scholarly journals HIV infected patients attendance in a Brazilian public health service: A short report

2018 ◽  
Author(s):  
Larissa Silva dos Santos ◽  
Kátia Azevedo ◽  
Licinio Silva ◽  
Solange Oliveira ◽  
Ledy Oliveira
Keyword(s):  
Public Health ◽  
Health Service ◽  
Retention In Care ◽  
Healthcare Services ◽  
Short Report ◽  
The Public ◽  
Sustained Viral Suppression ◽  
Immunodeficiency Virus ◽  
Structured Questionnaire

Background. Continuous health monitoring of human immunodeficiency virus (HIV) infected patients is critical to allow uninterrupted access to antiretroviral therapy (ART) and sustained viral suppression. Despite public health effort for patient retention in care, many HIV-infected patients fail to maintain effective engagement in Health Services. This study reports the attendance of HIV infected individuals for routine exams in a Brazilian outpatient clinic. Methods. Patients were enrolled in two moments, 2010/2011 and 2014/2015, as they attended the public service for monitoring HIV infection status. The individuals that agreed to participate the study signed an informed consent and completed a structured questionnaire. Results. Of 58 initially expected patients, only 31 participated in the second part of the study. The reasons for these individuals not returning to the health service during the study period were not related to death (1.7%) and the majority of them still remained enrolled in the service and in follow-up. Discussion. The difficulty of HIV infected patients in returning to healthcare services have been reported by several authors. Among the barriers that prevent monitoring, we suggest that noncompliance may also be linked to years of study. However this subject needs more investigation.

scholarly journals HIV infected patients attendance in a Brazilian public health service: A short report

2018 ◽  
Author(s):  
Larissa Silva dos Santos ◽  
Kátia Azevedo ◽  
Licinio Silva ◽  
Solange Oliveira ◽  
Ledy Oliveira
Keyword(s):  
Public Health ◽  
Health Service ◽  
Retention In Care ◽  
Healthcare Services ◽  
Short Report ◽  
The Public ◽  
Sustained Viral Suppression ◽  
Immunodeficiency Virus ◽  
Structured Questionnaire

Background. Continuous health monitoring of human immunodeficiency virus (HIV) infected patients is critical to allow uninterrupted access to antiretroviral therapy (ART) and sustained viral suppression. Despite public health effort for patient retention in care, many HIV-infected patients fail to maintain effective engagement in Health Services. This study reports the attendance of HIV infected individuals for routine exams in a Brazilian outpatient clinic. Methods. Patients were enrolled in two moments, 2010/2011 and 2014/2015, as they attended the public service for monitoring HIV infection status. The individuals that agreed to participate the study signed an informed consent and completed a structured questionnaire. Results. Of 58 initially expected patients, only 31 participated in the second part of the study. The reasons for these individuals not returning to the health service during the study period were not related to death (1.7%) and the majority of them still remained enrolled in the service and in follow-up. Discussion. The difficulty of HIV infected patients in returning to healthcare services have been reported by several authors. Among the barriers that prevent monitoring, we suggest that noncompliance may also be linked to years of study. However this subject needs more investigation.

scholarly journals Retention and sustained viral suppression in HIV patients transferred to community refill centres in Kinshasa, DRC

2020 ◽  
Vol 10 (1) ◽  
pp. 33-37
Author(s):  
R. Moudachirou ◽  
G. Van Cutsem ◽  
R. I. Chuy ◽  
H. Tweya ◽  
M. Senkoro ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Democratic Republic Of Congo ◽  
Retention In Care ◽  
Hiv Patients ◽  
Sustained Viral Suppression ◽  
Kaplan Meier ◽  
Immunodeficiency Virus ◽  
Set Up ◽  
Better Than

Setting: In 2010, Médecins Sans Frontières set up decentralised community antiretroviral therapy (ART) refill centres (“poste de distribution communautaire”, PODI) for the follow-up of stable human immunodeficiency virus (HIV) patients.Objective: To assess retention in care and sustained viral suppression after transfer to three main PODI in Kinshasa, Democratic Republic of Congo (DRC) (PODI Barumbu/Central, PODI Binza Ozone/West and PODI Masina I/East).Design: Retrospective cohort study using routine programme data for adult HIV patients transferred from Kabinda Hospital to PODIs between January 2015 and June 2017.Results: A total of 337 patients were transferred to PODIs: 306 (91%) were on ART for at least 12 months; 118 (39%) had a routine “12-month” viral load (VL) done, 93% (n = 110) of whom had a suppressed VL <1000 copies/ml. Median time from enrolment into PODI to 12-month routine VL was 14.6 months (IQR 12.2–20.8). Kaplan-Meier estimates of retention in care at 6, 12 and 18 months after enrolment into PODIs were respectively 96%, 92% and 88%.Conclusion: Retention in care and viral suppression among patients in PODI with VL results were better than patients in clinic care and national outcomes.

