems now facing children and youth, it is deemed imperative that new priorities be established. Thus, policies and methods of school health…

  15. Emergency Health Services Selected Bibliography.

    ERIC Educational Resources Information Center

    Health Services and Mental Health Administration (DHEW), Bethesda, MD.

    This annotated bibliography contains books, journal articles, visual aids, and other documents pertaining to emergency health care, which are organized according to: (1) publications dealing with day-to-day health emergencies that occur at home, work, and play, (2) documents that will help communities prepare for emergencies, including natural…

  16. [Reembursing health-care service provider networks].

    PubMed

    Binder, A; Braun, G E

    2015-03-01

    Health-care service provider networks are regarded as an important instrument to overcome the widely criticised fragmentation and sectoral partition of the German health-care system. The first part of this paper incorporates health-care service provider networks in the field of health-care research. The system theoretical model and basic functions of health-care research are used for this purpose. Furthermore already established areas of health-care research with strong relations to health-care service provider networks are listed. The second part of this paper introduces some innovative options for reimbursing health-care service provider networks which can be regarded as some results of network-oriented health-care research. The origins are virtual budgets currently used in part to reimburse integrated care according to §§ 140a ff. SGB V. Describing and evaluating this model leads to real budgets (capitation) - a reimbursement scheme repeatedly demanded by SVR-Gesundheit (German governmental health-care advisory board), for example, however barely implemented. As a final step a direct reimbursement of networks by the German sickness fund is discussed. Advantages and challenges are shown. The development of the different reimbursement schemes is partially based on models from the USA. PMID:25625796

  17. [Effective access to health services: operationalizing universal health coverage].

    PubMed

    Fajardo-Dolci, Germán; Gutiérrez, Juan Pablo; García-Saisó, Sebastián

    2015-01-01

    The right to health and its operational form, as an organized social response to health: the right to health protection, are the mainstay for the global push towards universal health coverage. The path to achieve this goal is particular to each country and relates to the baseline and specific context in relation to what is feasible. In practical terms, universal coverage involves the correlation between demand and supply of services (promotion, prevention, and care), expressed by the ability for each individual to make use of services when these are required. In those terms universal coverage is then effective access. The objective of the paper is to explore the conceptualization of effective access to health services and propose a definition that allows its operationalization thereof. This definition considers key elements of supply and demand of services, including the availability of resources and adequate provision (quality), as well as barriers to use them. PMID:26235780

  18. A Report on Student Health Services.

    ERIC Educational Resources Information Center

    Augustine, Merlin J.; And Others

    1980-01-01

    Most student health centers are similar in hours of operation, eligible populations, inpatient care, computerization of medical records and billing, and director qualifications. The centers tend to differ in funding sources, salaries, and availability of special services. (CMJ)

  19. Health services under the General Agreement on Trade in Services.

    PubMed Central

    Adlung, R.; Carzaniga, A.

    2001-01-01

    The potential for trade in health services has expanded rapidly in recent decades. More efficient communication systems have helped to reduce distance-related barriers to trade; rising incomes and enhanced information have increased the mobility of patients; and internal cost pressures have led various governments to consider possibilities for increased private participation. As yet, however, health services have played only a modest role in the General Agreement on Trade in Services (GATS). It is possible that Members of the World Trade Organization have been discouraged from undertaking access commitments by the novelty of the Agreement, coordination problems between relevant agencies, widespread inexperience in concepts of services trade, a traditionally strong degree of government involvement in the health sector, and concerns about basic quality and social objectives. However, more than five years have passed since GATS entered into force, allowing hesitant administrations to familiarize themselves with its main elements and its operation in practice. The present paper is intended to contribute to this process. It provides an overview of the basic structure of GATS and of the patterns of current commitments in health services and of limitations frequently used in this context. The concluding section discusses possibilities of pursuing basic policy objectives in a more open environment and indicates issues that may have to be dealt with in current negotiations on services. PMID:11357215

  20. Mental Health Services in Head Start

    ERIC Educational Resources Information Center

    Frey, Andy

    2008-01-01

    This dialog suggests that mental health services in Head Start should be more broadly defined than they currently are in many programs. Specifically, these services should emphasize the important role prevention (e.g., prereferral/identification) plays in promoting mental wellness. Additionally, this dialog briefly addresses the role of the mental…

  1. 78 FR 61367 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-03

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities; Proposed Collection; Public Comment Request AGENCY: Health Resources and Services Administration,...

  2. Green Infrastructure, Ecosystem Services, and Human Health

    PubMed Central

    Coutts, Christopher; Hahn, Micah

    2015-01-01

    Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture—in the form of a primer—of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being. PMID:26295249

  3. Green Infrastructure, Ecosystem Services, and Human Health.

    PubMed

    Coutts, Christopher; Hahn, Micah

    2015-08-01

    Contemporary ecological models of health prominently feature the natural environment as fundamental to the ecosystem services that support human life, health, and well-being. The natural environment encompasses and permeates all other spheres of influence on health. Reviews of the natural environment and health literature have tended, at times intentionally, to focus on a limited subset of ecosystem services as well as health benefits stemming from the presence, and access and exposure to, green infrastructure. The sweeping influence of green infrastructure on the myriad ecosystem services essential to health has therefore often been underrepresented. This survey of the literature aims to provide a more comprehensive picture-in the form of a primer-of the many simultaneously acting health co-benefits of green infrastructure. It is hoped that a more accurately exhaustive list of benefits will not only instigate further research into the health co-benefits of green infrastructure but also promote consilience in the many fields, including public health, that must be involved in the landscape conservation necessary to protect and improve health and well-being. PMID:26295249

  4. [Effectiveness of health examinations by occupational health services].

    PubMed

    Sauni, Riitta; Leino, Timo

    2016-01-01

    Health examinations are part of the activities of occupational health services in preventing diseases and promoting occupational health. Their aim is to protect workers from health risks on one hand but also to promote the worker's own resources and health in order to maintain their capacity for work. Initiation of preventive, corrective and rehabilitative measures and those directed toward the workplace is attempted at the earliest possible stage. When interpreting the examination data it is in fact important to recognize whether it is the effectiveness of the health examination visit or the subsequent procedures that is being evaluated. PMID:26939488

  5. Diabetes and Adult Day Health Services

    ERIC Educational Resources Information Center

    Dabelko, Holly I.; DeCoster, Vaughn A.

    2007-01-01

    The purpose of this study is to provide a profile of individuals with diabetes who receive services in adult day centers. This exploratory study uses an administrative data set (N = 280) from five programs in central Ohio to examine four areas: demographics, health and mental health, financial and social resources, and disenrollment status. Older…

  6. Mental Health Services for Children and Adolescents.

    ERIC Educational Resources Information Center

    Rotheram-Borus, Mary Jane

    This article reviews the progress made in meeting United States' existing mental health goals for adolescents, and identifies issues that will have to be considered in setting new goals. The article examines the substantial need for child mental health services, particularly among young, socioeconomically disadvantaged youth. The unmet need for…

  7. Challenging Heterosexism in College Health Service Delivery.

    ERIC Educational Resources Information Center

    McKee, Michael B.; And Others

    1994-01-01

    Explores how HIV/AIDS, substance abuse, violence and hate crimes, suicide, and heterosexism all adversely affect the physical and emotional health of nonheterosexual college students. College health services must assume a leadership role in combatting all forms of oppression by actively incorporating and addressing the unique needs of…

  8. Adolescent health services and contraceptive use.

    PubMed

    Mudd, E H; Dickens, H O; García, C R; Rickels, K; Freeman, E; Huggins, G R; Logan, J J

    1978-07-01

    A pilot study of a health services program for never-pregnant high-school students, which stresses development of incentives for personal involvement in their own health care, reports a low incidence of unintended pregnancy among girls who requested contraceptives. The social and emotional characteristics of those who continued contraceptive use are compared with the small group who had uninteneded pregnancies. PMID:677283

  9. Health Services and Rural America.

    ERIC Educational Resources Information Center

    Rural Housing Alliance, Washington, DC.

    Rural people lose more days of school and work due to illness than do urban people; have higher infant mortality rates, and have more work-related injuries, all of which are aggravated by lack of access to or even the absence of medical services. Lack of doctors is the most glaring problem (in 1973 there were 138 U.S. counties which had no…

  10. Auditing the standard of anaesthesia care in obstetric units.

    PubMed

    Mörch-Siddall, J; Corbitt, N; Bryson, M R

    2001-04-01

    We undertook an audit of 15 obstetric units in the north of England over a 10-month period to ascertain to what extent they conformed to the Obstetric Anaesthetists' Association 'Recommended Minimum Standards for Obstetric Anaesthetic Services' using a quality assurance approach. We demonstrated that all units conformed to the majority of standards but did not conform in at least one major and minor area. PMID:15321622

  11. 45 CFR 1308.18 - Disabilities/health services coordination.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 4 2013-10-01 2013-10-01 false Disabilities/health services coordination. 1308.18... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... DISABILITIES Health Services Performance Standards § 1308.18 Disabilities/health services coordination. (a)...

  12. 45 CFR 1308.18 - Disabilities/health services coordination.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 4 2014-10-01 2014-10-01 false Disabilities/health services coordination. 1308.18... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... DISABILITIES Health Services Performance Standards § 1308.18 Disabilities/health services coordination. (a)...

  13. 45 CFR 1308.18 - Disabilities/health services coordination.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 45 Public Welfare 4 2012-10-01 2012-10-01 false Disabilities/health services coordination. 1308.18... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... DISABILITIES Health Services Performance Standards § 1308.18 Disabilities/health services coordination. (a)...

  14. 45 CFR 1308.18 - Disabilities/health services coordination.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Disabilities/health services coordination. 1308.18... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... DISABILITIES Health Services Performance Standards § 1308.18 Disabilities/health services coordination. (a)...

  15. 45 CFR 1308.18 - Disabilities/health services coordination.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Disabilities/health services coordination. 1308.18... DEVELOPMENT SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND... DISABILITIES Health Services Performance Standards § 1308.18 Disabilities/health services coordination. (a)...

  16. [Quality assurance in occupational health services].

    PubMed

    Michalak, J

    1996-01-01

    The general conditions influencing the quality assurance and audit in Polish occupational health services are presented. The factors promoting or hampering the implementation of quality assurance and audits are also discussed. The major influence on the transformation of Polish occupational health services in exorted by employers who are committed to cover the costs of the obligatory prophylactic examination of their employees. This is the factor which also contributes to the improvement of quality if services. The definitions of the most important terms are reviewed to highlight their accordance with the needs of occupational health services in Poland. The examples of audit are presented and the elements of selected methods of auditing are suggested to be adopted in Poland. PMID:8760511

  17. Setting standards for primary health services.

    PubMed

    Garner, P; Thomason, J

    1993-10-01

    Clear performance guidelines, appropriate resources, supportive supervision, and appropriate training are needed to help primary health workers to uphold high-quality care. The Ministry of Health in Papua New Guinea and authorities of provincial health divisions have developed minimum standards for all levels of the primary health service, which supervisors use to monitor the performance of workers. These levels are aidposts with 1 community health worker, aidposts with 2 community health workers, health subcenters, health centers, and urban clinics. The standards are part of the National Health Plan. They form the basis for developing a national quality assurance plan. These standards allow health workers to understand what they need to do and supervisors to know on what to focus. They also allow the monitoring of quality care and rational planning. They guard against inappropriate health infrastructure development in areas where local politicians are active in sectoral investments. Some examples of standards for the first level of primary health services are: An orderly or a community health worker at an aidpost provides basic care for a population of 500-1000 people. The community health worker provides outpatient care each working day from 8 to 1300 hours. He/she needs to be available to provide care of acute minor illnesses evenings from 18 to 2000 hours and on call for serious illness at all times. The community health worker follows up on mothers and children seen at the maternal and child health clinic. He/she promotes family planning and provides oral contraceptives an injections. Each aidpost must have an outpatient treatment area suitable for conducting child clinics and patient examinations: sink; water supply; pharmacy; and sterilizer. The community health worker's house must have a tin roof, an external tank, and a latrine. PMID:8273154

  18. Sustaining an Aboriginal mental health service partnership.

    PubMed

    Fuller, Jeffrey D; Martinez, Lee; Muyambi, Kuda; Verran, Kathy; Ryan, Bronwyn; Klee, Ruth

    2005-11-21

    The Regional Aboriginal Integrated Social and Emotional (RAISE) Wellbeing program commenced in February 2003 as an Aboriginal mental health service partnership between one Aboriginal Health Service and three mainstream services: a community mental health team, a hospital mental health liaison, and an "outback" community counselling service. A case study method was used to describe the drivers (incentives for program development), linkage processes (structures and activities through which the partnership operated), and sustainability of the program. Program drivers were longstanding problems with Aboriginal peoples' access to mental health care, policy direction favouring shared service responsibility, and a relatively small amount of new funding for mental health that allowed the program to commence. Linkage processes were the important personal relationships between key individuals. Developing the program as a part of routine practice within and across the partner organisations is now needed through formal agreements, common care-management tools, and training. The program's sustainability will depend on this development occurring, as well as better collection and use of data to communicate the value of the program and support calls for adequate recurrent funds. The development of care-management tools, training and data systems will require a longer period of start-up funding as well as some external expertise. PMID:16296956

  19. Alcoholism treatment service systems: a health services research perspective.

    PubMed Central

    Wallen, J

    1988-01-01

    This article examines the role of health services research in alcoholism treatment. Alcoholism services research has only recently emerged as a self-defined discipline. Alcoholism services research can be grouped into five classifications: a) descriptive studies of resources for alcoholism treatment and of the use or cost of these services, b) estimates of the need or demand for alcohol services in the population or in particular subpopulations, c) studies of the costs or cost-effectiveness of alcoholism treatment or of alternative treatments, d) studies of the possible "cost-offsets" of treating alcoholism, and e) studies that examine strategies for financing and reimbursement for alcoholism treatment. Research is needed to determine how alcoholism treatment services are now delivered, who uses these services, how treatment setting and organization affect service delivery, who pays for alcoholism treatment, and how reimbursement policies affect the delivery of alcoholism services. Research on large-scale social issues is also needed, such as the effects of warning labels appearing on alcoholic beverage containers or estimates of the overall cost to society of alcohol abuse. PMID:3141954

  20. [Marketing mix in health service].

    PubMed

    Ameri, Cinzia; Fiorini, Fulvio

    2015-01-01

    The marketing mix is the combination of the marketing variables that a firm employs with the purpose to achieve the expected volume of business within its market. In the sale of goods, four variables compose the marketing mix (4 Ps): Product, Price, Point of sale and Promotion. In the case of providing services, three further elements play a role: Personnel, Physical Evidence and Processes (7 Ps). The marketing mix must be addressed to the consumers as well as to the employees of the providing firm. Furthermore, it must be interpreted as employees ability to satisfy customers (interactive marketing). PMID:26093140

  1. [The German occupation and health services].

    PubMed

    Gogstad, A C

    1990-12-10

    It was of considerable importance for the German occupants and their Norwegian collaborators, and for the Resistance Movement, to maintain a satisfactory status of health in the civilian population. Thus it was of common interest to keep the health services intact. Health aspects were also important elements of the nazi ideology. Recent studies of German archives reveal that the German civilian administration, Reichskommissariat, played a central role in the nazi revolution of the health services. But certain disagreements arose at an early stage between the German and Norwegian occupation administration concerning strategies of health policy. The collaborator party, Nasjonal Samling, tried to gain control over the professional organizations, but met great resistance. The Norwegian Medical Association lost 85% of its members and was reduced to an appendix of the Ministry. However, the health services were still kept under strict German control. A deterioration of the health services took place from 1944, mainly due to lack of resources because of increased German military needs. PMID:2281452

  2. Strategic service quality management for health care.

    PubMed

    Anderson, E A; Zwelling, L A

    1996-01-01

    Quality management has become one of the most important and most debated topics within the service sector. This is especially true for health care, as the controversy rages on how the existing American system should be restructured. Health care reform aimed at reducing costs and ensuring access to all Americans cannot be allowed to jeopardize the quality of care. As such, total quality management (TQM) has become a vital ingredient to strategic planning within the health care domain. At the heart of any such quality improvement effort is the issue of measurement. TQM cannot be effectively utilized as a competitive weapon unless quality can be accurately defined, measured, evaluated, and monitored over time. Through such analysis a hospital can elect how to expend its limited resources toward those quality improvement projects which will impact customer perceptions of service quality the most. Thus, the purpose of this report is to establish a framework by which to approach the issue of quality measurement, delineate the various components of quality that exist in health care, and explore how these elements affect one another. We propose that the issue of quality measurement in health care be approached as an integration of service quality attributes common to other service organizations and technical quality attributes unique to health care. We hope that this research will serve as a first step toward the synthesis of the various quality attributes inherent in the health care domain and encourage other researchers to address the interactions of the various quality attributes. PMID:8763215

  3. School Mental Health Resources and Adolescent Mental Health Service Use

    ERIC Educational Resources Information Center

    Green, Jennifer Greif; McLaughlin, Katie A.; Alegria, Margarita; Costello, E. Jane; Gruber, Michael J.; Hoagwood, Kimberly; Leaf, Philip J.; Olin, Serene; Sampson, Nancy A.; Kessler, Ronald C.

    2013-01-01

    Objective: Although schools are identified as critical for detecting youth mental disorders, little is known about whether the number of mental health providers and types of resources that they offer influence student mental health service use. Such information could inform the development and allocation of appropriate school-based resources to…

  4. Family socio-demographic factors and maternal obstetric factors influencing appropriate health-care seeking behaviours for newborn jaundice in Sagamu, Nigeria.

    PubMed

    Ogunlesi, Tinuade A; Ogunlesi, Funmilayo B

    2012-04-01

    Poor care-seeking behaviour of families may be responsible for the high prevalence of complications of newborn jaundice in the developing world. To examine the influence of family socio-demographic characteristics and maternal obstetric factors on health care-seeking behaviours for newborn jaundice and the inter-relationship between this behavior and severity of newborn jaundice. Mothers whose babies were referred to a Nigerian tertiary hospital with jaundice were studied in a cross-sectional survey for appropriate health-care seeking behaviours as well as the need for exchange transfusion and the occurrence of kernicterus in their babies. Out of 182 mother-baby pairs, 127 (69.8%) mothers recognized jaundice in their infants, 34.1% delayed care for ≥48 h, 40.6% sought medical care in orthodox health facilities while 20.9% did not seek care outside the home. In all, 61.5% mothers administered various medications to jaundiced babies. Appropriate health care-seeking behaviours were recorded among 28.6% mothers. Low maternal education had a significant relationship with delayed health care-seeking and the use of home remedies for newborn jaundice. A significantly higher proportion of babies who had home remedies had delayed care. Delayed care for ≥48 h was also significantly associated with high Total Serum Bilirubin on admission, higher requirement for exchange transfusion and higher occurrence of kernicterus. Intensive health education of families may help improve their health care-seeking behaviours for neonatal jaundice. PMID:21365297

  5. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health...

  6. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home health...

  7. Reproductive and Obstetric Factors Are Key Predictors of Maternal Anemia during Pregnancy in Ethiopia: Evidence from Demographic and Health Survey (2011)

    PubMed Central

    Alemu, Taddese; Umeta, Melaku

    2015-01-01

    Anemia is a major public health problem worldwide. In Ethiopia, a nationally representative and consistent evidence is lacking on the prevalence and determinants during pregnancy. We conducted an in-depth analysis of demographic and health survey for the year 2011 which is a representative data collected from all regions in Ethiopia. Considering maternal anemia as an outcome variable, predicting variables from sociodemographic, household, and reproductive/obstetric characteristics were identified for analyses. Logistic regression model was applied to identify predictors at P < 0.05. The prevalence of anemia among pregnant women was 23%. Maternal age, region, pregnancy trimester, number of under five children, previous history of abortion (termination of pregnancy), breastfeeding practices, and number of antenatal care visits were key independent predictors of anemia during pregnancy. In conclusion, the level of anemia during pregnancy is a moderate public health problem in Ethiopia. Yet, special preventive measures should be undertaken for pregnant women who are older in age and having too many under five children and previous history of abortion. Further evidence is expected to be generated concerning why pregnant mothers from the eastern part of the country and those with better access to radio disproportionately develop anemia more than their counterparts. PMID:26417454

  8. Leadership and the UK health service.

    PubMed

    Goodwin, N

    2000-02-01

    This paper explores future leadership requirements for health services in the context of relevant leadership theory and the changing environment for health services in the UK. The output of leadership research is both prolific and confusing and its applicability to health services management uncertain especially in the context of constraints on the strategic managerial behaviour and choices of public service managers. The introduction of general management to the UK NHS in the 1980s, followed by an internal market for health care in 1990 should have provided the opportunity for managers to work differently and to create personal space for leadership. However, it is not known whether sustainable , new ways of leadership working have emerged although it is reasonable to hypothesis from studies elsewhere that a number of contextual and behavioural leadership models are likely to be found in the NHS. Although management researchers have explored networking and referred to the impact of the external environment of leadership, insufficient importance has been attached to-date to the impact of future trends in health services on the leadership of change in the health sector. The paper argues that in future health services leadership will require much more than traditional networking with other organizations and groups and will need to focus on developing and securing external agreement to an agenda for positive change turning the apparent constraints of the external environment, determined primarily by government policies,into opportunities. In other words, the demands of external or contextual leadership will increase forcing a stronger focus on having to achieve change through others. PMID:11010225

  9. Public health capacity in the provision of health care services.

    PubMed

    Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

    2015-12-01

    In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services. PMID:24687803

  10. MEDICAL CARE AND PUBLIC HEALTH SERVICES

    PubMed Central

    Emerson, Haven

    1952-01-01

    Medical care applies to the individual, and public health to the community. One is the concentrated application of diagnosis and treatment for the life, the comfort of a patient, and includes guidance in health as for motherhood, infancy, childhood and old age. Public health services, provided by the community through its local government and the local department of health, are concerned with the prevention of diseases of all kinds. Some are controlled by sanitary authority, but the majority of preventable diseases are dealt with by public health education. It is not the function of the health department to treat the sick. The family physicians, the hospitals and dispensaries provide for medical care. Medical care of the sick and public health protection are two parallel activities to make use of medical science, one for treatment, the other for prevention of disease. PMID:13009462

  11. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 2 2012-07-01 2012-07-01 false Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  12. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 2 2011-07-01 2007-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  13. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 41 Public Contracts and Property Management 2 2014-07-01 2012-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  14. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 41 Public Contracts and Property Management 2 2010-07-01 2010-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  15. 41 CFR 101-5.307 - Public Health Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 2 2013-07-01 2012-07-01 true Public Health Service... AND COMPLEXES 5.3-Federal Employee Health Services § 101-5.307 Public Health Service. (a) The only authorized contact point for assistance of and consultation with the Public Health Service is the...

