Healthcare Services Interoperability in Kenya: Challenges and Opportunities

In an attempt to assess the Kenyan healthcare system, this study looks at the current efforts that are already in place, what challenges they face, and what strategies can be put into practice to foster interoperability. By reviewing a variety of literature and using statistics, the paper ascertains notable impediments such as the absence of standard protocols, lack of adequate technological infrastructure, and weak regulatory frameworks. Resultant effects from these challenges regarding health provision target enhanced data sharing and merging for better patient outcomes and allocation of resources. It also highlights several opportunities that include the adoption of emerging technologies, and the establishment of public-private partnerships to strengthen the healthcare framework among others. In this regard, the article provides recommendations based on stakeholder views and global best practices addressed to policymakers, medical practitioners, and IT specialists concerned with achieving effective interoperability within Kenya’s health system. This research is relevant because it adds knowledge to the existing literature on how healthcare quality can be improved to make it more patient-centered especially in Kenya.

Stress perceptions of nurses serving in home healthcare services during the COVID-19 pandemic:A qualitative research

Objective:To investigate the stress perceptions of nurses serving in home healthcare services during COVID-19.Methods:This study was qualitative research with a phenomenological design.Data were collected and recorded through in-depth interviews with 6 nurses working in MuşState Hospital,Home Healthcare Services Unit using a form consisting of 12 questions on an online platform between May 2021 and July 2021.The audio recordings were transcribed by the researcher and content analysis was performed by creating codes,categories,and themes.Results:The interviews yielded 10 categories and 59 sub-codes.These codes were addressed under the theme of"COVID-19 pandemic".Under this main theme,nurses expressed the problems they experienced in issues such as stress,support mechanisms,and family and social problems during COVID-19.They mentioned that they experienced high stress in this process,as well as social isolation and negative thoughts of society about them and that they could not spare time for themselves and their families.Conclusions:Nurses working in home healthcare services frequently express negativities such as high stress,isolation from society,and increased workload.Therefore,actions should be taken to raise awareness of society on these issues,increase the number of personnel,conduct more research,and share the results with the public.

Accessibility and utilization of healthcare services among diabetic patients:Is diabetes a poor man’s ailment?

Diabetes is a non-communicable ailment that has adverse effects on the individual’s overall well-being and productivity in society.The main objective of this study was to examine the empirical literature concerning the association between diabetes and poverty and the accessibility and utilization of medical care services among diabetic patients.The diabetes literature was explored using a literature review approach.This review revealed that diabetes is an ailment that affects all individuals irrespective of socioeconomic status;however,its prevalence is high in low-income countries.Hence,despite the higher prevalence of diabetes in developing countries compared with developed countries,diabetes is not a poor man’s ailment because it affects individuals of all incomes.While the number of diabetic patients that access and utilize diabetes medical care services has increased over the years,some personal and institutional factors still limit patients’access to the use of diabetes care.Also,there is a lacuna in the diabetes literature concerning the extent of utilization of available healthcare services by diabetic patients.

COVID-19 pandemic effects on the distribution of healthcare services in India: A systematic review

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has brought fundamental changes to our problems and priorities,especially those related to the healthcare sector.India was one of the countries severely affected by the harsh consequences of the COVID-19 pandemic.AIM To understand the challenges faced by the healthcare system during a pandemic.METHODS The literature search for this review was conducted using PubMed,EMBASE,Scopus,Web of Science,and Google Scholar.We also used Reference Citation Analysis(RCA)to search and improve the results.We focused on the published scientific articles concerned with two major vital areas:(1)The Indian healthcare system;and(2)COVID-19 pandemic effects on the Indian healthcare system.RESULTS The Indian healthcare system was suffering even before the pandemic.The pandemic has further stretched the healthcare services in India.The main obstacle in the healthcare system was to combat the rising number of communicable as well as noncommunicable diseases.Besides the pandemic measures,there was a diversion of focus of the already established healthcare services away from the chronic conditions and vaccinations.The disruption of the vaccination services may have more severe short and long-term consequences than the pandemic’s adverse effects.CONCLUSION Severely restricted resources limited the interaction of the Indian healthcare system with the COVID-19 pandemic.Re-establishment of primary healthcare services,maternal and child health services,noncommunicable diseases programs,National Tuberculosis Elimination Program,etc.are important to prevent serious long-term consequences of this pandemic.

