Review on Drug Utilization Assessment of Cephalosporin

Pediatric is the field of medicine that is concerned with the health of infants, children and adolescents. Globally, many infectious diseases have been controlled in the 20th century by improving People’s standard of living through public health campaigns and the use of various antimicrobial agents. Evidence suggests that the manner in which Primary Healthcare centers prescribe drugs has contributed to the high rise in Anti-Microbial Resistance (AMR). The extent of the resistance is determined by the site of antibiotic application and in this study oral usage of antibiotics was found to be the highest contributor to Anti-Microbial Resistance. A systematic review of the published literature on the conduct and reporting of meta-analyses in observational studies was done using databases searched included MEDLINE, Educational Resources Information Center, PsycLIT (http://www.wesleyan.edu/libr), Google Scholar, EMBASE, International Pharmaceutical Abstracts and the Current Index to Statistics. It was concluded that most of the articles reported that cephalosporin were widely used antibiotics and therefore its use must be rational; to avoid its abuse which may result to high level of resistance.

Evaluation of Patient’s Satisfaction Level with the Provided Healthcare in Primary Healthcare Centers in Saudi Arabia

The aim of this study was to evaluate patient’s satisfaction at primary health centers PHCCs in (Khobar, Jeddah, Riyadh, Jubail, Dhahran, Hail, Majmah, Abha, Baha, and Makkah) located in Saudi Arabia. The review finding shows that the highest overall satisfaction in Baha city (84.16%) followed by Majmah city with (81.7%), and the lowest overall satisfaction was the score (2.44) out of a maximum of 5 for Jubail city and Jeddah (2.45). Dhahran, Hail, Abha, Makkah, Riyadh, and Khobar were scored different scores; (3.66), (3.60), (57.7%), (70.1%), (64.2%) and (3.76). Nursing staff play a vital role in the satisfaction of patients in primary healthcare centers, including education, care and counselling, which is why all nursing staff should be skilled in clinical skills, level of education and interpersonal skills The highest domain of satisfaction was for nursing performance, and their treatment were found to be high (90.1%), but the lowest score was for the explanation of the medical conditions by the nurses, which could be due to language barrier. Medical care, laboratory services, and pharmacological services are other factors that may impact patient satisfaction with primary health centers. There are significant differences between Abha city (57.7%) and Baha city (84.16%) in south province in their overall satisfaction with Patient’s Satisfaction in primary healthcare centers PHCCs. And between Riyadh city (64.2%) and Majmah city (82.0%) in the middle province. In the eastern province, overall satisfaction for three cities Khobar city (3.76), Jubail city (2.44), and Dhahran city (3.66). The western province, overall satisfaction for two cities, Makkah city (70.1%), and Jeddah city (2.45). One city for north province Hail city (3.60). For comparison, the highest overall satisfaction in this study was Baha city (84.16%) located in south province, and the lowest one was Jubail city with score (2.44) out of 5.

An equity and efficiency integrated grid-to-level 2SFCA approach: spatial accessibility of multilevel healthcare

Background Equity of healthcare spatial access is essential for the health outcomes of medical investments and the welfare of populations, and efficiency of medical resource allocation is important for obtaining a supply-demand equilibrium with lower cost and higher outputs with limited inputs. However, the literature that involves both equity and efficiency in its analysis of healthcare spatial allocation is rare, and the spatial accessibility of multilevel healthcare is difficult to measure by traditional methods in a large region with diversified population distribution. Methods To assist in solving these issues, this paper aims to build an equity and efficiency integrated analytical framework by proposing a new “GTL-2SFCA” approach to analyze the spatial accessibility of multilevel healthcare; maximum and minimum floating catchments of different levels of healthcare were assigned to ensure a combination of universal search coverage and efficient hospitalization behavior simulation. Results The analytical framework was applied and tested in Hubei, China. Almost half of the residents (47.95%) and townships (44.98%) have access to both public general hospitals (PGHs) and primary healthcare centers (PHCs) services, 36.89% of the residents enjoy only one sufficient service, either PGHs or PHCs, and the remaining residents (15.16%) are faced with the risk of lacking access to both services. The results reveal that there are core-periphery effects of multilevel healthcare throughout Hubei and isolate clusters that have adequate access in the western region. The polarization effect of higher-level healthcare and the polycentric pattern of lower-level healthcare coexist. The multilevel healthcare shortage was identified in some areas in boundary and peripheral regions. Conclusions This study integrates equity and efficiency into the GTL-2SFCA framework, enriches the FCA series methodologies and provides a more operational solution for evaluating the access of residents in more sophisticated spatial units to each level of healthcare. By more significantly differing and quantifying the catchment area and distance decay effect, this methodology avoids overestimating or underestimating accessibility and discovers some imperceptible spatial inequities. This study has application value for researchers and decision-makers in other scenarios and regions with significant heterogeneity in medical resources and where the population has greater mobility.