  16. Occupational stress in health service employees.

    PubMed

    Rees, D W; Cooper, C L

    1990-11-01

    Levels of occupational stress were examined in 383 employees of various occupations in one health district, as a preliminary to devising a strategy to reduce the negative effects of stress in the workplace. In comparison with white collar and professional workers in industry, health workers reported significantly greater pressure at work, higher ratings of physical and mental ill health, lower job satisfaction, less internal control over their working environment but used more coping strategies. Approximately one in eight of the subjects has stress symptoms of equal magnitude to patients attending clinical psychology outpatient clinics. It was also found that job satisfaction and psychosomatic ill health were related to sickness absence amongst health employees. The implications of these findings and the consequent challenges facing health service managers are discussed. PMID:10125073

  17. Obstetric ultrasound simulation.

    PubMed

    Nitsche, Joshua F; Brost, Brian C

    2013-06-01

    Obstetric ultrasound is becoming an increasingly important part of the practice of maternal-fetal medicine. Thus, it is important to develop rigorous and effective training curricula for obstetrics and gynecology residents and maternal-fetal medicine fellows. Traditionally, this training has come almost entirely from exposure to ultrasound in the clinical setting. However, with the increased complexity of modern ultrasound and advent of duty-hour restrictions, a purely clinical training model is no longer viable. With the advent of high-fidelity obstetric ultrasound simulators, a significant amount of training can occur in a non-clinical setting which allows learners to obtain significant skill prior to their first patient ultrasound encounter and obtain proficiency in a shorter period of time. In this manuscript we discuss the available obstetric ultrasound simulators and ways to construct a comprehensive ultrasound training curricula to meet the increasing demands of modern maternal-fetal medicine. PMID:23721777

  18. Essential Concepts in Modern Health Services

    PubMed Central

    El Taguri, A

    2008-01-01

    Health services have the functions to define community health problems, to identify unmet needs and survey the resources to meet them, to establish SMART objectives, and to project administrative actions to accomplish the purpose of proposed action programs. For maximum efficacy, health systems should rely on newer approaches of management as management-by-objectives, risk-management, and performance management with full and equal participation from professionals and consumers. The public should be well informed about their needs and what is expected from them to improve their health. Inefficient use of budget allocated to health services should be prevented by tools like performance management and clinical governance. Data processed to information and intelligence is needed to deal with changing disease patterns and to encourage policies that could manage with the complex feedback system of health. e-health solutions should be instituted to increase effectiveness and improve efficiency and informing human resources and populations. Suitable legislations should be introduced including those that ensure coordination between different sectors. Competent workforce should be given the opportunity to receive lifetime appropriate adequate training. External continuous evaluation using appropriate indicators is vital. Actions should be done both inside and outside the health sector to monitor changes and overcome constraints. PMID:21499457

  19. Health services reforms in revolutionary Nicaragua.

    PubMed Central

    Garfield, R M; Taboada, E

    1984-01-01

    Before the Nicaraguan revolution of 1979, access to health services was largely limited to the affluent sectors of the urban population and the minority of workers with social security coverage. Repeated attempts at reform by organized medicine were ineffective. Since the revolution, a tremendous expansion in health services has occurred. The national health system receives approximately one-third of its funds from the social security system. Steadily increasing equity in access is a result of the promotion of primary care, health campaigns involving up to 10 per cent of the general population as volunteers, the use of paramedical aides, and foreign assistance. Private practice nevertheless remains strong. In the coming years, several complex issues must be examined, including: a balance in the number of nurses and doctors trained, the role of private practice, and the relationship of the Ministry of Health to the social security system. Further progress in health reforms may be delayed by the defensive war which Nicaragua is fighting on its northern and southern borders. Despite emergent health problems in the war zones, most of the innovative aspects of the health system remain intact as of this writing. PMID:6476169

  20. Obstetric life support.

    PubMed

    Puck, Andrea Lorraine; Oakeson, Ann Marie; Morales-Clark, Ana; Druzin, Maurice

    2012-01-01

    The death of a woman during pregnancy is devastating. Although the incidence of maternal cardiac arrest is increasing, it continues to be a comparatively rare event. Obstetric healthcare providers may go through their entire career without participating in a maternal cardiac resuscitation. Concern has been raised that when an arrest does occur in the obstetric unit, providers who are trained in life support skills at 2-year intervals are ill equipped to provide the best possible care. The quality of resuscitation skills provided during cardiopulmonary arrest of inpatients often may be poor, and knowledge of critical steps to be followed during resuscitation may not be retained after life support training. The Obstetric Life Support (ObLS) training program is a method of obstetric nursing and medical staff training that is relevant, comprehensive, and cost-effective. It takes into consideration both the care needs of the obstetric patient and the adult learning needs of providers. The ObLS program brings obstetric nurses, obstetricians, and anesthesiologists together in multidisciplinary team training that is crucial to developing efficient emergency response. PMID:22551860

  1. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... for a supplemental health service provided an enrollee who is a full-time student at an accredited... 42 Public Health 3 2011-10-01 2011-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND...

  2. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home...

  3. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home...

  4. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  5. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS,...

  6. 42 CFR 417.104 - Payment for basic health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Payment for basic health services. 417.104 Section 417.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL PLANS,...

  7. 42 CFR 417.105 - Payment for supplemental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for supplemental health services. 417.105 Section 417.105 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  8. 42 CFR 417.104 - Payment for basic health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Payment for basic health services. 417.104 Section 417.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  9. 42 CFR 424.22 - Requirements for home health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Requirements for home health services. 424.22 Section 424.22 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN... Requirements § 424.22 Requirements for home health services. Medicare Part A or Part B pays for home...

  10. 42 CFR 417.104 - Payment for basic health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Payment for basic health services. 417.104 Section 417.104 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  11. Public Private Partnerships for Emergency Obstetric Care: Lessons from Maharashtra

    PubMed Central

    Chaturvedi, Sarika; Randive, Bharat

    2011-01-01

    Background: The National Rural Health Mission of India advocates public private partnerships (PPPs) to meet its “service guarantee” of Emergency obstetric care (EmOC) provision. The Janani Suraksha Yojana (JSY) has a provision of Rs. 1500 for contracting in obstetric specialists. Objectives: The study aimed to understand the issues in the design and implementation of the PPPs for EmOC under the JSY in Maharashtra and how they affect the availability of EmOC services to women. Materials and Methods: A cross-sectional study using the rapid assessment approach was conducted in Ahmednagar district of Maharashtra spanning 1-year duration ending in June 2009. Primary data were obtained through interviews with women, providers, and administrators at various levels. Data were analyzed thematically. Results: The PPP scheme for EmOC is restricted to deliveries by Caesarean section.The administrators prefer subsidization of costs for services in private facilities to contracting in. There are no PPPs executed in the study district. This study identifies barriers to women in accessing the benefit and the difficulties faced by administrators in implementing the scheme. Conclusion: The PPPs for EmOC under the JSY have minimally influenced the out-of-pocket payments for EmOC. Infrastructural inadequacies and passive support of the implementers are major barriers to the implementation of contracting-in model of PPPs. Capacities in the public health system are inadequate to design and manage PPPs. PMID:21687376

  12. 78 FR 46352 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Announcement of Requirements and Registration for ``Care Counts: Educating Women and Families Challenge'' AGENCY: Health Resources and...

  13. Department of Health and Human Services, Office for Civil Rights

    MedlinePlus

    ... Civil Rights Search U.S. Department of Health & Human Services Search Close HHS A-Z Index About Us ... to participate in certain health care and human services programs without unlawful discrimination. HIPAA - Health Information Privacy ...

  14. Public Service Announcement: Your Guide to Better Health Series

    MedlinePlus

    ... of the U.S. Department of Health and Human Services. Visit the Your Guide Series Web site at: ... 592-8573. U.S. Department of Health and Human Services National Institutes of Health National Heart, Lung and ...

  15. The obstetric consequences of female genital mutilation/cutting: a systematic review and meta-analysis.

    PubMed

    Berg, Rigmor C; Underland, Vigdis

    2013-01-01

    Various forms of female genital mutilation/cutting (FGM/C) have been performed for millennia and continue to be prevalent in parts of Africa. Although the health consequences following FGM/C have been broadly investigated, divergent study results have called into question whether FGM/C is associated with obstetric consequences. To clarify the present state of empirical research, we conducted a systematic review of the scientific literature and quantitative meta-analyses of the obstetric consequences of FGM/C. We included 44 primary studies, of which 28 were comparative, involving almost 3 million participants. The methodological study quality was generally low, but several studies reported the same outcome and were sufficiently similar to warrant pooling of effect sizes in meta-analyses. The meta-analyses results showed that prolonged labor, obstetric lacerations, instrumental delivery, obstetric hemorrhage, and difficult delivery are markedly associated with FGM/C, indicating that FGM/C is a factor in their occurrence and significantly increases the risk of delivery complications. There was no significant difference in risk with respect to cesarean section and episiotomy. These results can make up the background documentation for health promotion and health care decisions that inform work to reduce the prevalence of FGM/C and improve the quality of services related to the consequences of FGM/C. PMID:23878544

  16. Validation of Health Services Careers Curriculum Manual.

    ERIC Educational Resources Information Center

    Stone, Sheila D.

    This report is the result of a field test of "Health Service Careers" curriculum materials developed and published by the Curriculum and Instructional Materials Center, Oklahoma State Department of Vocational Technical Education. The results and conclusions reported in the study relate to student achievement and teacher evaluations and comments.…

  17. Electronic Health Record Application Support Service Enablers.

    PubMed

    Neofytou, M S; Neokleous, K; Aristodemou, A; Constantinou, I; Antoniou, Z; Schiza, E C; Pattichis, C S; Schizas, C N

    2015-08-01

    There is a huge need for open source software solutions in the healthcare domain, given the flexibility, interoperability and resource savings characteristics they offer. In this context, this paper presents the development of three open source libraries - Specific Enablers (SEs) for eHealth applications that were developed under the European project titled "Future Internet Social and Technological Alignment Research" (FI-STAR) funded under the "Future Internet Public Private Partnership" (FI-PPP) program. The three SEs developed under the Electronic Health Record Application Support Service Enablers (EHR-EN) correspond to: a) an Electronic Health Record enabler (EHR SE), b) a patient summary enabler based on the EU project "European patient Summary Open Source services" (epSOS SE) supporting patient mobility and the offering of interoperable services, and c) a Picture Archiving and Communications System (PACS) enabler (PACS SE) based on the dcm4che open source system for the support of medical imaging functionality. The EHR SE follows the HL7 Clinical Document Architecture (CDA) V2.0 and supports the Integrating the Healthcare Enterprise (IHE) profiles (recently awarded in Connectathon 2015). These three FI-STAR platform enablers are designed to facilitate the deployment of innovative applications and value added services in the health care sector. They can be downloaded from the FI-STAR cataloque website. Work in progress focuses in the validation and evaluation scenarios for the proving and demonstration of the usability, applicability and adaptability of the proposed enablers. PMID:26736531

  18. Who killed the English National Health Service?

    PubMed Central

    Powell, Martin

    2015-01-01

    The death of the English National Health Service (NHS) has been pronounced many times over the years, but the time and cause of death and the murder weapon remains to be fully established. This article reviews some of these claims, and asks for clearer criteria and evidence to be presented. PMID:25905477

  19. School-Based Health Services: Administrative Rules.

    ERIC Educational Resources Information Center

    Oregon State Dept. of Human Resources, Salem.

    This manual outlines the State of Oregon's program to reimburse medical providers furnishing health services to students with medical disabilities in special education settings. The program was established to comply with federal provisions of the Individuals with Disabilities Education Act of 1990. The guide will assist school personnel in…

  20. Problem solving in health services organizations.

    PubMed

    Rakich, J S; Krigline, A B

    1996-01-01

    Health services organization managers at all levels are constantly confronted with problems. Conditions encountered that initiate the need for problem solving are opportunity, threat, crisis, deviation, and improvement. A general problem-solving model presenting an orderly process by which managers can approach this important task is described. An example of the model applied to the current strategic climate is presented. PMID:10158720

  1. Women's health centers and specialized services.

    PubMed

    LaFleur, E K; Taylor, S L

    1996-01-01

    More than 75% of the female respondents in this study would choose a women's health center (WHC) over a standard health facility. Women who worked outside the home perceived a greater WHC need. And almost all respondents were interested in communications from the center via a quarterly newsletter. Significant test results related to age, income, education, and work status as segmentation variables, offering WHC's an opportunity to target their patients with specialized services such as cosmetic surgery, infertility treatment, breast imaging, etc. If enough resources are allocated, a WHC can design itself to attract highly lucrative patients. Little difference was found in the opinions of women regarding the need for a WHC or the core services desired, but the specific service mix decision must be carefully considered when designing a WHC. PMID:10163055

  2. Marketing service guarantees for health care.

    PubMed

    Levy, J S

    1999-01-01

    The author introduces the concept of service guarantees for application in health care and differentiates between explicit, implicit, and conditional vs. unconditional types of guarantees. An example of an unconditional guarantee of satisfaction is provided by the hospitality industry. Firms conveying an implicit guarantee are those with outstanding reputations for products such as luxury automobiles, or ultimate customer service, like Nordstrom. Federal Express and Domino's Pizza offer explicit guarantees of on-time delivery. Taking this concept into efforts to improve health care delivery involves a number of caveats. Customers invited to use exceptional service cards may use these to record either satisfaction or dissatisfaction. The cards need to provide enough specific information about issues so that "immediate action could be taken to improve processes." Front-line employees should be empowered to respond to complaints in a meaningful way to resolve the problem before the client leaves the premises. PMID:10711165

  3. Mental health services--the user's view.

    PubMed Central

    Campbell, P

    1993-01-01

    The needs of people with serious mental illnesses have dominated much of the debate on reforming community care. In this article Peter Campbell, who has used mental health services many times in the past, explains how the reforms could affect people like him. He welcomes the thinking behind the changes, particularly the idea that people who use community care should take part in planning services, but he warns that implementing the new philosophy might prove very difficult. Mr Campbell is secretary of a voluntary organisation for users of mental health services called Survivors Speak Out. The views he expresses here are his own, and do not necessarily reflect those of Survivors Speak Out. Images p849-a p850-a PMID:8490382

  4. 77 FR 8330 - Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-14

    ... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting... Committee Act) that various subcommittees of the Health Services Research and Development Service Scientific... applications involving the measurement and evaluation of health care services, the testing of new methods...

  5. The Effect of Maternal Health Beliefs on Utilization of Childhood Preventive Health Services and Child Health.

    ERIC Educational Resources Information Center

    Tinsley, Barbara J.

    Relationships among mothers' beliefs and values concerning their children's health, utilization of childhood preventive health services, and children's health status were examined. Mothers' health beliefs were measured with Parental Health Belief scales developed to explore three factors: (1) mothers' degree of perceived control or internality…

  6. Organisation for Change: The British National Health Service.

    ERIC Educational Resources Information Center

    Chester, T. E.

    Begun in 1948, The National Health Service was organized in a "functional" pattern of three main groups: hospital service, primary health care, and community health services and personal social services. Dissatisfaction led to a reorganization in 1974 along geographical divisions for region, area, and district levels, necessitating a managing…

  7. Understanding privacy in occupational health services.

    PubMed

    Heikkinen, Anne; Wickström, Gustav; Leino-Kilpi, Helena

    2006-09-01

    The aim of this study was to gain a deeper understanding of privacy in occupational health services. Data were collected through in-depth theme interviews with occupational health professionals (n = 15), employees (n = 15) and employers (n = 14). Our findings indicate that privacy, in this context, is a complex and multilayered concept, and that companies as well as individual employees have their own core secrets. Co-operation between the three groups proved challenging: occupational health professionals have to consider carefully in which situations and how much they are entitled to release private information on individual employees for the benefit of the whole company. Privacy is thus not an absolute right of an individual, but involves the idea of sharing responsibility. The findings open up useful new perspectives on ethical questions of privacy and on the development of occupational health practices. PMID:16961115

  8. Health services at the Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.

    1992-01-01

    Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.

  9. HIV-Related Illnesses: Topics for Health Services Research.

    ERIC Educational Resources Information Center

    National Center for Health Services Research and Health Care Technology Assessment (DHHS/PHS), Rockville, MD.

    Topics addressed in this report were suggested at a meeting of staff from the National Center for Health Services Research and Health Care Technology Assessment (NCHSR) and other Public Health Service representatives held in 1988 to update the Public Health Service's plan for the prevention and control of human immunodeficiency virus (HIV).…

  10. 43 CFR 17.250 - Health, welfare, and social services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 43 Public Lands: Interior 1 2013-10-01 2013-10-01 false Health, welfare, and social services. 17... § 17.250 Health, welfare, and social services. This subpart applies to health, welfare, and other...) General. In providing health, welfare, or other social services or benefits, a recipient may not, on...

  11. 43 CFR 17.250 - Health, welfare, and social services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Health, welfare, and social services. 17... § 17.250 Health, welfare, and social services. This subpart applies to health, welfare, and other...) General. In providing health, welfare, or other social services or benefits, a recipient may not, on...

  12. 43 CFR 17.250 - Health, welfare, and social services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Health, welfare, and social services. 17... § 17.250 Health, welfare, and social services. This subpart applies to health, welfare, and other...) General. In providing health, welfare, or other social services or benefits, a recipient may not, on...

  13. 43 CFR 17.250 - Health, welfare, and social services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 43 Public Lands: Interior 1 2012-10-01 2011-10-01 true Health, welfare, and social services. 17... § 17.250 Health, welfare, and social services. This subpart applies to health, welfare, and other...) General. In providing health, welfare, or other social services or benefits, a recipient may not, on...

  14. The organization of health services for Indian people.

    PubMed Central

    Rhoades, E R; Reyes, L L; Buzzard, G D

    1987-01-01

    The Indian Health Service (IHS) is a bureau of the Health Resources and Services Administration, an agency of the Public Health Service. It was formed in 1955 by a transfer of health services from the Bureau of Indian Affairs, Department of the Interior. Since that time, IHS has grown larger and more complicated and has become a truly complex national organization that is responsible for direct and contract health care services to approximately 1 million Indian people. The historical background of the Service, its present organization, and the services that it provides through a variety of organizational structures are outlined in this report. PMID:3112842

  15. [Universal coverage of health services in Mexico].

    PubMed

    2013-01-01

    The reforms made in recent years to the Mexican Health System have reduced inequities in the health care of the population, but have been insufficient to solve all the problems of the MHS. In order to make the right to health protection established in the Constitution a reality for every citizen, Mexico must warrant effective universal access to health services. This paper outlines a long-term reform for the consolidation of a health system that is akin to international standards and which may establish the structural conditions to reduce coverage inequity. This reform is based on a "structured pluralism" intended to avoid both a monopoly exercised within the public sector and fragmentation in the private sector, and to prevent falling into the extremes of authoritarian procedures or an absence of regulation. This involves the replacement of the present vertical integration and segregation of social groups by a horizontal organization with separation of duties. This also entails legal and fiscal reforms, the reinforcement of the MHS, the reorganization of health institutions, and the formulation of regulatory, technical and financial instruments to operationalize the proposed scheme with the objective of rendering the human right to health fully effective for the Mexican people. PMID:24570037

  16. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS,...

  17. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS,...

  18. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  19. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE ORGANIZATIONS,...

  20. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 3 2013-10-01 2013-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE...

  1. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 3 2011-10-01 2011-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  2. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 3 2012-10-01 2012-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE...

  3. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE...

  4. 42 CFR 417.101 - Health benefits plan: Basic health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 3 2010-10-01 2010-10-01 false Health benefits plan: Basic health services. 417.101 Section 417.101 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM HEALTH MAINTENANCE ORGANIZATIONS, COMPETITIVE MEDICAL...

  5. 42 CFR 417.102 - Health benefits plan: Supplemental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 3 2014-10-01 2014-10-01 false Health benefits plan: Supplemental health services. 417.102 Section 417.102 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICARE PROGRAM (CONTINUED) HEALTH MAINTENANCE...

