Perception of Adolescents on the Attitudes of Providers on Their Access and Use of Reproductive Health Services in Delta State, Nigeria

This paper examines the perception of adolescents on the attitudes of providers on their access and use of reproductive health services (ARHS) in Delta State, Nigeria, with a view of assessing the impact of providers’ attitude on the use of adolescents’ reproductive health services in Delta State. The study adopted a survey design to collect primary data using questionnaires and focus group discussions (FGDs) from adolescents in a sample of schools. A sample size of 1500 respondents was taken from 12 schools in six Local Government Areas in three Senatorial Districts in Delta State, Nigeria. The locations of the schools were such that six each were in rural and urban communities respectively. The result from the study was that unfriendly attitudes of providers which keep adolescents waiting, inadequate duration of consultations, judgmental attitudes of some providers, lack of satisfactory services provision and lack of confidentiality will put off adolescents from accessing and using adolescents’ reproductive health services irrespective of their sex, age, class, religion, residence, ethnic group, parents’ education or income levels. The paper concludes that medical personnel take all these issues very seriously when dealing with adolescents to enhance access and use adolescents’ reproductive health services in Delta State and indeed Nigeria.

Mining and Modelling the Dynamic Patterns of Service Providers in Cellular Data Network Based on Big Data Analysis

Understanding the dynamic traffic and usage characteristics of data services in cellular networks is important for optimising network resources and improving user experience.Recent studies have illustrated traffic characteristics from specific perspectives,such as user behaviour,device type,and applications.In this paper,we present the results of our study from a different perspective,namely service providers,to reveal the traffic characteristics of cellular data networks.Our study is based on traffic data collected over a five-day period from a leading mobile operator's core network in China.We propose a Zipf-like model to characterise the distributions of the traffic volume,subscribers,and requests among service providers.Nine distinct diurnal traffic patterns of service providers are identified by formulating and solving a time series clustering problem.Our work differs from previous related works in that we perform measurements on a large quantity of data covering 2.2 billion traffic records,and we first explore the traffic patterns of thousands of service providers.Results of our study present mobile Internet participants with a better understanding of the traffic and usage characteristics of service providers,which play a critical role in the mobile Internet era.

Study on Task Assignment of Two-stage Multi-service Capability Port Logistics Service Providers

This paper mainly studies the problem of multi-task assignment of providers in port logistics service supply chain.As a core enterprise,port plays the role of logistics service integrator.With the continuous development of industrial integration,logistics service providers not only provide one kind of logistics service,but also develop into composite suppliers who capable of providing a variety of logistics services.This paper studies the task assignment problem of multi-service capability providers in the port logistics service supply chain.The two-stage logistics service provider task assignment model was built,which is based on the mixed evaluation method(including MOORA and FMEA)and the multi-objective planning method.Eventually,the effectiveness of the model method was verified by combining with an example.

The Relationship between Size and Performance of Palestinian Water Service Providers

Studies investigating the relationship between size and performance of water service providers are abundant. Yet, this relationship has not been fully addressed in Palestinian water sector, particularly, after the issuance of water law 2014 which calls for merging water providers into large regional utilities. This research evaluates the significant effect of the size of Palestinian water service providers on non-revenue water, staff productivity, collection efficiency, average consumption, average price, operating and maintenance cost, working ratio, and gross profit. The multivariate analysis shows that there are significant differences in working ratio, non-revenue water, staff productivity, average price, and gross profit based on the size. On the other side, no significant differences have been found in average daily consumption, operating and maintenance cost per unit, and collection efficiency based on those providers’ size. The small service providers perform better in non-revenue water, staff productivity, and collection efficiency;wherein, large service providers are more profitable than small service providers. Implications of these findings by conducting further studies will add the value for better merging of the Palestinian water providers and the reforming process.