Corrupt Practices in the Public Health Sector: A Focus on Metropolitan Local Government Areas of Kano State, Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 149
Author(s):  
Mohammed Mustapha Namadi
Keyword(s):  
Public Health ◽  
Local Government ◽  
Health Sector ◽  
Sampling Technique ◽  
Healthcare Services ◽  
Healthcare Sector ◽  
Healthcare Provision ◽  
The Public ◽  
Public Health Sector ◽  
The Government

Corruption is pervasive in Nigeria at all levels. Thus, despite recent gains in healthcare provision, the health sector faces numerous corruption related challenges. This study aims at examining areas of corruption in the health sector with specific focus on its types and nature. A sample size of 480 respondents aged 18 years and above was drawn from the eight Metropolitan Local Government Areas of Kano State, using the multistage sampling technique. The results revealed evidence of corrupt practices including those related to unnecessary-absenteeism, diversion of patients from the public health facilities to the private sector, diverting money meant for the purchase of equipment, fuel and diesel, bribery, stealing of medications, fraud, misappropriation of medications and unjustifiable reimbursement claims. In order to resolve the problem of corrupt practices in the healthcare sector, the study recommended the need for enforcement of appropriate code of ethics guiding the conduct of the health professionals, adoption of anti-corruption strategies, and strengthening the government monitoring system to check corruption in public health sector in order to ensure equitable access to healthcare services among the under-privileged people in the society.

Funding models and expenditures with primary healthcare in Salvador, Bahia, Brazil metropolitan area

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
T Vivas ◽  
M Duarte ◽  
A Pitta ◽  
B Christovam
Keyword(s):  
Public Health ◽  
Metropolitan Area ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Ministry Of Health ◽  
Healthcare Budget ◽  
Health Budget ◽  
The Public ◽  
Before And After ◽  
The Government

Abstract Background The government investments in quality primary healthcare are the basis to strengthening the health systems and monitoring the public expenditure in this area is a way to assess the effectiveness and efficiency of the public health policies. The Brazil Ministry of Health changed, in 2017, the method of onlending federal resources to states and cities seeking to make the public funds management more flexible. This change, however, suppressed mandatory investments in primary healthcare. This research aims to determine the difference of expenditures on primary healthcare in Salvador, Bahia, Brazil metropolitan area before and after this funding reform, seeking to verify how it can impact the quality of primary healthcare services and programs. Methods This is an ecological time-series study that used data obtained in the Brazil Ministry of Health budget reports. The median and interquartile range of expenditures on primary healthcare (set as the percentage of total public health budget applied in primary care services and programs) of the 13 cities in the Salvador metropolitan area were compared two years before and after the reform. Results The median of expenditures on primary healthcare in Salvador metropolitan area was 25.5% (13,9% - 32,2%) of total public health budget before and 24.8% (20.8% - 30.0%) of total public health budget after the reform (-0.7% difference). Seven cities decreased the expenditures on primary healthcare after the reform, ranging from 1.2% to 10.8% reduction in the primary healthcare budget in five years. Conclusions Expenditures on primary healthcare in Salvador metropolitan area decreased after the 2017 funding reform. Seven of 13 cities reduced the government investments on primary healthcare services and programs in this scenario. Although the overall difference was -0.7%, the budget cuts ranged from 1.2% to 10.8% in the analyzed period and sample. More studies should assess these events in wide areas and with long time ranges. Key messages Public health funding models can impact the primary healthcare settings regardless of the health policy. Reforms in the funding models should consider the possible benefits before implementation. Funding models and methods that require mandatory investments in primary healthcare may be considered over more flexible ones.

scholarly journals The potential dangers of not understanding COVID-19 public health restrictions in dementia: “It’s a groundhog day – every single day she does not understand why she can’t go out for a walk”

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clarissa Giebel ◽  
Kerry Hanna ◽  
Manoj Rajagopal ◽  
Aravind Komuravelli ◽  
Jacqueline Cannon ◽  
...  
Keyword(s):  
Public Health ◽  
Cognitive Deficits ◽  
Third Sector ◽  
Cognitive Capacity ◽  
The Public ◽  
Health Measures ◽  
Third Sector Organisations ◽  
The Uk ◽  
Second Wave

Abstract Background Sudden public health restrictions can be difficult to comprehend for people with cognitive deficits. However, these are even more important for them to adhere to due to their increased levels of vulnerability, particularly to COVID-19. With a lack of previous evidence, we explored the understanding and changes in adherence to COVID-19 public health restrictions over time in people living with dementia (PLWD). Methods Unpaid carers and PLWD were interviewed over the phone in April 2020, shortly after the nationwide UK lockdown, with a proportion followed up from 24th June to 10th July. Participants were recruited via social care and third sector organisations across the UK, and via social media. Findings A total of 70 interviews (50 baseline, 20 follow-up) were completed with unpaid carers and PLWD. Five themes emerged: Confusion and limited comprehension; Frustration and burden; Putting oneself in danger; Adherence to restrictions in wider society; (Un) changed perceptions. Most carers reported limited to no understanding of the public health measures in PLWD, causing distress and frustration for both the carer and the PLWD. Due to the lack of understanding, some PLWD put themselves in dangerous situations without adhering to the restrictions. PLWD with cognitive capacity who participated understood the measures and adhered to these. Discussion In light of the new second wave of the pandemic, public health measures need to be simpler for PLWD to avoid unwilful non-adherence. Society also needs to be more adaptive to the needs of people with cognitive disabilities more widely, as blanket rules cause distress to the lives of those affected by dementia.

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