Anesthesia Health System Capacities in Public Hospitals of Punjab, Pakistan.
Ontology highlight
ABSTRACT:
SUBMITTER: Shahbaz S
PROVIDER: S-EPMC8671656 | biostudies-literature | 2021 Jan-Dec
REPOSITORIES: biostudies-literature
Publications
Anesthesia Health System Capacities in Public Hospitals of Punjab, Pakistan.
Shahbaz Sumbal S Zakar Rubeena R Fischer Florian F
Inquiry : a journal of medical care organization, provision and financing 20210101
<b>Purpose:</b> This study intends to outline the capacity of anesthesia health system in public hospitals of Punjab, Pakistan.<b>Methods:</b> A cross-sectional survey among public hospitals of Punjab was carried out that provide emergency and elective surgical care. We measured capacity in terms of infrastructure; surgical, anesthetic, and obstetric (SAO) workforce; surgical interventions; information management; equipment; and medication which was accomplished between October 2020 and February ...[more]
Similar Datasets
Project description:An extended range of host susceptibility including camel has been evidenced for some of the important veterinary and public health pathogens, such as brucellosis, peste des petits ruminants (PPR) and bluetongue (BT). However, in disease endemic settings across many parts of the globe, most of the disease control interventions accounts for small and large ruminants, whereas unusual hosts and/or natural reservoirs, such as camels, remain neglected for disease control measures including routine vaccination. Such a policy drawback not only plays an important role in disease epizootiology particularly in settings where disease is endemic, but also serves an obstacle in disease control and subsequent eradication in future. With this background, using pre-validated ELISA and molecular assays [multiplex PCR, reverse transcriptase (RT)-PCR and real-time (rt)-PCR], we conducted a large-scale pathogen- and antibody-based surveillance for brucellosis, peste des petits ruminants and bluetongue in camel population (n = 992) originating from a wide geographical region in southern part of the Punjab province, Pakistan. Varying in each of the selected districts, the seroprevalence was found to be maximum for bluetongue [n = 697 (70.26%, 95% CI: 67.29-73.07)], followed by PPR [n = 193 (19.46%, 95% CI: 17.07-22.09)] and brucellosis [n = 66 (6.65%, 95% CI: 5.22-8.43)]. Odds of seroprevalence were more significantly associated with pregnancy status (non-pregnant, OR = 2.23, 95% CI: 1.86-5.63, p<0.01), farming system (mixed-animal, OR = 2.59, 95% CI: 1.56-4.29, p<0.01), breed (Desi, OR = 1.97, 95% CI: 1.28-4.03, p<0.01) and farmer education (illiterate, OR = 3.17, 95% CI: 1.45-6.93, p<0.01) for BTV, body condition (normal, OR = 3.54, 95% CI: 1.92-6.54, p<0.01) and breed (Desi, OR = 2.19, 95% CI: 1.09-4.40, p<0.01) for brucellosis, and feeding system for PPR (grazing, OR = 2.75, 95% CI: 1.79-4.22, p<0.01). Among the total herds included (n = 74), genome corresponding to BT virus (BTV) and brucellosis was detected in 14 (18.92%, 95 CI: 11.09-30.04) and 19 herds (25.68%, 95% CI: 16.54-37.38), respectively. None of the herds was detected with genome of PPR virus (PPRV). Among the positive herds, serotype 1, 8 and 11 were detected for BTV while all the herds were exclusively positive to B. abortus. Taken together, the study highlights the role of potential disease reservoirs in the persistence and transmission of selected diseases in their susceptible hosts and, therefore, urges necessary interventions (e.g., inclusion of camels for vaccine etc.) for the control of diseases from their endemic setting worldwide.
| S-EPMC7092811 | biostudies-literature
Project description:This study was to determine risk assessment associated with bed bugs (Insecta: Hemiptera: Cimicidae) using participatory epidemiological tools in the selected public hospitals of district Faisalabad, Punjab, Pakistan. Bed bugs were collected and morphologically identified through a standard taxonomic key. A descriptive cross-sectional survey of patients using a pre-designed questionnaire containing open-ended and closed-ended questions was conducted for six months between January 2023 and June 2023. Of the 384 participants, 113 (29.43%) had experienced itching or skin irritation presumably from the bed bug feeding activity. The study further revealed patients above age 40 (35.43%) and males (30.57%) experienced greater skin irritation responses compared to other participants. Among administrative divisions (tehsils) in the city of Faisalabad, Tehsil Sadar had the highest number of participants with itching or skin irritation (35.48%), while Tehsil Chak Jhumra had the lowest number (24.62%). Most observations of bed bugs by patients were in their beds (10.42%), with chairs (3.91%) being the second most reported location. However, we found bed bugs from only 17 (4.42%) beds and 5 (1.30%) from chairs. A majority of patients (60.9%) reported daily change of bedding; however, a significant proportion (29.9%) reported infrequent changes. About 25.5% of the patients shared beds with others and about 77.1% of patients brought their own bedding or clothing to the hospitals. The current study concluded that the bed bug infestation is a problem in the public hospitals of Faisalabad, Punjab, Pakistan. Risk factors such as sharing a bed, infrequent change of bedding, and bringing personal bedding to hospital while having medical treatment pose a concern.
