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Zhang Z. Survey and analysis on the resource situation of primary health care institutions in rural China. Front Public Health 2024; 12:1394527. [PMID: 38919917 PMCID: PMC11196621 DOI: 10.3389/fpubh.2024.1394527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Background China's rural population is immense, and to ensure the well-being of rural residents through healthcare services, it is essential to analyze the resources of rural grassroots healthcare institutions in China. The objective is to examine the discrepancies and deficiencies in resources between rural grassroots healthcare institutions and the national average, providing a basis for future improvements and supplementation of rural healthcare resources. Methodology The study analyzed data from 2020 to 2022 on the number of healthcare establishments, the capacity of hospital beds, the number of healthcare professionals, and the number of physicians in both rural and national settings. Additionally, it examined the medical service conditions and ratios of township health centers in rural areas to assess the resource gap between rural areas and the national average. Results Healthcare establishments: On average, there were 2.2 fewer healthcare institutions per 10,000 persons in rural areas compared to the national average over three years. Hospital beds: On average, there were approximately 36 fewer hospital beds per 10,000 persons in rural areas compared to the national average over three years. Healthcare professionals and physicians: On average, there were about 48 fewer healthcare technical personnel and 10 fewer practicing (including assistant) physicians per 10,000 persons in rural areas compared to the national average over three years. Conclusion Compared to the national average, there are significant discrepancies and deficiencies in grassroots healthcare resources in rural China. This underscores the necessity of increasing funding to progressively enhance the number of healthcare institutions in rural areas, expand the number of healthcare personnel, and elevate medical standards to better align with national benchmarks. Improving rural healthcare resources will strategically equip these institutions to cater to rural communities and effectively handle public health emergencies. Ensuring that the rural population in China has equal access to healthcare services as the rest of the country is crucial for promoting the well-being of rural residents and achieving health equity.
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Affiliation(s)
- Zhaoting Zhang
- School of Public Policy and Management, China University of Mining and Technology, Xuzhou, China
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Dudley L, Couper I, Kannangarage NW, Naidoo S, Ribas CR, Koller TS, Young T. COVID-19 preparedness and response in rural and remote areas: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002602. [PMID: 37967067 PMCID: PMC10651055 DOI: 10.1371/journal.pgph.0002602] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 10/23/2023] [Indexed: 11/17/2023]
Abstract
This scoping review used the Arksey and O'Malley approach to explore COVID-19 preparedness and response in rural and remote areas to identify lessons to inform future health preparedness and response planning. A search of scientific and grey literature for rural COVID-19 preparedness and responses identified 5 668 articles published between 2019 and early 2022. A total of 293 articles were included, of which 160 (54.5%) were from high income countries and 106 (36.2%) from middle income countries. Studies focused mostly on the Maintenance of Essential Health Services (63; 21.5%), Surveillance, epidemiological investigation, contact tracing and adjustment of public health and social measures (60; 20.5%), Coordination and Planning (32; 10.9%); Case Management (30; 10.2%), Social Determinants of Health (29; 10%) and Risk Communication (22; 7.5%). Rural health systems were less prepared and national COVID-19 responses were often not adequately tailored to rural areas. Promising COVID-19 responses involved local leaders and communities, were collaborative and multisectoral, and engaged local cultures. Non-pharmaceutical interventions were applied less, support for access to water and sanitation at scale was weak, and more targeted approaches to the isolation of cases and quarantine of contacts were preferable to blanket lockdowns. Rural pharmacists, community health workers and agricultural extension workers assisted in overcoming shortages of health professionals. Vaccination coverage was hindered by weaker rural health systems. Digital technology enabled better coordination, communication, and access to health services, yet for some was inaccessible. Rural livelihoods and food security were affected through disruptions to local labour markets, farm produce markets and input supply chains. Important lessons include the need for rural proofing national health preparedness and response and optimizing synergies between top-down planning with localised planning and coordination. Equity-oriented rural health systems strengthening and action on rural social determinants is essential to better prepare for and respond to future outbreaks.
