Are hospitals prepared to support newborn survival? – an evaluation of eight first‐referral level hospitals in Kenya*

Objective To assess the availability of resources that support the provision of basic neonatal care in eight first‐referral level (district) hospitals in Kenya. Methods We selected two hospitals each from four of Kenya’s eight provinces with the aim of representing the diversity of this part of the health system in Kenya. We created a checklist of 53 indicator items necessary for providing essential basic care to newborns and assessed their availability at each of the eight hospitals by direct observation, and then compared our observations with the opinions of health workers providing care to newborns on recent availability for some items, using a self‐administered structured questionnaire. Results The hospitals surveyed were often unable to maintain a safe hygienic environment for patients and health care workers; staffing was insufficient and sometimes poorly organised to support the provision of care; some key equipment, laboratory tests, drugs and consumables were not available while patient management guidelines were missing in all sites. Conclusion Hospitals appear relatively poorly prepared to fill their proposed role in ensuring newborn survival. More effective interventions are needed to improve them to meet the special needs of this at‐risk group.     

Vers des indicateurs de continuité des soins : suivi à deux ans de patients hospitalisés en 1999

The paper presents a two-year follow-up of the patients admitted in 1999 in three catchment areas (sectors). By comparing the group of patients who were new in 1999 (N = 321) to the group of those who were already treated (N = 498), the paper describes the type of care received by the patients in 1999, 2000 and 2001 according to age, gender, diagnosis, and type of care. The paper describes the probability of follow up according to the above data. The paper shows the value of a knowledge of the actual pathways of the patients within the psychiatric care organization.     

Médecin traitant et médecin correspondant: mécanisme et missions

Résumé: La loi du 13 août 2004 relative à l’assurance maladie a instauré un système de coordination des soins reposant sur une centralisation de la prise en charge par un médecin traitant choisi par le patient.Dans ce système en vigueur depuis le 1^er juillet 2005, le médecin traitant assure la coordination des soins et les soins de premier recours. Les médecins intervenant en concertation avec le médecin traitant, les médecins correspondants, assurent quant à eux le second recours au système de soins, et notamment les soins les plus spécialisés.Les patients qui ne désignent pas un médecin traitant seront financièrement pénalisés.D’un commun accord avec son patient, tout cancérologue peut exercer la fonction de médecin traitant.     

Bilan des enquêtes 2012, 2013 et 2014 de l’Observatoire national français des centres spécialisés de l’obésité (oNCSO)

Objective and method

The French Obesity Plan enabled the creation of 37 Specialized Obesity Centers (CSOs) in 2012 to ensure a dual mission, the multidisciplinary management of severe or complex obesity and the organization of care channels in the regions. This report takes stock of the first three years of operation of the CSOs, based on the data collected by the National Observatory of CSOs (oNCSO), set up by the General Directorate of Hospitalization and Care.