| S-EPMC11787733 | biostudies-literature
Project description:Informed public health measures are crucial to curb the COVID-19 pandemic. The sociocultural context is important to understand the success or failure of implementing public health measures. This study explores the social and behavioral response to COVID-19 and unveils challenges in the implementation of related public health measures in Pakistan. Within this qualitative study, we conducted 34 telephonic/online in-depth interviews with youths, adults, elderly people, and healthcare professionals in the Punjab province of Pakistan. Framework analysis was used for data analysis. People's poor understanding about COVID-19 and the need for preventive measures were the major challenge in implementing public health preventive strategies. Study participants reported that the lockdown strategy increased poverty and unemployment. People's poor living conditions and living environment compelled them not to follow social distancing and restricting themselves to home. Additionally, an underdeveloped healthcare system was one of the major challenges for Pakistan. The culture of denial in Pakistan related to the epidemiology of COVID-19 was an important challenge within the implementation of public health preventive measures. It is extremely important that public health experts and social scientists work together to understand the contextual sociocultural factors which shape behaviors associated with the spread of a pandemic.
| S-EPMC8329025 | biostudies-literature
Project description:The overpopulation of stray dogs is a serious public health and animal welfare concern in India. Neglected zoonotic diseases such as rabies and echinococcosis are transmitted at the stray-dog human interface, particularly in low to middle-income countries. The current study was designed to estimate the stray dog populations in Punjab to enhance the implementation of animal birth and disease (for example, rabies vaccination) control programs. This is the first systematic estimation of the stray dog population using a recommended method (mark-re-sight) in Punjab, India. The study was conducted from August 2016 to November 2017 in selected villages or wards in Punjab. For the rural areas, 22 sub-districts in each district were randomly selected, then one village from each of the 22 selected sub-districts was selected (by convenience sampling). For urban areas, 3 towns (less than 100,000 human population) and 2 large cities (more than or equal to 100,000 human population) were randomly selected, followed by convenience selection of two wards from each of the 5 selected towns/cities. To estimate the dog population size, we used a modified mark-re-sight procedure and analysed counts using two methods; the Lincoln-Petersen formula with Chapman's correction, and an application of Good-Turing theory (SuperDuplicates method; estimated per km2 and per 1000 adult humans and were compared between localities (villages vs. towns), dog sex (male vs. female) and age group (young vs. adult) using linear mixed models with district as a random effect. The predicted mean (95% CI) count of the dogs per village or ward were extrapolated to estimate the number of stray dogs in Punjab based on (a) the number of villages and wards in the state; (b) the adult human population of the state and (c) the built-up area of the state. Median stray dog populations per village and per ward using the Lincoln-Petersen formula with Chapman's correction were estimated to be 33 and 65 dogs, respectively. Higher estimates of 61 per village and 112 per ward are reported using the SuperDuplicates method. The number of males was significantly higher than the number of females and the number of adult dogs was about three times the number of young dogs. Based on different methods, estimates of the mean stray dog population in the state of Punjab ranged from 519,000 to 1,569,000. The current study revealed that there are a substantial number of stray dogs and a high number reside in rural (versus urban) areas in Punjab. The estimated stray dog numbers pose a potential public health hazard in Punjab. This impact requires assessment. The estimated stray dog numbers will help develop a dog population and rabies control program in which information about the logistics required as well as costs of implementing such programmes in Punjab can be incorporated.
| S-EPMC8878280 | biostudies-literature
Project description:ObjectivesAnaesthesia delivery in Pakistan remains limited to conventional intraoperative procedures, with research showing ongoing challenges in quality and resourcing. We aimed to identify systemic challenges in the delivery of the WHO-World Federation of Societies of Anaesthesiologists' (WHO-WFSA) 'highly recommended' standards of quality anaesthesia services for surgical support in Pakistan's Punjab province.Study design and settingThis single-method qualitative study included 22 semistructured interviews with purposively selected anaesthesia system experts in Punjab province, including heads of teaching hospital anaesthesia departments, healthcare commission (HCC) representatives and health department officials. We analysed data thematically, using deductive and inductive coding.Participants10 participants worked as anaesthesia department heads of teaching hospitals across Punjab, 5 worked for the HCC and 7 worked for the health department. All were selected purposively and had at least 5 years of experience working as head of department or serving in legislative departments.ResultsWe identified three themes experienced as major challenges within the specialty, namely anaesthetist recruitment and retention, quality of care and in-service training, and discrepancies between specialities. Findings indicated that workforce shortages and maldistribution, insufficient in-service training and standards, inadequate equipment maintenance and lack of anaesthesia representation in decision-making compromised anaesthesia provision quality and safety.ConclusionsImproving anaesthesia provision in Punjab would require increasing physician and non-physician anaesthetist numbers and rotation to peripheral postings, strengthening training quality and ensuring availability of WFSA-specified essential equipment and supplies. To achieve essential anaesthesia provision standards, policy interventions are needed to, for example, balance anaesthesiologist and surgeon/obstetrician-gynaecologist numbers, require that anaesthesiology postgraduates work a few years in-country (eg, scholarship bonds), ensure in-service training attendance for skills updates and implement quality assurance standards for equipment and supplies.