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Affiliation(s)
- Lilian Dudley
- Division of Health Systems and Public Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Ian Couper
- Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | | | - Selvan Naidoo
- Ukwanda Centre for Rural Health, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Clara Rodriguez Ribas
- Health Emergencies Program, World Health Organisation, Headquarters, Geneva, Switzerland
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Theadora Swift Koller
- Department for Gender, Equity and Human Rights, Director General’s Office, World Health Organization, Headquarters, Geneva, Switzerland
| | - Taryn Young
- Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa
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Öcek ZA, Geise M, Volkmann AM, Basili A, Klünder V, Coenen M. Strengthening the social resilience of people living at the intersection of precariousness and migration during pandemics: action recommendations developed in Munich, Germany. Front Public Health 2023; 11:1201215. [PMID: 37601211 PMCID: PMC10433162 DOI: 10.3389/fpubh.2023.1201215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/19/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction An EU-funded project in five countries examined vulnerability mechanisms during the COVID-19 pandemic. The research team in Germany concentrated on people living at the intersection of migration and precariousness. The study aimed first to provide an understanding of how migrants living in precarious conditions in Munich had been affected by the pandemic, both from their own and from experts' perspectives. The second aim was to develop action recommendations to reduce structural vulnerabilities and increase resilience with a view towards improved pandemic preparedness. Methods The study followed a two-phase process. The first was a qualitative study based on interviews with 25 migrants and 13 experts. In the second, researchers developed action recommendations based on the vulnerability/ resilience factors that had been generated in the first phase. Three consecutive meetings with stakeholders (expert panel, focus group discussion with two migrant organization, meeting with the Munich Migration Council) were then held to further strengthen the draft recommendations. Results Content analysis revealed twelve vulnerability and eight resilience factors in three domains (COVID-19 prevention; human rights, living and housing environment; social support). Migrants had limited access to COVID-19 prevention measures; living conditions made outbreaks inevitable; uncertainty about legal status, employment, and housing, as well as stigma and discrimination, exacerbated their precariousness; social support had decreased; and resilience mechanisms had failed. The initial draft of recommendations contained 24 proposed actions. The meetings added recommendations such as enhancing psychosocial support, preventing ghettoization, improving social housing, preventing the interruption of language education in times of crisis, severe penalties for media stigmatisation and proactive truth-telling. The final list included 30 actions. Conclusion In Munich, the COVID-19 pandemic exacerbated vulnerability mechanisms commonly associated with being a migrant. The recommendations developed here speak to those vulnerabilities but need to be refined further to be more actionable and comprehensive. Nonetheless, the recommendations and the processes that led to them highlight the importance of migrant-inclusive approaches and empowerment in increasing migrants' resilience to future crises.
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Affiliation(s)
- Zeliha Asli Öcek
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Rachel Carson Centre for Environment and Society, LMU Munich, Munich, Germany
| | - Mandy Geise
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | | | - Acelya Basili
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
| | - Vera Klünder
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
| | - Michaela Coenen
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Chair for Public Health and Health Services Research, Medical Faculty, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
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Shim J, Lee E, Kim E, Choi Y, Kang G, Kim BI. COVID-19 outbreak in a religious village community in Republic of Korea and risk factors for transmission. Osong Public Health Res Perspect 2023; 14:110-118. [PMID: 37183331 PMCID: PMC10211447 DOI: 10.24171/j.phrp.2023.0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/22/2023] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
OBJECTIVES This study aimed to assess the scale and transmission patterns of coronavirus disease 2019 (COVID-19) in a religious village community in South Korea, to determine the risk factors of transmission, and to evaluate vaccine effectiveness. METHODS An epidemiological survey was conducted, and data were collected and analyzed from 602 villagers in the religious village community. Multivariate logistic regression analysis was used to identify the risk factors for COVID-19 transmission and to evaluate vaccine effectiveness. RESULTS The outbreak attack rate was 72.1% (434/602). The attack rate was high among women in their 60s, the unemployed, residents living near religious facility (<500 m), and the unvaccinated. Age, the distance between religious facility and residences, and the absence of vaccination were identified as risk factors for transmission. Vaccine effectiveness was 49.0%, and the highest effectiveness was seen in the age group of 59 years or younger (65.8%). CONCLUSION This village community was isolated, with little communication with the outside world. However, the frequency of close contact between residents was relatively high, contributing to the spread of COVID-19 in the village even with relatively short exposure. Vaccination rates in the village community were also lower than those in the general public. Public health authorities should consider the potential impact of cultural factors, including religion, that could lead to the exponential spread of COVID-19 in closed village communities.
