Public Health Commons^™

Multi-Sector Analysis Of The Progress And Challenges Of Soil-Transmitted Helminth Eradication In Rural Udaipur, Jessica Ellis

Independent Study Project (ISP) Collection

India is home to 240 million children currently at risk of Soil-Transmitted Helminthiasis, which is spread via unclean water, soil, and food, and causes acute pain and malnutrition. While acknowledging the research debates over WASH and mass drug administration, this study seeks to identify the systemic multidisciplinary issues affecting STH elimination efforts in rural Udaipur. Twenty-three interviews were conducted in villages, government departments, NGOs, and medical sectors to identify the challenges within each approach to deworming, and their experiences with multi-sectoral collaboration. The most recurring issues across disciplines were need for invested local leadership, increase in health literacy of adults, …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Access Is Not Enough: Family Planning In Dar Es Salaam, Claire Burrus

Independent Study Project (ISP) Collection

Population growth is a large problem, both globally and at local levels. The global population is growing at an unsustainable rate, particularly in developing nations. Tanzania, as a developing nation, is one of the fastest growing countries in the world, and as a result, faces many hardships related to high population. The Tanzanian government, non-governmental organizations, and private institutions have made attempts to address these concerns by encouraging family planning. Even so, the national population continues to rise. Many social and cultural factors have contributed to this phenomenon. This study was performed in the Women’s Clinic at Sanitas Hospital in …

Self-Perceptions Of Disability And Impairment In An Indian Prosthetic Population Using Jaipur Foot Technology, Litany Esguerra

Independent Study Project (ISP) Collection

Twenty-nine first time and repeat prosthetic users were interviewed over a period of three weeks to determine how they perceived their own disability at Bhagwan Mahaveer Viklang Sahayata Samiti, or Jaipur Foot, located in Jaipur, India. The questions delineated different aspects of people’s disabilities and impairment, and asked a multitude of questions regarding social, economic, political, and other contexts, influenced by the conceptual framework of the International Classification of Functioning (ICF). The study analyzed all of the factors as specified by the questionnaire and found that many varying trends over all types of prosthetic users. The study also used the …

The Road Into The Future Of Health Care: The Importance Of Addressing Access To Health Facilities In Transportation Infrastructure Investment Decisions, Nicola (Nikki) Van Den Heever

Independent Study Project (ISP) Collection

Background: One school of thought argues that transportation infrastructure is not an ultimate end goal of development and therefore shouldn’t be addressed within development funding decisions while the other argues that transportation infrastructure is the crucial foundation from which all development efforts are based and therefore needs to be addressed within development funding decisions. Within this framework, there is a lack of academic and other research addressing how physical access to health care for pregnant women can better be addressed when making decisions regarding funding of transportation infrastructure projects.

Purpose: To demonstrate the importance of considering access to health care …

Health Insurance Co-Ops: Product Availability And Premiums In Rural Counties, Erika C. Ziller Phd, Zachariah T. Croll Ba, Andrew F. Coburn Phd

Access / Insurance

Created by the Affordable Care Act (ACA), Consumer Operated and Oriented Plans (CO-OPs) are private, non-profit health insurers that were designed to increase insurance plan choice and lower premiums in the Health Insurance Marketplaces. Early analyses of the ACA suggested that CO-OPs may be particularly beneficial for rural communities, where fewer individual and small group health insurance options have traditionally been available.

This Research and Policy Brief, authored by research staff at the Maine Rural Health Research Center, explores the early availability and role of CO-OPs in rural and urban counties. We describe the regional distribution and market prevalence of …

Health Departments’ Engagement In Emergency Preparedness Activities: The Influence Of Health Informatics Capacity, Gulzar H. Shah, Bobbie J. Newell, Ruth E. Whitworth

Health Policy & Management: Faculty Publications (2006-2018)

Background: Local health departments (LHDs) operate in a complex and dynamic public health landscape, with changing demands on their emergency response capacities. Informatics capacities might play an instrumental role in aiding LHDs emergency preparedness. This study aimed to explore the extent to which LHDs’ informatics capacities are associated with their activity level in emergency preparedness and to identify which health informatics capacities are associated with improved emergency preparedness.