Frequency of smoking cessation interventions from health care providers in Minnesota

Objective: There is strong evidence supporting the impact of health care provider advice on patients’ smoking behavior. This paper examines adult smoker reports of health care provider smoking cessation interventions. Design: The 2010 Minnesota Adult Tobacco Survey (MATS) is a random digit dial telephone survey with 7057 Minnesota adults. Both landline and mobile telephone samples were included. These samples were combined and weighted to represent the population of adults in Minnesota. Results: Among adult Minnesotans, 16.1% were current smokers, 80.9% reported seeing a health care provider in the past 12 months and 80.2% of those adults were asked if they smoke. Among smokers who saw any provider in the past 12 months, 94.4% reported they were asked about smoking and 71.8% were advised not to smoke. In contrast, 43.9% of smokers received referrals from a health care provider and among those, 37.5% were recommended medications and 24.8% were referred to a quit smoking program. Conclusion: Given the large body of evidence supporting cessation interventions by health care providers, the increase in use of electronic medical records and the availability and success of evidence-based cessation programs, efforts to improve rates of identifying and treating each tobacco user are needed. Further research is needed to explore how cessation intervention responsibilities can be shared among the clinical team and integrated into ongoing clinical care.

Identifying Service Needs from the Perspective of Service Providers—A Qualitative Study

The provision of high-quality medical care has become a key challenge in many countries. At the same time, there is a growing awareness that the early detection of chronic diseases can reduce mortality rates. Therefore, it is important to identify service needs which influence to participate in health screening. To date, little research has been conducted into the perspectives of service providers on this topic. In this preliminary study, we aimed to explore the perspectives of service providers who work in a community-based setting in order to identify perceived barriers to chronic disease screening and incentives which can increase participation rates. In-depth interviews were conducted with 10 experienced health service providers from October 2017 to December 2017. Interviewees included physicians and community health representatives who had been working in a community-based health screening service for at least 3 years. The study identified several aspects of health screening services for chronic diseases that are in need of improvement, including a shortage of appropriate health service providers, inadequate attendance promoting measures, a lack of continually accessible and affordable medical services, healthcare professionals who possess inadequate communication skills, and rural-urban health care disparities. Service providers believe that current services do not fulfill community needs. Older adults who live in rural areas experience especially significant screening-related health disparities, which are mainly affected by structural service barriers. To improve the quality of medical services, healthcare screening services should be evaluated according to the perspectives of both participants and service providers.

“It All Goes Back to the Services”: A Rural/Urban Comparison of Service Providers’ Perceptions of Challenges and Facilitators to Disability Services

Purpose: The purpose of this qualitative study was to explore rural/urban differences in service providers’ perceptions of challenges and facilitators to services for children with special health care needs (CSHN) and their families in southeast Georgia. Methodology: A total of 23 individual interviews were conducted with service providers in one rural county in southeast Georgia (N = 12) and in one urban county in north central Georgia (N = 11). Interviews were based on the National Survey of Children with Special Health Care Needs 2009-2010 survey. All interviews were audio recorded, transcribed and coded with the intent of identifying themes and illustrative quotes. Findings: Service providers discussed a variety of challenges to accessing services related to socioeconomic status and the transition out of the school system. Urban and rural service providers’ perceptions were similar overall, with the exception of lack of transportation and access to a variety of services in rural area. Service providers overcome challenges through identifying parents’ needs and limitations and adapting service provision. Some of the facilitators mentioned by both urban and rural service providers are availability of transportation and resources. Practical Implications: The results of this study provide public health practice and policy implications that could guide the pathways of targeted interventions to improve the access and availability of variety of services for CSHCN. Originality/value of paper: This paper represents an in-depth exploration of service provider’s perceptions of challenges and facilitators related to service provision for children with special healthcare needs.

