Influence of Distance to Health Facilities on the Use of Skilled Attendants at Birth in Kenya

We sought to determine the spatial variation in the use of skilled providers during deliveries across Kenya and the relationship between distance to health facilities and the use of skilled delivery. We found that women who resided 5 km or less from the nearest health facility were more likely to use skilled care at delivery than women residing at greater distances, although the pattern of choice of health facility level for delivery differed at this distance. Outreach maternity services are urgently required in counties with remote communities in order to improve access to skilled attendants during deliveries in these areas.     

我国城市公立医疗机构管理体制的目标模式构建

在宏观层面上，从产权制度重构和国有资产重组角度，构建了我国公立医疗机构管理体制改革的目标模式框架。在微观层面上，从完善医院治理结构角度，分析了适应经济发展的现代医院制度应具备的基本特征．并指出了目标模式中应注意的若干问题。     

我国县级公立医院发展的制度结构

优先发展县级公立医院是我国县域医药卫生体制改革的核心举措。建构医疗服务的横向竞争机制和纵向整合机制是县级公立医院发展的前提,改革医疗保险的付费制度是县级公立医院发展的关键,重构医疗机构的监管机制是县级公立医院发展的保障。     

美国公共医疗保险的影响效应分析

作为美国医疗保险市场的重要组成部分,公共医疗保险近年来在市场上占据了相当可观的份额,并显现出强劲增长的态势。文章通过相关文献厘清目前美国公共医疗保险所产生的一系列影响,进而关注美国公共医疗保险的影响情况和溢出效应,并提出在未来研究公共医疗保险时应当着重考虑的方向和突破的重点难点问题,以及由此对我国医疗保险改革的经验借鉴。     

Measuring Patient Satisfaction: A Case Study to Improve Quality of Care at Public Health Facilities

Objective:

The main objective of the study is to measure the satisfaction of OPD (Outpatient Department) patients in public health facilities of Madhya Pradesh in India.

Materials and Methods:

Data were collected from OPD patients through pre-structured questionnaires at public health facilities in the sampled eight districts of Madhya Pradesh. The data were analyzed using SPSS.

Settings:

Outpatient Departments of district hospital, civil hospital, community health centre, and primary health centre of the eight selected districts of Madhya Pradesh.

Results:

A total of 561 OPD patients were included in the study to know their perceptions towards the public health facilities, choosing health facility, registration process, basic amenities, perception towards doctors and other staff, perception towards pharmacy and dressing room services. It was found that most of the respondents were youth and having low level of education. The major reason of choosing the public health facility was inexpensiveness, infrastructure, and proximity of health facility. Measuring patient satisfaction were more satisfied with the basic amenities at higher health facilities compared to lower level facilities. It was also observed that the patients were more satisfied with the behavior of doctors and staff at lower health facilities compared to higher level facilities.     

Tackling the Urban Health Divide Though Enabling Intersectoral Action on Malnutrition in Chile and Kenya

As momentum grows for a sustainable urbanisation goal in the post-2015 development agenda, this paper reports on an action research study that sought to tackle the urban health divide by enabling intersectoral action on social determinants at the local level. The study was located in the cities of Mombasa in Kenya and Valparaíso in Chile, and the impact of the intervention on child nutrition was evaluated using a controlled design. The findings showed that an action research process using the social educational process known as PLA could effectively build the capacity of multisectoral teams to take coordinated action which in turn built the capacity of communities to sustain them. The impact on child nutrition was inconclusive and needed to be interpreted within the context of economic collapse in the intervention area. Four factors were found to have been crucial for creating the enabling environment for effective intersectoral action (i) supportive government policy (ii) broad participation and capacity building (iii) involving policy makers as advisors and establishing the credibility of the research and (iii) strengthening community action. If lessons learned from this study can be adapted and applied in other contexts then they could have a significant economic and societal impact on health and nutrition equity in informal urban settlements.     

黄岛口岸公共卫生核心能力建设的成效及分析

目的 分析黄岛口岸公共卫生核心能力建设的内外因素,提出推动口岸公共卫生核心能力建设的对策.方法 对黄岛口岸公共卫生核心能力建设成效与难点进行对比分析.结果 黄岛口岸在个人防护、组织协调、联防联控、口岸服务、口岸营商环境方面取得成效,但专业人员不足、技术支持不力、监管对象不配合、业务系统和人员培训不足制约黄岛口岸公共卫生...     