  6. Obstetrical data management systems.

    PubMed

    1997-03-01

    Obstetrical data management systems (OBDMSs) are computer systems designed to interface with fetal and maternal monitors. This allows monitoring and charting records to be created and maintained electronically and to be viewed from centralized workstations. In theory, these systems could eliminate paper record keeping from the obstetrics department altogether, although currently at least some paper documentation, such as fetal monitoring strips, is being kept. We evaluated five OBDMSs, one of which is no longer on the market and which we did not rate. Of the remaining systems, three were rated Acceptable; the fourth was rated Acceptable-Not Recommended because it lacks several important features and functions. This Evaluation also includes a Technology Overview, in which we discuss how OBDMSs function. The Overview incorporates a supplementary article, "Obstetrical Care Monitoring and Documentation," describing the monitoring and documentation typically performed during a pregnancy. And in the Selection and Use Guide, we discuss issues involved in choosing, purchasing, and implementing an OBDMS. PMID:9067726

  7. Women workers in the health service industry.

    PubMed

    Brown, C A

    1975-01-01

    The health service industry is unusual in that most of the skilled as well as unskilled workers are women, although the industry is largely controlled by men. Women are hired because they constitute an inexpensive, available, and seemingly powerless work force. Women enter health service because they have few alternatives to the low-paying, dead-end jobs found there. Health service occupations are organized like craft unions, with rigid hierarchical separations and control by the top occupation. Conflicts between men and women-between management and workers-are often played out as conflicts between occupations. Challenges to physicians come from various nursing specialties as well as from technical professions. Physicians in turn create lower-level occupations which challenge the nurses' status. Increasing industrialization alters the pattern of conflict, creating opportunities for individual bureaucratic mobility as well as favorable conditions for unionization drives. Unionism is often held back by sex, race, and professional conflicts, which must be overcome if the status of women is to be changed in the industry. PMID:1181296

  8. Information Technology in Complex Health Services

    PubMed Central

    Southon, Frank Charles Gray; Sauer, Chris; Dampney, Christopher Noel Grant (Kit)

    1997-01-01

    Abstract Objective: To identify impediments to the successful transfer and implementation of packaged information systems through large, divisionalized health services. Design: A case analysis of the failure of an implementation of a critical application in the Public Health System of the State of New South Wales, Australia, was carried out. This application had been proven in the United States environment. Measurements: Interviews involving over 60 staff at all levels of the service were undertaken by a team of three. The interviews were recorded and analyzed for key themes, and the results were shared and compared to enable a continuing critical assessment. Results: Two components of the transfer of the system were considered: the transfer from a different environment, and the diffusion throughout a large, divisionalized organization. The analyses were based on the Scott-Morton organizational fit framework. In relation to the first, it was found that there was a lack of fit in the business environments and strategies, organizational structures and strategy-structure pairing as well as the management process-roles pairing. The diffusion process experienced problems because of the lack of fit in the strategy-structure, strategy-structure-management processes, and strategy-structure-role relationships. Conclusion: The large-scale developments of integrated health services present great challenges to the efficient and reliable implementation of information technology, especially in large, divisionalized organizations. There is a need to take a more sophisticated approach to understanding the complexities of organizational factors than has traditionally been the case. PMID:9067877

  9. Methicillin-resistant Staphylococcus aureus in obstetrics.

    PubMed

    Sheffield, Jeanne S

    2013-02-01

    Methicillin-resistant Staphylococcus aureus (MRSA) remains one of the major multiple antibiotic-resistant bacterial pathogens causing serious community-associated and health care-associated infections. It is now pervasive in the obstetric population associated with skin and soft tissue infections, mastitis, episiotomy, and cesarean wound infections and urinary tract infections. This review addresses the epidemiology, definitions, microbiology, and pathogenesis as well as common clinical presentations. A discussion of the 2011 Infectious Diseases Society of America MRSA treatment guidelines details available antibiotics, invasive and noninvasive MRSA management, and specific factors related to obstetrics. Finally, prevention strategies including decolonization are discussed. PMID:23292915

  10. Home health services in New Hampshire.

    PubMed

    Hale, F A; Jacobs, A R

    1976-01-01

    While home health services have traditionally been an underused component of the health care system, current trends suggest the desirability of expanding these services. These trends include an increase in the number of elderly who need the benefits of home care, the recognition that long-term chronic illnesses require appropriate management at home, and concern that patients have access to care at the level most appropriate to their illnesses. In New Hampshire, 41 certified home health agencies offer services. Little systematic research has been conducted on the kinds of services they provide and the patients seen by their staffs. Patient encounter data were collected from a sample of eight agencies for a 4-week period. Staff of the agencies used the patient contact record developed by the National Functional Task Analysis Cooperative Study to collect data. The data reflected differences among the agencies in the size of the populations they serve, organizational characteristics, reasons for patients' visits, expected sources of the revenue that supported them, and the diagnosis of the patients they cared for. The agencies served areas with populations ranging from 1,000 to 40,000. The staffs ranged from 1 to 14 full-time persons. Two were public agencies; the others had voluntary sponsorship. When data on reasons for visits were averaged for the eight agencies, it was shown that 72% of the visits were made for disease control activities such as care for a chronic or acute condition or for treatment or a laboratory test. Disease prevention activities such as a checkup for adults, children, prenatal or postnatal care, or health education accounted for only 24% of the visits. This result may indicate that, in areas short of physician manpower, the community health nurse is taking on increasing responsibility for medical care as well as health and education. Reimbursement for the visits came from Medicare, 25%; Medicaid-welfare, 14%; the patients, 18%; and health

  11. 45 CFR 147.130 - Coverage of preventive health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 45 Public Welfare 1 2014-10-01 2014-10-01 false Coverage of preventive health services. 147.130 Section 147.130 Public Welfare Department of Health and Human Services REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE MARKETS § 147.130 Coverage of preventive...

  12. 45 CFR 147.130 - Coverage of preventive health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Coverage of preventive health services. 147.130 Section 147.130 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES REQUIREMENTS RELATING TO HEALTH CARE ACCESS HEALTH INSURANCE REFORM REQUIREMENTS FOR THE GROUP AND INDIVIDUAL HEALTH INSURANCE...

  13. Providers' Perceptions of Challenges in Obstetrical Care for Somali Women

    PubMed Central

    Lazar, Jalana N.; Johnson-Agbakwu, Crista E.; Davis, Olga I.; Shipp, Michele P.-L.

    2013-01-01

    Background. This pilot study explored health care providers' perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers' experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter for both patients and providers entails establishing effective dialogue, enhancing clinical and cultural training of providers, improving health literacy, and developing trust through community engagement. PMID:24223041

  14. Managing diversity in health services organizations.

    PubMed

    Muller, H J; Haase, B E

    1994-01-01

    The changing ethnic, racial, and gender workforce characteristics require innovations in management philosophy and practice. Valuing employees' differences is believed to be a competitive advantage in many modern corporations. This article offers recommendations to health care managers for rethinking and improving the management of their heterogeneous workforces. A conceptual framework and evaluative criteria are developed in an attempt to better understand the factors that influence effective diversity management. The experiences of health services institutions in the Southwest (already a multicultural region) are studied to illustrate various approaches to diversity management. Leader philosophy and support, organizational policies and programs, workforce composition, structural integration, and organizational type constitute the main elements in this study. As the nation debates restructuring the health industry, it should also take the opportunity to integrate a management philosophy that values diversity and its practice. PMID:10138715

  15. The impact of health insurance on health services utilization and health outcomes in Vietnam.

    PubMed

    Guindon, G Emmanuel

    2014-10-01

    In recent years, a number of low- and middle-income country governments have introduced health insurance schemes. Yet not a great deal is known about the impact of such policy shifts. Vietnam's recent health insurance experience including a health insurance scheme for the poor in 2003 and a compulsory scheme that provides health insurance to all children under six years of age combined with Vietnam's commitment to universal coverage calls for research that examines the impact of health insurance. Taking advantage of Vietnam's unique policy environment, data from the 2002, 2004 and 2006 waves of the Vietnam Household Living Standard Survey and single-difference and difference-in-differences approaches are used to assess whether access to health insurance--for the poor, for children and for students--impacts on health services utilization and health outcomes in Vietnam. For the poor and for students, results suggest health insurance increased the use of inpatient services but not of outpatient services or health outcomes. For young children, results suggest health insurance increased the use of outpatient services (including the use of preventive health services such as vaccination and check-up) but not of inpatient services. PMID:24661805

  16. Health Service Utilization and Poor Health Reporting in Asthma Patients

    PubMed Central

    Behr, Joshua G.; Diaz, Rafael; Akpinar-Elci, Muge

    2016-01-01

    The management and treatment of adult asthma has been associated with utilization of health services. Objectives: First, to investigate the likelihood of health service utilization, including primary care, emergency department, and hospital stays, among persons diagnosed with an asthma condition relative to those that do not have an asthma condition. Second, to examine the likelihood of poor physical health among asthma respondents relative to those that do not have an asthma condition. Third, to demonstrate that these relationships vary with frequency of utilization. Fourth, to discuss the magnitude of differences in frequent utilization between asthma and non-asthma respondents. Data Source: Data is derived from a random, stratified sampling of Hampton Roads adults, 18 years and older (n = 1678). Study Design: Study participants are interviewed to identify asthma diagnosis, access to primary care, frequency of emergency department utilization, hospital admissions, and days of poor physical health. Odds-ratios establish relationships with the covariates on the outcome variable. Findings: Those with asthma are found more likely (OR 1.50, 95% CI 1.05–2.15) to report poor physical health relative to non-asthma study participants. Further, asthma respondents are found more likely (OR 4.23, 95% CI 1.56–11.69) to frequently utilize primary care that may be associated with the management of the condition and are also more likely to utilize treatment services, such as the emergency department (OR 1.87, 95% CI 1.32–2.65) and hospitalization (OR 2.21, 95% CI 1.39–3.50), associated with acute and episodic care. Further, it is a novel finding that these likelihoods increase with frequency of utilization for emergency department visits and hospital stays. Conclusion: Continuity in care and better management of the diseases may result in less demand for emergency department services and hospitalization. Health care systems need to recognize that asthma patients are

  17. Quality Assurance for Social Service Programs: Lessons from Health Care.

    ERIC Educational Resources Information Center

    Coulton, Claudia J.

    1982-01-01

    Suggests that many aspects of quality assurance in health care can be applied to social service agencies. Reviews what has been learned about quality assurance in health care and suggests guidelines for its implementation in social services. (Author/JAC)

  18. Access to Rural Mental Health Services: Service Use and Out-of-Pocket Costs

    ERIC Educational Resources Information Center

    Ziller, Erika C.; Anderson, Nathaniel J.; Coburn, Andrew F.

    2010-01-01

    Purpose: To examine rural-urban differences in the use of mental health services (mental health and substance abuse office visits, and mental health prescriptions) and in the out-of-pocket costs paid for these services. Methods: The pooled 2003 and 2004 Medical Expenditure Panel Surveys were used to assess differences in mental health service use…

  19. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health...

  20. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 2 2011-10-01 2011-10-01 false Payment for rural health clinic and Federally... AND DISABLED Rural Health Clinic and Federally Qualified Health Center Services Payment for Rural Health Clinic and Federally Qualified Health Center Services § 405.2462 Payment for rural health...

  1. CORBA security services for health information systems.

    PubMed

    Blobel, B; Holena, M

    1998-01-01

    The structure of healthcare systems in developed countries is changing to 'shared care', enforced by economic constraints and caused by a change in the basic conditions of care. That development results in co-operative health information systems across the boundaries of organisational, technological, and policy domains. Increasingly, these distributed and, as far as their domains are concerned, heterogeneous systems are based on middleware approaches, such as CORBA. Regarding the sensitivity of personal and medical data, such open, distributed, and heterogeneous health information systems require a high level of data protection and data security, both with respect to patient information and with respect to users. This paper, relying on experience gained through our activities in CORBAmed, describes the possibilities the CORBA middleware provides to achieve application and communication security. On the background of the overall CORBA architecture, it outlines the different security services previewed in the adopted CORBA specifications which are discussed in the context of the security requirements of healthcare information systems. Security services required in the healthcare domain but not available at the moment are mentioned. A solution is proposed, which on the one hand allows to make use of the available CORBA security services and additional ones, on the other hand remains open to other middleware approaches, such as DHE or HL7. PMID:9848400

  2. Dysfunctional health service conflict: causes and accelerants.

    PubMed

    Nelson, H Wayne

    2012-01-01

    This article examines the causes and accelerants of dysfunctional health service conflict and how it emerges from the health system's core hierarchical structures, specialized roles, participant psychodynamics, culture, and values. This article sets out to answer whether health care conflict is more widespread and intense than in other settings and if it is, why? To this end, health care power, gender, and educational status gaps are examined with an eye to how they undermine open communication, teamwork, and collaborative forms of conflict and spark a range of dysfunctions, including a pervasive culture of fear; the deny-and-defend lawsuit response; widespread patterns of hierarchical, generational, and lateral bullying; overly avoidant conflict styles among non-elite groups; and a range of other behaviors that lead to numerous human resource problems, including burnout, higher staff turnover, increased errors, poor employee citizenship behavior, patient dissatisfaction, increased patient complaints, and lawsuits. Bad patient outcomes include decreased compliance and increased morbidity and mortality. Health care managers must understand the root causes of these problems to treat them at the source and implement solutions that avoid negative conflict spirals that undermine organizational morale and efficiency. PMID:22534973

  3. Marital Distress and Mental Health Care Service Utilization

    ERIC Educational Resources Information Center

    Schonbrun, Yael Chatav; Whisman, Mark A.

    2010-01-01

    Objective: This study was designed to evaluate the association between marital distress and mental health service utilization in a population-based sample of men and women (N = 1,601). Method: The association between marital distress and mental health care service utilization was evaluated for overall mental health service utilization and for…

  4. Practice Makes Perfect and Other Myths about Mental Health Services.

    ERIC Educational Resources Information Center

    Bickman, Leonard

    1999-01-01

    Examines forces motivating reform in mental health services, suggesting that mental health practitioners and researchers have relied on traditional and apparently unsuccessful methods (with little or no scientific support) to ensure service quality and effectiveness; debunking six myths about mental health services; and suggesting that…

  5. Health Services Research: Work Force and Educational Issues.

    ERIC Educational Resources Information Center

    Field, Marilyn J., Ed.; And Others

    Health services research is a multidisciplinary field that investigates the structure, processes, and effects of health care services. This report focuses on one part of the field of health services research--its work force and its programs for educating and training that work force. This study undertook the following information collection…

  6. 75 FR 21508 - Health and Human Services Acquisition Regulation; Corrections

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-26

    ... HUMAN SERVICES 48 CFR Chapter 3 Health and Human Services Acquisition Regulation; Corrections AGENCY: Department of Health and Human Services. ACTION: Correcting amendments. SUMMARY: This action corrects minor errors, inconsistencies and omissions in the final rule, which revised the Health and Human...

  7. 38 CFR 18.452 - Health and other social services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Health and other social... Social Services § 18.452 Health and other social services. (a) General. In providing health, or other social services or benefits, a recipient may not, on the basis of handicap: (1) Deny a...

  8. 43 CFR 17.250 - Health, welfare, and social services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 43 Public Lands: Interior 1 2014-10-01 2014-10-01 false Health, welfare, and social services. 17... § 17.250 Health, welfare, and social services. This subpart applies to health, welfare, and other social service programs or activities that receive Federal financial assistance and to recipients...

  9. 19 CFR 4.70 - Public Health Service requirements.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 19 Customs Duties 1 2014-04-01 2014-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  10. 19 CFR 4.70 - Public Health Service requirements.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 1 2013-04-01 2013-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  11. 38 CFR 3.753 - Public Health Service.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  12. 38 CFR 3.753 - Public Health Service.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  13. 38 CFR 3.753 - Public Health Service.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  14. 19 CFR 4.70 - Public Health Service requirements.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 1 2011-04-01 2011-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  15. 78 FR 2229 - Health and Human Services Acquisition Regulation

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-10

    ... From the Federal Register Online via the Government Publishing Office ] DEPARTMENT OF HEALTH AND HUMAN SERVICES 48 CFR Parts 327 and 352 RIN 0991-AB87 Health and Human Services Acquisition Regulation AGENCY: Department of Health and Human Services; Office of the Assistant Secretary for...

  16. 38 CFR 3.753 - Public Health Service.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  17. 19 CFR 4.70 - Public Health Service requirements.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 1 2012-04-01 2012-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  18. 38 CFR 3.753 - Public Health Service.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Public Health Service. 3... Pension, Compensation, and Dependency and Indemnity Compensation Retirement § 3.753 Public Health Service... of the Public Health Service, who was receiving disability compensation on December 31, 1956,...

  19. 19 CFR 4.70 - Public Health Service requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 1 2010-04-01 2010-04-01 false Public Health Service requirements. 4.70 Section 4... THE TREASURY VESSELS IN FOREIGN AND DOMESTIC TRADES Foreign Clearances § 4.70 Public Health Service... Public Health Service....

  20. Immunization Services for Adolescents within Comprehensive School Health Programs.

    ERIC Educational Resources Information Center

    Vernon, Mary E.; Bryan, Gloria; Hunt, Pete; Allensworth, Diane; Bradley, Beverly

    1997-01-01

    Discusses school health services, adolescent immunization, current school immunization practices, and support for school-based immunization programs. Children and adolescents can receive preventive health services, including immunizations and monitoring of immunization levels. Expanding school health services could improve the immunization levels…

  1. The Unmet Need for Mental Health Services among Probationers' Children

    ERIC Educational Resources Information Center

    Phillips, Susan D.; Venema, Rachel; Roque, Lorena

    2010-01-01

    This study explores the unmet need for mental health services among children with parents on probation. A group of 77 probationers provided information on 170 children. Information about children's need for mental health services was based on the Child Behavior Checklist and information about children's receipt of mental health services was based…

  2. 77 FR 62243 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-12

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration National Advisory Council on the National Health Service Corps Notice of Meeting In accordance with section 10(a)(2) of the Federal...

  3. 38 CFR 18.452 - Health and other social services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Health and other social... Social Services § 18.452 Health and other social services. (a) General. In providing health, or other social services or benefits, a recipient may not, on the basis of handicap: (1) Deny a...

  4. Public Health Service report on fluoride benefits and risks

    SciTech Connect

    Not Available

    1991-06-14

    This report, Public Health Service Report on Fluoride Benefits and Risks is a summary of the findings, conclusions, and recommendations of Review of Fluoride Benefits and Risks: Report of the Ad Hoc Subcommittee on Fluoride of the Committee to Coordinate Environmental Health and Related Programs, published in February 1991. The full report was prepared by an ad hoc subcommittee of the United States Public Health Service's Committee to Coordinate Environmental Health and Related Programs (CCEHRP) at the request of the Assistant Secretary for Health. The full report can be obtained from the Public Health Service, Department of Health and Human Services.

  5. Progressive segmented health insurance: Colombian health reform and access to health services.

    PubMed

    Ruiz, Fernando; Amaya, Liliana; Venegas, Stella

    2007-01-01

    Equal access for poor populations to health services is a comprehensive objective for any health reform. The Colombian health reform addressed this issue through a segmented progressive social health insurance approach. The strategy was to assure universal coverage expanding the population covered through payroll linked insurance, and implementing a subsidized insurance program for the poorest populations, those not affiliated through formal employment. A prospective study was performed to follow-up health service utilization and out-of-pocket expenses using a cohort design. It was representative of four Colombian cities (Cendex Health Services Use and Expenditure Study, 2001). A four part econometric model was applied. The model related medical service utilization and medication with different socioeconomic, geographic, and risk associated variables. Results showed that subsidized health insurance improves health service utilization and reduces the financial burden for the poorest, as compared to those non-insured. Other social health insurance schemes preserved high utilization with variable out-of-pocket expenditures. Family and age conditions have significant effect on medical service utilization. Geographic variables play a significant role in hospital inpatient service utilization. Both, geographic and income variables also have significant impact on out-of-pocket expenses. Projected utilization rates and a simulation favor a dual policy for two-stage income segmented insurance to progress towards the universal insurance goal. PMID:16929487

  6. Qualitative Methods in Mental Health Services Research

    PubMed Central

    Palinkas, Lawrence A.

    2014-01-01

    Qualitative and mixed methods play a prominent role in mental health services research. However, the standards for their use are not always evident, especially for those not trained in such methods. This paper reviews the rationale and common approaches to using qualitative and mixed methods in mental health services and implementation research based on a review of the papers included in this special series along with representative examples from the literature. Qualitative methods are used to provide a “thick description” or depth of understanding to complement breadth of understanding afforded by quantitative methods, elicit the perspective of those being studied, explore issues that have not been well studied, develop conceptual theories or test hypotheses, or evaluate the process of a phenomenon or intervention. Qualitative methods adhere to many of the same principles of scientific rigor as quantitative methods, but often differ with respect to study design, data collection and data analysis strategies. For instance, participants for qualitative studies are usually sampled purposefully rather than at random and the design usually reflects an iterative process alternating between data collection and analysis. The most common techniques for data collection are individual semi-structured interviews, focus groups, document reviews, and participant observation. Strategies for analysis are usually inductive, based on principles of grounded theory or phenomenology. Qualitative methods are also used in combination with quantitative methods in mixed method designs for convergence, complementarity, expansion, development, and sampling. Rigorously applied qualitative methods offer great potential in contributing to the scientific foundation of mental health services research. PMID:25350675

  7. Function Model for Community Health Service Information

    NASA Astrophysics Data System (ADS)

    Yang, Peng; Pan, Feng; Liu, Danhong; Xu, Yongyong

    In order to construct a function model of community health service (CHS) information for development of CHS information management system, Integration Definition for Function Modeling (IDEF0), an IEEE standard which is extended from Structured Analysis and Design(SADT) and now is a widely used function modeling method, was used to classifying its information from top to bottom. The contents of every level of the model were described and coded. Then function model for CHS information, which includes 4 super-classes, 15 classes and 28 sub-classed of business function, 43 business processes and 168 business activities, was established. This model can facilitate information management system development and workflow refinement.

