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Hon KY, McMillan N, Fitridge RA. Gap analysis of diabetes-related foot disease management systems in Pacific Islands Countries and Territories. BMC Health Serv Res 2024; 24:324. [PMID: 38468255 PMCID: PMC10929083 DOI: 10.1186/s12913-024-10768-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 02/21/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Pacific Island Countries and Territories (PICTs) are known to have high prevalence of Diabetes Mellitus and high incidence of diabetes-related foot disease. Diabetes-related foot disease can lead to lower limb amputation and is associated with poor outcomes, with increased morbidity and mortality. The purpose of this study was to gain a better understanding of diabetes-related foot disease management in selected countries in PICTs and to identify potential barriers in management of diabetes-related foot disease management in the region. METHODS A cross-sectional survey was sent to eleven hospitals across six selected PICTs. The survey instrument was designed to provide an overview of diabetes-related foot disease (number of admissions, and number of lower limb amputations over 12 months) and to identify clinical services available within each institution. Two open-ended questions (free text responses) were included in the instrument to explore initiatives that have helped to improve management and treatment of diabetes-related foot diseases, as well as obstacles that clinicians have encountered in management of diabetes-related foot disease. The survey was conducted over 6 weeks. RESULTS Seven hospitals across four countries provided responses. Number of admissions and amputations related to diabetes-related foot disease were only reported as an estimate by clinicians. Diabetes-related foot disease was managed primarily by general medicine physician, general surgeon and/or orthopaedic surgeon in the hospitals surveyed, as there were no subspecialty services in the region. Only one hospital had access to outpatient podiatry. Common themes identified around barriers faced in management of diabetes-related foot disease by clinicians were broadly centred around resource availability, awareness and education, and professional development. CONCLUSION Despite the high prevalence of diabetes-related foot disease within PICTs, there appears to be a lack of functional multi-disciplinary foot services (MDFs). To improve the outcomes for diabetes-related foot disease patients in the region, there is a need to establish functional MDFs and engage international stakeholders to provide ongoing supports in the form of education, mentoring, as well as physical resources.
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Affiliation(s)
- Kay Y Hon
- Discipline of Surgical Specialties, The University of Adelaide, Adelaide, SA, Australia.
- Department of Vascular and Endovascular Surgery, Royal Adelaide Hospital, 1 Port Road, Adelaide, SA, Australia.
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia.
| | - Neil McMillan
- Discipline of Surgical Specialties, The University of Adelaide, Adelaide, SA, Australia
- Department of Vascular and Endovascular Surgery, Royal Adelaide Hospital, 1 Port Road, Adelaide, SA, Australia
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia
| | - Robert A Fitridge
- Discipline of Surgical Specialties, The University of Adelaide, Adelaide, SA, Australia
- Department of Vascular and Endovascular Surgery, Royal Adelaide Hospital, 1 Port Road, Adelaide, SA, Australia
- Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA, Australia
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Gholipour K, Shokri A, Yarahmadi AA, Tabrizi JS, Iezadi S, Naghibi D, Bidarpoor F. Barriers to community participation in primary health care of district health: a qualitative study. BMC PRIMARY CARE 2023; 24:117. [PMID: 37193954 DOI: 10.1186/s12875-023-02062-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/13/2023] [Indexed: 05/18/2023]
Abstract
INTRODUCTION Community participation is one of the principles of primary health care (PHC). However, it has not been adequately institutionalized due to numerous barriers. Therefore, the present study is conducted to identify barriers to community participation in primary health care in the district health network from the perspectives of stakeholders. METHODS This qualitative case study was conducted in 2021 in Divandareh city, Iran. A total of 23 specialists and experts experienced in community participation, including nine health experts, six community health workers, four community members, and four health directors in primary health care programs, were selected using the purposive sampling method until complete saturation. Data was collected using semi-structured interviews and analyzed simultaneously using qualitative content analysis. RESULTS After data analysis, 44 codes, 14 sub-themes, and five themes were identified as barriers to community participation in primary health care in the district health network. The themes included community trust in the healthcare system, the status of community participation programs, the community and system's perception of participation programs, health system management approaches, and cultural barriers and institutional obstacles. CONCLUSION Based on the results of this study most important barriers to community participation relate to community trust, the organizational structure, community and the health profession's perception regarding the participatory programs. It seems necessary to take measures to remove barriers in order to realize community participation in primary healthcare system.