The Effect of Public Healthcare Service Quality on Residents’ Satisfaction in the United Arab Emirates (UAE), the Case of Ajman Emirate

The quality of healthcare services is becoming a major concern in all countries, through improving performance to maximize the population health, effectively and efficiently, by doing the right thing, at the right time, in the right way, for the right person and having the best possible results, through well-managed hospitals and clinics. The purpose of this paper is to identify and measure Ajman residents’ satisfaction on healthcare service, using data of a sample of 1035 households, randomly selected from a total of 95,531 households, who were permanently residing in the Emirate of Ajman and having prior experience in availing any healthcare service. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 22 and AMOS version 22. Structural Equation Modeling (SEM) analysis showed an acceptable model fit used to measure residents’ satisfaction. Findings showed that in the government sector only reliability and empathy correlated positively with healthcare service quality, which also had a strong, positive correlation with residents’ satisfaction, while tangible, assurance and responsiveness were not sufficiently correlated to healthcare service quality. On the other hand, for private sector, except for responsiveness and tangible dimensions, reliability, assurance, and empathy correlated positively with healthcare service quality, which also had a strong, positive correlation with residents’ satisfaction. This study used healthcare service quality dimensions, namely, tangible, reliability, responsiveness, assurance, and empathy, to determine the residents’ satisfaction within the public hospitals and to provide an empirical contribution to understanding the factors associated with public satisfaction and healthcare systems. According to the survey results, Ajman residents were satisfied 82% on Quality Dimension, 77% on Empathy Dimension, 80% on both Assurance and responsiveness Dimensions, 89% on Reliability Dimension and 88% on Tangible Dimension. Moreover, Statistical analysis revealed that, each of Tangible Dimension, Healthcare Service Quality Dimension and Empathy Dimension, is positively correlated with Healthcare Service Quality. Likewise, Healthcare Service Quality, is also positively correlated with residents’ satisfaction. But Reliability, Responsiveness, and Assurance Dimensions, are not positively correlated with Healthcare Service Quality.

A Study on Smart Home Design Incorporating Ubiquitous Healthcare Services

The smart home using ubiquitous technology can effectively provide services to the elderly and the physically impaired. However, such services are accompanied by high initial cost of installation and the operating inefficiency due to the absence of design guidelines. To solve these, the integrated management of the process by supplying the public service like voucher schemes to the dwelling is needed. This paper mainly proposes a research about the healthcare service in a residential environment, which includes medical service and safety service and so on, by surveying the voucher program and the in-house infra status. Finally, the house planning elements for healthcare-based smart home are drawn and the planning directions through expert survey are suggested. Therefore, this study surveyed on voucher program and in-house infra status, and drew the house planning elements for health-based care smart home. In addition, this study suggested the planning direction through expert survey. This study can be used as a guideline for constructing a smart home, which supplies healthcare service.

Sociodemographic Predictors of Health-Related Quality of Life and Healthcare Service Utilisation among Young Refugees in South Australia

Although refugee adolescents and children are recognised as a health risk population, few studies have explored their Health-related Quality of Life (HRQOL). The present study investigated 1) the sociodemographic predictors of HRQOL such as ethnicity, trauma exposure, and length of residency in Australia in a multiethnic paediatric population with refugee experiences and 2) the relationship between mental healthcare utilisation and HRQOL. Method: Participants were 458 adolescents and children, aged 4 - 17 years, living in South Australia. Parents provided data across the sample and adolescents also completed questionnaires. Overall HRQOL and its composite functional dimensions were assessed using the Paediatric Quality of Life (PedsQL) instrument. Questions from the Child and Adolescent Component of the Australian National Survey of Mental Health and Wellbeing were used to assess service utilisation. Results: Migration region/ethnicity predicted better HRQOL as well as physical, emotional and psychosocial functioning for both children and adolescents. African youths indicated higher HRQOL than those from the former Yugoslavia and the Middle East/South Asia respectively. Pre-migration trauma exposure was associated with lower HRQOL;and longer stay in Australia was related to lower emotional functioning in children. There was a negative association between healthcare service utilisation and PedsQL scores, with participants accessing services demonstrating lower HRQOL. Conclusion: Using more rigorous methods, future research is needed to investigate additional sociodemographic predictors of HRQOL, and protective/risk factors that impact on HRQOL of young refugees.

Effect of the pandemic on rehabilitation healthcare services in India:Breaking barriers

We would like to highlight the rehabilitation medicine perspective from India.Difficulties are impacted by the pandemic during this time,especially for people with disabilities.Awareness building among the public regarding the need for rehabilitation along with improvement in infrastructure is the key unmet need.