  8. Prohemostatic interventions in obstetric hemorrhage.

    PubMed

    Bonnet, Marie-Pierre; Basso, Olga

    2012-04-01

    Obstetric hemorrhage is a major cause of maternal morbidity and mortality. Pregnancy is associated with substantial hemostatic changes, resulting in a relatively hypercoagulable state. Acquired coagulopathy can, however, develop rapidly in severe obstetric hemorrhage. Therefore, prohemostatic treatments based on high fresh frozen plasma and red blood cell (FFP:RBC) ratio transfusion and procoagulant agents (fibrinogen concentrates, recombinant activated factor VII, and tranexamic acid) are crucial aspects of management. Often, evidence from trauma patients is applied to obstetric hemorrhage management, although distinct differences exist between the two situations. Therefore, until efficacy and safety are demonstrated in obstetric hemorrhage, clinicians should be cautious about wholesale adoption of high FFP:RBC ratio products. Applications of transfusion protocols, dedicated to massive obstetric hemorrhage and multidisciplinarily developed, currently remain the best available option. Similarly, while procoagulant agents appear promising in treatment of obstetric hemorrhage, caution is nonetheless warranted as long as clear evidence in the context of obstetric hemorrhage is lacking. PMID:22510859

  9. Progress and gaps in reproductive health services in three humanitarian settings: mixed-methods case studies

    PubMed Central

    2015-01-01

    Background Reproductive health (RH) care is an essential component of humanitarian response. Women and girls living in humanitarian settings often face high maternal mortality and are vulnerable to unwanted pregnancy, unsafe abortion, and sexual violence. This study explored the availability and quality of, and access barriers to RH services in three humanitarian settings in Burkina Faso, Democratic Republic of the Congo (DRC), and South Sudan. Methods Data collection was conducted between July and October 2013. In total, 63 purposively selected health facilities were assessed: 28 in Burkina Faso, 25 in DRC, and nine in South Sudan, and 42 providers completed a questionnaire to assess RH knowledge and attitudes. Thirty-four focus group discussions were conducted with 29 members of the host communities and 273 displaced married and unmarried women and men to understand access barriers. Results All facilities reported providing some RH services in the prior three months. Five health facilities in Burkina Faso, six in DRC, and none in South Sudan met the criteria as a family planning service delivery point. Two health facilities in Burkina Faso, one in DRC, and two in South Sudan met the criteria as an emergency obstetric and newborn care service delivery point. Across settings, three facilities in DRC adequately provided selected elements of clinical management of rape. Safe abortion was unavailable. Many providers lacked essential knowledge and skills. Focus groups revealed limited knowledge of available RH services and socio-cultural barriers to accessing them, although participants reported a remarkable increase in use of facility-based delivery services. Conclusion Although RH services are being provided, the availability of good quality RH services was inconsistent across settings. Commodity management and security must be prioritized to ensure consistent availability of essential supplies. It is critical to improve the attitudes, managerial and technical

  10. 42 CFR 417.104 - Payment for basic health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... HEALTH CARE PREPAYMENT PLANS Qualified Health Maintenance Organizations: Services § 417.104 Payment for... services, and without substantial utilization by any two components of the same health care facilities. The... the Office of Prepaid Health Care, Division of Qualification Analysis, HHS Cohen Bldg., room 4360,...

  11. 38 CFR 18.452 - Health and other social services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Health and other social...-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 Nondiscrimination on the Basis of Handicap Health and Social Services § 18.452 Health and other social services. (a) General. In providing health, or...

  12. 38 CFR 18.452 - Health and other social services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Health and other social...-EFFECTUATION OF TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 Nondiscrimination on the Basis of Handicap Health and Social Services § 18.452 Health and other social services. (a) General. In providing health, or...

  13. Improving Child Health Services: Lessons Learned from Nine Community Efforts.

    ERIC Educational Resources Information Center

    Hobson, William D.

    One of the major reasons many children do not receive efficient, effective health care is that much of public spending for child health services has been funneled through categorical funding programs. The Child Health Initiative provided an opportunity to learn how different communities would approach improving child health services through…

  14. Development of an obstetric vital sign alert to improve outcomes in acute care obstetrics.

    PubMed

    Behling, Diana J; Renaud, Michelle

    2015-01-01

    Maternal morbidity and mortality is a national health problem. Causal analysis of near-miss and actual serious patient safety events, including those resulting in maternal death, within obstetric units often highlights a failure to promptly recognize and treat women who were exhibiting signs of decompensation/deterioration. The Obstetric Vital Sign Alert (OBVSA) is an early warning tool that leverages discrete data points in the electronic health record, calculating a risk score that is displayed as a visual cue for acute care obstetric staff. When studied in a cohort of women with postpartum hemorrhage, use of the OBVSA reduced symptom-to-response time and intervention time, as well as key process and outcome measures. PMID:25900584

  15. Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers

    PubMed Central

    2014-01-01

    Background Complementary and alternative medicine (CAM) is increasingly included within mainstream integrative healthcare (IHC) services. Health service managers are key stakeholders central to ensuring effective integrative health care services. Yet, little research has specifically investigated the role or perspective of health service managers with regards to integrative health care services under their management. In response, this paper reports findings from an exploratory study focusing exclusively on the perspectives of health service managers of integrative health care services in Australia regarding the role of CAM within their service and the health service managers rational for incorporating CAM into clinical care. Methods Health service managers from seven services were recruited using purposive and snowball sampling. Semi-structured interviews were conducted with the health service managers. The services addressed trauma and chronic conditions and comprised: five community-based programs including drug and alcohol rehabilitation, refugee mental health and women’s health; and two hospital-based specialist services. The CAM practices included in the services investigated included acupuncture, naturopathy, Western herbal medicine and massage. Results Findings reveal that the health service managers in this study understand CAM to enhance the holistic capacity of their service by: filling therapeutic gaps in existing healthcare practices; by treating the whole person; and by increasing healthcare choices. Health service managers also identified CAM as addressing therapeutic gaps through the provision of a mind-body approach in psychological trauma and in chronic disease management treatment. Health service managers describe the addition of CAM in their service as enabling patients who would otherwise not be able to afford CAM to gain access to these treatments thereby increasing healthcare choices. Some health service managers expressly align the notion

  16. Obstetric Provider Trainees in Georgia: Characteristics and Attitudes About Practice in Obstetric Provider Shortage Areas.

    PubMed

    Smulian, Elizabeth A; Zahedi, Leilah; Hurvitz, Julie; Talbot, Abigail; Williams, Audra; Julian, Zoë; Zertuche, Adrienne D; Rochat, Roger

    2016-07-01

    Objectives In Georgia, 52 % of the primary care service areas outside metropolitan Atlanta have a deficit of obstetric providers. This study was designed to identify factors associated with the likelihood of Georgia's obstetric trainees (obstetrics and gynecology (OB/GYN) residents and certified nurse midwifery (CNM) students) to practice in areas of Georgia that lack obstetric providers and services, i.e. rural Georgia. Methods Pilot-tested electronic and paper surveys were distributed to all of Georgia's OB/GYN residents (N = 95) and CNM students (N = 28). Mixed-methods survey questions assessed characteristics, attitudes, and incentives that might be associated with trainee desire to practice in areas of Georgia that lack obstetric providers and services. Surveys also gathered information about concerns that may prevent trainees from practicing in shortage areas. Univariate and bivariate analyses were performed, and qualitative themes were abstracted from open-ended questions. Results The survey response rate was 87.8 % (108/123). Overall, 24.4 % (19/78) of residents and 53.6 % (15/28) of CNM students expressed interest in practicing in rural Georgia, and both residents and CNM students were more likely to desire to practice in rural Georgia with the offer of any of six financial incentives (P < 0.001). Qualitative themes highlighted trainees' strong concerns about Georgia's political environment as it relates to reproductive healthcare. Conclusions Increasing state-level, rurally-focused financial incentive programs and emphasizing the role of CNMs may alleviate obstetric provider shortages in Georgia. PMID:27072048

  17. Characteristics of Telemental Health Service Use by American Indian Veterans

    PubMed Central

    Shore, Jay H.; Brooks, Elizabeth; Anderson, Heather; Bair, Byron; Dailey, Nancy; Kaufmann, L. Jeanne; Manson, Spero

    2016-01-01

    Objective This study examined use by American Indian and Alaska Native veterans of services provided by specialty telemental health clinics focused on posttraumatic stress disorder. These clinics offer services via videoconferencing to address challenges faced by rural veterans in accessing care. Methods A retrospective chart and electronic medical record review was conducted for 85 male veteranswho used services at two rural telemental health clinics in 2006 and 2007. Service use and other characteristics were documented before and after their initial telemental health intake. Results After intake, patients use of any health services (both general medical and mental health services) significantly increased (p<.01), as did the proportion receiving appropriate psychotropic medication (p<.01). Conclusions This first examination of service use by American Indian and Alaska Native veterans at specialty telemental health clinics will help inform research and clinical strategies for improving telemental health for this and other rural populations. PMID:22302338

  18. Strengthening national health systems for improving efficiency of health service delivery in Nepal.

    PubMed

    Shakya, H S; Adhikari, S; Gurung, G; Pant, S; Aryal, S; Singh, A B; Sherpa, M G

    2012-05-01

    The success of Nepal's community-based health programmes in promoting maternal and child health has been achieved due to an overall improvement in service delivery facilities and health support systems. This article assesses the progress made by the Government of Nepal in improving health service delivery by introducing three key components: an improved health logistics management, facility-based maternal and neonatal health services, and decentralized health facility management. PMID:23034370

  19. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services”...

  20. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services”...

  1. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services”...

  2. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services”...

  3. 20 CFR 1002.58 - Is service in the commissioned corps of the Public Health Service considered “service in the...

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... Public Health Service considered âservice in the uniformed services?â 1002.58 Section 1002.58 Employees... commissioned corps of the Public Health Service considered “service in the uniformed services?” Yes. Service in the commissioned corps of the Public Health Service (PHS) is “service in the uniformed services”...

  4. [Supply services at health facilities: measuring performance].

    PubMed

    Dacosta Claro, I

    2001-01-01

    Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals. PMID:11693070

  5. Assessing skilled birth attendants and emergency obstetric care in rural Tanzania: the inadequacy of using global standards and indicators to measure local realities.

    PubMed

    Spangler, Sydney A

    2012-06-01

    Current efforts to reduce maternal mortality and morbidity in low-resource settings often depend on global standards and indicators to assess obstetric care, particularly skilled birth attendants and emergency obstetric care. This paper describes challenges in using these standards to assess obstetric services in the Kilombero Valley of Tanzania. A health facility survey and extensive participant observation showed existing services to be complicated and fluid, involving a wide array of skills, resources, and improvisations. Attempts to measure these services against established standards and indicators were not successful. Some aspects of care were over-valued while others were under-valued, with significant neglect of context and quality. This paper discusses the implications of these findings for ongoing maternal health care efforts in unique and complex settings, questioning the current reliance on generic (and often obscure) archetypes of obstetric care in policy and programming. It suggests that current indicators may be insufficient to assess services in low-resource settings, but not that these settings should settle for lower standards of care. In addition to global benchmarks, assessment approaches that emphasize quality of care and recognize available resources might better account for local realities, leading to more effective, more sustainable service delivery. PMID:22789091

  6. Malpractice Burden, Rural Location, and Discontinuation of Obstetric Care: A Study of Obstetric Providers in Michigan

    ERIC Educational Resources Information Center

    Xu, Xiao; Siefert, Kristine A.; Jacobson, Peter D.; Lori, Jody R.; Gueorguieva, Iana; Ransom, Scott B.

    2009-01-01

    Context: It has long been a concern that professional liability problems disproportionately affect the delivery of obstetrical services to women living in rural areas. Michigan, a state with a large number of rural communities, is considered to be at risk for a medical liability crisis. Purpose: This study examined whether higher malpractice…

  7. Assimilation and health service utilization of Korean immigrant women.

    PubMed

    Son, Juyeon

    2013-11-01

    In this case study, I present descriptive findings with regard to immigrant incorporation and health service utilization. Using focus groups and survey of Korean immigrant women in Wisconsin, I examine whether the ways in which they adapt to the U.S. society is relevant to their health services utilization and the alternatives they seek when available health services are less than satisfactory. The findings suggest that adherence to Korean identity appears to be associated with health service utilization. This is evident in the immigrants' evaluation of the U.S. health services as compared to those of Korea, and the consideration given by these immigrants to seeking health services in Korea instead of the United States. Such concerns on the part of these immigrants have important implications for health researchers, as they highlight the significance of immigrants' transnational experiences and their sense of personal agency in the use of health care. PMID:24108090

  8. Public health nutrition services: issues today and tomorrow.

    PubMed

    Egan, M C

    1980-10-01

    The accomplishments of the past are reviewed in this paper to give public health nutritionists perspective in dealing with the problems of the present and of the future. Positive and negative observations on the current scene in nutrition services follow. Issues and concerns for the future that are discussed are: Defining and planning for public health nutrition services, paying for nutrition services, training for public health nutrition, and advocacy for nutrition services. PMID:6999067

  9. Sexual reproductive health service provision to young people in Kenya; health service providers’ experiences

    PubMed Central

    2013-01-01

    Background Addressing the sexual and reproductive health (SRH) needs of young people remains a challenge for most developing countries. This study explored the perceptions and experiences of Health Service Providers (HSP) in providing SRH services to young people in Kenya. Methods Qualitative study conducted in eight health facilities; five from Nairobi and three rural district hospitals in Laikipia, Meru Central, and Kirinyaga. Nineteen in-depth interviews (IDI) and two focus group discussions (FGD) were conducted with HSPs. Interviews were tape recorded and transcribed. Data was coded and analysed using the thematic framework approach. Results The majority of HSPs were aware of the youth friendly service (YFS) concept but not of the supporting national policies and guidelines. HSP felt they lacked competency in providing SRH services to young people especially regarding counselling and interpersonal communication. HSPs were conservative with regards to providing SRH services to young people particularly contraception. HSP reported being torn between personal feelings, cultural and religious values and beliefs and their wish to respect young people’s rights to accessing and obtaining SRH services. Conclusion Supporting youth friendly policies and competency based training of HSP are two common approaches used to improve SRH services for adolescents. However, these may not be sufficient to change HSPs’ attitude to adolescents seeking help. There is need to address the cultural, religious and traditional value systems that prevent HSPs from providing good quality and comprehensive SRH services to young people. Training updates should include sessions that enable HSPs to evaluate how their personal and cultural values and beliefs influence practice. PMID:24229365

  10. 75 FR 39734 - Health Services Research and Development Service Merit Review Board; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-07-12

    ... AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting The...) that a meeting of the Health Services Research and Development Service Merit Review Board will be held... cover administrative matters and to discuss the general status of the program. The remaining portion...

  11. 78 FR 12422 - Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-22

    ... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board, Notice of Meeting... States Code Appendix 2, that the Health Services Research and Development Service Scientific Merit Review Board will conduct telephone conference call and web-conference based meetings of its six...

  12. Obstetric antiphospholipid syndrome.

    PubMed

    Galarza-Maldonado, Claudio; Kourilovitch, Maria R; Pérez-Fernández, Oscar M; Gaybor, Mariana; Cordero, Christian; Cabrera, Sonia; Soroka, Nikolai F

    2012-02-01

    Antiphospholipid syndrome (APS) in pregnancy has a serious impact on maternal and fetal morbidity. It causes recurrent pregnancy miscarriage and it is associated with other adverse obstetric findings like preterm delivery, intrauterine growth restriction, preeclampsia, HELLP syndrome and others. The 2006 revised criteria, which is still valid, is used for APS classification. Epidemiology of obstetric APS varies from one population group to another largely due to different inclusion criteria and lack of standardization of antibody detection methods. Treatment is still controversial. This topic should include a multidisciplinary team and should be individualized. Success here is based on strict control and monitoring throughout pregnancy and even in the preconception and postpartum periods. Further research in this field and unification of criteria are required to yield better therapeutic strategies in the future. PMID:22001418

  13. Cell Salvage in Obstetrics.

    PubMed

    Goucher, Haley; Wong, Cynthia A; Patel, Samir K; Toledo, Paloma

    2015-08-01

    Intraoperative cell salvage is a strategy to decrease the need for allogeneic blood transfusion. Traditionally, cell salvage has been avoided in the obstetric population because of the perceived risk of amniotic fluid embolism or induction of maternal alloimmunization. With advances in cell salvage technology, the risks of cell salvage in the obstetric population parallel those in the general population. Levels of fetal squamous cells in salvaged blood are comparable to those in maternal venous blood at the time of placental separation. No definite cases of amniotic fluid embolism have been reported and appear unlikely with modern equipment. Cell salvage is cost-effective in patients with predictably high rates of transfusion, such as parturients with abnormal placentation. PMID:26197375

  14. Obstetric (nonfetal) complications.

    PubMed

    Shanbhogue, Alampady K P; Menias, Christine O; Lalwani, Neeraj; Lall, Chandana; Khandelwal, Ashish; Nagar, Arpit

    2013-11-01

    Pregnancy predisposes women to a wide array of obstetric and gynecological complications which are often complex, challenging and sometimes life-threatening. While some of these are unique to pregnancy, a few that occur in nonpregnant women are more common during pregnancy. Imaging plays a crucial role in the diagnosis and management of pregnancy-related obstetric and gynecologic complications. Ultrasonography and magnetic resonance imaging confer the least risk to the fetus and should be the preferred examinations for evaluating these complications. Multidetector computed tomography should be used after carefully weighing the risk-benefit ratio based on the clinical condition in question. Interventional radiology is emerging as a preferred, noninvasive or minimally invasive treatment option that can obviate surgery and its antecedent short term and long term complications. Knowledge of appropriateness of imaging and image guided intervention is necessary for accurate patient management. PMID:24210440

  15. Blood transfusion in obstetrics.

    PubMed

    Nigam, A; Prakash, A; Saxena, P

    2013-01-01

    Transfusion of blood and blood components is a common practice in obstetric wards but it is not without risk. The incidence of transfusion reactions varies from 4 in every hundred transfusions for non-haemolytic reactions to one in every 40,000 for haemolytic transfusion reactions. The physiological basis of blood transfusion is outlined in this article. Most of the donated blood is processed into components: packed red cells (PRBCs), platelets, and fresh frozen plasma (FFP) or cryoprecipitate. Various alternatives to blood transfusion exist and include autotransfusion, pre-autologous blood storage, use of oxygen carrying blood substitutes and intraoperative cell salvage. Despite the risks associated with transfusions, obstetricians are frequently too aggressive in transfusing blood and blood products to their patients. Acute blood loss in obstetrics is usually due to placenta praevia, postpartum blood loss and surgery related. An early involvement of a consultant obstetrician, anaesthetist, haematologist and the blood bank is essential. There are no established criteria for initiating red cell transfusions and the decision is purely based on clinical and haematological parameters, which have been discussed along with the general principles of blood transfusion in obstetrics and some practical guidelines. PMID:24899337

  16. Coordination between Child Welfare Agencies and Mental Health Service Providers, Children's Service Use, and Outcomes

    ERIC Educational Resources Information Center

    Bai, Yu; Wells, Rebecca; Hillemeier, Marianne M.

    2009-01-01

    Objective: Interorganizational relationships (IORs) between child welfare agencies and mental health service providers may facilitate mental health treatment access for vulnerable children. This study investigates whether IORs are associated with greater use of mental health services and improvement in mental health status for children served by…

  17. Innovations in Mental Health Services to Disaster Victims.

    ERIC Educational Resources Information Center

    Lystad, Mary, Ed.

    This monograph was developed to provide mental health and other service delivery workers with an overview of conceptual, programmatic, and educational developments in mental health services to disaster victims over the past 10 years. It was written primarily for national policymakers, administrators, and service providers of disaster relief…

  18. Mental Health Service Providers: College Student Perceptions of Helper Effectiveness

    ERIC Educational Resources Information Center

    Ackerman, Ashley M.; Wantz, Richard A.; Firmin, Michael W; Poindexter, Dawn C.; Pujara, Amita L.