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Affiliation(s)
- Kamal Gholipour
- Social Determinants of Health Research Center, Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azad Shokri
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Akbar Yarahmadi
- Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Jafar Sadegh Tabrizi
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shabnam Iezadi
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Deniz Naghibi
- Department of Public Health Sciences, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA
| | - Farzam Bidarpoor
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
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Bayugo YV, Labarda M, Cruz JRB, Mier-Alpaño JD, Tiangco PMP, Oyene UE, Omoleke SA, Ulitin A, Ong A, Fajardo MS, Echavarria MI, Alger J, Mathanga D, Msiska BK, Ekwunife OI, Nwaorgu O, Abella Lizcano L, Gomez Quenguan N, Nieto Anderson CI, Beltran BY, Carcamo Rodriguez ED, Núñez ES, Nkosi-Kholimeliwa V, Mwafulirwa-Kabaghe G, Juban N. Description of global innovative methods in developing the WHO Community Engagement Package. BMJ Open 2022; 12:e063144. [PMID: 35672075 PMCID: PMC9174797 DOI: 10.1136/bmjopen-2022-063144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Development of a Community Engagement Package composed of (1) database of community engagement (CE) experiences from different contexts, (2) CE learning package of lessons and tools presented as online modules, and (3) CE workshop package for identifying CE experiences to enrich the CE database and ensure regular update of learning resources. The package aims to guide practitioners to promote local action and enhance skills for CE. SETTING AND PARTICIPANTS The packages were co-created with diverse teams from WHO, Social Innovation in Health Initiative, UNICEF, community practitioners, and other partners providing synergistic contributions and bridging existing silos. METHODS The design process of the package was anchored on CE principles. Literature search was performed using standardised search terms through global and regional databases. Interviews with CE practitioners were also conducted. RESULTS A total of 356 cases were found to fit the inclusion criteria and proceeded to data extraction and thematic analysis. Themes were organised according to rationale, key points and insights, facilitators of CE and barriers to CE. Principles and standards of CE in various contexts served as a foundation for the CE learning package. The package comprises four modules organised by major themes such as mobilising communities, strengthening health systems, CE in health emergencies and CE as a driver for health equity. CONCLUSION After pilot implementation, tools and resources were made available for training and continuous collection of novel CE lessons and experiences from diverse socio-geographical contexts.
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Affiliation(s)
| | - Meredith Labarda
- School of Health Sciences, University of the Philippines Manila, Manila, Philippines
| | | | | | | | | | | | - Allan Ulitin
- Institute of Health Policy and Development Studies - National Institutes of Health, University of the Philippines Manila, Manila, Philippines
| | - Alberto Ong
- Alliance for Improving Health Outcomes, Quezon City, Philippines
| | | | - Maria Isabel Echavarria
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Jackeline Alger
- Hospital Escuela, Tegucigalpa, Honduras
- Instituto de Enfermedades Infecciosas y Parasitologia Antonio Vidal, Tegucigalpa, Honduras
| | - Don Mathanga
- College of Medicine, University of Malawi, Blantyre, Malawi
| | | | - Obinna Ikechukwu Ekwunife
- Department of Clinical Pharmacy and Pharmacy Management, Nnamdi Azikiwe University, Awka, Nigeria
- Social Innovation in Health Initiative (SIHI), Nnamdi Azikiwe University, Awka, Nigeria
| | - Obioma Nwaorgu