Managing the Needs of Older Patients with Multimorbidity—A Systematic Review of the Challenges Faced by the Healthcare Services

Research fails to provide an overview of the challenges involved in caring for older patients with multimorbidity. Multimorbidity is defined as the presence of two or more chronic conditions in the same person, leading to a high risk of care dependency. The aim of this review was to illuminate the challenges faced by the healthcare services in managing the needs of older patients with multimorbidity. A systematic review was performed, a total of 1,965 abstracts were read and nine quantitative studies included. Data were analysed by thematic synthesis, revealing six themes: A frequent problem in older female patients;High healthcare expenditure and costs, Medication management problems, Social inequities, Complex healthcare and consultation needs and High mortality. The study highlights that healthcare professionals struggle to obtain suitable guidelines for the care of patients with multimorbidity while trying to respond to their needs. Patient-centred integration across settings and coordination in clinical practice are necessary. The healthcare system today does not seem to focus on patient safety and preventing harm. Older patients should be reviewed by a healthcare professional responsible for coordinating their care. To ensure safe and effective care for elderly persons with multimorbidity, the healthcare services should abandon the current focus on managing innumerable individual diseases and conditions.

Health awareness and lifestyle toward healthcare-seeking behavior among students in Universitas Advent Indonesia

Objective:Healthcare-seeking behavior(HSB)would affect the prevalence of morbidity and mortality.There are various factors that affect one's HSB.This study aimed to determine if health awareness and lifestyle might relate to HSB.Methods:A cross-sectional study was applied by using three questionnaires to determine par ticipants'health awareness,lifestyle,and HSB.This study took place in Universitas Advent Indonesia and the students were recruited to be par ticipants.Results:There were 39 par ticipants joined in this study.Most of the par ticipants were females,third-year students,and from Accounting major.Almost all participants were aware of their low risk of health issues,had a fine lifestyle,and had moderate HSB.Conclusions:One's urge to seek health care facilities was not related to their health awareness and lifestyle.There was no fur ther study to contradict with this finding at this moment.

Healthcare Services Demand in Post-disaster Settings:The 2014 Earthquake in Ludian County,Yunnan Province,China

Healthcare relief teams dispatched to rural areas often face difficulties due to limited initial and ongoing health information in the affected community.The present study investigated patterns of healthcare service demand for a rural displaced population in a post-disaster situation.Three weeks after the 2014 Ludian County earthquake,the Institute for Disaster Management and Reconstruction(IDMR) at Sichuan University and Hong Kong Polytechnic University organized a disaster nursing team to support the rural community in Longtoushan,at the epicenter of the earthquake.A cross-sectional,records-based study of 2484 records obtained from a temporary hospital in Longtoushan(for the period of 14 September-1 October 2014) was conducted.The daily number of records by patients' sociodemographic characteristics and medical diagnoses were plotted on a time series graph to explore the temporal change during the study period.Findings indicate that healthcare service demand from younger age groups was higher than that of the older adult group.Three major health problems were observed:respiratory disease,skin problems,and ear,eye,and throat(EET) problems.All of these very real health problems are chronic issues that require long-term care.They are not health issues directly related to the disaster emergency itself.Yet disaster relief nursing teams were selected on the basis of their ability to cope primarily with traumatic disaster-related injuries.The existing practice of teaming up disaster relief professions might not be optimal.To better understand the healthcare needs of a displaced population,short- and long-term planning is needed.Planning will allow disaster response professionals to better organize and deploy healthcare personnel to manage the above-listed problems in a postdisaster situation.

The home healthcare nursing services provided to the elderly patients: a systematic review

Background:Home healthcare(HHC)services entail quality and transitional care offered to patients.Doctors recommend HHC to the elderly patients to manage conditions and improve outcomes outside inpatient setting.The systematic review aimed to assess the home health care nurse services to elderly patients.The question of this study is“what are the home nursing care services provided to the elderly patient.Methods:A systematic review methodology was adopted.A search was conducted on PubMed,MEDLINE,and ScienceDirect using keywords such as“home healthcare”,“nurse services”,“home nurses”,“elderly patients”.The search generated 1829 articles,but 16 were selected for qualitative synthesis for meeting the eligibility criteria.Joana Briggs Institute’s critical appraisal tools helped in the assessment of the primary studies.A data extraction matrix generated themes,while a narrative synthesis presented the studies.Results:The review found administration of HHC nursing services in different settings.The studies confirmed varied nature of HHC,types of HHC services,transitional care,challenges,or barriers of offering HHC,relationships,and decision-making process in offering care to the patients and family.The studies presented HHC as a multifaceted component with diverse impact on the patients and family.The analysis revealed that HHC nurses services served elderly persons as the main target group.HHC faces different challenges,barriers,or obstacles such as work,role conflict,organization,elderly patients,and decision-making.Conclusion and Future Research:The assessment of the HHC nursing services provided to the elderly patients reveals different facets of the healthcare process that reduce readmissions and hospital costs.Further studies could explore the provision of care to other target groups such as middle-aged patients to understand the impact of the services.