Methods: We used the 2013 National Profile of LHDs study to perform Poisson regression of emergency preparedness activities.

Results: Only 38.3% of LHDs participated in full-scale exercises or drills for an emergency …

“Always A Double-Edged Sword”: How Women And Health Care Providers Navigate Issues Of Contraception In Differing Senegalese Communities, Angelina Strohbach

Independent Study Project (ISP) Collection

This paper examines how women and health care providers in two distinct Senegalese settings—Dakar and Mouit, a village located within the Gandiol region-- navigate contraception as both a social and medical good. Contraception is an invaluable tool in terms of advancing women’s right to reproductive health, but major discrepancies in its usage exist across a variety of social lines in Senegal, including level of education, marital status, occupation, age, and living in a rural versus urban setting. What socially constructed thought processes and lived experiences contribute to these discrepancies? In a cultural context heavily based upon tradition and Islamic faith, …

Emergency Medical Services And Public Policy In Durban, Kwazulu-Natal, John Buyske

Independent Study Project (ISP) Collection

This project seeks to explore the realities of the emergency medical system in the Durban area, particularly relative to government policy. It contextualizes its findings within the literature on public policy. Data for the project was collected via nine in-depth interviews with various professionals working in the field of emergency medical services, as well as a survey of fourteen citizens conducted in the peri-urban township of Cato Manor. This data was analyzed using qualitative methods. While every participant had different views and a different perspective on emergency services, some recurring themes and trends became evident, allowing for conclusions to be …

Current Practices Of Obesity Pharmacotherapy, Bariatric Surgery Referral And Coding For Counselling By Healthcare Professionals, Christine Petrin, Scott Kahan, Monique Turner, C. Gallagher, William Dietz

Health Policy and Management Faculty Publications

Introduction

Rates of obesity pharmacotherapy use, bariatric surgery and intensive behavioural counselling have been extremely low.

Objectives

The primary objective of this study was to survey healthcare provider beliefs, practice and knowledge regarding obesity management.

Methods

Primary care physicians (PCPs), OB‐GYN physicians and nurse practitioners (NPs) responded to a web‐based survey related to drug therapy practice, bariatric surgery referral and reimbursement coding practice.

Results

Rates of reported use of obesity pharmacotherapy appear to be increasing among PCPs, which is likely related to the approval of four new obesity pharmacotherapy agents since 2012. Rates of pharmacotherapy use among OB‐GYNs and NPs …

Variation Of Driving Skill Among Elderly Drivers Compared To Young Drivers In Japan, Indri Hapsari Susilowati, Akira Yasukouchi

Kesmas

Penelitian ini menganalisis kemampuan mengemudi pada pengemudi lanjut usia (lansia) dibandingkan dengan usia muda di Jepang dan melihat keterampilan mengemudi yang kurang sehingga dapat memengaruhi risiko kecelakaan di jalan raya. Subjek penelitian adalah pengemudi usia muda dan lansia, terdiri dari 10 mahasiswa (20 - 24 tahun) dan 25 pengemudi lansia (14 laki-laki dan 11 perempuan) berasal dari The Silver Menpower Center, organisasi bagi lansia > 60 tahun. Pengemudi lansia dibagi menjadi dua kelompok, yaitu lansia 1 berusia 60 - 65 tahun (10 orang) dan lansia 2 berusia > 65 tahun (15 orang). Kemampuan mengemudi dievaluasi dengan simulator permainan mengemudi dalam laboratorium. Analisis …

Rural-Based Health Promotion Model For Pregnant Women In Banyumas District, Elviera Gamelia, Dian Anandari, Dyah Umiyarni Purnamasari