    2014-01-01

    Undergraduate perceptions of the overall effectiveness of six types of mental health service providers (MHSPs) were obtained with a survey. Although many mental health services are available to consumers in the United States, research has indicated that these services are underutilized. Perceptions have been linked to therapeutic outcomes and may…

  19. Risk factors for obstetric fistulae in north-eastern Nigeria.

    PubMed

    Melah, G S; Massa, A A; Yahaya, U R; Bukar, M; Kizaya, D D; El-Nafaty, A U

    2007-11-01

    This prospective comparative study of obstetric fistulae (OF) was aimed at identifying risk factors. A total of 80 obstetric fistulae treated at the gynaecological unit of the FMCG, and 80 inpatients without fistulae recruited randomly as controls formed the basis of this study. Through interview and case record review, information on age, parity and marital status was collected. Other features were educational status, occupation and booking status of the pregnancy that might have led to this condition. The duration of labour, place of birth and mode of delivery, including its outcome were also collected. The data were analysed using the Epi Info. The majority of the patients were Hausa/Fulani 87.5%, Muslims 91.2%, with large vesicovaginal fistulae (average size 5.0 cm) mainly resulting from obstructed labour (93.7%). Major risk factors included early age at first marriage (average 14 years), short stature (average height 146.2 cm) and illiteracy (96.3%). Also low social class and lack of gainful employment were factors. Failure to book for antenatal care (93.7%), and rural place of residence (95%) were also factors associated with acquiring the fistulae. Living far away (>3 km) from a health facility also contributed or predisposed to the development of an obstetric fistula. Social violence and stigma associated with the fistulae included divorce, being ostracised as a social outcast, and lack of assistance from relations in terms of finding and funding treatment. This study supports improved access to basic essential obstetric care, family planning services, and timely referral when and where necessary. Universal education will provide a long-term solution by improving the standard of living and quality of life. Especially important are media- and community-based programmes on the ills of teenage marriage and child pregnancy using cultural and religiously-based values to give sound advice. In a male dominated society, reaching out to men with traditionally

  20. Sex, Kids, and Politics. Health Services in Schools.

    ERIC Educational Resources Information Center

    Emihovich, Catherine; Herrington, Carolyn D.

    This book examines practical, cultural, and political implications of placing health service programs in public schools, detailing three cases of Florida school districts, where a controversial statewide initiative for health services in schools recently went into effect. The plan supports programs to promote the health of medically underserved…

  1. Dementia in Ontario: Prevalence and Health Services Utilization

    ERIC Educational Resources Information Center

    Tranmer, J. E.; Croxford, R.; Coyte, P. C.

    2003-01-01

    To understand the impact of ongoing reform of mental health and dementia care in Ontario, an examination of prevalence and health services utilization rates is needed. However, there exists a gap in current prevalence and health services research specific to dementia care in Ontario. The objective of this study was to address these concerns using…

  2. School Health Services in Wisconsin. Staff Brief 94-7.

    ERIC Educational Resources Information Center

    Wisconsin State Legislative Council, Madison.

    This Staff Brief was prepared for the Joint Legislative Council's Special Committee on School Health Services, which was established to study pupil health services within the public school system. Part 1 provides background information on selected federal initiatives and programs, including a joint statement on school health, and a discussion of…

  3. 20 CFR 638.510 - Health care and services.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 3 2011-04-01 2011-04-01 false Health care and services. 638.510 Section 638... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and...

  4. 20 CFR 638.510 - Health care and services.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 3 2012-04-01 2012-04-01 false Health care and services. 638.510 Section 638... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and...

  5. 20 CFR 638.510 - Health care and services.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Health care and services. 638.510 Section 638... UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.510 Health care and services. The center operator shall provide a health program, including basic medical, dental, and...

  6. 77 FR 76052 - Health Resources and Services Administration

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities... States Code, as amended by the Paperwork Reduction Act of 1995, Public Law 104-13), the Health...

  7. 75 FR 27348 - Public Health Services Act; Delegation of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-14

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Public Health Services Act; Delegation of Authority Notice is hereby given that I have delegated to the Director, Office of Public Health...

  8. National School Health Service Program. Special Report. Number 1, 1985.

    ERIC Educational Resources Information Center

    Robert Wood Johnson Foundation, New Brunswick, NJ.

    A five-year School Health Service demonstration program, sponsored by The Robert Wood Johnson Foundation, tested whether School Nurse Practitioners (SNP's) supported by community physicians could improve children's access to health care by expanding the health services in schools. The program was conducted in 18 school districts in medically…

  9. Federal Program Encourages Health Service Innovations on Developmental Disabilities

    ERIC Educational Resources Information Center

    Nix, Mary P.

    2009-01-01

    There is always room for improvement in the delivery of health services. This article discusses the U.S. Agency for Healthcare Research and Quality's (AHRQ) Health Care Innovations Exchange (www.innovations.ahrq.gov), a comprehensive program that aims to increase awareness of innovative strategies to meet health service delivery challenges and…

  10. The Indian Health Program of the U.S. Public Health Service, 1972.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Washington, DC. Div. of Indian Health.

    The American Indian Health Service (AIHS) is a component of the Department of Health, Education, and Welfare's Health Services and Mental Health Administration. AIHS is responsible to 422,000 Indians belonging to more than 250 tribes and 53,000 Indians living in 300 Alaskan villages. The goal of the AIHS is to raise the health of the Indian and…

  11. 76 FR 52335 - National Advisory Committee on Rural Health and Human Services; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-22

    ... HUMAN SERVICES Health Resources and Services Administration National Advisory Committee on Rural Health... on Rural Health and Human Services, Health Resources and Services Administration, Parklawn Building... recommendations to the Secretary with respect to the delivery, research, development, and administration of...

  12. Community-oriented integrated mental health services

    PubMed Central

    Morris, David

    2014-01-01

    Unprecedented levels of cost containment in NHS and social care organisations – together with integration as a policy priority – make this a key moment for fresh ways of thinking about how to commission and provide community-based integrated services that meet the challenge of local accountability and citizen participation. This is nowhere more important than in mental health. Primary care with its local orientation is properly at the heart of this agenda, but there is a need for new forms of leadership for collaboration in the sector. In this context, the contribution of general practitioner (GP) networks is likely to be fundamental. This paper is a brief discussion of some of the issues associated with GP networks and mental health, set in the context of a round table discussion with three sets of participants at a 2014 London Journal of Primary Care/Royal College of General Practitioners conference. The conference provided a forum for capturing a diversity of experience and knowledge and for turning this into a force for critical transformation. This paper describes a contribution to the day. PMID:25949738

  13. [Consumer health web service at DIMDI].

    PubMed

    Hasky-Günther, K

    2004-10-01

    The German Institute of Medical Documentation and Information (DIMDI) extended its Internet services targeted at patients in order to meet the rising interest of the public for understandable, high-quality medical information. Medical terminology is made clear to nonprofessionals by voluminous reference books such as the Roche Encyclopedia of Medicine. By using free offers, such as the possibilities to search in up-to-date medical literature and studies, laypersons can find valuable and quality assured information on their fields of interest. Graphic and film material, which is offered in the virtual medical video shop (VVFM), covers the en-tire spectrum of specific medical fields and brings the areas of prevention, diagnostics, therapy, aftercare as well as nursing care up for discussion. It is easy to find physicians, hospitals, and self-help groups. Future plans include an extension of the offer to a substantial database-supported information portal for health-related subjects, which will provide the public with simple and speedy access to the health information of the DIM-DI and other trustworthy providers under one interface. PMID:15490083

  14. The prisoner as patient - a health services satisfaction survey

    PubMed Central

    Bjørngaard, Johan Håkon; Rustad, Åse-Bente; Kjelsberg, Ellen

    2009-01-01

    Background There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects. Methods The survey took part in 29 prisons in the southern and central part of Norway, representing 62% of the total prison capacity in Norway. A total of 1,150 prison inmates with prison health services experiences completed a satisfaction questionnaire (90% response rate). The patients' satisfaction was measured on a 12-item index. Multilevel analyses were used to analyze both patient and service characteristics as predictors of satisfaction. Results The study revealed high levels of dissatisfaction with prison health services. There were substantial differences between services, with between-service-variance accounting for 9% of the total variance. Satisfaction was significantly associated with a senior staff member's evaluation of the health services possessing adequate resources and the quality of drug abuse treatment. At the patient level, satisfaction was significantly associated with older age, frequent consultations and better self-perceived health. Conclusion Prison inmates' satisfaction with the health services provided are low compared with patient satisfaction measured in other health areas. The substantial differences observed between services - even when adjusting for several known factors associated with patient satisfaction - indicate a potential for quality improvement. PMID:19785736

  15. Contemporary issues in obstetrics and gynecology for the consultation-liaison psychiatrist.

    PubMed

    Stotland, N L

    1985-10-01

    Medical advances in obstetrics and gynecology, combined with the depersonalization of health care and changes in sexual and reproductive behaviors in the general population, lead to challenging new problems for the psychiatric consultant who deals with reproductive issues. The author describes contemporary issues encountered in consultation-liaison work with the obstetrics and gynecology service in a general hospital. They include the reproductive implications of medical illnesses, the stress of deciding whether to continue a pregnancy known to carry genetic risk, the intrusiveness of certain options for dealing with infertility, parental expectations for a perfect baby, and the difficulties some traditional practitioners have in adapting their practice styles to the changing needs of the patient population. PMID:4054867

  16. Health Services Research and Development: the Veterans Administration Program.

    PubMed Central

    Goldschmidt, P G

    1986-01-01

    Health expenditures are rising inexorably; health status shows relatively little gain; technological possibilities are outstripping our ability or willingness to provide a commensurate level of resources. Clinical and administrative managers face increasingly difficult choices among alternative interventions in attempting to resolve these problems. If health services research is to succeed as a tool for assisting these decisions, clinicians, administrators, and researchers must view it as an integral part of management. This paper describes this concept of health services research and its implementation by the VA HSR&D Service, results from 1981 to date, and future directions. Four programs implement the Service's system to make relevant, valid information accessible to VA staff who can use it to improve veterans' health care: Investigator-Initiated Research (IIR) Program; HSR&D Field Program, which implements the Service's mission in various local areas VA-wide; Special Projects Program, responsive to system-wide issues, including technology assessment and transfer; and Resources Program, the Service's own management system. The Service's impact on improving veterans health care is already apparent. However, the true value of the HSR&D system will become apparent only in the 1990s, after the capacity for conducting health services research has been built and integrated fully with clinical and administrative practice. The VA, the nation's largest health care system, has a unique opportunity to demonstrate how health services research can improve health care. PMID:3081467

  17. Rhetoric and Reality in the English National Health Service

    PubMed Central

    Klein, Rudolf

    2015-01-01

    Despite fiscal stress, public confidence in the National Health Service (NHS) remains strong; privatisation has not hollowed out the service. But if long term challenges are to be overcome, pragmatism not rhetoric should be the guide PMID:26340494

  18. Public Health Services for Foreign Workers in Malaysia.

    PubMed

    Noh, Normah Awang; Wahab, Haris Abd; Bakar Ah, Siti Hajar Abu; Islam, M Rezaul

    2016-01-01

    The objective of this study was to know the status of the foreign workers' access to public health services in Malaysia based on their utilization pattern. The utilization pattern covered a number of areas, such as frequency of using health services, status of using health services, choice and types of health institutions, and cost of health treatment. The study was conducted on six government hospitals in the Klang Valley area in Kuala Lumpur, Malaysia. Data were collected from 600 foreign patients working in the country, using an interview method with a structured questionnaire. The results showed that the foreign workers' access to public health services was very low. The findings would be an important guideline to formulate an effective health service policy for the foreign workers in Malaysia. PMID:27177326

  19. Physical health nurse consultant role to improve physical health in mental health services: A carer's perspective.

    PubMed

    Happell, Brenda; Wilson, Karen; Platania-Phung, Chris; Stanton, Robert

    2016-06-01

    The physical health of people diagnosed with a mental illness is significantly poorer in comparison with the general population. Awareness of this health disparity is increasing; however, strategies to address the problem are limited. Carers play an important role in the physical health care of people with mental illness, particularly in facilitating navigation of and advocating in the health care system. A specialist physical health nurse consultant position has been suggested as a way to address the physical health care disparity and limited research available suggests that positive outcomes are possible. In the present study, a qualitative exploratory research project was undertaken, involving in-depth interviews with people identifying as mental health carers. Two focus groups and one individual interview were conducted involving a total of 13 carers. The resulting data were analyzed thematically. Views and opinions about the proposed physical health nurse consultant (PHNC) position were sought during these interviews and are reported in this paper. Two main sub-themes were evident relating to characteristics of this role: reliability and consistency; and communication and support. Essentially carers expressed a need for support for themselves and consumers in addressing physical health concerns. Successful implementation of this position would require a consistent and reliable approach. Carers are significant stakeholders in the physical health of consumers of mental health services and their active involvement in identifying and tailoring services, including development of the physical health nurse consultant must be seen as a priority. PMID:26876094

  20. Telemental Health Technology in Deaf and General Mental-Health Services: Access and Use

    ERIC Educational Resources Information Center

    Austen, Sally; McGrath, Melissa

    2006-01-01

    Long-distance travel to provide mental health services for deaf people has implications for efficiency, safety, and equality of service. However, uptake of Telemental Health (TMH) has been slow in both deaf and general mental health services. A quantitative study was used to investigate access to TMH and whether staff confidence, experience, or…

  1. 78 FR 6854 - Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    .... App. 2, that the Centers of Innovation subcommittee of the Health Services Research and Development... AFFAIRS Health Services Research and Development Service Scientific Merit Review Board; Notice of Meeting... the Chief Research and Development Officer. During the closed portion of the meeting, discussion...

  2. 75 FR 4453 - Health Services Research and Development Service Merit Review Board; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-27

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Health Services Research and Development Service Merit Review Board; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Health Services Research...

  3. A multidimensional approach to case mix for home health services

    PubMed Central

    Manton, Kenneth G.; Hausner, Tony

    1987-01-01

    Developing a case-mix methodology for home health services is more difficult than developing one for hospitalization and acute health services, because the determinants of need for home health care are more complex and because of the difficulty in defining episodes of care. To evaluate home health service case mix, a multivariate grouping methodology was applied to records from the 1982 National Long-Term Care Survey linked to Medicare records on home health reimbursements. Using this method, six distinct health and functional status dimensions were identified. These dimensions, combined with factors describing informal care resources and local market conditions, were used to explain significant proportions of the variance (r2 = .45) of individual differences in Medicare home health reimbursements and numbers of visits. Though the data were not collected for that purpose, the high level of prediction strongly suggests the feasibility of developing case-mix strategies for home health services. PMID:10312187

  4. Marriage, Cohabitation, and Men's Use of Preventive Health Care Services

    MedlinePlus

    ... NCHS Marriage, Cohabitation, and Men's Use of Preventive Health Care Services Recommend on Facebook Tweet Share Compartir NCHS ... other not-married men to have had a health care visit in the past 12 months. Figure 1. ...

  5. Incorporating Health Services Research into Nursing Doctoral Programs.

    ERIC Educational Resources Information Center

    Jones, Cheryl Bland; Lusk, Sally L.

    2002-01-01

    Offers a rationale for involvement of nursing doctoral programs in health services research, which examines health care delivery. Presents recommendations of the Re-envisioning the Ph.D. project, which identified problems in doctoral programs. (Contains 46 references.) (SK)

  6. Rhetoric and Reality in the English National Health Service Comment on "Who Killed the English National Health Service?".

    PubMed

    Klein, Rudolf

    2015-09-01

    Despite fiscal stress, public confidence in the National Health Service (NHS) remains strong; privatisation has not hollowed out the service. But if long term challenges are to be overcome, pragmatism not rhetoric should be the guide. PMID:26340494

  7. Health Care Delivery Performance: Service, Outcomes, and Resource Stewardship

    PubMed Central

    Cowing, Michelle; Davino-Ramaya, Carrie M; Ramaya, Krishnan; Szmerekovsky, Joseph

    2009-01-01

    As competition intensifies within the health care industry, patient satisfaction and service quality are providing the evidentiary basis for patient outcomes. We propose a conceptual model of three interrelated areas, service, health outcomes, and resource stewardship, all affected by the clinician-patient relationship. Our model considers the perspectives of the health care organization, the clinician, and the patient to define a more comprehensive measure of health care delivery performance. Research and managerial aspects, including implementation, are discussed. PMID:20740107

  8. [Counseling and Guidance in Health Care and Psychological Services.

    ERIC Educational Resources Information Center

    Hubble, Kenneth O.

    A health aide is defined as an individual living in one of the organized living units on campus, employed by the University Health Center, who assists in extending preventive and therapeutic health services to house members. Three major objectives are enumerated: 1) early identification of health problems; 2) environmental control of factors which…

  9. Knowledge of obstetric fistula prevention amongst young women in urban and rural Burkina Faso: a cross-sectional study.

    PubMed

    Banke-Thomas, Aduragbemi O; Kouraogo, Salam F; Siribie, Aboubacar; Taddese, Henock B; Mueller, Judith E

    2013-01-01

    Obstetric fistula is a sequela of complicated labour, which, if untreated, leaves women handicapped and socially excluded. In Burkina Faso, incidence of obstetric fistula is 6/10,000 cases amongst gynaecological patients, with more patients affected in rural areas. This study aims to evaluate knowledge on obstetric fistula among young women in a health district of Burkina Faso, comparing rural and urban communities. This cross-sectional study employed multi-stage sampling to include 121 women aged 18-20 years residing in urban and rural communities of Boromo health district. Descriptive statistics and multiple logistic regression analysis were used to compare differences between the groups and to identify predictors of observed knowledge levels. Rural women were more likely to be married (p<0.000) and had higher propensity to teenage pregnancy (p=0.006). The survey showed overall poor obstetric fistula awareness (36%). Rural residents were less likely to have adequate preventive knowledge than urban residents [OR=0.35 (95%-CI, 0.16-0.79)]. This effect was only slightly explained by lack of education [OR=0.41 (95%-CI, 0.18-0.93)] and only slightly underestimated due to previous pregnancy [OR=0.27 (95%-CI, 0.09-0.79)]. Media were the most popular source of awareness amongst urban young women in contrast to their rural counterparts (68% vs. 23%). Most rural young women became 'aware' through word-of-mouth (68% vs. 14%). All participants agreed that the hospital was safer for emergency obstetric care, but only 11.0% believed they could face pregnancy complications that would require emergency treatment. There is urgent need to increase emphasis on neglected health messages such as the risks of obstetric fistula. In this respect, obstetric fistula prevention programs need to be adapted to local contexts, whether urban or rural, and multi-sectoral efforts need to be exerted to maximise use of other sectoral resources and platforms, including existing routine health

  10. Use of facility assessment data to improve reproductive health service delivery in the Democratic Republic of the Congo

    PubMed Central

    2009-01-01

    Background Prolonged exposure to war has severely impacted the provision of health services in the Democratic Republic of the Congo (DRC). Health infrastructure has been destroyed, health workers have fled and government support to health care services has been made difficult by ongoing conflict. Poor reproductive health (RH) indicators illustrate the effect that the prolonged crisis in DRC has had on the on the reproductive health (RH) of Congolese women. In 2007, with support from the RAISE Initiative, the International Rescue Committee (IRC) and CARE conducted baseline assessments of public hospitals to evaluate their capacities to meet the RH needs of the local populations and to determine availability, utilization and quality of RH services including emergency obstetric care (EmOC) and family planning (FP). Methods Data were collected from facility assessments at nine general referral hospitals in five provinces in the DRC during March, April and November 2007. Interviews, observation and clinical record review were used to assess the general infrastructure, EmOC and FP services provided, and the infection prevention environment in each of the facilities. Results None of the nine hospitals met the criteria for classification as an EmOC facility (either basic or comprehensive). Most facilities lacked any FP services. Shortage of trained staff, essential supplies and medicines and poor infection prevention practices were consistently documented. All facilities had poor systems for routine monitoring of RH services, especially with regard to EmOC. Conclusions Women's lives can be saved and their well-being improved with functioning RH services. As the DRC stabilizes, IRC and CARE in partnership with the local Ministry of Health and other service provision partners are improving RH services by: 1) providing necessary equipment and renovations to health facilities; 2) improving supply management systems; 3) providing comprehensive competency-based training for

  11. Barriers to mental health services utilization in the Niger Delta region of Nigeria: service users’ perspectives

    PubMed Central

    Jack-Ide, Izibeloko Omi; Uys, Leana

    2013-01-01

    Introduction There is only one neuro-psychiatric hospital for over four million people in the Niger Delta region of Nigeria. Low-income groups in urban and rural areas who access care through public mental health clinics are at greater risk of not accessing the needed mental health care. This study aimed to explored barriers that prevent people from utilizing mental health services, and to identifies key factors to increase access and improved service delivery. Methods A qualitative study was conducted among 20 service users attending the outpatient clinic of Rumuigbo neuropsychiatric hospital. Ten participants were caregivers and 10 were clients, both having accessed services for at least one year. Results The mean age was 37.7 years, 60% were males, 40% were unemployed and only 15% had a regular monthly income, while 65% live in rural areas. Barriers observed in mental health services use were physical, financial and cultural. These include absence of service in rural communities, poor knowledge of mental health services, stigma, transportation problems, waiting time at the facility and cost of service. Conclusion Stigma remains a strong barrier to accessing mental health services, and extensive efforts need to be made to overcome ignorance and discrimination. Mental health services need to be provided throughout the health care system to enable people to access them locally and affordably, preventing the need to travel and promoting service uptake and treatment continuation. PMID:23785564

  12. Tuberculosis diagnosis: primary health care or emergency medical services?

    PubMed Central

    Andrade, Rubia Laine de Paula; Scatolin, Beatriz Estuque; Wysocki, Anneliese Domingues; Beraldo, Aline Ale; Monroe, Aline Aparecida; Scatena, Lúcia Marina; Villa, Tereza Cristina Scatena

    2013-01-01

    OBJECTIVE To assess primary health care and emergency medical services performance for tuberculosis diagnosis. METHODS Cross-sectional study were conducted with 90 health professionals from primary health care and 68 from emergency medical services, in Ribeirao Preto, SP, Southeastern Brazil, in 2009. A structured questionnaire based on an instrument of tuberculosis care assessment was used. The association between health service and the variables of structure and process for tuberculosis diagnosis was assessed by Chi-square test, Fisher's exact test (both with 5% of statistical significance) and multiple correspondence analysis. RESULTS Primary health care was associated with the adequate provision of inputs and human resources, as well as with the sputum test request. Emergencial medical services were associated with the availability of X-ray equipment, work overload, human resources turnover, insufficient availability of health professionals, unavailability of sputum collection pots and do not request sputum test. In both services, tuberculosis diagnosis remained as a physician's responsibility. CONCLUSIONS Emergencial medical services presented weaknesses in its structure to identify tuberculosis suspects. Gaps on the process were identified in both primary health care and emergencial medical services. This situation highlights the need for qualification of health services that are the main gateway to health system to meet sector reforms that prioritize the timely diagnosis of tuberculosis and its control. PMID:24626553

  13. The Indian Health Program of the U.S. Public Health Service.

    ERIC Educational Resources Information Center

    Public Health Service (DHEW), Arlington, VA.