- Social Innovation in Health Initiative (SIHI), Nnamdi Azikiwe University, Awka, Nigeria
- Department of Parasitology and Entomology, Nnamdi Azikiwe University, Awka, Nigeria
| | - Lorena Abella Lizcano
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | - Natalia Gomez Quenguan
- Centro Internacional de Entrenamiento e Investigaciones Médicas (CIDEIM), Cali, Colombia
- Universidad Icesi, Cali, Colombia
| | | | | | | | - Eduardo Salomón Núñez
- Facultad de Ciencias Médicas, Universidad Católica de Honduras Nuestra Señora Reina de la Paz Facultad de Ciencias de la Salud, Tegucigalpa, Honduras
- Cirugía General, Hospital General Santa Teresa, Comayagua, Honduras
| | | | | | - Noel Juban
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
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D’Apice C, Ghirotto L, Bassi MC, Artioli G, Sarli L. A realist synthesis of staff-based primary health care interventions addressing universal health coverage. J Glob Health 2022; 12:04035. [PMID: 35569053 PMCID: PMC9107778 DOI: 10.7189/jogh.12.04035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Methods Results Conclusions
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Affiliation(s)
- Clelia D’Apice
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Luca Ghirotto
- Qualitative Research Unit, Azienda USL – IRCCS, Reggio Emilia, Italy
| | - Maria C Bassi
- Medical Library, Azienda USL – IRCCS, Reggio Emilia, Italy
| | - Giovanna Artioli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
| | - Leopoldo Sarli
- University of Parma, Department of Medicine and Surgery, Parma, Italy
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Tafuna'i M, Turner R, Matalavea B, Voss D, Hazelman L, Richards R, Walker R. Results of a community-based screening programme for chronic kidney disease and associated risk factors, (obesity, diabetes and hypertension) in a Samoan cohort. BMJ Open 2022; 12:e056889. [PMID: 35396298 PMCID: PMC8996012 DOI: 10.1136/bmjopen-2021-056889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES In 2019, under the World Kidney Day theme of 'Kidney health for everyone everywhere', the National Kidney Foundation of Samoa undertook an extensive community screening campaign to detect the estimated prevalence of chronic kidney disease (CKD) and its associated risk factors in the community. SETTING Fifteen screening sites, with 11 urban and rural sites on the main island of Upolu, and 4 in different rural areas on the island of Savaii. PARTICIPANTS All participants were self-referrals to the various screening sites. In total, 1163 Samoans were screened, with similar numbers from both urban and rural areas and similar numbers of female and male. SCREENING ACTIVITIES All participants were screened for CKD using point of care serum creatinine determinations, with calculation of estimated glomerular filtration rate using the CKD-EPI formula and dipstix urinalysis. A standardised screening survey was used to capture demographic and medical history with associated risk factors of obesity, diabetes, using point of care determination of HbA1c and hypertension. Logistic regression was used to investigate the association of CKD with risk factors. RESULTS In total, 1163 people were screened for CKD within the month of March 2019. The prevalance of CKD (grades 1-5) was 44.5% (95% CI 41.6% to 47.4) with individual grade prevalence CKD 1: 3.7%, CKD 2: 6.1%, CKD 3: 30.7%, CKD 4: 2.9% and CKD 5: 1.0%. The prevalence of obesity (body mass index ≥32), diabetes and hypertension was 66.3%, 30.8% and 54.3%, respectively. CONCLUSIONS This is the first paper to report the estimated prevalence of CKD in Samoa or any other Pacific Island nation. It reveals an urgent need for further studies on the epidemiology of CKD in Samoa, to develop country-specific prevention strategies to mitigate this growing burden and prevent subsequent CKD associated complications including development of kidney failure and premature death.