Patient Satisfaction with Primary Health Care Services in Riyadh City, Saudi Arabia

Patient satisfaction is a crucial measure of healthcare quality and plays a vital role in ensuring effective healthcare systems. This study aims to assess the level of patient satisfaction with primary healthcare services in Riyadh, Saudi Arabia, identify social factors affecting satisfaction, and determine the reasons behind dissatisfaction and how to improve satisfaction. The study employed a cross-sectional observational design and included a random sample of 400 patients from primary healthcare centers in Riyadh. Data were collected using an electronic questionnaire and analyzed using SPSS software. The study found that patients were generally satisfied with the primary healthcare services provided in Riyadh, with high levels of satisfaction reported for booking appointments, triage services, and emergency care. However, some aspects of the healthcare experience, such as long waiting times and the physical design of healthcare centers, need improvement. These findings can be used to inform the development of policies and interventions aimed at enhancing healthcare quality in Saudi Arabia.

Health care service usage and costs for high-needs elderly patients with heart failure

Heart failure(HF)has been defined as global disease of pandemic proportions,since it affects around 26 million people worldwide.[1]According to a recent study,age is the most important factor influencing the prevalence of HF,as it is for most other chronic conditions.[2]This means that,with the predicted aging of the population(the proportion of the world’s population aged 60 years and over will nearly double from 2015 to 2050),[3]there will be a growth in the total burden of HF,and a rise in the number of comorbidities in HF patients.According to a recent study,almost 86%of adults with HF have two or more comorbid conditions.[4]Comorbidity,defined as the co-existence of one or more additional conditions in individuals with a specified index medical condition,[5]adds to the complexity of treating elderly patients with HF.

Interdepartmental miscommunication regarding radiology:Addressing chronic challenges and exploring solutions

Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services provided.In the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice.Practical solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.

Nurses’experiences in providing antenatal care during COVID-19 lockdown in Ghana

Background:The coronavirus disease 2019(COVID-19)pandemic posed a major global health threat,leading to the disruption and strain of numerous health systems globally.The situation deprived essential routine healthcare services,including antenatal care,of the needed attention,significantly affecting facility workers.This study therefore aimed to explore the lived experiences and challenges faced by nurses providing antenatal care during the COVID-19 pandemic.Methods:Data were collected through in-depth interviews with seven antenatal care nurses.The interviews were transcribed and analyzed using thematic analysis to identify recurring themes.Four main themes emerged:(1)Knowledge capital,which refers to the essential knowledge and skills required;(2)Interventions,highlighting the measures taken to adapt care;(3)Antenatal care challenges,detailing the specific obstacles faced;and(4)Coping strategies,outlining the methods used by nurses to manage stress and maintain care quality.Results:The results highlight the emotional and economic toll of the pandemic on antenatal care nurses and the importance of effective collaboration and coping strategies.The findings also underscore the crucial role of teamwork,dedication,quick adjustment,and the role of information communication technology in maneuvering through pandemics to provide continuous essential care.Conclusion:These insights are crucial for health agencies and organizations to develop supportive strategies that ensure the continuity of healthcare delivery and safeguard the well-being of healthcare workers during crises.

Access to Supportive Health Services for People with Physical Disabilities: A Case of Health Facilities in Singida Rural District, Tanzania