    As reported in this publication, about 410,000 Alaskan Indians, Eskimos, and Aleuts receive a full range of curative, preventive, and rehabilitative health services--including hospitalization, outpatient medical care, public health nursing, maternal and child health care, dental and nutrition services, and health education. The U.S. Public Health…

  14. Indian Health Service: A Comprehensive Health Care Program for American Indians and Alaska Natives.

    ERIC Educational Resources Information Center

    Indian Health Service (PHS/HSA), Rockville, MD.

    Comprehensive health care (preventive, curative, rehabilitative, and environmental) for more than 930,000 eligible American Indians and Alaska Natives is the responsibility of the Indian Health Service (IHS). Since 1955, this agency of the U.S. Public Health Service has made notable progress in raising the health status of Indians and Alaska…

  15. Mental Health Services in School-Based Health Centers: Systematic Review

    ERIC Educational Resources Information Center

    Bains, Ranbir Mangat; Diallo, Ana F.

    2016-01-01

    Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

  16. School Health Services for Children with Special Health Care Needs in California

    ERIC Educational Resources Information Center

    Baker, Dian L.; Hebbeler, Kathleen; Davis-Alldritt, Linda; Anderson, Lori S.; Knauer, Heather

    2015-01-01

    Children with special health care needs (CSHCN) are at risk for school failure when their health needs are not met. Current studies have identified a strong connection between school success and health. This study attempted to determine (a) how schools meet the direct service health needs of children and (b) who provides those services. The study…

  17. Accreditation of occupational health services in Norway

    PubMed Central

    Bjørnstad, O.

    2015-01-01

    Background In 2010, an accreditation system for occupational health services (OHS) in Norway was implemented. Aims To examine OHS experiences of the accreditation system in Norway 4 years after its implementation. Methods A web-based questionnaire was sent to all accredited OHS asking about their experiences with the accreditation system. Responses were compared with a similar survey conducted in 2011. Results The response rate was 76% (173/228). OHS reported that the most common changes they had had to make to achieve accreditation were: improvement of their quality assurance system (53%), a plan for competence development (44%) and increased staffing in occupational hygiene (36%) and occupational medicine (28%). The OHS attributed improved quality in their own OHS (56%) and in OHS in Norway (47%), to the accreditation process. Conclusions The accreditation system was well accepted by OHS, who reported that it had improved the quality of their OHS and of OHS in Norway. The results are similar to the findings of a 2011 survey. PMID:26276757

  18. Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India

    PubMed Central

    2014-01-01

    Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas. PMID:24977099

  19. Utilization of maternal and child health care services by primigravida females in urban and rural areas of India.

    PubMed

    Mahajan, Hemant; Sharma, Bhuwan

    2014-01-01

    Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas. PMID:24977099

  20. The use of information and communications technology for health service delivery in Namibia: perspectives of the health service providers.

    PubMed

    Shivute, Meke I; Maumbe, Blessing M; Owei, Vesper T

    2008-01-01

    We surveyed health service providers in Namibia to find out how they used information and communication technologies (ICTs) to deliver health services to their patients. A structured questionnaire was administered to 21 health service providers in two regions of the country (one urban, one rural). There was overwhelming consensus among the health service providers that ICTs were very important, especially for medical services (100%). Ninety-one percent of health service providers viewed ICT as helping them to interact with other providers in other health institutions. The most commonly used ICT was the telephone, which was used in the admission areas of most health institutions (36%); the next most commonly used ICT was the PC (23%). The most commonly used channels for communication with patients were the telephone followed by TV. Some of the problems common to all health institutions in Namibia were poor budgetary resources and lack of basic infrastructure such as electricity or telephone lines. There is a need to promote ICT use for health service delivery and also to stimulate patients to use ICT to access health services and relevant information. PMID:18776072

  1. Establishing a people-centered health service in Gwent, Wales.

    PubMed

    Wilson, B

    1992-01-01

    The Welsh Health Planning Forum has developed a "Strategic Intent and Direction for the NHS in Wales." The aim is "to take the people of Wales into the 21st Century with a level of health on course to compare with the best in Europe" (Welsh Office NHS Directorate, The Welsh Health Planning Forum, 1989). Gwent Health, one of the nine health authorities in Wales, provides a comprehensive health service to its population of 445,000 and was chosen to develop a prototype for the provision of cancer services. Gwent residents were invited to seminars to express their opinions of the health service that was provided and describe the type of service they would like to have in the future. The response was encouraging enough to engender the planning of future seminars. PMID:10119895

  2. Mexican immigrant mothers' expectations for children's health services.

    PubMed

    Clark, Lauren; Redman, Richard W

    2007-10-01

    Women of Mexican descent living in the United States raise children who use health care services. What do immigrant Mexican mothers expect from children's health care services? And how do their expectations for children's health services compare to acculturated Mexican American mothers' expectations? This focused ethnographic study, based on repeated interviews with 28 mothers of varying acculturation levels, describes their expectations and experiences with children's health care services in the United States. Findings support a shared core of expectations for both Mexican immigrant and Mexican American mothers, and differences in health care access and financing, time spent in health care encounters, and cultural and linguistic expectations for care. Health care providers can use this information to approach Mexican-descent mothers and children with their expectations in mind, and craft a negotiated plan of care congruent with their expectations. PMID:17557932

  3. [110 years--University Obstetrics and Gynecology Hospital "Maichin dom"].

    PubMed

    Zlatkov, V

    2014-01-01

    The first specialized Obstetrics and Gynecology Hospital in Bulgaria was founded based on the idea of Queen Maria Luisa (1883). Construction began in 1896 and the official opening of the hospital took place on November 19, 1903. What is unique about the University Obstetrics and Gynecology Hospital "Maichin dom" is above all the fact that the Bulgarian school of obstetrics and gynecology was founded within its institution. Currently, the hospital has nearly 400 beds and 600 employees who work at nine clinics and six laboratories, covering the entire spectrum of obstetric and gynecological activities. Its leading specialists still continue to embody the highest level of professionalism and dedication. The future development of the hospital is chiefly associated with the renovation of facilities, resources and equipment and with the enhancement of the professional competence of the staff and of the quality of hospital products to improve the health and satisfaction of the patients. PMID:24919335

  4. Obstetric audit: the Bradford way

    PubMed Central

    Lomas, Karen; Jaworskyj, Suzanne; Thomson, Heidi

    2014-01-01

    Ultrasound is widely used as a screening tool in obstetrics with the aim of reducing maternal and foetal morbidity. However, to be effective it is recommended that scanning services follow standard protocols based on national guidelines and that scanning practice is audited to ensure consistency. Bradford has a multi-ethnic population with one of the highest rates of birth defects in the UK and it requires an effective foetal anomaly screening service. We implemented a rolling programme of audits of dating scans, foetal anomaly scans and growth scans carried out by sonographers in Bradford. All three categories of scan were audited using measurable parameters based on national guidelines. Following feedback and re-training to address issues identified, re-audits of dating and foetal anomaly scans were carried out. In both cases, sonographers being re-audited had a marked improvement in their practice. Analysis of foetal abnormality detection rates showed that as a department, we were reaching the nationally agreed detection rates for the Fetal Anomaly Screening Programme auditable conditions. Audit has been shown to be a useful and essential process in achieving consistent scanning practices and high quality images and measurements.

  5. Universalizing health services in India: the techno-managerial fix.

    PubMed

    Nayar, K R

    2013-01-01

    The non-universal nature of health services in India can also be the result of many reforms and milestones the health services had passed through since independence. The reform era during the post-nineties is replete with many new trends in organizational strategies which could have led to crises in health services. The salient crises need to be dissected from a larger societal crisis and the specific crises in the health services system. It is evident that non-accessibility and non-availability and the sub-optimal functioning of the primary health centers are perennial issues which could not be addressed by indigenous, imposed or cocktail reforms (such as National Rural Health Mission) and by targeting as these only tinker with the health services. Needless to reiterate that there is a need to address the social dimensions which fall outside the technical sphere of health services. This paper based on an analytical review of relevant literature concludes that any efforts to universalize health and health-care can not only focus on technical components but need to address the larger social determinants and especially the societal crisis, which engender ill-health. PMID:24351387

  6. Correlates of Home Health Care Services Use among the Elderly.

    ERIC Educational Resources Information Center

    Starrett, Richard A.; And Others

    The use of health and social services is influenced by economic, community, geographic, organizational, societal, and environmental factors. A study was conducted to examine predisposing, enabling, and need-for-care factors related to the use of home health care services by a stratified random sample of 400 older adults. Predisposing factors…

  7. 38 CFR 17.98 - Mental health services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ..., 1713, or 1717, or 38 CFR 17.84 of this part, prior to the veteran's death, but may only be furnished in... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran,...

  8. 38 CFR 17.98 - Mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ..., 1713, or 1717, or 38 CFR 17.84 of this part, prior to the veteran's death, but may only be furnished in... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran,...

  9. 38 CFR 17.98 - Mental health services.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ..., 1713, or 1717, or 38 CFR 17.84 of this part, prior to the veteran's death, but may only be furnished in... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran,...

  10. 38 CFR 17.98 - Mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ..., 1713, or 1717, or 38 CFR 17.84 of this part, prior to the veteran's death, but may only be furnished in... 38 Pensions, Bonuses, and Veterans' Relief 1 2013-07-01 2013-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran,...

  11. 38 CFR 17.98 - Mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ..., 1713, or 1717, or 38 CFR 17.84 of this part, prior to the veteran's death, but may only be furnished in... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Mental health services... Outpatient Treatment § 17.98 Mental health services. (a) Following the death of a veteran,...

  12. Parental Cultural Affiliation and Youth Mental Health Service Use

    ERIC Educational Resources Information Center

    Ho, Judy; Yeh, May; McCabe, Kristen; Hough, Richard L.

    2007-01-01

    Studies indicate that African American, Asian/Pacific Islander, and Latino youth have higher rates of unmet mental health needs and lower rates of mental health service utilization compared to non-Hispanic White youth, suggesting that obstacles may exist in the help-seeking and service utilization pathway for minority youth. Parental cultural…

  13. Guidelines for Health Services for Migrant Students. 1984 Edition.

    ERIC Educational Resources Information Center

    California State Dept. of Education, Sacramento. Bureau of Community Services and Migrant Education.

    To promote uniformity and continuity, standards have been established for planning, implementing, and evaluating student health programs provided by grade K-12 migrant education programs throughout California. State mandated health requirements, the rationale for supplemental services, methods of providing supplemental services, and community…

  14. Services Shared by Health Care Organizations: An Annotated Bibliography.

    ERIC Educational Resources Information Center

    Hospital Research and Educational Trust, Chicago, IL.

    This bibliography is designed to assist planners in the field of institutional health and health support services in gaining access to knowledge that will enhance their efforts to achieve new or expanded arrangements of service sharing. Entries are cross-referenced to as many categories as the material warrants. Case studies that are not annotated…

  15. The Technological Growth in eHealth Services.

    PubMed

    Srivastava, Shilpa; Pant, Millie; Abraham, Ajith; Agrawal, Namrata

    2015-01-01

    The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services. PMID:26146515

  16. The Technological Growth in eHealth Services

    PubMed Central

    Srivastava, Shilpa; Pant, Millie; Abraham, Ajith; Agrawal, Namrata

    2015-01-01

    The infusion of information communication technology (ICT) into health services is emerging as an active area of research. It has several advantages but perhaps the most important one is providing medical benefits to one and all irrespective of geographic boundaries in a cost effective manner, providing global expertise and holistic services, in a time bound manner. This paper provides a systematic review of technological growth in eHealth services. The present study reviews and analyzes the role of four important technologies, namely, satellite, internet, mobile, and cloud for providing health services. PMID:26146515

  17. Health literacy: applying current concepts to improve health services and reduce health inequalities.

    PubMed

    Batterham, R W; Hawkins, M; Collins, P A; Buchbinder, R; Osborne, R H

    2016-03-01

    The concept of 'health literacy' refers to the personal and relational factors that affect a person's ability to acquire, understand and use information about health and health services. For many years, efforts in the development of the concept of health literacy exceeded the development of measurement tools and interventions. Furthermore, the discourse about and development of health literacy in public health and in clinical settings were often substantially different. This paper provides an update about recently developed approaches to measurement that assess health literacy strengths and limitations of individuals and of groups across multiple aspects of health literacy. This advancement in measurement now allows diagnostic and problem-solving approaches to developing responses to identified strengths and limitations. In this paper, we consider how such an approach can be applied across the diverse range of settings in which health literacy has been applied. In particular, we consider some approaches to applying health literacy in the daily practice of health-service providers in many settings, and how new insights and tools--including approaches based on an understanding of diversity of health literacy needs in a target community--can contribute to improvements in practice. Finally, we present a model that attempts to integrate the concept of health literacy with concepts that are often considered to overlap with it. With careful consideration of the distinctions between prevailing concepts, health literacy can be used to complement many fields from individual patient care to community-level development, and from improving compliance to empowering individuals and communities. PMID:26872738

  18. International survey of occupational health nurses' roles in multidisciplinary teamwork in occupational health services.

    PubMed

    Rogers, Bonnie; Kono, Keiko; Marziale, Maria Helena Palucci; Peurala, Marjatta; Radford, Jennifer; Staun, Julie

    2014-07-01

    Access to occupational health services for primary prevention and control of work-related injuries and illnesses by the global workforce is limited (World Health Organization [WHO], 2013). From the WHO survey of 121 (61%) participating countries, only one-third of the responding countries provided occupational health services to more than 30% of their workers (2013). How services are provided in these countries is dependent on legal requirements and regulations, population, workforce characteristics, and culture, as well as an understanding of the impact of workplace hazards and worker health needs. Around the world, many occupational health services are provided by occupational health nurses independently or in collaboration with other disciplines' professionals. These services may be health protection, health promotion, or both, and are designed to reduce health risks, support productivity, improve workers' quality of life, and be cost-effective. Rantanen (2004) stated that basic occupational health services must increase rather than decline, especially as work becomes more complex; workforces become more dynamic and mobile, creating new models of work-places; and jobs become more precarious and temporary. To better understand occupational health services provided by occupational health nurses globally and how decisions are made to provide these services, this study examined the scope of services provided by a sample of participating occupational health nurses from various countries. PMID:25000546

  19. 78 FR 50144 - Health Services Research and Development Service, Scientific Merit Review Board; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-16

    ... health care services, the testing of new methods of health care delivery and management, and nursing... protection of human and animal subjects. Recommendations regarding funding are submitted to the...

  20. Consumption of Mental Health Services by People with Intellectual Disabilities

    ERIC Educational Resources Information Center

    Spiller, Mary Jane; Costello, Helen; Bramley, Agnieszka; Bouras, Nick; Martin, Graham; Tsakanikos, Elias; Holt, Geraldine

    2007-01-01

    Background: Although research is starting to identify those factors that predict contact with mental health services in individuals with intellectual disabilities, very little is known about the patterns of service use following referral. Yet, this information is vital for effective service planning and development. We therefore examined the…

  1. An Evaluation of an Occupational Health Advice Service

    ERIC Educational Resources Information Center

    Shearn, P.; Ford, Norma J.; Murphy, R. G.

    2010-01-01

    Objective: The objective of this article is to identify the profile of service users of an occupational health (OH) support service and establish areas of need, and to gather client feedback on the experience of participating in the support service and perceived outcomes and the impact of the advice received. Design and Setting: We carried out…

  2. Mental Health Services Coordination: Working towards Utopia. Human Resources Series.

    ERIC Educational Resources Information Center

    Paterson, Andrea

    1986-01-01

    The need for mental health services coordination is discussed in this report. It is noted that, without coordination, government units and service providers can operate independently and in competition with one another. The move to deinstitutionalization is discussed, including the lack of service coordination resulting from this move and the…

  3. Obesity and obstetric anaesthesia.

    PubMed

    Mace, H S; Paech, M J; McDonnell, N J

    2011-07-01

    Obesity is increasing in the population as a whole, and especially in the obstetric population, among whom pregnancy-induced physiological changes impact on those already present due to obesity. In particular, changes in the cardiovascular and respiratory systems during pregnancy further alter the physiological effects and comorbidities of obesity. Obese pregnant women are at increased risk of diabetes, hypertensive disorders of pregnancy, ischaemic heart disease, congenital malformations, operative delivery postpartum infection and thromboembolism. Regional analgesia and anaesthesia is usually preferred but may be challenging. Obese pregnant women appear to have increased morbidity and mortality associated with caesarean delivery and general anaesthesia for caesarean delivery in particular, and more anaesthesia-related complications. This article summarises the physiological and pharmacological implications of obesity and pregnancy and describes the issues surrounding the management of these women for labour and delivery. PMID:21823371

  4. Comparing Health and Mental Health Needs, Service Use, and Barriers to Services among Sexual Minority Youths and Their Peers

    ERIC Educational Resources Information Center

    Williams, Kelly A.; Chapman, Mimi V.

    2011-01-01

    Using a representative national sample (N = 20,745), this article explores health and mental health needs, service use, and barriers to services among sexual minority youths (SMYs) and heterosexual peers. SMYs were defined by ever having a same-sex romantic attraction or having a recent same-sex romantic relationship or sexual partner. SMYs…

  5. Integrating Ecosystem Services Into Health Impact Assessment

    EPA Science Inventory

    Health Impact Assessment (HIA) provides a methodology for incorporating considerations of public health into planning and decision-making processes. HIA promotes interdisciplinary action, stakeholder participation, and timeliness and takes into account equity, sustainability, and...

  6. Is there a place for traditional midwives in the provision of community-health services?

    PubMed

    Piper, C J

    1997-04-01

    Traditional midwives (TM) have been involved in delivering babies, and providing a broad range of other services to women, for hundreds of years. They are usually local women with little formal education. As they are well known in their communities they are often called to assist women at the time of delivery. Two opposite views persist about the continuation of their role; some health workers would like to see them trained better and incorporated into the formal health system. Other health workers feel that all deliveries should be attended by either a nurse/midwife or a doctor, and that TM should eventually be phased out. Traditional midwives currently perform > 60% of deliveries in some developing countries and have had their role expanded in some places. Recruiting nurse/midwives and doctors to work in remote areas remains difficult and, even if they were recruited, there is no guarantee that their obstetric services would be used. The evaluation of training programmes has not produced any clear-cut answers in the debate about the long-term role or existence of TM. Rather, the studies have shown that the success of the programmes depends on the resources available, the people involved in the training and how the training is carried out. Some of the lessons learnt from working with TM apply to any two groups of people working together. If TM are going to be offered training, and this must be a local decision made after consultation and an evaluation of prevailing resources and conditions, the training should be a two-way process, with both parties learning from each other. PMID:9229017

  7. 42 CFR 136.22 - Establishment of contract health service delivery areas.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... areas. 136.22 Section 136.22 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Contract Health... area after consultation with the tribal governing body or bodies on those reservations included...

  8. 42 CFR 136.22 - Establishment of contract health service delivery areas.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... areas. 136.22 Section 136.22 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES INDIAN HEALTH Contract Health... area after consultation with the tribal governing body or bodies on those reservations included...

  9. Health Services: Results from the School Health Policies and Programs Study 2006

    ERIC Educational Resources Information Center

    Brener, Nancy D.; Wheeler, Lani; Wolfe, Linda C.; Vernon-Smiley, Mary; Caldart-Olson, Linda

    2007-01-01

    Background: The specific health services provided to students at school and the model for delivering these services vary across districts and schools. This article describes the characteristics of school health services in the United States, including state- and district-level policies and school practices. Methods: The Centers for Disease Control…

  10. Using community-based research to shape the design and delivery of maternal health services in Northern Nigeria.

    PubMed

    Doctor, Henry V; Findley, Sally E; Ager, Alastair; Cometto, Giorgio; Afenyadu, Godwin Y; Adamu, Fatima; Green, Cathy

    2012-06-01

    Maternal mortality ratios in northern Nigeria are among the worst in the world, over 1,000 per 100,000 live births in 2008, with a very low level and quality of maternity services. In 2009, we carried out a study of the reasons for low utilisation of antenatal and delivery care among women with recent pregnancies, and the socio-cultural beliefs and practices that influenced them. The study included a quantitative survey of 6,882 married women, 119 interviews and 95 focus group discussions with community and local government leaders, traditional birth attendants, women who had attended maternity services and health care providers. Only 26% of the women surveyed had received any antenatal care and only 13% delivered in a facility with a skilled birth attendant for their most recent pregnancy. However, those who had had at least one antenatal consultation were 7.6 times more likely to deliver with a skilled birth attendant. Most pregnant women had little or no contact with the health care system for reasons of custom, lack of perceived need, distance, lack of transport, lack of permission, cost and/or unwillingness to see a male doctor. Based on these findings, we designed and implemented an integrated package of interventions that included upgrading antenatal, delivery and emergency obstetric care; providing training, supervision and support for new midwives in primary health centres and hospitals; and providing information to the community about safe pregnancy and delivery and the use of these services. PMID:22789087

  11. Behavioral Systems Analysis in Health and Human Services

    ERIC Educational Resources Information Center

    McGee, Heather M.; Diener, Lori H.