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Affiliation(s)
- Jiae Shim
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Eunju Lee
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Eunyoung Kim
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Yeonhwa Choi
- Division of Infectious Disease Response, Chungnam Regional Center for Disease Control and Prevention, Korea Disease Control and Prevention Agency, Daejeon, Republic of Korea
| | - Giseok Kang
- Chungnam Center for Infectious Diseases Control and Prevention, Hongseong, Republic of Korea
| | - Bryan Inho Kim
- Division of Infectious Disease Control, Bureau of Infectious Disease Policy, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
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Al-Talib M, Bailey PK, Zhou Q, Wong K. The experiences of UK-Chinese individuals during the COVID-19 pandemic: A qualitative interview study. PLoS One 2023; 18:e0280341. [PMID: 36649253 PMCID: PMC9844865 DOI: 10.1371/journal.pone.0280341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 12/27/2022] [Indexed: 01/18/2023] Open
Abstract
Infectious disease outbreaks have historically been associated with stigmatisation towards minority groups, specifically those associated with the geographical region that the disease was first identified. We aimed to investigate how the emerging COVID-19 pandemic was experienced by UK-resident individuals of Chinese ethnicity: how their perceived cultural and ethnic identity influenced their experiences, and how early insights into the pandemic in China influenced attitudes and behaviours. We undertook in-depth semi-structured interviews with individuals who self-identified as UK-Chinese. Participants were recruited from three cities in the UK. Interviews were undertaken over the telephone between 9th April 2020 and 16th July 2020. Interviews were digitally recorded and transcribed verbatim. Transcripts were coded using NVivo software and analysed using inductive thematic analysis. Sixteen individuals were interviewed. Three main themes were identified: (1) Attribution of stigma, (2) Pandemic legacies, and (3) Individual versus societal responses. These reflected six sub-themes: (1) Stigmatisation through (mis)identity, (2) Markers of pandemic awareness, (3) Legacies of previous pandemics, (4) Ascription of blame, (5) Extent of freedom, and (6) Implicit faith in government. Experiences of xenophobia included accounts of physical violence. UK-Chinese individuals experienced and perceived widespread xenophobia, in the context of media representations that ascribed blame and exacerbated stigmatisation. Prior experience of respiratory epidemics, and insight into the governmental and societal response in China, contributed to the early adoption of face masks. This in turn marked UK-Chinese individuals as targets for abuse. Awareness is needed to safeguard stigmatized groups from social and economic harm in future infectious disease pandemics.
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Affiliation(s)
- Mohammed Al-Talib
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Pippa K. Bailey
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, United Kingdom
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Qiaoling Zhou
- Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom
| | - Katie Wong
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, United Kingdom
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Falla-Aliabadi S, Heydari A, Fatemi F, Yoshany N, Lotfi MH, Sarsangi A, Hanna F. Impact of social and cultural factors on incidence, transmission and control of Coronavirus disease in Iran: a qualitative study. BMC Public Health 2022; 22:2352. [PMID: 36522718 PMCID: PMC9753076 DOI: 10.1186/s12889-022-14805-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 12/05/2022] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION COVID-19 pandemic has had mixed reactions from nations, people and governments about ways to cope with, prevent and control the disease. The current study identifies social, cultural and policy factors affecting the incidence and control of Coronavirus disease in Iran. METHODS A qualitative study consists of content analysis as well as the views of 20 experienced and knowledgeable subjects specialized in social and cultural health management. The data were gathered using three semi-structured interviews and then continued by 17 semi-structured interviews. Data analysis was done using Graneheim approach. After each interview, the recorded audio files transcript and reviewed. Then codes extracted and divided to categories and sub-categories. RESULTS There are distinct social and cultural factors in coping with Coronavirus disease. These consisted of three categories of governance, individual and community related factors. A total of 17 subcategories and 215 primary codes that were extracted from the text of interviews as variables of the study and in relation to the research question. Ten subdomains of governance including vaccination, political issues, knowledge, support services, administrative services, transportation, health and treatment, culturalization, legislation and, managerial and financial policies impacted the spread and mitigation of the pandemic at various levels. CONCLUSION The management of pandemics requires a comprehensive capacity for identifying and determining social and cultural criteria. A healthy partnership between governments and the community may be required to remove unnecessary obstacles that hinder public health attempt to alleviate the risk. The obtained criteria and indicators from this study may be utilized by policy makers in an attempt to strengthen protocols for mitigating pandemics. Further studies may be warranted to confirm these findings.