Health care providers’ attitudes towards termination of pregnancy: A qualitative study in Western Nigeria

Background: Despite restrictive abortion law in Nigeria, women still seek abortion services. Restrictive policies on abortion make it difficult for safe and legal abortion to be obtained. Hence, abortion is provided on clandestine basis in some private health facilities, and where the cost of such service is prohibitory, women resort to unsafe methods, including visiting quacks and self medication, resulting in severe complications including death. In Nigeria, little is known about the personal and professional attitudes of individuals who are currently providing abortion services. Exploring the factors which determine health care providers’ involvement in or disengagement from abortion services may facilitate improvement in the planning and provision of future services. Methods: Data were collected using qualitative research methods. Thirty-six in-depth interviews and one focus group discussion were conducted between January 2010 and July 2010 with health care providers who were involved in a range of abortion services provision in theWestern Nigeria. Data were analysed using a thematic analysis approach. Results: Complex patterns of service delivery were prevalent throughout many of the health care facilities. Fragmented levels of service provision operated in order to accommodate health care providers’ willingness to be involved in different aspects of abortion provision. Closely linked with this was the urgent need expressed by many providers for liberalization of abortion laws inNigeriain order to create a supportive environment for both clients and providers. Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care. An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision. Conclusion: This is the first known qualitative study undertaken in Nigeria exploring providers’ attitudes towards abortion and it adds to the body of information addressing the barriers to safe abortion services. In order to provide an enabling environment and sustain a pool of abortion service providers, a drastic change in Nigerian abortion laws is mandatory, after which policies that both attract prospective abortion service providers and retain existing ones can be developed.

Hepatitis B Virus (HBV) Infection in Pregnancy: Knowledge and Practice of Care Providers in Nigeria

Purpose: To determine the practice of obstetric care providers regarding routine screening for hepatitis B virus infection, and to assess their knowledge of the management of the positive pregnant women. Methods: A cross sectional descriptive study of obstetric care providers in southwestern Nigeria. Mean and standard deviation was used to summarize continuous variables while frequency and percentage was used for categorical variables. Categorical variables were compared with chi-square test and Fisher’s exact tests as appropriate;while continuous variables were compared using the t-test. The level of statistical significance was set at P ≤ 0.05. Scoring of the outcome variables for knowledge was done, and the score categorized into good and poor knowledge, depending on if the respondent scored above or below the mean score. Results: Three hundred and eighty-one (67.4%) of the care givers routinely screen pregnant women for the serum marker (HBSAg) of HBV infection. Two hundred and seventy-four (48.5%) of the respondents had good knowledge score of the management of HBV infection in pregnancy. Routine screening for HBV infection was significantly associated with age (p = 0.002), years of practice (p < 0.001), specialty (p = 0.001) and professional cadre (p < 0.001), while knowledge was significantly associated with age (p = 0.012), years of practice (p = 0.003), specialty (p = 0.047) and types of practice (p = 0.014). Conclusion: Screening for HBV infection in pregnant women is not universal in southwestern Nigeria, and the care providers have poor knowledge of the management of the positive mothers.

Safe Use and Disposal of Injections: Saudi Health Providers’ Perception

Injection is said to be safe when causing no harm to the recipient, and it does not expose provider to avoidable risk and does not result in any waste that is dangerous for other people. Purpose: The study was carried out to determine the perspectives of the Saudi health care providers on the safe use and disposal of injection. Methods: Prospective cross sectional survey was used, structured interviews were carried out by the use of pretested questionnaire to elicit general opinions on injection practices skills, and disposal processes in different health settings in Taif Area. Results: Females were dominant injection providers 82.3%. About 80% of providers tend to discard single use injection at once after administration and 84% tend to safely dispose them. Hygienic measures were well maintained. Increased used pattern of injection was observed 46%. Providers were well satisfied by the measures adopted to curb after using hazards. High rate of injection sticks 74.3% was observed. Conclusion: Although some measures of safe disposal were maintained by Saudi injections’ providers, still some regulation efforts should be done to curb spreading out of infection due to mal use and disposal of injection.