Kesmas

Penelitian sebelumnya menunjukkan bahwa pengetahuan pelayanan prenatal di wilayah pedesaan masih rendah yang berdampak pada perilaku buruk sehingga mengembangkan model promosi kesehatan dibutuhkan untuk meningkatkan pengetahuan prenatal, sikap dan perilaku. Penelitian ini bertujuan untuk mengembangkan model promosi kesehatan pelayanan prenatal di wilayah pedesaan berdasarkan penilaian kebutuhan. Penelitian dilakukan pada Juni 2015 dengan pendekatan kualitatif melibatkan 16 ibu hamil pertama di trimester ketiga dengan kehamilan berisiko sebagai informan kunci dan 16 anggota keluarga yang tinggal bersama ibu hamil dan mengetahui kehidupan sehari-harinya, 27 bidan dan 3 tokoh agama sebagai informan tambahan. Teknik pengumpulan data adalah wawancara mendalam dan observasi untuk ibu …

Well Water Consumed And Urolithiasis In Gedangsari Subdistrict, Yogyakarta, Sulistyawati Sulistyawati, Fardhiasih Dwi Astuti, Ruri Trisasri, Asep Rustiawan

Kesmas

Tanah di wilayah Kecamatan Gedangsari mengandung batuan kapur. Masyarakat di daerah ini banyak yang mengkonsumsi air minum dari sumur gali yang mengandung kadar kalsium tinggi, dan banyak yang menderita urolithiasis. Penelitian ini bertujuan untuk mendapatkan gambaran distribusi kalsium atau Ca(OH)2 pada air sumur dan menjelaskan hubungannya dengan kejadian urolithiasis. Penelitian dilakukan di Kecamatan Gedangsari, Kabupaten Gunungkidul selama Juli sampai November 2013. Penelitian dilakukan secara potong lintang dengan konfirmasi uji titrasi di laboratorium. Sejumlah 94 sampel sumur dipilih secara acak dari populasi 3.849 sumur. Kriteria pemilihan sampel adalah sumur gali yang telah digunakan untuk minum oleh penduduk berusia lebih dari 30 …

Identification Of Pathogenic Leptospira In Rat And Shrew Populations Using Rpob Gene And Its Spatial Distribution In Boyolali District, Dyah Widiastuti, Zumrotus Sholichah, Agustiningsih Agustiningsih, Nastiti Wijayanti

Kesmas

Leptospirosis merupakan masalah kesehatan di Indonesia. Hingga April 2014, dilaporkan kasus leptospirosis yang ditularkan oleh tikus di Kabupaten Boyolali dengan angka kematian 83,3%. Genus Leptospira terdiri dari ratusan serovar dan tipe genetik yang hidup di pelbagai jenis habitat. Pengelompokan spesies Leptospira berdasarkan gen rpoB dapat digunakan karena tingkat polimorfisme gen tersebut tinggi. Penelitian ini bertujuan untuk mengidentifikasi serovar bakteri Leptospira pada populasi tikus di Kabupaten Boyolali menggunakan analisis hubungan kekerabatan didasarkan pada polimorfisme gen rpoB dan menggambarkan distribusi spasial tikus positif Leptospira di Kabupaten Boyolali. Penelitian potong lintang dilaksanakan pada bulan April 2014 di Desa Sindon Kecamatan Ngemplak dan Desa …

Measles Immunization And Vitamin A For Prevention Of Pneumonia In Indonesia, Ratno Widoyo