    2010-01-01

    This article provides a behavioral systems approach to improve operational performance in health and human service organizations. This article provides six performance truths that are relevant to any organization and a case study from a community mental health network of agencies. A comprehensive analysis, as described here, will help health and…

  12. 42 CFR 417.104 - Payment for basic health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... PLANS, AND HEALTH CARE PREPAYMENT PLANS Qualified Health Maintenance Organizations: Services § 417.104... Rating by Class” may be obtained from the Office of Prepaid Health Care, Division of Qualification... contract with a governmental authority under section 1079 (“Contracts for Medical Care for Spouses...

  13. Infusing Early Childhood Mental Health into Early Intervention Services

    ERIC Educational Resources Information Center

    Grabert, John C.

    2009-01-01

    This article describes the process of enhancing early childhood mental health awareness and skills in non-mental health staff. The author describes a pilot training model, conducted the U.S. Army's Early Intervention Services, that involved: (a) increasing early childhood mental health knowledge through reflective readings, (b) enhancing…

  14. ADHD and Health Services Utilization in the National Health Interview Survey

    ERIC Educational Resources Information Center

    Cuffe, Steven P.; Moore, Charity G.; McKeown, Robert

    2009-01-01

    Objective: Describe the general health, comorbidities and health service use among U.S. children with ADHD. Method: The 2001 National Health Interview Survey (NHIS) contained the Strengths and Difficulties Questionnaire (SDQ; used to determine probable ADHD), data on medical problems, overall health, and health care utilization. Results: Asthma…

  15. Promoting Teen Health and Reducing Risks: A Look at Adolescent Health Services in New York City.

    ERIC Educational Resources Information Center

    Citizens' Committee for Children of New York, NY.

    This study examined data from focus groups with New York City adolescents and interviews with health care providers serving New York City adolescents (hospital based clinics, school based health centers, child health clinics, community health centers, and a multi-service adolescent center) in order to determine how to promote health and reduce…

  16. Palestinian mothers' perceptions of child mental health problems and services

    PubMed Central

    THABET, ABDEL AZIZ; EL GAMMAL, HOSSAM; VOSTANIS, PANOS

    2006-01-01

    The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

  17. Palestinian mothers' perceptions of child mental health problems and services.

    PubMed

    Thabet, Abdel Aziz; El Gammal, Hossam; Vostanis, Panos

    2006-06-01

    The aim of this study was to explore Palestinian mothers' perceptions of child mental health problems and their understanding of their causes; to determine Palestinian mothers' awareness of existing services and sources of help and support; to identify professionals in the community whom Palestinian mothers would consult if their child had mental health problems; and to establish their views on ways of increasing awareness of child mental health issues and services. Checklists exploring the above issues were completed by 249 Palestinian mothers living in refugee camps in the Gaza Strip. Palestinian mothers equally perceived emotional, behavioural and psychotic symptoms as suggestive of mental ill health in childhood. Mothers perceived multiple causes of child mental health problems, including family problems, parental psychiatric illness and social adversity. A substantial proportion (42.6%) had knowledge of local child mental health care services. Overall, mothers preferred Western over traditional types of treatment, and were keen to increase mental health awareness within their society. Despite a different cultural tradition, Palestinian mothers appear open to a range of services and interventions for child mental health problems. As in other non-Western societies, child mental health service provision should be integrated with existing primary health care, schools, and community structures. PMID:16946953

  18. The Effects of Head Start Health Services: Executive Summary of the Head Start Health Evaluation.

    ERIC Educational Resources Information Center

    Fosburg, Linda B.; And Others

    This report summarizes findings of an evaluation of Head Start health services. Chapter one presents an overview of the background of the evaluation project. Chapter two highlights findings for the major evaluation questions. These questions focus specifically on children's health status prior to entry into Head Start, health services subsequently…

  19. Career Education for Mental Health Workers. Health Assessment. Human Service Instructional Series. Module No. 6.

    ERIC Educational Resources Information Center

    Redcay, Madeleine C.

    This module on health assessment is one of a set of six developed to prepare human services workers for the changing mental health service delivery system. A total of seven objectives are included to help students utilize knowledge of physical factors which may influence health and behavior in order to recognize signs and symptoms which indicate…

  20. A Study of the Indian Health Service and Indian Tribal Involvement in Health.

    ERIC Educational Resources Information Center

    Press, Daniel S.; And Others

    Addressing American Indians and the Indian Health Service (IHS), this report focuses on the process of Indian involvement and self-determination in health, emphasizing improvement of the effectiveness and responsiveness of Indian health services. Data derived from written documents, statistical figures, and personal interviews with over 200 people…

  1. Equity in Access to Health Promotion and Risk Reduction Services: Implications for Elder Health.

    ERIC Educational Resources Information Center

    Smith, Nancy H.; Howze, Elizabeth Harper

    Although there is a national emphasis on health promotion and preventive practices, questions remain regarding the equity of access to these services by low income and minority groups, and the implications of inequities for elder health. Data from a systematic survey of 500 public and private providers of health promotion services in northern…

  2. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... services means preventive, diagnostic, therapeutic, rehabilitative, or palliative services that— (1) Are... prohibited by State law from furnishing primary health care, “rural health clinic services” means the... and supplies are included under this paragraph.) (4) Part-time or intermittent visiting nurse care...

  3. The Stigma of Reproductive Health Services Utilization by Unmarried Women

    PubMed Central

    Mohammadi, Fatemeh; Kohan, Shahnaz; Mostafavi, Firoozeh; Gholami, Ali

    2016-01-01

    Background: Fear of the stigma associated with reproductive health services has always been one of the reasons why youth and unmarried individuals avoid making use of such services. This stigma imposes a great deal of mental stress, fear, and depression on patients and causes delays in the diagnosis and treatment of their conditions. Objectives: This paper explores the concept of stigma in the context of the utilization of reproductive health services by unmarried women. Patients and Methods: This study is qualitative in nature. Purposive sampling was employed, and semi-structured interviews were conducted with 16 unmarried women, five midwives, and two physicians. The data were analyzed using the conventional content analysis method. Results: Four main categories constituted the general concept concerning the stigma suffered by unmarried women for using reproductive health services, i.e., prevalent stereotypical thinking patterns in society, the fear of being judged and labeled by others, discrimination, and feeling ashamed of seeking reproductive health services. Conclusions: The findings indicated that society associates reproductive health issues with sexual relations, which in turn shapes the stigma and places limitations on unmarried women for using reproductive health services. Thus, while reproductive health services are planned and provided to unmarried women, strategies are demanded for overcoming this stigma. PMID:27247794

  4. Afghanistan's basic package of health services: its development and effects on rebuilding the health system.

    PubMed

    Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah

    2014-01-01

    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404

  5. Afghanistan's Basic Package of Health Services: Its development and effects on rebuilding the health system

    PubMed Central

    Newbrander, William; Ickx, Paul; Feroz, Ferozuddin; Stanekzai, Hedayatullah

    2014-01-01

    In 2001, Afghanistan's Ministry of Public Health inherited a devastated health system and some of the worst health statistics in the world. The health system was rebuilt based on the Basic Package of Health Services (BPHS). This paper examines why the BPHS was needed, how it was developed, its content and the changes resulting from the rebuilding. The methods used for assessing change were to review health outcome and health system indicator changes from 2004 to 2011 structured along World Health Organisation's six building blocks of health system strengthening. BPHS implementation contributed to success in improving health status by translating policy and strategy into practical interventions, focusing health services on priority health problems, clearly defining the services to be delivered at different service levels and helped the Ministry to exert its stewardship role. BPHS was expanded nationwide by contracting out its provision of services to non-governmental organisations. As a result, access to and utilisation of primary health care services in rural areas increased dramatically because the number of BPHS facilities more than doubled; access for women to basic health care improved; more deliveries were attended by skilled personnel; supply of essential medicines increased; and the health information system became more functional. PMID:24865404

  6. Using geographic information systems to match local health needs with public health services and programs.

    PubMed

    Dubowitz, Tamara; Williams, Malcolm; Steiner, Elizabeth D; Weden, Margaret M; Miyashiro, Lisa; Jacobson, Dawn; Lurie, Nicole

    2011-09-01

    Local health departments (LHDs) play an important role in ensuring essential public health services. Geographic information system (GIS) technology offers a promising means for LHDs to identify geographic gaps between areas of need and the reach of public health services. We examined how large LHDs could better inform planning and investments by using GIS-based methodologies to align community needs and health outcomes with public health programs. We present a framework to drive LHDs in identifying and addressing gaps or mismatches in services or health outcomes. PMID:21778479

  7. 76 FR 50485 - Obstetrics and Gynecology Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-15

    ... Obstetrics and Gynecology Devices Panel of the Medical Devices Advisory Committee. This meeting was announced in the Federal Register of July 14, 2011 (76 FR 41507). The amendment is being made to reflect a... HUMAN SERVICES Food and Drug Administration Obstetrics and Gynecology Devices Panel of the...

  8. Evolution of Women's Trauma-Integrated Services at the Substance Abuse and Mental Health Services Administration

    ERIC Educational Resources Information Center

    Salasin, Susan E.

    2005-01-01

    In this article a historical overview of the evolution of the Women's Trauma Integrated Services model at the Substance Abuse and Mental Health Services Administration (SAMHSA) is presented. Milestones in women's services policy development at SAMHSA (1992-1998) and in trauma treatment development for four different trauma populations (1960-1998)…

  9. Organizational Capacity for Service Integration in Community-Based Addiction Health Services

    PubMed Central

    Guerrero, Erick G.; Aarons, Gregory A.; Palinkas, Lawrence A.

    2014-01-01

    Objectives. We examined factors associated with readiness to coordinate mental health, public health, and HIV testing among community-based addiction health services programs. Methods. We analyzed client and program data collected in 2011 from publicly funded addiction health services treatment programs in Los Angeles County, California. We analyzed a sample of 14 379 clients nested in 104 programs by using logistic regressions examining odds of service coordination with mental health and public health providers. We conducted a separate analysis to examine the percentage of clients receiving HIV testing in each program. Results. Motivational readiness and organizational climate for change were associated with higher odds of coordination with mental health and public health services. Programs with professional accreditation had higher odds of coordinating with mental health services, whereas programs receiving public funding and methadone and residential programs (compared with outpatient) had a higher percentage of clients receiving coordinated HIV testing. Conclusions. These findings provide an evidentiary base for the role of motivational readiness, organizational climate, and external regulation and funding in improving the capacity of addiction health services programs to develop integrated care. PMID:24524525

  10. Experiences in the health services network and in the street: Captures and detours in psychology training for public health services.

    PubMed

    de Sousa Severo, Ana Kalliny; de Melo Arraes Amorim, Ana Karenina; Romagnoli, Roberta Carvalho

    2016-03-01

    This article discusses the internships at the psychosocial health system of Natal, Northeast region of Brazil, as part of training in psychology. The objective of these internships is to offer students work experiences in public health both inside and outside health services. Based on Institutional Analysis and Schizoanalysis, these experiences were examined through two analysers: (1) the power of knowledge and (2) the need for by-passes. We conclude that health provokes tensions between instituted practices in health services and those instituted in psychology training. PMID:26987825

  11. Child and adolescent mental health emergency services in Macedonia.

    PubMed

    Releva, M; Boskovska, M; Apceva, A; Polazarevska, M; Novotni, A; Bonevski, D; Sargent, J

    2001-01-01

    This paper describes the development of child and adolescent mental health emergency services in Macedonia since 1993. The evolution of services through the Mental Crisis Centre for Children and Adolescents, funded by the Open Society Institute, and located in six cities is outlined. The paper also defines traditional services, the nature of child mental health emergencies, the evaluation process, follow-up care and training and supervision. It concludes with concern that the mental health emergency system is not sufficient to meet the needs of the child and adolescent population, particularly in the face of the Kosovar refugee crisis. Recommendations for the future are made. PMID:11508566

  12. Honoring their service: behavioral health services in North Carolina for military service members, veterans, and their families.

    PubMed

    Alexander-Bratcher, Kimberly M; Martin, Grier; Purcell, William R; Watson, Michael; Silberman, Pam

    2011-01-01

    The North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families examined the adequacy of Medicaid- and state-funded services for mental health conditions, developmental disabilities (including traumatic brain injury), and substance abuse that are currently available in North Carolina to military service members, veterans, and their families. The task force determined that there are several gaps in services and made 13 recommendations related to federal, state, and local community resources. This article reviews the work of the task force and current efforts to improve services in North Carolina. PMID:21678686

  13. Health services research: the gradual encroachment of ideas.

    PubMed

    Black, Nick

    2009-04-01

    There is increasing pressure on researchers and research funding bodies to demonstrate the value of research. Simple approaches, consistent with the biomedical paradigm, based on relating the cost of research to its supposed impact are being investigated and adopted in laboratory and clinical research. While this may be appropriate in such research areas, it should not be applied to health services research which aims to alter the ways policy-makers and managers think about health, disease and health care or, as John Maynard Keynes put it, 'the gradual encroachment of ideas'. By considering six fundamental assumptions about health care that have been successfully challenged and overturned over the past few decades, the profound and sustained impact of health services research can be demonstrated. The application of economic models of 'payback' would fail to recognize such contributions which, in turn, could threaten future funding of health services research. PMID:19299268

  14. [Cervical cancer: integral care to the woman in health services].

    PubMed

    Soares, Marilu Correa; Mishima, Silvana Martins; da Silva, Renata Cunha; Ribeiro, Caroline Vargas; Meincke, Sonia Maria Könzgen; Corrêa, Ana Cândida Lopes

    2011-09-01

    This study aims to understand how the health services of the Brazilian Public Health System (BPHS) are organized to give an integral care to the woman with cervical cancer. This is a descriptive, qualitative research with 20 women. Semistructured interviews were coupled with participant observation in data collection. The thematic analysis revealed the theme: "The search for care: access to BPHS and use of health services in the search for integral care". In the use of health services, women have exposed their views on the received care, and on the potentialities and limits of integrality in this context. The conclusion is that the effectivation of health actions that aim at the integrality of care for women requires courage and the promotion of a dialogue between social actors as a way to build a health awareness that allows an ethical commitment pointing towards the necessary changes in care. PMID:22165396

  15. Doing obstetrics and staying alive.

    PubMed Central

    Reynolds, J. L.

    1993-01-01

    Many family physicians have a love-hate relationship with childbirth care and struggle to balance their personal and family needs with the need to provide high-quality personal care during labour and birth. Many false assumptions undermine family practice obstetrics. Strategies are presented to simplify obstetric care for women and families while promoting reasoned self-care for physicians. Images p1948-a PMID:8219843

  16. Obstetric management of conjoined twins.

    PubMed

    Sakala, E P

    1986-03-01

    Three cases of conjoined twins are presented: two thorocopagus and one craniopagus. The diagnosis of conjoining varied from late second trimester to time of term delivery. Delivery mode was both by vaginal and cesarean routes, and occurred at both level one and level three hospitals. Antenatal diagnostic procedures and issues in obstetric management are discussed. A suggested obstetric management sequence for conjoined twins is proposed. PMID:3511423

  17. Three-dimensional obstetric ultrasound.

    PubMed

    Tache, Veronique; Tarsa, Maryam; Romine, Lorene; Pretorius, Dolores H

    2008-04-01

    Three-dimensional ultrasound has gained a significant popularity in obstetrical practice in recent years. The advantage of this modality in some cases is in question, however. This article provides a basic review of volume acquisition, mechanical positioning, and display modalities. Multiple uses of this technique in obstetrical care including first trimester applications and its utility in clarification of fetal anatomy such as brain, face, heart, and skeleton is discussed. PMID:18450140

  18. School Health Services: A Facility Planning and Design Guide for School Systems.

    ERIC Educational Resources Information Center

    Maryland State Dept. of Education, Baltimore.

    This guide for Maryland schools outlines the role of school health services and proper facility design for these services. Chapter 1 provides an overview, describing coordinated school health programs, school health services programs, school health services programs in Maryland, how school health services are delivered, trends, the number of…

  19. Mental Health Services at Selected Private Schools

    ERIC Educational Resources Information Center

    Van Hoof, Thomas J.; Sherwin, Tierney E.; Baggish, Rosemary C.; Tacy, Peter B.; Meehan, Thomas P.

    2004-01-01

    Private schools educate a significant percentage of US children and adolescents. Private schools, particularly where students reside during the academic year, assume responsibility for the health and well-being of their students. Children and adolescents experience mental health problems at a predictable rate, and private schools need a mechanism…

  20. Mental health services and R&D in South Korea.

    PubMed

    Roh, Sungwon; Lee, Sang-Uk; Soh, Minah; Ryu, Vin; Kim, Hyunjin; Jang, Jung Won; Lim, Hee Young; Jeon, Mina; Park, Jong-Ik; Choi, SungKu; Ha, Kyooseob

    2016-01-01

    World Health Organization has asserted that mental illness is the greatest overriding burden of disease in the majority of developed countries, and that the socioeconomic burden of mental disease will exceed that of cancer and cardiovascular disorders in the future. The life-time prevalence rate for mental disorders in Korea is reported at 27.6 %, which means three out of 10 adults experience mental disorders more than once throughout their lifetime. Korea's suicide rate has remained the highest among Organization for Economic Cooperation and Development (OECD) nations for 10 consecutive years, with 29.1 people out of every 100,000 having committed suicide. Nevertheless, a comprehensive study on the mental health services and the Research and Development (R&D) status in Korea is hard to find. Against this backdrop, this paper examines the mental health services and the R&D status in Korea, and examines their shortcomings and future direction. The paper discusses the mental health service system, budget and human resources, followed by the mental health R&D system and budget. And, by a comparison with other OECD countries, the areas for improvement are discussed and based on that, a future direction is suggested. This paper proposes three measures to realize mid and long-term mental health promotion services and to realize improvements in mental health R&D at the national level: first, establish a national mental health system; second, forecast demand for mental health; and third, secure and develop mental health professionals. PMID:27257434

  1. The management of health care service quality. A physician perspective

    PubMed Central

    Bobocea, L; Gheorghe, IR; Spiridon, St; Gheorghe, CM; Purcarea, VL

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer’s perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician’s perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician’s perspective. PMID:27453745

  2. The management of health care service quality. A physician perspective.

    PubMed

    Bobocea, L; Gheorghe, I R; Spiridon, St; Gheorghe, C M; Purcarea, V L

    2016-01-01

    Applying marketing in health care services is presently an essential element for every manager or policy maker. In order to be successful, a health care organization has to identify an accurate measurement scale for defining service quality due to competitive pressure and cost values. The most widely employed scale in the services sector is SERVQUAL scale. In spite of being successfully adopted in fields such as brokerage and banking, experts concluded that the SERVQUAL scale should be modified depending on the specific context. Moreover, the SERVQUAL scale focused on the consumer's perspective regarding service quality. While service quality was measured with the help of SERVQUAL scale, other experts identified a structure-process-outcome design, which, they thought, would be more suitable for health care services. This approach highlights a different perspective on investigating the service quality, namely, the physician's perspective. Further, we believe that the Seven Prong Model for Improving Service Quality has been adopted in order to effectively measure the health care service in a Romanian context from a physician's perspective. PMID:27453745

  3. Enhancing patient experience through personalization of health services.

    PubMed

    Snowdon, Anne W; Alessi, Charles; Bassi, Harpreet; DeForge, Ryan T; Schnarr, Karin

    2015-09-01

    Patient engagement is a challenge many leaders are facing, as consumer expectations of health services demand a more personalized approach to care. This article examines consumer trends that are influencing patient engagement and empowerment relative to the use of digital technologies. Informed by consumer and population health trends that can personalize health services, three strategies leaders can engage to strengthen patient experience include placing greater focus on personal health and wellness, shifting towards personalized rather than standardized healthcare, and facilitating the democratization of healthcare information. PMID:26135292

  4. [Tuberculosis screening in school health services in Geneva, Switzerland].