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Affiliation(s)
- Malama Tafuna'i
- National Kidney Foundation of Samoa, Apia, Samoa
- Centre for Pacific Health, University of Otago Division of Health Sciences, Dunedin, New Zealand
| | - Robin Turner
- Centre for Biostatistics, University of Otago Division of Health Sciences, Dunedin, New Zealand
| | | | | | | | - Rosalina Richards
- Centre for Pacific Health, University of Otago Division of Health Sciences, Dunedin, New Zealand
| | - Robert Walker
- Medicine, University of Otago Medical School, Dunedin, New Zealand
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LaMonica LC, McGarvey ST, Rivara AC, Sweetman CA, Naseri T, Reupena MS, Kadiamada H, Kocher E, Rojas-Carroll A, DeLany JP, Hawley NL. Cascades of diabetes and hypertension care in Samoa: Identifying gaps in the diagnosis, treatment, and control continuum - a cross-sectional study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 18:100313. [PMID: 35024652 PMCID: PMC8669362 DOI: 10.1016/j.lanwpc.2021.100313] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/06/2021] [Accepted: 10/09/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Samoa is a Pacific Island country facing one of the highest burdens of non-communicable disease globally. METHODS In this study, we apply a cascade-of-care approach to understand gaps in the awareness, treatment, and control cascade of diabetes and hypertension in a cross-sectional, convenience sample of 703 young, high-risk Samoan adults (29.5-50.9 years). FINDINGS Non-communicable diseases were prevalent in the study sample: 19.5% (95% CI: 16.6%-22.7%) of participants had diabetes; 47.6% (95% CI: 43.7%-51.4%) presented with pre-diabetes or diabetes; 31.0% (95% CI: 27.5%-34.6%) had hypertension; and nearly 90% (95% CI: 86.7%-91.5%) had overweight or obesity. Among those with diabetes and hypertension, only 20.5% (95% CI: 13.9%-28.4%) and 11.8% (95% CI: 7.8%-16.9%) of participants were aware of their condition, respectively. Only 0.8% (95% CI: 0.0%-4.2%) of all participants with diabetes had achieved glycemic control; only 2.8% (95% CI: 1.1%-6.1%) of those with hypertension achieved control. INTERPRETATION We found a significant burden of diabetes and hypertension in Samoa, exceeding the recent prevalence estimates of other low- to middle-income countries by nearly two-fold. A severe unmet need in both detection and subsequent control and monitoring of these chronic conditions exists. Our results suggest that the initial diagnosis and surveillance stage in the cascade of care for chronic conditions should be a major focus of primary care efforts; national screening campaigns and programs that leverage village and district nurses to deliver community-based primary care may significantly impact gap closure in the NCD cascade. FUNDING This study was supported by the U.S. National Institutes of Health R01HL140570 (PIs: McGarvey and DeLany); AR was supported by NIH FIC D43TW010540; HK and AR-C were supported by the Minority Health and Health Disparities International Research Training (MHIRT) Program at Brown University, NIH Grant # 5T37MD008655.
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Affiliation(s)
- Lauren C. LaMonica
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Stephen T. McGarvey
- International Health Institute and Department of Epidemiology, School of Public Health, and Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Anna C. Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Chlöe A. Sweetman
- Department of Anthropology, Guarini School of Graduate and Advanced Studies at Dartmouth College, Hanover, New Hampshire, USA
| | | | | | - Hemant Kadiamada
- International Health Institute and Department of Epidemiology, School of Public Health, and Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Erica Kocher
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
| | - Alexa Rojas-Carroll
- International Health Institute and Department of Epidemiology, School of Public Health, and Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - James P. DeLany
- AdventHealth Orlando, Translational Research Institute, Orlando, FL, US
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut, USA
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Tripathy JP, Mishra S. How effective was implementation of the package of essential non-communicable disease (PEN) interventions: A review of evidence? Diabetes Metab Syndr 2021; 15:102266. [PMID: 34496339 DOI: 10.1016/j.dsx.2021.102266] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/28/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
AIMS This paper reviewed the outcomes, cost-effectiveness and challenges of implementation of WHO PEN protocol in LMICs. METHODS MEDLINE databases, the Cochrane Central Register of Controlled Trials and Google Scholar were searched and content analysis of the included studies was done. RESULTS A total of 14 articles were included. Lack of essential medicines and manpower, poor recording and mis-calculation of CVD risk score, suboptimal recording of patient information and loss-to-follow-up were the key challenges reported in various PEN implementation settings. CONCLUSION The study has highlighted concerns and recommendations which need to be addressed before scale up.
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Affiliation(s)
- Jaya Prasad Tripathy
- Department of Community Medicine, All India Institute of Medical Sciences, Nagpur, India.