Kesmas

Pneumonia merupakan penyebab kematian tertinggi pada anak di Indonesia setelah diare. Pengendalian pneumonia dapat dilakukan dengan peningkatan cakupan imunisasi campak, pertusis, Streptococcus pneumoniae (Spn), dan Haemophilus influenzae b (Hib). Vaksin Spn dan Hib belum masuk ke dalam kategori imunisasi wajib di Indonesia. Vaksin campak lebih memiliki pengaruh langsung terhadap pneumonia dibandingkan dengan vaksin pertusis. Pemberian imunisasi yang disertai pemberian vitamin A akan meningkatkan titer antibodi pada anak. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian imunisasi campak dan vitamin A terhadap kejadian pneumonia. Metode penelitian adalah potong lintang dengan menggunakan 13.062 data anak yang terdapat pada data Survei Demografi dan Kesehatan …

Role Of Hearth Program With Undernutrition Incidence Among Toddlers In Tangerang City, Gizella Gizella, Dany Hilmanto, Dedi Rachmadi

Kesmas

Kelompok yang rentan terhadap gizi kurang adalah balita. World Health Organization (WHO) menyatakan kematian anak bawah lima tahun (balita) akibat gizi kurang sebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% pada tahun 2010 menjadi 19,6% pada tahun 2013. Di Kota Tangerang, terdapat 1,43% balita yang mengalami gizi buruk pada tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan antara Program Pos Gizi yang meliputi perilaku pemberian makan, perilaku kebersihan balita, perilaku mencari pelayanan kesehatan dan perilaku pengasuhan balita dengan kejadian gizi kurang pada balita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta …

Good Corporate Governance Implementation And Performance Of Civil Servant, Muhammad Hasan, Dumilah Ayuningtyas, Misnaniarti Misnaniarti

Kesmas

Dalam rangka mencapai visi dan misi, setiap rumah sakit harus menjalankan tata kelola perusahaan yang baik (Good Corporate Governance/GCG). Penerapan GCG sendiri bertujuan untuk meningkatkan kinerja pegawai secara optimal, yang akhirnya akan meningkatkan kinerja organisasi. Penelitian ini bertujuan untuk menganalisis hubungan penerapan prinsip-prinsip GCG terhadap kinerja pegawai negeri sipil (PNS) Rumah Sakit Umum Lapangan Natuna Kabupaten Kepulauan Anambas. Jenis penelitian ini adalah deskriptif analitik dengan desain potong lintang pada 56 PNS. Pengumpulan data dilakukan pada tahun 2012 dengan kuesioner terstruktur. Digunakan analisis dengan uji kai kuadrat dan regresi logistik, dan untuk penyederhanaan model dilakukan eliminasi terhadap faktor perancu dengan menggunakan …

Environmental, Behavioral Factors And Filariasis Incidence In Bintan District, Riau Islands Province, Zainul Ikhwan, Lucky Herawati, Suharti Suharti

Kesmas

Tingkat mikrofilaria filariasis di Kabupaten Bintan masih tinggi, khususnya di Kecamatan Teluk Bintan, Teluk Sebong, dan Sri Kuala Lobam. Penelitian ini bertujuan untuk mengetahui hubungan faktor risiko lingkungan (faktor fisik, biologi, kimia, sosial budaya, ekonomi) dan faktor perilaku dengan kejadian filariasis. Jenis penelitian observasional analitik yang dilakukan pada Mei – September 2015 dengan desain kasus kontrol, yang terdiri dari jumlah kasus 33 orang penderita filariasis dan kontrol 65 orang bukan penderita filariasis dengan teknik cluster sampling. Populasi penelitian adalah masyarakat di Kabupaten Bintan. Data yang diperoleh dianalisis menggunakan uji kai kuadrat dan regresi logistik. Hasil menunjukkan adanya hubungan pengetahuan (nilai …

‘Project Spraoi’: A Randomized Control Trial To Improve Nutrition And Physical Activity In School Children, Tara Coppinger, Seán Lacey, Cian O'Neill, Con Burns

Publications

Background

Recent evidence predicts that by 2030, Ireland will have the highest rate of obesity in Europe. Consequently, there are concerns that health problems associated with this condition will present in childhood. Studies have shown that interventions based on increasing physical activity (PA) levels, reducing sedentary lifestyles and improving nutritional habits all pose protective mechanisms against obesity and its related disorders in youth. Yet, to date, there are no interventions being delivered in Ireland that concurrently target PA, nutritional habits and sedentary time amongst school children.