The Pattern of Women’s Reliance on Family Planning Providers in Egypt

Understanding choice of family planning provider is fundamental for policy makers and program managers as they seek ways to both improve the coverage and increase the sustainability and efficiency of family planning services for Egypt to achieve its population objectives. This study focuses first on providing a descriptive profile of the patterns of reliance on sources of family planning services during the early 2000s. Binomial logit models are then estimated to obtain a more in depth understanding of the determinants of the choice of family planning providers in Egypt using the 2000 Egypt Demographic and Health Survey. The study offers insights into a number of aspects of family planning service provision about which there has been less previous investigation. There are marked differences in the extent to which Egyptian women rely on public or private providers for family planning services depending on the type of method they are seeking. Among the more important findings is the consistency women display in the choice of provider among women reporting multiple segments of use. With regard to the determinants of the choice of provider for family planning services, perhaps the most interesting finding is that household wealth was not a significant determinant of the choice of provider. This may reflect that private sources met the demand for family planning services of significant proportions of women in rural areas and among those in the low income groups.

Health Providers’ Points of View on the Impact of the Project to Strengthen the Expanded Program of Routine Vaccination from 2014 to 2018 in the Barumbu Health Zone in Kinshasa, Democratic Republic of Congo

According to the World Health Organization, approximately 3 million deaths are prevented each year in the world thanks to vaccination and then, in addition, each year, it makes it possible to avoid nearly 750,000 children suffering from serious physical, mental or neurological handicaps and 1.5 million other deaths could be avoided if the vaccination coverage is improved. However, vaccination coverage is often not achieved due to various difficulties encountered by health providers in the expanded program on vaccination activities. Yet, it is important to strengthen the program. This research paper aimed to assess health providers’ points of view on the impact of the project to strengthen the routine expanded program on vaccination in the Barumbu health zone in Kinshasa, Democratic Republic of Congo (RDC). To do so, we surveyed a convenience sample of 234 health providers involved in the implementation of the project, including 210 community relays, 9 permanent nurses, 9 health committee chairpersons and 6 health authorities. A questionnaire related to the objective of the research was submitted to them. After analyzing the data, we found that the points of view of health providers are negative. The performance of the vaccination program was not great. Several reasons were given for this, including the non-involvement of the political and administrative authorities, the failure to respect the funds disbursement circuit and the non-effective financing of vaccination activities in the Barumbu health zone in Kinshasa, DRC.

DOST Model’ for DR-TB Patients, New Delhi: Perspectives of Healthcare Providers

Introduction: In India, tuberculosis continues to be a major public health problem and there is a growing concern about drug-resistant tuberculosis as most of the patients are from private sector. The National TB Elimination Programme (NTEP) in collaboration with TB Alert, India (TBAI) and Clinton Health Association of India (CHAI) had implemented a collaborative project to strengthen the network between the private practitioners and public healthcare facilities in New Delhi during 2019 and 2020. Methods: A study was conducted to understand the enablers and challenges encountered by them during the implementation of the project. This is a qualitative exploration of the “healthcare providers” on a project linking DR-TB patients in private sector with government health facilities. The process of data collection involved face-to-face in-depth interviews of healthcare providers, the Doctors mainly from private and public health facilities, the paramedical workers from general health system and paramedical from the project using an interview guide administered through a trained researcher. Results: The study findings revealed that all healthcare providers were completely aware of the DOST project in the health system, the model led to early diagnosis and initiation of quality treatment. There were no major challenges to the implementation of the project. The healthcare providers wish to have this project implemented for a longer duration. Conclusion: The perspectives of healthcare providers towards the “DOST” project were optimistic and call for re-initiating the project in the area.