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Affiliation(s)
- Saeed Falla-Aliabadi
- Department of Health in Emergencies and Disasters, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Accident Prevention and Crisis Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ahad Heydari
- Department of Health in Disaster and Emergencies, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farin Fatemi
- Social Determinant of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Nooshin Yoshany
- Department of Health education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Hasan Lotfi
- Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Alireza Sarsangi
- GIS and Remote Sensing Department, University of Tehran, Tehran, Iran
| | - Fahad Hanna
- Program of Public Health, Torrens University Australia, Melbourne, VIC Australia
- Higher Education College, Chisholm Institute, Dandenong, VIC Australia
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COVID-19 and Vulnerable Children Well-Being: Interview with Left-Behind Children in Rural China. CHILDREN 2022; 9:children9091317. [PMID: 36138627 PMCID: PMC9498038 DOI: 10.3390/children9091317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 08/15/2022] [Accepted: 08/26/2022] [Indexed: 11/16/2022]
Abstract
Purpose of the study: This study sought to explore the psychological well-being, academic adjustment, and quality of parental attachment of LBC during COVID-19 based on Left-Behind Children’s (LBC) word of mouth. Method: In light of the abundance of quantitative studies, this qualitative study explored the psychological, academic, and parental attachment experiences of rural LBC during COVID-19. To this end, we conducted semi-structured interviews with 22 LBCs aged 10–15 in May 2021. Result: The study results reveal that LBCs developed severe psychological illnesses after the pandemic severely disrupted their already disturbed lives. Our findings showed that most LBCs feel they do not need their parents, which reflects their long record of hopelessness and agony regarding the absence of their parents. Conclusion: Although COVID-19 is a global problem, its impact was particularly devastating for LBCs who have nobody around who could help them with their academic, personal and social need. In the modern COVID-19 era, it seems that Chinese grandparenting has become unreliable in the face of radical change in contemporary Education, society, and the economic system. Therefore, this study suggests that the Chinese government should seek to identify and monitor these children by working with NGOs that target such children.
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Alsaqqa HH. The Populations' Resilience Toward the Policymaking Discrepancies in the Pandemic Covid-19 Period. Front Public Health 2021; 9:733519. [PMID: 34712638 PMCID: PMC8545791 DOI: 10.3389/fpubh.2021.733519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 09/17/2021] [Indexed: 11/13/2022] Open
Abstract
The world is in the midst of a crisis unlike any other in recent memory. COVID-19 is a pandemic that is urgent, global in scope, and has huge consequences. The policy sciences provide insights into unfolding trends, and this article uses the lessons of the literature to better understanding the policymaking shifts and population acceptability of COVID-19. The author attempts to investigate how policymakers' emotions and narratives affect policy decisions and form policymaker-population relationships. The author addresses policymaking processes, transitions, interpretations of policy responses, policy implementation through multilateral topics and evaluating policy progress and failure. Trust is linked to cultural norms, values, and faiths in policy literature, and it is seen as a component of key social and economic policy outcomes. The author ends by identifying understudied facets of policymaking that need to be addressed during pandemics.
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Affiliation(s)
- Hatem H Alsaqqa
- Ph.D. Health Services Management, Ministry of Health, Gaza, Palestine
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