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Fraser-Hurt N, Naseri LT, Thomsen R, Matalavea A, Ieremia-Faasili V, Reupena MS, Hawley NL, Pomer A, Rivara AC, Obure DC, Zhang S. Improving services for chronic non-communicable diseases in Samoa: an implementation research study using the care cascade framework. Aust N Z J Public Health 2021; 46:36-45. [PMID: 34309937 DOI: 10.1111/1753-6405.13113] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 12/01/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Samoa needs to intensify the response to the growing non-communicable disease burden. This study aimed to assess bottlenecks in the care continuum and identify possible solutions. METHODS The mixed-methods study used the cascade framework as an analysis tool and hypertension as a tracer condition for chronic non-communicable diseases. Household survey data were integrated with medical record data of hypertension patients and results from focus group discussions with patients and healthcare providers. RESULTS Hypertension prevalence was 38.1% but only 4.7% of hypertensive individuals had controlled blood pressure. There were large gaps in the care continuum especially at screening and referral due to multiple socio-cultural, economic and service delivery constraints. CONCLUSIONS In Samoa, care for chronic non-communicable diseases is not effectively addressing patient needs. This calls for better health communication, demand creation, treatment support, nutritional interventions and health service redesign, with a focus on primary healthcare and effective patient and community engagement. Implications for public health: The proposed actions can improve the reach, accessibility, quality and effectiveness of Samoa's chronic care services. Health system redesign is necessary to ensure continuity of care and more effective primary prevention. The findings are useful for other countries in the region facing similar challenges.
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Affiliation(s)
| | | | | | | | | | | | - Nicola L Hawley
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Alysa Pomer
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | - Anna C Rivara
- Department of Chronic Disease Epidemiology, Yale School of Public Health, USA
| | | | - Shuo Zhang
- The World Bank Group, Washington DC, USA
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Özgül E, Dinçer H, Yüksel S. HoQ-based evaluation of UHC competencies using an extension of interval-valued spherical fuzzy and hesitant 2-tuple linguistic term sets. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2021. [DOI: 10.3233/jifs-202818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Healthy life is recognized as one of the most fundamental human rights. However, even today, millions of people around the world are forced to choose between their basic needs and fundamental rights. Half of the world’s population does not have access to the healthcare they need. Universal Health Coverage (UHC) aims to ensure that all individuals receive the quality health services they need without incurring a financial burden, and to protect them from risk factors that threaten their health. The aim of this study is to identify the significant factors to improve UHC in the countries. For this purpose, house of quality (HoQ) approach is used in the analysis process so that both customer expectations and technical requirements are considered. Within this framework, a novel hybrid model has been proposed which has three different stages. Firstly, 3 groups of diseases and 4 clinical services for each group are determined regarding the customer needs. Secondly, these factors are weighted by using interval-valued intuitionistic hesitant 2-tuple fuzzy decision making and trial evaluation laboratory (DEMATEL). In the final stage, 9 different technical requirements are ranked by using interval-valued intuitionistic hesitant 2-tuple fuzzy technique for order preference by similarity to ideal solution (TOPSIS). Additionally, another evaluation has also been conducted by considering Spherical fuzzy sets. Similarly, a comparative analysis has also been performed with VIKOR while ranking the alternatives. It is concluded that analysis results of both evaluations are quite similar. This situation gives an information about the coherency and consistency of the analysis results. The findings indicate that treatment services in noncommunicable diseases play the most significant role in this respect. Moreover, according to the ranking results, it is concluded that strategic policies should be related to improving the social security and special physician capacity as well as decreasing the out-of-pocket payment.