Healthcare Providers' Perceptions of the Sexual and Reproductive Health Needs (Including Family Planning) of Elderly Women from Selected Sites in Botswana

Much of the sexual and reproductive health services and service delivery including family planning target women of child bearing ages (15 - 49 years) and sometimes men. Hardly are there programmes/interventions that specifically target the needs of the elderly women (50 years and above), yet this group has serious sexual and reproductive health needs as many of them are still sexually active. This cross-sectional study obtained the views of a stratified random sample of 169 healthcare providers (doctors, nurses and pharmacists) from four selected sites, Gaborone, Selibe Phikwe, Barolong and Kweneng East health districts in Botswana on how the healthcare system in the selected sites is meeting the SRH/FP needs of the elderly women. The study found out that while overwhelming majority of the healthcare providers feltthat the healthcare system has no programme that specifically target the SRH/FP needs of this significant others and their SRH/FP needs are not being met ,less than 15% indicated that Pap smear screening as well as screening of cervical cancer were on-going. Although there are SRH/FP services available in the healthcare system, the elderly women are minimally accessing these services. Only condom, combined oral contraceptives, progestogen-only pills, treatment of STIs, screening for HIV/AIDS and screening for cervical cancer are accessed and information is also limited to these services. Reasons given by the healthcare providers for the non-accessibility of these services were cultural diversity (80%), people's sexual behavior and perceptions about sex (79%), lack of knowledge about the desired SRH/FP services (76%), religion (73%) and gender issues (62%). The study, advocates as part of policy options to mitigate the obstacles to accessing SRH/FP services, the expansion of counseling programmes, screening and treatment for breast cancer, public awareness campaigns, production and circulation of appropriate educational materials, effective training of healthcare providers and the establishment of separate clinic days for the elderly women' SRH/FP services.

Does Quality of Care Differ When HIV Patients Are Treated by Non-Specialist and Specialist HIV Healthcare Providers in Developed Countries? A Systematic Narrative Review

Introduction: In developed countries, HIV care is mostly provided by trained specialist healthcare professionals. Due to the increasing demand for HIV care, pressure on healthcare providers to reduce cost and the current global economic constraints, many developed countries are searching for alternative HIV care models. This review aims to consider whether HIV treatment and care can be provided as effectively and safely by doctors and nurses with no HIV-specialist training compared to those with HIV-specialist training. Methods: Three electronic bibliographic databases MEDLINE, EMBASE and the Cochrane Library were searched for studies conducted between January 1996 and March 2015. Manual searches of reference lists of all relevant reports retrieved from the electronic databases were conducted. All comparative studies examining the quality of HIV care provided by different types of healthcare providers in developed countries were included. Results: Nine observational studies involving 27,015 patients were included in the review. Eight studies were conducted in the USA and one study in Switzerland. Healthcare providers with HIV-related expertise and or training and those without HIV-related expertise or training who collaborated with providers with HIV-related expertise and or training outperformed other healthcare providers in many virological, immunological and ART-related outcomes. Conclusion: This review found moderate quality evidence that HIV care can be provided effectively by non-HIV specialists if they have access to HIV specialists or experts for advice and support.

The Success of Healthcare Providers Who Fought the Epidemic of the Meiji Era in Mizunami City, Gifu Prefecture, Japan

Introduction: Knowing an epidemic existed in Mizunami city and knowing the healthcare provided to overcome the disease may give hints on how the epidemic was handled. Aim: To examine the literature on the epidemic that occurred in the Meiji era and the contributions of healthcare providers who were active in the history of Mizunami city. Method: This is a historical study, mainly using literature. In collaboration with the Mizunami City Board of Education, we searched for materials stored by Mizunami city. In addition, with the cooperation of the local residents of the healthcare providers who were active in Mizunami city, we collected materials in reference to our purpose. Result: The outbreak of the epidemic near Mizunami city was seen as a fight against smallpox. In addition, cholera, dysentery, Spanish flu, and typhoid fever also occurred. Vaccinations were carried out in the Tono region. Healthcare providers who were active in the Meiji era include six doctors and two midwives. Discussion: In the future, it will be necessary to provide more in-depth evidence through surveys, such as interviews with the cooperation of relatives of the active healthcare providers. Conclusion: In the Meiji era, in the vicinity of Mizunami city, doctors and midwives actively fought against epidemics, such as smallpox and other infectious diseases.

