Health Policy Commons^™

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 …

Best Practices For Self-Exclusion Reinstatement And Renewal, Alex Price

International Conference on Gambling & Risk Taking

While many studies have examined self-exclusion few have focused on the processes through which gamblers return at the end of their agreements. In 2014, the RGC Centre for the Advancement of Best Practices examined voluntary self-exclusion reinstatement and renewal in an effort to develop evidence-informed best-practices for both land-based and online gambling operations. The presentation outlines the findings of the study and the recommended best practices for reintegration and ban renewal.

The study examined a range of practices around the world. In the end the study recommended an active reinstatement process in which all participants are required to apply to …

The South African Elderly: Neglect, Social Contribution And The Hiv/Aids Epidemic, Alessia Frisoli

Dissertations, Theses, and Capstone Projects

With a slowing fertility rate and an increasing longevity, the world population is aging. Both developed and developing countries have seen their elderly become more numerous with an increasing burden on their financial, medical and social system. Many scholars have suggested immediate change of policies to contain the predicted crisis that will affect the health care and the pension schemes in the next decades. However, few have investigated the positive role that the seniors play contributing to society, beyond the complications caused to the economy and welfare system. This thesis will support the argument that the elderly, if appropriately cared …

A Clinical Score To Predict Dose Reductions Of Antidiabetes Medications With Intentional Weight Loss: A Retrospective Cohort Study., Ghanshyam Palamaner Subash Shantha, Anita Ashok Kumar, Vimal Ravi, Rohit C Khanna, Scott Kahan, Lawrence J Cheskin

Health Policy and Management Faculty Publications

Abstract

Background

We assessed the predictive accuracy of an empirically-derived score (weight loss, insulin resistance, and glycemic control: “WIG”) to predict patients who will be successful in reducing diabetes mellitus (DM) medication use with weight loss.

Methods

Case records of 121 overweight and obese patients with DM at two outpatient weight management centers were analyzed.

Results

Mean period of follow-up was 12.5 ± 3.5 months. To derive the “WIG” scoring algorithm, one point each was assigned to “W” (loss of 5% of initial body weight within the first 3 months of attempting weight loss), “I” (triglyceride [TGL]/highdensity lipoprotein ratio >3 …

Book Review: Laugesen & Gauld. Democratic Governance & Health: Hospitals, Politics And Health In New Zealand, Vivienne Byers

Articles

No abstract provided.

Effect Of Ambient Particulate Matter 2.5 Micrometer (Pm2.5) To Prevalence Of Impaired Lung Function And Asthma In Tangerang And Makassar, Budi Haryanto, Budy Resosoedarmo, Sri Tjahjani Budi Utami, Budi Hartono, Ema Hermawati

Kesmas

Emisi partikel debu 2,5 mikrometer (PM2.5) meningkat dengan bertambahnya jumlah penduduk kota akibat peningkatan angka kendaraan bermotor sebagai transportasi penduduk sehari-hari. Penelitian ini bertujuan untuk mengetahui tingkat gangguan fungsi paru dan asma serta hubungannya dengan kadar ambien PM2.5 pada masyarakat migran di Tangerang dan Makassar dan kondisi sosial ekonomi. Desain potong lintang digunakan dengan melibatkan 4.250 dan 2.900 responden di Tangerang dan Makassar pada bulan April sampai September 2010. Pendekatan cluster sampling diterapkan. Pengukuran ambien PM2.5 di masing-masing kota berdasarkan koordinat 40 lokasi Global Positioning System (GPS). Kadar PM2.5 ditemukan lebih tinggi pada pagi hari dibandingkan siang hari di kedua …

Birth Intervals Among Multiparous Women In Indonesia, Dini Kurniawati, Sabarinah Prasetyo

Kesmas

Angka kematian ibu dan angka kematian bayi di Indonesia masih tinggi. Salah satu faktor yang menyebabkan tingginya risiko kematian pada ibu dan bayi adalah kelahiran terlalu dekat. Penelitian ini bertujuan untuk mempelajari determinan jarak antarkelahiran pada perempuan multipara di Indonesia. Penelitian ini menggunakan data Survei Demografi Kesehatan Indonesia tahun 2012 pada 9.945 perempuan multipara. Analisis data menggunakan uji Mann Whitney, Kruskal Wallis, dan regresi logistik. Median jarak antarkelahiran sebesar 62 bulan dan 22,8% perempuan memiliki jarak antarkelahiran kurang dari tiga tahun. Hasil menunjukkan determinan jarak antarkelahiran pendek meliputi pendidikan ibu, usia terakhir melahirkan, ukuran ideal keluarga, pemakaian kontrasepsi, riwayat kematian …

Husband’S Support Towards Unmet Need Of Hiv Positive-Infected Women Of Childbearing Age, Sophia Sophia, Anita Deborah Anwar, Bony Wiem Lestari