Purpose

The purpose of this study is to implement and evaluate an intervention that …

Policy Implementation Of Health Coverage For Indonesian Migrant Workers, Risky Kusuma Hartono, Budi Hidayat, Pujiyanto Pujiyanto

Journal of Indonesian Health Policy and Administration

The purpose of this research is to analyze the policy implementation of health coverage for TKI. This research uses a qualitative method with in-depth interview. The framework of this research consists of the aspect of the advisable policy, the implementation factors, and the schematic representation of the problem by using SWOT. The result of this research is the health insurance owned by TKI comes from TKI insurance, the membership of JKN, and insurance during their employment abroad. TKI insurance policy is the instruction of Law No. 39 of 2004 which regulates the obligation of the ownership of the social security …

Study On Public Health Financing In Pidie Jaya District In 2013, Hanifah Hasnur, Purnawan Junadi

Journal of Indonesian Health Policy and Administration

Albeit high dependency on central government transfer (around 69% of total health expenditure), funding from local PAD has been increasing. The revenue shall support priority health programs. This study aims to analyze local health financing system and as input for health program planning. Health financing portrait how fund being spent, and identfying who the agents are as well as the beneficiaries. The study shows spending on health from local budget is Rp130,000. Expenditures on operational costs for direct activities and community-based health efforts or Upaya Kesehatan Masyarakat (UKM) are still low (41%). Puskesmas needs to do more health-related activities for …

An Analysis Of The Usage Patterns Of Health Services Funded Through Capitation And Noncapitation In Government Owned Primary Healthcare Facilities In The District Of Pandeglang, Arovian Yuliardi, Amal Chalik Sjaaf

Journal of Indonesian Health Policy and Administration

The National Health Insurance (JKN) is basically a form of managed care, a technique that integrates health costing and service quality through cost control and quality control. In that concept, the Puskesmas acts as the government’s primary healthcare facility, its vanguard. The aim of this research is to discover and analyze the healthcare usage patterns funded by capitation and non-capitation in government primary healthcare facilities (FKTP). This was an analytical study utilizing a cross-sectional design. 615 patients visiting the government’s FKTP were involved in this research. The results indicated that 47.3% of patients utilizing the government’s FKTP at Pandeglang district …

An Analysis Of The Implementation Of The Policy To Integrate Of National Defense Components In Managing Non-Military Threats In The Health Sector, Sugeng Winarno, Prastuti Soewondo

Journal of Indonesian Health Policy and Administration

This research was based on the Minister of Defense’s Decree No. 16/2012 that stated that all national defense components to integrate into one unit when they encounter military and non-military threats. The Ministry of Health, as the main player, and other governmental and private agencies would also play a role in overcoming complex and multidimensional non-military threats, especially in the health sector. Among those threats are infectious diseases such as HIV/AIDS and Ebola. We aim to discover the implementation process of the law above in the management of those two diseases. This was a qualitative analytical research with in-depth interviews. …

The Effectiveness Of The Posyandu And Its Relation To Leadership And Management, Husnah Maryati, Vetty Yulianty Permanasari

Journal of Indonesian Health Policy and Administration

Data on infant mortality in the city of Bogor has increased from 26 to be 62 cases in 2013. Posyandu is one of the facility in a society that runs the health program where one goal is carrying out activities to accelerate the decline in the death rate of mothers and babies. The problems at posyandu in Bogor is the number of active cadres continue to decline while cadre recruitment insufficient, and less active of the function of The National Working team of posyandu. The report of newborn deaths by 2013 and 2014 stated that more than half (55 and …