Background: It is estimated that above one billion people (15%) of the world’s populations are living with disabilities. The poor and unfriendly infrastructure at health facilities is the core challenge for people with physical disabilities in accessing healthcare. This study aimed to explore at what extent the existing infrastructure and design of health facilities in Singida rural district, Tanzania supports people with physical disabilities to access healthcare. Methods: A cross sectional health facility-based assessment of all thirty-two functioning health facilities in the district was done between June and December 2020 using observational checklist and key informants’ interviews consist of measurement procedures of the architectural condition of health facilities. Observation checklist was designed based on standard of health facilities in Tanzania, national guideline for safe care standards for dispensaries, health centers and district hospital of 2014 and national guideline for water, sanitation and hygiene in healthcare facilities of 2017. Data were analyzed by SPSS-26 using descriptive statistics to obtain frequencies tables, percentage and figure. Qualitative data were analyzed by using NVivo-12 software. Results: The study revealed that there was no signage, entrance area, parking and toilets designated for people with physical disabilities in all health facilities. There was no special seat, examination table/bed and special weight scale for people with physical disabilities in all facilities. Also, the doors were not wide enough to support wheelchair user to maneuver in all health centers and dispensaries. In addition, door handles were not user friendly for wheelchair users. In fact, only the hospital and health centers had wheelchairs while 27 (96.4%) of all dispensaries had no wheelchairs. Furthermore, ramp and pathways were not available in all dispensaries. All health facilities had stairs but the challenge was most of the staircases had no floor located before the steps. Conclusion: The study revealed that the infrastructures in most healthcare facilities pose challenges to people with physical disabilities when they access healthcare services. These findings call for need of improving health facilities’ infrastructure to accommodate people with physical disabilities and this should be given a priority.

中国8省市50岁及以上人群卫生保健服务满意度与生活质量的关联研究

目的探讨50岁及以上人群卫生保健服务满意度和生活质量之间的关系。方法利用世界卫生组织(World Health Organization,WHO)全球老龄化与成人健康研究中国项目基线调查资料,选取我国8个省/直辖市15050名50岁及以上的中老年人,使用全球老龄化与成人健康研究问卷和WHO生活质量量表8项简化版评估卫生保健服务满意度和生活质量,并获取社会人口学及慢性病患病情况等信息,使用多元线性回归模型分析两者之间的关系并按居住地、性别和年龄组进行分层分析。结果研究共纳入研究对象13408人,平均年龄为(63.86±10.24)岁,对本市(区)提供的卫生保健服务感到非常满意的占4.16%,感到满意的占58.90%,感到一般的占30.81%,感到不满意的占5.69%,感到非常不满意的占0.44%。研究对象生活质量得分为(40.25±15.56)分,多元线性回归分析显示研究对象的卫生保健服务满意度越高,生活质量越好(P<0.001)。在分层分析中,该关联在不同居住地区、不同性别以及不同年龄组中均有统计学意义(P<0.001)。结论50岁及以上的人群中,较高的卫生保健服务满意度和较高的生活质量相关。

桂林中老年群体智慧医疗服务使用意愿调查:基于技术采纳与应用整合理论模型

目的对中老年群体智慧医疗服务使用情况及其影响因素进行调查分析,为医疗机构优化智慧医疗服务、推动中老年群体数字鸿沟治理提供参考。方法在广西壮族自治区桂林市采用线下问卷调查、访谈等方法收集数据,结合技术采纳与应用整合理论模型,使用SPSS 26.0和AMOS 24.0进行不同变量描述统计、单因素分析、不同维度相关分析和结构方程模型路径分析,研究中老年群体在使用智慧医疗服务过程中的影响因素。结果桂林市中老年群体对智慧医疗服务的使用意愿得分为(3.14±0.76)分,除了性别,不同变量对中老年群体的使用意愿差异分别有统计学意义(P<0.05)。中老年群体的绩效期望、社群影响、配合情况对中老年群体使用智慧医疗服务意愿有正向影响,努力期望对于使用意愿的影响不明显。结论桂林市中老年群体智慧医疗服务使用意愿还有很大的提升空间,要从各维度入手提高中老年群体的使用意愿,多方共同努力推进智慧医疗服务的使用。

Enhancing customers prevention efforts:An incentive feedback mechanism design

To improve the inefficient prevention caused by customers unwillingness to adopt prevention strategies in health management,an incentive feedback mechanism that is based on game theory and contract design theory is introduced.The conditions for making customers and health maintenance organizations(HMOs)willing to participate in the proposed mechanism are given.A dual nonlinear programming model is used to identify the optimal prevention effort of customers and the pricing strategy of HMOs.Results show that to generate increased benefits,HMOs need to consider cost sharing when customers are not familiar with the proposed health services.When health services are gradually accepted,the cost sharing factor can be gradually reduced.Simulation shows that under random circumstances in which the market reaches a certain size,the proposed method exhibits a positive network externality.Motivated by network externality,HMOs only need to make their customers understand that the larger the number of participants,the greater the utility of each person.Such customers may then spontaneously invite others to purchase insurance.