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Affiliation(s)
- Ercan Özgül
- School of Business, Istanbul Medipol University, South Campus, Istanbul, Turkey
| | - Hasan Dinçer
- School of Business, Istanbul Medipol University, South Campus, Istanbul, Turkey
| | - Serhat Yüksel
- School of Business, Istanbul Medipol University, South Campus, Istanbul, Turkey
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10
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Cuesta-Briand B, Hansell D, Burich S, Loimata T. Delays in the Pathway to Cancer Diagnosis in Samoa: A Qualitative Study of Patients' Experiences. Asia Pac J Public Health 2021; 33:707-713. [PMID: 34075810 DOI: 10.1177/10105395211019857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Cancer is a leading cause of death in Samoa, with cancer patients presenting late and experiencing poor outcomes. Barriers to early diagnosis are complex, and cultural factors play an important part. This qualitative study explored the barriers to cancer diagnosis in Samoa through semistructured interviews conducted with 19 Samoan patients. Thematic data analysis was informed by socioecological theory and yielded 4 themes: knowledge and beliefs about cancer; pain as a trigger for health care-seeking behavior; follow-up issues; and communication and trust. Cancer knowledge and attitudes toward pain were strongly influenced by culture and community beliefs. Lack of follow-up resulted in significant delays, and ineffective patient-doctor communication triggered feelings of uncertainty and mistrust in the health care system. Efforts to address knowledge gaps will not be effective unless they are accompanied by broader strategies addressing local health care capacity issues. Adopting a socioecological framework lens within a regional collaborative approach provides a way forward.
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Affiliation(s)
| | | | | | - Terri Loimata
- National University of Samoa, Apia, Samoa.,Samoa Cancer Society, Apia, Samoa
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11
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Middleton K, Bowen AC. Addressing normalization using culturally relevant approaches: An important adjunct to reducing the burden of impetigo and scabies. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2021; 7:100102. [PMID: 34327421 PMCID: PMC8315659 DOI: 10.1016/j.lanwpc.2021.100102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 01/20/2021] [Indexed: 11/23/2022]
Affiliation(s)
- Katherine Middleton
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
| | - Asha C Bowen
- Division of Paediatrics, School of Medicine, University of Western Australia, Perth, Western Australia, Australia
- Department of Infectious Diseases, Perth Children's Hospital, Child and Adolescent Health Service, Perth, Western Australia, Australia
- Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Perth, Western Australia, Australia
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
- Institute for Health Research, The University of Notre Dame Australia, Perth, Western Australia, Australia
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Jiang JJ, Reupena SM, Naseri T, Swift RM, McGeary JE, McGarvey ST. Alcohol Consumption among Samoan Adults in 2010: Patterns, Correlates and Health Implications. Alcohol Alcohol 2020; 55:681-689. [PMID: 32666120 DOI: 10.1093/alcalc/agaa066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/12/2020] [Accepted: 06/12/2020] [Indexed: 11/12/2022] Open
Abstract
AIMS We aim to describe alcohol consumption and related problems from a nationwide survey in 2010 in Samoa in association with sociodemographic variables as part of an intervention development. METHODS The sample consisted of 3463 adults, 25-65 years of age. Participants self-reported alcohol consumption in the previous 12 months, patterns of drinking and alcohol-related psychosocial problems. Data about age, census region of residence, highest attained education level, employment, marital status, household assets score and current smoking status were gathered. RESULTS More than one-third of men, 36.1%, and 4.1% of women consumed alcohol in the past year. There were greater proportions of alcohol users among younger adults, <45 years, in both men and women. Among men, being unemployed and residing outside of rural Savai'i and smoking cigarettes were associated with current alcohol use. Among women, tertiary education and cigarette smoking were strongly associated with alcohol use. Among alcohol consumers, almost 75% of both men and women reported being drunk more than once in the prior month, and 58% of men and 81% of women drank heavily, consuming >4 drinks for women and >5 drinks for men at least once per episode in the prior week. More men than women, 51% versus 26%, felt that alcohol consumption had interfered with their daily life. CONCLUSION Our analyses identified correlates of alcohol consumption and associated problems that can help guide the development of targeted interventions for different sex and age groups to mitigate the social and physiological harms of alcohol misuse.
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Affiliation(s)
- Joy J Jiang
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetic, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.,International Health Institute & Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | | | - Take Naseri
- Ministry of Health, Government of Samoa, Apia, Samoa
| | - Robert M Swift
- Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Center for Alcohol and Addictions & Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, Rhode Island, USA
| | - John E McGeary
- Providence Veterans Affairs Medical Center, Providence, Rhode Island, USA.,Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Stephen T McGarvey
- International Health Institute & Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA.,Department of Anthropology, Brown University, Providence, Rhode Island, USA
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