Prevalence of Overweight and Obesity in Type 2 Diabetic Patients Visiting PHC in the Dubai Health Authority

<b><i>Background:</i></b> Diabetes is a highly prevalent global and local major health problem according to the International Diabetes Federation (IDF) and will double by 2045. A strong relationship between obesity and type 2 diabetes has been found. Both are leading causes of cardiovascular disease and death; thus, understanding the prevalence of obesity in type 2 diabetes is crucial for planning obesity management and preventing complications. <b><i>Objectives:</i></b> This study aimed to determine the prevalence of obesity and overweight among people with type 2 diabetes attending primary healthcare centers (PHC) in the Dubai Health Authority (DHA). <b><i>Methods:</i></b> The study sample consisted of type 2 diabetes mellitus patients who attended family medicine clinics in primary healthcare centers in DHA. All cases with type 2 diabetes attending family clinics for their periodic health checkup screening were included in the study. Patients &#x3c;18 years old, pregnant, and/or those with cancer and/or chronic kidney disease were excluded. <b><i>Results:</i></b> Our study sample had 9,198 type 2 diabetes mellitus cases with 51.6% males, 69.7% United Arab Emirates nationals, 7.9% who exercised regularly, and 1.8% who followed a healthy diet. Obesity and overweight cases were 49.5% and 35.5%, respectively. <b><i>Conclusion:</i></b> Without an aggressive obesity management approach, control of diabetes is difficult. The prevalence of obesity and overweight among people with type 2 diabetes is high. Obesity and overweight cases were 49.5% and 35.5%, respectively, among diabetic patients attending PHC. Over 50% (55%) of UAE nationals were obese, while 31.8% were overweight, suggesting that active interventions to control weight gain would be appropriate.

Stakeholder perspectives to inform adaptation of a hypertension treatment program in primary healthcare centers in the Federal Capital Territory, Nigeria: a qualitative study

Background Implementing an evidence-based hypertension program in primary healthcare centers (PHCs) in the Federal Capital Territory, Nigeria is an opportunity to improve hypertension diagnosis, treatment, and control and reduce deaths from cardiovascular diseases. This qualitative research study was conducted in Nigerian PHCs with patients, non-physician health workers, administrators and primary care physicians to inform contextual adaptations of Kaiser Permanente Northern California's hypertension model and the World Health Organization’s HEARTS technical package for the system-level, Hypertension Treatment in Nigeria (HTN) Program. Methods Purposive sampling in 8 PHCs identified patients (n = 8), non-physician health workers (n = 12), administrators (n = 3), and primary care physicians (n = 6) for focus group discussions and interviews. The Primary Health Care Performance Initiative (PHCPI) conceptual framework and Consolidated Framework for Implementation Research (CFIR) domains were used to develop semi-structured interviews (Appendix 1, Supplemental Materials) and coding guides. Content analysis identified multilevel factors that would influence program implementation. Results Participants perceived the need to strengthen four major health system inputs across CFIR domains for successful adaptation of the HTN Program components: (1) reliable drug supply and blood pressure measurement equipment, (2) enable and empower community healthcare workers to participate in team-based care through training and education, (3) information systems to track patients and medication supply chain, and (4) a primary healthcare system that could offer a broader package of health services to meet patient needs. Specific features of the PHCPI framework considered important included: accessible and person-centered care, provider availability and competence, coordination of care, and proactive community outreach. Participants also identified patient-level factors, such as knowledge and beliefs about hypertension, and financial and transportation barriers that could be addressed with better communication, home visits, and drug financing. Participants recommended using existing community structures, such as village health committees and popular opinion leaders, to improve knowledge and demand for the HTN Program. Conclusions These results provide information on specific primary care and community contextual factors that can support or hinder implementation and sustainability of an evidence-based, system-level hypertension program in the Federal Capital Territory, Nigeria, with the ultimate aim of scaling it to other parts of the country.

Review: Primary healthcare in six sub-Saharan African countries: an impact assessment using a systematic review

Primary healthcare is provided in most developing and developed countries to enhance healthcare accessibility for the population. This study accesses the impact of primary healthcare in six Sub-Saharan countries. A systematic search for qualitative and quantitative studies published before the end of 2017 was conducted online. Inclusion criteria were met by 6 studies, one each from Ghana, Malawi, Nigeria, Tanzania, Zambia and Zimbabwe. Five studies are peer-reviewed, and one is a working paper. Three studies reported on the impact of primary healthcare on healthcare accessibility. Four studies reported on the role healthcare resources play in enhancing primary healthcare services. Two other studies mentioned how cost-sharing mechanism led to an increase in healthcare utilization and how the reduction in user changes in all primary healthcare centers led to the reduction in out-of-pocket spending on healthcare services in a short-term. Primary healthcare offers access and utilization to healthcare services in most countries. It also offers protection against the detrimental effects of user fees. However, concerted efforts are still needed in most African countries in revitalizing the operations of primary healthcare centers for the improvement of healthcare services.