    PubMed

    Meynard, Anne; Pfarrwaller, Eva; Lazarevic, Claire-Anne Wyler

    2016-06-01

    Recent immigrantyouth have multiple health needs that need to be adapted to the context of migration. School health services provide a systematic health check to allyoung immigrants starting school in Geneva, including a tuberculin skin test if coming from a middle or high incidence country. Positive tests are confirmed with Interferon Gamma Release Assay (IGRA) and if indicated, offered treatment of latent tuberculosis even in the absence of clear guidelines. Collective and individual benefits outweigh the difficult logistics: reducing risk of reactivation of latent tuberculosis for populations living in promiscuity, effective collaboration between primary care and school health services to answer the needs of these underserved youth. PMID:27451510

  5. Health services system for seafarers and fishermen in Iran.

    PubMed

    Ali Hasanzadeh, Mohammad; Azizabadi, Ebrahim; Allah Alipour, Nosrat

    2005-01-01

    The maritime health services system is presented in this review article. The national Iranian shipping line IRISL owns the largest commercial fleet in the Middle East and it operates 137 ships. This company and several other national shipping companies employ over 5900 seafarers. There are 11,000 fishing ships and boats and the number of Iranian fishermen reaches 124,000. Seafarers and fishermen are regularly medically examined and issued health certificates, according to the national regulations. The health services system for them is linked to the port authorities throughout the country. Observations, data and relevant statistics on the health problems of the national maritime workers have been regularly collected. PMID:16532596

  6. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...

  7. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...

  8. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...

  9. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...

  10. 42 CFR 51.46 - Disclosing information obtained from a provider of mental health services.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... mental health services. 51.46 Section 51.46 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND... a provider of mental health services. (a) Except as provided in paragraph (b) of this section, if a... of mental health services, it may not disclose information from such records to the individual who...

  11. Analgesia in Obstetrics

    PubMed Central

    Heesen, M.; Veeser, M.

    2012-01-01

    Background: An effective relief of labour pain has become an important part of obstetric medicine. Therefore regional nerve blocks, systemic analgesic and non-pharmacologic techniques are commonly used. This review article gives a summary of pathophysiology and anatomy of labour pain as well as advantages, disadvantages, risks and adverse reactions of analgesic techniques in newborns and parturients. Methods: We performed a selective literature search in Medline via PubMed using the search-terms “Analgesia” and “Obstetrics”. We also included the current guidelines of the German Society for Anesthesiology and Intensive Care Medicine. Results: PDA and CSE are safe techniques for the relief of labour pain if contraindications are excluded. The risk for instrumental delivery but not for caesarean section is increased under neuraxial analgesia. PDA and CSE should be performed in an early stage of labour using low doses of local anaesthetics if possible. It is not necessary to wait for a defined cervical dilatation before starting neuraxial analgesia. Anesthesiologists and obstetricians should inform patients as soon as possible before the situation of stress during labour. Systemic opioid analgesia is a possible alternative for neuraxial techniques. Because of possible side effects systemic remifentanil analgesia should only be performed under continuous monitoring. Several nonpharmacologic methods can also relieve labour pain, but results of studies about their effectiveness are inconsistent. PMID:25264376

  12. Achieving Quality Health Services for Adolescents.

    PubMed

    2016-08-01

    This update of the 2008 statement from the American Academy of Pediatrics redirects the discussion of quality health care from the theoretical to the practical within the medical home. This statement reviews the evolution of the medical home concept and challenges the provision of quality adolescent health care within the patient-centered medical home. Areas of attention for quality adolescent health care are reviewed, including developmentally appropriate care, confidentiality, location of adolescent care, providers who offer such care, the role of research in advancing care, and the transition to adult care. PMID:27432849

  13. [Distribution of educational and health services].

    PubMed

    Aspe, P; Beristáin, J

    1989-01-01

    This paper presents some ideas on the relation between personal income and the quantity and quality of education and health. It is suggested that the high degree of inequality in income in Mexico could be attributed to ancestral differences in educative and health care opportunities. In the short run, the desirable decrease in educative and health inequities will not modify the income concentration rates. However it is a powerful tool in the struggle against poverty and a necessary condition for the gradual reduction of inequities in the long run. PMID:2740950

  14. Accounts of severe acute obstetric complications in Rural Bangladesh

    PubMed Central

    2011-01-01

    Background As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. Though access to medical care is considered to be life-saving during obstetric emergencies, data on the factors associated with health care decision-making during obstetric emergencies are lacking. We aim to describe the health care decision-making process during severe acute obstetric complications among women and their families in rural Bangladesh. Methods Using the pregnancy surveillance infrastructure from a large community trial in northwest rural Bangladesh, we nested a qualitative study to document barriers to timely receipt of medical care for severe obstetric complications. We conducted 40 semi-structured, in-depth interviews with women reporting severe acute obstetric complications and purposively selected for conditions representing the top five most common obstetric complications. The interviews were transcribed and coded to highlight common themes and to develop an overall conceptual model. Results Women attributed their life-threatening experiences to societal and socioeconomic factors that led to delays in seeking timely medical care by decision makers, usually husbands or other male relatives. Despite the dominance of male relatives and husbands in the decision-making process, women who underwent induced abortions made their own decisions about their health care and relied on female relatives for advice. The study shows that non-certified providers such as village doctors and untrained birth attendants were the first-line providers for women in all categories of severe complications. Coordination of transportation and finances was often arranged through mobile phones, and referrals were likely to be provided by village doctors. Conclusions Strategies to increase timely and appropriate care seeking

  15. Mental Health Services for Children and Youth: Strengthening the Promise of the Future. Human Services Series.

    ERIC Educational Resources Information Center

    Craig, Rebecca T.

    1988-01-01

    Many mentally ill children, especially those who are seriously disturbed, are not receiving the mental health care they need. Although the federal government offers financing to the states for child and adolescent mental health programming, the primary responsibility for financing mental health services has been assumed by state governments. At…

  16. Provision of Personal Healthcare Services by Local Health Departments

    PubMed Central

    Luo, Huabin; Sotnikov, Sergey; Winterbauer, Nancy

    2016-01-01

    Introduction The scope of local health department (LHD) involvement in providing personal healthcare services versus population-based services has been debated for decades. A 2012 IOM report suggests that LHDs should gradually withdraw from providing personal healthcare services. The purpose of this study is to assess the level of LHD involvement in provision of personal healthcare services during 2008–2013 and examine the association between provision of personal healthcare services and per capita public health expenditures. Methods Data are from the 2013 survey of LHDs and Area Health Resource Files. The number, ratio, and share of revenue from personal healthcare services were estimated. Both linear and panel fixed effects models were used to examine the association between provision of personal healthcare services and per capita public health expenditures. Data were analyzed in 2014. Results The mean number of personal healthcare services provided by LHDs did not change significantly in 2008–2013. Overall, personal services constituted 28% of total service items. The share of revenue from personal services increased from 16.8% in 2008 to 20.3% in 2013. Results from the fixed effect panel models show a positive association between personal healthcare services’ share of revenue and per capita expenditures (b=0.57, p<0.001). Conclusions A lower share of revenue from personal healthcare services is associated with lower per capita expenditures. LHDs, especially those serving <25,000 people, are highly dependent on personal healthcare revenue to sustain per capita expenditures. LHDs may need to consider strategies to replace lost revenue from discontinuing provision of personal healthcare services. PMID:25997902

  17. Streptococcal Infections, Rheumatic Fever and School Health Services.

    ERIC Educational Resources Information Center

    Markowitz, Milton

    1979-01-01

    Because rheumatic fever is a potentially serious complication of a streptococcal sore throat which can lead to permanent heart disease, this article advocates the expansion of school health services in medically underserved areas. (JMF)

  18. The Corporate State, the Health Service and the Professions

    ERIC Educational Resources Information Center

    Klein, Rudolf

    1977-01-01

    The problems of the National Health Service in Great Britain are examined with regard to the relationship between public authority and social economy. Attention is directed toward the implications for the position of the medical profession. (LBH)

  19. Building the national health information infrastructure for personal health, health care services, public health, and research

    PubMed Central

    Detmer, Don E

    2003-01-01

    Background Improving health in our nation requires strengthening four major domains of the health care system: personal health management, health care delivery, public health, and health-related research. Many avoidable shortcomings in the health sector that result in poor quality are due to inaccessible data, information, and knowledge. A national health information infrastructure (NHII) offers the connectivity and knowledge management essential to correct these shortcomings. Better health and a better health system are within our reach. Discussion A national health information infrastructure for the United States should address the needs of personal health management, health care delivery, public health, and research. It should also address relevant global dimensions (e.g., standards for sharing data and knowledge across national boundaries). The public and private sectors will need to collaborate to build a robust national health information infrastructure, essentially a 'paperless' health care system, for the United States. The federal government should assume leadership for assuring a national health information infrastructure as recommended by the National Committee on Vital and Health Statistics and the President's Information Technology Advisory Committee. Progress is needed in the areas of funding, incentives, standards, and continued refinement of a privacy (i.e., confidentiality and security) framework to facilitate personal identification for health purposes. Particular attention should be paid to NHII leadership and change management challenges. Summary A national health information infrastructure is a necessary step for improved health in the U.S. It will require a concerted, collaborative effort by both public and private sectors. If you cannot measure it, you cannot improve it. Lord Kelvin PMID:12525262

  20. Health workforce governance: Processes, tools and actors towards a competent workforce for integrated health services delivery.

    PubMed

    Barbazza, Erica; Langins, Margrieta; Kluge, Hans; Tello, Juan

    2015-12-01

    A competent health workforce is a vital resource for health services delivery, dictating the extent to which services are capable of responding to health needs. In the context of the changing health landscape, an integrated approach to service provision has taken precedence. For this, strengthening health workforce competencies is an imperative, and doing so in practice hinges on the oversight and steering function of governance. To aid health system stewards in their governing role, this review seeks to provide an overview of processes, tools and actors for strengthening health workforce competencies. It draws from a purposive and multidisciplinary review of literature, expert opinion and country initiatives across the WHO European Region's 53 Member States. Through our analysis, we observe distinct yet complementary roles can be differentiated between health services delivery and the health system. This understanding is a necessary prerequisite to gain deeper insight into the specificities for strengthening health workforce competencies in order for governance to rightly create the institutional environment called for to foster alignment. Differentiating between the contribution of health services and the health system in the strengthening of health workforce competencies is an important distinction for achieving and sustaining health improvement goals. PMID:26489924

  1. The Role of Bilingual Workers without Professional Mental Health Training in Mental Health Services for Refugees.

    ERIC Educational Resources Information Center

    Egli, Eric

    This paper discusses the use of bilingual workers who do not have formal mental health training as mediators and providers of mental health care for refugees. The introduction provides a background discussion of the need for refugee mental health services, the characteristics of bilingual mental health workers, and the work places and expectations…

  2. Assessing Health Services Delivery for Children with Special Health Care Needs (CSHCN) in School.

    ERIC Educational Resources Information Center

    Networks: A Newsletter of the National MCH Center at Children's Hospital, 1993

    1993-01-01

    Children and youth with special health care needs frequently require health care during the school day. School evaluations and Individual Educational Plans should include health information addressing students' daily health and emergency needs, should assure services in a setting that is academically appropriate and in the least restrictive…

  3. Conceptualizing and Categorizing Race and Ethnicity in Health Services Research

    PubMed Central

    Ford, Marvella E; Kelly, P Adam

    2005-01-01

    Objectives Veterans Affairs (VA) patient populations are becoming increasingly diverse in race and ethnicity. The purpose of this paper is to (1) document the importance of using consistent standards of conceptualizing and categorizing race and ethnicity in health services research, (2) provide an overview of different methods currently used to assess race and ethnicity in health services research, and (3) suggest assessment methods that could be incorporated into health services research to ensure accurate assessment of disease prevalence and incidence, as well as accounts of appropriate health services use, in patients with different racial and ethnic backgrounds. Design A critical review of published literature was used. Principal Findings Race is a complex, multidimensional construct. For some individuals, institutionalized racism and internalized racism are intertwined in the effects of race on health outcomes and health services use. Ethnicity is most commonly used as a social–political construct and includes shared origin, shared language, and shared cultural traditions. Acculturation appears to affect the strength of the relationships among ethnicity, health outcomes, and health services use. Conclusions Improved and consistent methods of data collection need to be developed for use by VA researchers across the country. VA research sites with patients representing specific population groups could use a core set of demographic items in addition to expanded modules designed to assess the ethnic diversity within these population groups. Improved and consistent methods of data collection could result in the collection of higher-quality data, which could lead to the identification of race- and ethnic-specific health services needs. These investigations could in turn lead to the development of interventions designed to reduce or eliminate these disparities. PMID:16179001

  4. Access of rural AFDC Medicaid beneficiaries to mental health services.

    PubMed

    Lambert, D; Agger, M S

    1995-01-01

    This article examines geographic differences in the use of mental health services among Aid to Families with Dependent Children (AFDC)-eligible Medicaid beneficiaries in Maine. Findings indicate that rural AFDC beneficiaries have significantly lower utilization of mental health services than urban beneficiaries. Specialty mental health providers account for the majority of ambulatory visits for both rural and urban beneficiaries. However, rural beneficiaries rely more on primary-care providers than do urban beneficiaries. Differences in use are largely explained by variations in the supply of specialty mental health providers. This finding supports the long-held assumption that lower supply is a barrier to access to mental health services in rural areas. PMID:10153467

  5. Health visitors' awareness and perception of clinical genetic services.

    PubMed Central

    Guilbert, P; Cheater, F

    1990-01-01

    A questionnaire was sent to 84 health visitors to assess their awareness and perception of genetic services and how they perceived their role in the referral of patients. The study showed that while health visitors had a reasonable knowledge of the more obvious aspects of genetic services, there were a number of areas in which they were unsure. The respondents did not identify themselves as prime initiators in the process of referring patients to a genetic service, although they appeared able to identify families on their caseloads for whom this service may be relevant. Health visitors viewed their own knowledge of genetics as poor, a factor which may account for the low referral rate initiated by this group of professionals. The respondents attached importance to genetic issues and 76 (95%) wished to be better informed about the subject. It is suggested that the inclusion of genetics as part of an in-service training programme might fulfil this need and lead to greater advocacy of genetic services among the families in their care. These findings are of interest in view of the proposals within the recent Royal College of Physicians report (Prenatal screening and genetic counselling) suggesting that community genetic services should make use of primary health care workers such as health visitors. PMID:2213844

  6. NATIONAL COLLABORATIVE PERINATAL PROJECT (AAD - HEALTH AND SOCIAL SERVICES BRANCH)

    EPA Science Inventory

    Study was conducted by NIH's National Institute of Neurological Diseases and Stroke. Biomedical and behavioral research in many areas of obstetrics, perinatology, pediatrics, and developmental psychology. The data also provide a prospective base for examining neurological and neu...

  7. Has universal health insurance reduced socioeconomic inequalities in urban and rural health service use in Thailand?

    PubMed

    Yiengprugsawan, Vasoontara; Carmichael, Gordon A; Lim, Lynette L-Y; Seubsman, Sam-Ang; Sleigh, Adrian C

    2010-09-01

    This study analyses urban and rural health service use before and after the introduction of the Universal Coverage Scheme (UCS). Using data from the Thai national health surveys of 2001 and 2005, the study utilises age-sex adjusted concentration indices to measure within-area differences in use of health services among populations distinguished by socioeconomic status. Between 2001 and 2005, the UCS substantially reduced Thailand's uninsured population (from 42.5% to 7.0% in urban areas and from 24.9% to 2.7% in rural areas). The implementation of the UCS changed patterns of health services use, particularly for rural people and the urban poor, by placing greater emphasis on primary healthcare. Relevant policy recommendations should focus on continued improvement of primary health services, and ensuring adequate and timely referrals to secondary and tertiary health services when the need arises. PMID:20634120

  8. Perceived Barriers to Mental Health Services among Youths in Detention

    ERIC Educational Resources Information Center

    Abram, Karen M.; Paskar, Leah D.; Washburn, Jason J.; Teplin, Linda A.

    2008-01-01

    The psychiatric disorder in juvenile systems is on the increase and this study examines the detained youth's perceived barriers and attitudes towards the mental health service use. Results concluded that experiences with past services contributed to negative perceptions, which need to be solved by providing educational outreach programs that helps…

  9. School-Based Mental Health Services: The Baltimore Models.

    ERIC Educational Resources Information Center

    Flaherty, Lois T.; Weist, Mark D.

    1999-01-01

    Describes the expanded school mental health (ESMH) programs that have developed over the past decade. These programs augment existing services provided by schools and help assure that a comprehensive range of services (assessment, prevention, case management, and treatment) are available to youth in special and regular education. Shares…

  10. Southeast Asian Mental Health: Treatment, Prevention, Services, Training and Research.

    ERIC Educational Resources Information Center

    Owan, Tom Choken, Ed.

    This sourcebook contains 19 papers which discuss the mental health service needs of Southeast Asian refugees in the United States. The volume is divided into five sections: Treatment; Prevention; Services; Training; and Research. The papers (and their authors) are: (1) "Psychiatric Care for Southeast Asians: How Different Is Different?" (Tran Minh…

  11. Changing practice: involving mental health service users in planning service provision.

    PubMed

    Rea, David M

    2004-01-01

    Changes to professional work now ensure that social care and health care workers should be accountable to service users, and not only to their professional colleagues. This paper seeks to explore how this may eventually be realised in new working relationships that will profoundly affect mental health social work. These changes are driven by factors that are external to the social work profession-in policy initiatives that introduce measures of performance that incorporate the service user in both evaluating and planning services, in efforts to build new relationships, and in a breakdown of barriers between social work practitioners and service managers. While these changes are sometimes likely to be resisted by practitioners and service users alike, the demands of policy makers for a new professional accountability to service users can be used to pave the way for effective dialogue. The paper outlines the steps necessary to build confidence among both service users and service providers. This requires sensitive management and leadership. It also requires that action demonstrably follows from such dialogue. The paper uses evidence from Community Mental Health Teams in Swansea, over a three-year period, to demonstrate how the policy and management imperatives faced by service providers can be reconciled with the expressed desires of mental health service users. PMID:15774399

  12. Availability and Quality of Emergency Obstetric and Newborn Care in Bangladesh.

    PubMed

    Wichaidit, Wit; Alam, Mahbub-Ul; Halder, Amal K; Unicomb, Leanne; Hamer, Davidson H; Ram, Pavani K

    2016-08-01

    Bangladesh's maternal mortality and neonatal mortality remain unacceptably high. We assessed the availability and quality of emergency obstetric care (EmOC) and emergency newborn care (EmNC) services at health facilities in Bangladesh. We randomly sampled 50 rural villages and 50 urban neighborhoods throughout Bangladesh and interviewed the director of eight and nine health facilities nearest to each sampled area. We categorized health facilities into different quality levels (high, moderate, low, and substandard) based on staffing, availability of a phone or ambulance, and signal functions (six categories for EmOC and four categories for EmNC). We interviewed the directors of 875 health facilities. Approximately 28% of health facilities did not have a skilled birth attendant on call 24 hours per day. The least commonly performed EmOC signal function was administration of anticonvulsants (67%). The quality of EmOC services was high in 33% and moderate in 52% of the health facilities. The least common EmNC signal function was kangaroo mother care (7%). The quality of EmNC was high in 2% and moderate in 33% of the health facilities. Approximately one-third of health facilities lack 24-hour availability of skilled birth attendants, increasing the risk of peripartum complications. Most health facilities offered moderate to high quality services for EmOC and low to substandard quality for EmNC. PMID:27273640

  13. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 32 National Defense 5 2012-07-01 2012-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64...

  14. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 32 National Defense 5 2011-07-01 2011-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64...

  15. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 32 National Defense 5 2013-07-01 2013-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64...

  16. 32 CFR 728.54 - U.S. Public Health Service (USPHS), other than members of the uniformed services.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 32 National Defense 5 2014-07-01 2014-07-01 false U.S. Public Health Service (USPHS), other than... FACILITIES Beneficiaries of Other Federal Agencies § 728.54 U.S. Public Health Service (USPHS), other than... 43 (Contract Health Service Purchase Order for Hospital Services Rendered) or HRSA form 64...

  17. The contributions of Henry E. Sigerist to health service organization.

    PubMed

    Terris, M

    1975-01-01

    Henry E. Sigerist made profound and strikingly original contributions to health service organization. Not only did he expand greatly our concepts of the functions of medicine, but he redefined health in a manner which was later to be paraphrased by the World Health Organization. Sigerist's account of the evolution of the physician and his discussion of the role of the people in the fight for health provide important new insights into current realities, while his remarkable analysis of the genesis of national health insurance makes it possible to understand its continued absence in the United States. Although he was in the forefront of the campaign for national health insurance, Sigbrist always considered it inferior to a national health service. His thorough studies of the Soviet national health service opened new vistas in the promotion of health and prevention of disease and the development of team practice in health centers. Sigerist's impact was world-wide, and was particularly important in Chile, Cuba, China, and Great Britain. PMID:765888

  18. Megamarketing strategies for health care services.

    PubMed

    Mobley, M F; Elkins, R L

    1990-01-01

    Megamarketing, as coined by Kotler (1968), is a strategic way of thinking which takes an enlarged view of the skills and resources needed to enter and operate in obstructed or protected markets. The concept of megamarketing emphasizes the mastering and coordination of economic, psychological, political, and public relation skills and suggest that organizations can take a proactive stance in shaping macroenvironmental conditions. As health care delivery is characterized by a highly regulated environment, this marketing approach has definite applications for the health care marketer. PMID:10106844

  19. Portraying Reflexivity in Health Services Research.

    PubMed

    Rae, John; Green, Bill

    2016-09-01

    A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. PMID:26935721

  20. Mental Health and Service Delivery Systems for Black Women.

    ERIC Educational Resources Information Center

    Smith, Elsie H.

    1981-01-01

    Examines mental health issues, especially alcoholism, suicide, and social depression, related to the counseling of Black women. Recommends improved mental health services, counselor/clinical training programs, and additional research focusing on the causes of stress among Black women. (Author/MW)