An Analysis Of The National Health Insurance Policy Implementation In 2014 (Presidential Regulation No. 12 And 111/2013 On Health Insurance) From The Regulator’S Position, Muhammad Arief Rosyid Hasan, Puput Oktamianti, Dumilah Ayuningtyas

Journal of Indonesian Health Policy and Administration

JKN (National Health Insurance) is a government program that aims to provide health assurance for all Indonesian citizens for a healthy, productive, and prosperous life. In the two years after JKN was implemented, various problems occurred. This research used the qualitative approach with the Edward II implementation theory. Results of the research indicated that there were problems in communication, stemming from the lack of socialization and inharmonic regulations, there was also the problem of the lack of healthcare resources. From the disposition side, the policy makers often obstructs the implementation preparation, this is evident from the information on determining the …

The Carefirst Patient-Centered Medical Home Program: Cost And Utilization Effects In Its First Three Years, Alison Cuellar, Lorens A. Helmchen, Gilbert Gimm, Jay Want, Sriteja Burla, Bradley Kells, Iwona Kicinger, Len M. Nichols

Health Policy and Management Faculty Publications

Background

Enhanced primary care models have diffused slowly and shown uneven results. Because their structural features are costly and challenging for small practices to implement, they offer modest rewards for improved performance, and improvement takes time.

Objective

To test whether a patient-centered medical home (PCMH) model that significantly rewarded cost savings and accommodated small primary care practices was associated with lower spending, fewer hospital admissions, and fewer emergency room visits.

Design

We compared medical care expenditures and utilization among adults who participated in the PCMH program to adults who did not participate. We computed difference-in-difference estimates using two-part multivariate generalized …

Economic Windfalls And The Affordable Care Act: A Policy Proposal, Joshua Congdon-Hohman, Victor Matheson

Economics Department Working Papers

This paper identifies a major issue with windfall payments under either possible interpretation of the ACA as it currently stands. Several alternatives are proposed that would eliminate the windfalls. We advocate the establishment of a tort award funded “Federal Stabilization Fund” to improve the economic efficiency of future health care awards in the age of the Affordable Care Act

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Racial Disparities In Emergency General Surgery: Do Differences In Outcomes Persist Among Universally Insured Military Patients?, Cheryl Zogg, Wei Jiang, Muhammed Ali Chaudhary, John Scott, Adil A. Shah, Stuart R. Lipsitz, Joel S. Weissman, Zara Cooper, Ali Salim, Stephanie L. Nitzschke, Louis L. Nguyen, Lorens A. Helmchen, Linda G. Kimsey, Samuel Olaiya, Peter A. Learn, Adil H. Haider

Health Policy & Management: Faculty Presentations (2008-2022)

Research Objective: Described as one of the most serious health problems affecting the nation, racial disparities are estimated to account for >83,000 deaths, >$57 billion per year. They have been identified in multiple surgical settings, including differences in outcomes by race among emergency general surgery(EGS) patients. As many minority patients are uninsured, increasing access to care is thought to be a viable solution to mitigate inequities. The objectives of this study were to determine whether racial disparities in 30/90/180day outcomes exist within a universally-insured population of military/civilian-dependent EGS patients and whether differences in outcomes differentially persist in care received at …

Georgia’S Rural Hospital Closures: The Common-Good Approach To Ethical Decision-Making, Randi G. Bastain, Marcus Garner, John S. Barron, Emmanuel A. Akowuah, William A. Mase

Health Policy & Management: Faculty Publications (2006-2018)

Background: Critical access hospitals provide several essential services to local communities. Along with the functions associated with providing necessary medical care, they also offer employment opportunities and other economic benefits to the communities they serve. Since 2010, the number of rural hospitals closures has steadily increased. The common-good approach to ethical decision-making provides a framework that aids in evaluation of the effects that hospital closures have on rural residents and communities.

Methods: This analysis includes results of a systematic overview of peer-reviewed literature to address the following research questions: 1) How have state policies and the adoption of Medicaid expansion …