Kesmas

Jutaan wanita usia subur (WUS) dengan HIV positif di negara berkembang saat ini tidak menggunakan kontrasepsi untuk menunda atau mengakhiri kehamilan. Pencegahan kehamilan yang tidak diinginkan pada WUS dengan HIV positif sangat penting untuk meningkatkan kualitas hidup ibu dan anak. Tujuan penelitian ini untuk menganalisis faktor-faktor yang berpengaruh terhadap unmet need pada WUS dengan HIV positif. Metode penelitian adalah cross sectional dengan sampel berjumlah 130 WUS dengan HIV positif yang diambil secara consecutive sampling. Penelitian dilakukan pada 24 Maret - 30 Juni 2015 di Klinik Mawar Kota Bandung. Pengumpulan data dilakukan melalui wawancara dengan menggunakan kuesioner, kemudian data dianalisis dengan …

Impact Of Husband’S Participation In Antenatal Care On The Use Of Skilled Birth Attendant, Febri Wicaksono

Kesmas

Pendekatan alternatif diperlukan untuk mengatasi persoalan kesehatan reproduksi, salah satunya dengan meningkatkan partisipasi laki-laki pada kesehatan reproduksi perempuan. Penelitian ini bertujuan untuk menelusuri dampak partisipasi suami dalam pelayanan antenatal pada penggunaan tenaga persalinan terlatih setelah mengontrol karakteristik sosial demografi. Sampel sebanyak 4.000 perempuan berusia 15 – 49 tahun yang memiliki persalinan terakhir pada tahun lalu sebelum survei diambil dari Survei Demografi dan Kesehatan Indonesia tahun 2012. Penelitian menggunakan model regresi logistik biner untuk mengidentifikasi dampak partisipasi suami dalam pelayanan antenatal pada penggunaan tenaga persalinan terlatih setelah mengontrol karakteristik ibu dan sosial demografi. Peluang setelah mengontrol faktor lainnya mengindikasikan perempuan yang …

Child Health Improvement Through Implementation Of Food Safety Model, Arief Safari, Machfud Machfud, Eriyatno Eriyatno, Heny Kuswanti Daryanto

Kesmas

Pemenuhan akan pangan merupakan komponen dasar untuk mewujudkan sumber daya manusia yang berkualitas. Namun, masih terdapat permasalahan dalam mewujudkannya, di antaranya masalah keamanan pangan dengan persentase kasus keracunan makanan masih tinggi. Penelitian ini bertujuan untuk menganalisis situasi pelaksanaan keamanan Pangan Jajanan Anak Sekolah (PJAS) yang ada saat ini dan memilih alternatif model keamanan pangan yang paling efektif dan efisien diterapkan di usaha mikro kecil (UMK) guna meningkatkan keamanan pangan yang dihasilkannya sehingga terjadi peningkatan kesehatan anak. Penelitian dilakukan pada kuartal II tahun 2015 sampai dengan awal kuartal III tahun 2015 melalui survei lapangan dan survei pakar dengan mengambil studi kasus …

Housewives’ Compliance In Reading Food Labels In Gorontalo City, Imran Tumenggung, Lucky Herawati, Sofyawati Talibo

Kesmas

Di Indonesia, masalah label pada kemasan makanan kurang mendapat perhatian konsumen. Penelitian ini bertujuan untuk mempelajari determinan kepatuhan membaca label pada kemasan makanan oleh ibu rumah tangga di Kota Gorontalo. Penelitian dengan metode survei ini dilakukan dari bulan Juni sampai Agustus 2013. Data dikumpulkan secara potong lintang dengan menggunakan angket. Variabel terikat adalah kepatuhan membaca label pada kemasan makanan yang terdiri dari label informasi nilai gizi, komposisi makanan, masa kedaluwarsa, harga, dan status halal. Variabel bebas adalah usia, tingkat pendidikan, dan keterpaparan dengan media informasi. Besar sampel 262 orang ditentukan secara accidental technique. Analisis data menggunakan uji kai kuadrat. Hasil …

The Effect Of Structured Counseling Towards Knowledge, Attitude, And Participation Of Modern Contraceptive Among Unmet Need Couples, Herlina Simanjuntak, Bony Wiem Lestari, Anita Debora Anwar