口岸卫生检疫监管体系研究

〔目的〕在人们对健康、疾病的认识发生了巨大变化的今天,探讨我国口岸卫生检疫监管机制、模式的转变,探索建立和完善适应WHO《国际卫生条例(2005年)》要求的口岸卫生检疫监管体系。〔方法〕通过对《国际卫生条例(2005年)》对口岸卫生控制核心能力的要求、对出入境人员、交通工具、物品等卫生控制的规定,以及我国口岸卫生检疫监管工作现状的研究、分析,提出完善口岸卫生检疫监管新机制、新模式的建议。〔结果〕①口岸卫生检疫工作由口岸卫生安全维持系统和口岸突发公共卫生事件应急系统2部分组成,口岸突发公共卫生事件应急系统有赖于口岸卫生检疫监测预警应对机制的建立;②口岸卫生检疫监测预警应对机制包括科学决策的组织指挥体系、快速获悉疫情的监测网络与预警系统、根据事件性质和严重程度做出不同应对的响应系统、强有力的后勤保障系统。〔结论〕适应《国际卫生条例(2005)》的要求,承担国际条约的义务,提高口岸应对国际关注公共卫生突发事件核心能力,防止传染病传入传出,促进和保障社会经济快速健康增长,成为我们的当务之急。     

2002—2011年上海市公共卫生机构经济运行状况分析

目的:了解上海市公共卫生机构经济运行状况.方法:收集2002--2011年上海市公共卫生机构卫生财务年报数据,进行描述性分析.结果:财政补助逐步成为公共卫生机构筹资来源的主体,财政投入方式逐步从“养人”到“养事”转变;但公共卫生费用占卫生总费用的比例偏低,不同类型公共卫生机构、不同区县之间财政补助力度差异较大.结论:将公共卫生机构纳入全额预算管理后,应切实落实财政补助,规范公共卫生机构特别是有偿服务的运行,将公共卫生经费提高到市级统筹,并建立动态增长机制.     

城市社区公共卫生服务财政补偿绩效评价机制研究

从建立缋效评价机制的依据、主要思路、建立绩效评价机制的意义等方面,探讨了城市社区公共卫生服务财政补偿绩效评价机制.旨在提高城市社区公共卫生服务财政补偿经费的使用效益,改善社区公共卫生服务的质量和效果,促进城市社区卫生服务可持续发展.     

甘肃省卫生监督机构突发公共卫生事件处置能力调查分析

目的：对各级卫生监督机构的突发公共卫生事件处置能力进行调查,以了解其应对突发公共卫生事件的能力状况,为探索卫生监督机构应急能力的提升提供依据。方法采取抽样调查的方法,对省、市、县共20个卫生监督机构进行问卷调查。结果甘肃省各级卫生监督机构已经基本具备突发公共卫生事件的处置能力,但处置能力依然有待于提高,主要问题有人力资源不足及整体素质不高、经费不足、仪器设备匮乏以及应急预案的制定机制不够完善等。结论各级卫生监督机构必须正视自身存在的问题,找出问题的突破口,弥补自己的不足,进一步提升应对突发公共卫生事件的处置能力。     

"阳雪"轮突发公共卫生事件的成功处置

[目的]为口岸突发公共卫生事件的有效处置积累宝贵经验。[方法]总结对巴拿马籍“阳雪”轮上发生1名中国船员突然死亡,另1名船员同样症状并已送往菲律宾医院进行抢救,船舶还载有20名密切接触患者的船员的突发公共卫生事件的处置经验。[结果]紧急启动预案,精心做好各种应急准备工作；加强组织领导,成立疫情处置领导小组和4个工作小组；果断处置,及时沟通,消除了口岸突发公共卫生事件的危害。[结论]应急预案要周密,疫情报告要迅速,防控措施要果断,沟通协调要及时。     

城市突发公共卫生事件应急指挥系统信息化建设的探索

目的：探讨城市突发公共卫生事件应急指挥系统信息化建设。方法：从城市公共卫生应急工作遇到的挑战入手．分析系统建设的业务模型,设计出系统的总体框架与业务功能实现。结果：提出城市突发公共卫生应急指挥中心系统建设的新思路。结论：通过信息化手段,构建城市突发公共卫生应急指挥系统,使决策者在最短的时间内对公共卫生危机事件做出反应,采取合适的措施,有效地动员和调度各种资源进行指挥决策。     

A Nationwide Survey of School Health Services Delivery in Urban Schools

ABSTRACT: To understand school health service delivery models, and to plan for reorganization of a local school health service, a telephone survey of school-based health programs from around the country was conducted in 1992. Responses were elicited from 33 school departments in some of the largest American cities. Respondents described their current programs, obstacles they face, and approaches they have chosen to address the needs of urban schoolchildren. City size did affect amount of services provided overall, but a clear relationship existed between number of providers employed, and the number/amount of screening services available. Cities employed a range of strategies to enhance services, including collaboration with local health authorities, creation of school clinics, and billing for services.