Knowledge of coronavirus disease 2019(COVID-19) among healthcare providers: A cross-sectional study in Indonesia

Objective:To assess healthcare workers’knowledge of novel coronavirus disease 2019(COVID-19)in the early phase of the outbreak in Indonesia.Methods:A cross-sectional survey was conducted in 12 hospitals in Indonesia from March 6 to March 25,2020.Healthcare workers’knowledge on COVID-19 was assessed,and demographic data,workplace characteristics,and medical professional characteristics as well as the current local situation of COVID-19 were collected.To characterize determinants associated with knowledge,a logistic regression analysis was employed.Results:Out of 288 healthcare workers who completed the interview-assisted questionnaire,149(51.7%)respondents had a good knowledge.Nurses and other types of healthcare workers had lower odds of having good knowledge compared to doctors:adjusted odds ratio(aO R):0.38;95%CI:0.20-0.72 and aO R:0.31;95%CI:0.13-0.73,respectively.Compared to healthcare workers who had medical practice experience less than 5 years,those who had worked for more than 10 years had lower knowledge(a OR:0.43;95%CI:0.20-0.90).Healthcare workers who worked in the infection department had higher knowledge compared to those in the emergency room(aO R:14.33;95%CI:3.67-55.88).Conclusions:The knowledge of COVID-19 among surveyed healthcare workers was relatively low.The COVID-19 response in Indonesia will require further education and enhancement of the capacity of healthcare workers in the emergency room where COVID-19 patients may be treated the earliest.

The Impact of Water Price on the Financial Sustainability of the Palestinian Water Service Providers

The impactof water sales price on the performance of water service providers is typically something of a mystery. High prices mean more revenue and profit;but it may lead to less bills collection and encourage the illegal connections. Yet, this argument has not been fully addressed in the Palestinian water sector;this research evaluates the effect of average water prices on the financial sustainability key indicators as collection efficiency, profit or loss percentage, non-revenue water, staff productivity, daily consumption, operating, and maintenance cost. The average price of cubic meter sold is segmented into low, medium, and high categories. Multivariate analysis shows that there are significant differences in profit or working ratio, daily consumption, and operating cost based on the different price categories. Further significant differences have been found in non-revenue water, collection efficiency, and water production based on low and high price categories. On the other hand, no significant difference has been found in staff productivity. The results show high price set by Palestinian water providers, leads to an increase in the bill collection rate and profit margin. However, negative relationship has been found between the price on one hand, and non-revenue water, average daily consumption, and water production on the other hand. The implication of these findings reveal that the Palestinian water providers should increase water prices gradually to cover operating and maintenance cost for better financial performance and sustainability.

Prediction-Based Resource Assignment Scheme to Maximize the Net Profit of Cloud Service Providers

In a cloud computing environment, users using the pay-as-you-go billing model can relinquish their services at any point in time and pay accordingly. From the perspective of the Cloud Service Providers (CSPs), this is not beneficial as they may lose the opportunity to earn from the relinquished resources. Therefore, this paper tackles the resource assignment problem while considering users relinquishment and its impact on the net profit of CSPs. As a solution, we first compare different ways to predict user behavior (i.e. how likely a user will leave the system before its scheduled end time) and deduce a better prediction technique based on linear regression. Then, based on the RACE (Relinquishment-Aware Cloud Economics) model proposed in [1], we develop a relinquishment-aware resource optimization model to estimate the amount of resources to assign on the basis of predicted user behavior. Simulations performed with CloudSim show that cloud service providers can gain more by estimating the amount of resources using better prediction techniques rather than blindly assigning resources to users. They also show that the proposed prediction-based resource assignment scheme typically generates more profit for a lower or similar utilization.

Emergency medicine providers＇ opioid prescribing practices stratified by gender, age, and years in practice

BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.