Kesmas

Unmet need Keluarga Berencana (KB) masih tinggi di negara berkembang termasuk di Indonesia. Konseling kontrasepsi terstruktur berpotensi meningkatkan penggunaan kontrasepsi secara efektif, menjaga keberlangsungan penggunaan dan meningkatkan kepuasan klien. Selama ini seling kontrasepsi yang dilakukan belum optimal, sehingga penelitian ini bertujuan untuk menganalisis pengaruh konseling terstruktur terhadap peningkatan pengetahuan, sikap dan partisipasi kontrasepsi modern pada pasangan usia subur (PUS) yang unmet need. Penelitian ini merupakan eksperimen semu dengan rancangan pretest-posttest dengan kelompok kontrol. Penelitian ini dilakukan pada periode Maret – Juni 2015. Pengambilan sampel dilakukan dengan stratified random sampling pada 48 orang untuk kelompok perlakuan (konseling terstruktur) dan 48 orang …

Toward A Common Secure Future: Four Global Commissions In The Wake Of Ebola, Lawrence O. Gostin, Oyewale Tomori, Suwit Wibulpolprasert, Ashish K. Jha, Julio Frenk, Suerie Moon, Joy Phumaphi, Peter Piot, Barbara Stocking, Victor J. Dzau, Gabriel M. Leung

Georgetown Law Faculty Publications and Other Works

The world is becoming increasingly vulnerable to pandemics resulting from globalization, urbanization, intense human/animal interchange, and climate change. A series of global health crises have emerged since 2000, ranging from Severe Acute Respiratory Syndrome (SARS) and its phylogenetic cousin Middle East Respiratory Syndrome (MERS), to pandemic Influenza A (H1N1), Ebola, and the ongoing Zika virus epidemic. The Ebola epidemic gave rise to four global commissions proposing a bold new agenda for global health preparedness and response for future infectious disease threats.

Four global commissions reviewing the recent Ebola virus disease epidemic response consistently recommended strengthening national health systems, consolidating and …

Increasing Access To Primary Care Using Np’S: The Framework For An Academic Based Nurse-Managed Center In California, Prabjot (Jodie) Sandhu

Doctor of Nursing Practice (DNP) Projects

The dynamics of health care delivery and the role of health care providers is a changing canvas in the United States. The implementation of the Affordable Care Act (ACA), sets a goal to increase access to health care. The systems that support the ACA are constantly under scrutiny as failing to provide key answers to provider shortage and health care access issues. Nurse Practitioners (NPs) who are recognized by the ACA as a comprehensive part of this revolution are in a unique place to find opportunities to promote increased access to health and primary care services. While NPs in California …

How Are Migrant Health Centers And Their Patients Faring Under The Affordable Care Act?, Jessica Sharac, Rachel Gunsalus, Chi Tran, Peter Shin, Sara Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

Migratory and seasonal agricultural workers (MSAWs) provide essential labor for farming in all its branches in the United States. Between 2.4 and 3 million MSAWs live across the U.S. in every state but are clustered in areas dense with agricultural employment. As a population already susceptible to poor health outcomes because of poverty and work-related health risks, MSAWs depend on community health centers, especially those known as migrant health centers that receive additional migrant funding. Reporting data from a national survey of agricultural workers, as well as findings from analyses of data from the Uniform Data System (UDS) that covers …

Public Health Spending And Its Contributions To The Total Spend On Health, Glen P. Mays

Health Management and Policy Presentations

This presentation provides an overview of recent research on governmental public health expenditures and their interaction with medical spending, carried out through the Robert Wood Johnson Foundation supported initiatives on Public Health Services and Systems Research (PHSSR) and the new Systems for Action research program. This work illustrates the value of tracking resource use across multiple sectors that influence health and well-being in American communities. As such, this work can inform the ongoing dialogue about methodologies for summarizing total health spending for the U.S. and for state and local areas.

A Yellow Fever Epidemic: A New Global Health Emergency?, Lawrence O. Gostin, Daniel Lucey

Georgetown Law Faculty Publications and Other Works

The worst yellow fever epidemic in Angola since 1986 is rapidly spreading, including the capital, Luanda. In Angola, the epidemic began in December 2015 and the laboratory-confirmed outbreak was reported to the World Health Organization (WHO) on January 21, 2016. Angola has had 2023 suspected cases and 258 deaths as of April 26, 2016. China, the Democratic Republic of Congo, and Kenya also have reported cases arising from infected travelers from Angola. Namibia and Zambia also share a long border with Angola, with considerable population movement between the countries. Similar to other recent epidemics, quick and effective action to stop …

Landfill Communities Within The Land Of Eternal Spring, Blanca Vaneza Guzmán

ENV 434 Environmental Justice

This paper examines the placement and impact of landfills within Guatemala City, Guatemala. By examining the municipal cite and its accessibility to policy taken on towards proper waste management, the recurring theme of lack of information will be obvious. It specifically looks at the lack of information provided and describes the landfill communities by looking at the minimal scholarship and media attention offered. This paper will also interrelate the importance of all beings, living and non-living with its surroundings and highlight ideas of ecological thinking. An emphasis on environmental racism will be stressed, particularly with the enormous impact it has …