| S-EPMC10748997 | biostudies-literature
Project description:Plant species of the Poaceae family are not only used as fodder and forage but also contribute substantially to the treatment of various health disorders, particularly in livestock. Consequently, the present study was aimed to document the therapeutic uses of Poaceae practiced by the inhabitants of the Punjab Province for the treatment of various veterinary health disorders. Semi structured interviews, group discussion and field walks were conducted to collect the data. Quantitative indices including cultural significance index (CSI), relative frequency of citations (RFC), fidelity level (FL), relative popularity level (RPL), and Jaccard Index (JI) were used for the data analysis. Traditional uses of 149 species belonging to 60 genera and 16 tribes of 5 sub families of Poaceae were recorded. Whole plants and leaves were the most consistently used parts with 40.94 and 29.53%. The plants were mainly given orally as fodder (59 reports) without processing followed by decoction (35 reports). Most of the species were employed to treat infectious diseases (25.93%), and digestive disorders (14.10%). Triticum aestivum had the highest CSI, RFC and RPL levels at 8.00, 0.96, 1.00, respectively, followed by Oryza sativa and Poa annua. Likewise, T. aestivum and Saccharum spontaneum had 100% FL and ROP. Jaccard index ranged from 12.25 to 0.37. Twelve plant species namely Chrysopogon zizanioides (anti-inflammatory), Pennisetum lanatum (improve bull fertility), Cymbopogon citratus (glandular secretion), Sorghum saccharatum and Themeda triandra (malaria), Aristida funiculate (anticancer), Koeleria argentia (skin allergies), Tetrapogon villosus (antibacterial), Cynodon radiatus (eyes infection), Sporobolus nervosa (Jaundice), Enneapogon persicus (antifungal), and Panicum repens (dysfunctional cattle organs) were reported for the first time, with novel ethnoveterinary uses. The inhabitants of the study area had a strong association with their surrounding plant diversity and possessed significant knowledge on therapeutic uses of Poaceae to treat various health disorders in animals. Plant species with maximum cultural and medicinal values could be a potential source of novel drugs to cure health disorders in animals and human as well.
| S-EPMC7608896 | biostudies-literature
Project description:Arsenic (As) contamination in groundwater is a worldwide concern for drinking water safety. Environmental changes and anthropogenic activities are making groundwater vulnerable in Pakistan, especially in Southern Punjab. This study explores the distribution, hydrogeochemical behavior, and pathways of As enrichment in groundwater and discusses the corresponding evolution mechanism, mobilization capability, and health risks. In total, 510 groundwater samples were collected from three tehsils in the Punjab province of Pakistan to analyze As and other physiochemical parameters. Arsenic concentration averaged 14.0 μg/L in Vehari, 11.0 μg/L in Burewala, and 13.0 μg/L in Mailsi. Piper-plots indicated the dominance of Na+, SO42-, Ca2+, and Mg2+ ions in the groundwater and the geochemical modeling showed negative saturation indices with calcium carbonate and salt minerals, including aragonite (CaCO3), calcite (CaCO3), dolomite (CaMg(CO3)2), and halite (NaCl). The dissolution process hinted at their potential roles in As mobilization in groundwater. These results were further validated with an inverse model of the dissolution of calcium-bearing mineral, and the exchange of cations between Ca2+ and Na+ in the studied area. Risk assessment suggested potential carcinogenic risks (CR > 10-4) for both children and adults, whereas children had a significant non-carcinogenic risk hazard quotient (HQ > 1). Accordingly, children had higher overall health risks than adults. Groundwater in Vehari and Mailsi was at higher risk than in Burewala. Our findings provide important and baseline information for groundwater As assessment at a provincial level, which is essential for initiating As health risk reduction. The current study also recommends efficient management strategies for As-contaminated groundwater.
| S-EPMC9603767 | biostudies-literature
Project description:This study determined the total and speciated arsenic (As) concentrations and other health-related water quality parameters for unraveling the health risk of As from drinking water to humans. Groundwater samples (n = 62) were collected from three previously unexplored rural areas (Chichawatni, Vehari, Rahim Yar Khan) of Punjab in Pakistan. The mean and median As concentrations in groundwater were 37.9 and 12.7 µg·L(-1) (range = 1.5-201 µg·L(-1)). Fifty three percent groundwater samples showed higher As value than WHO safe limit of 10 µg·L(-1). Speciation of As in groundwater samples (n = 13) showed the presence of inorganic As only; arsenite (As(III)) constituted 13%-67% of total As and arsenate (As(V)) ranged from 33% to 100%. For As health risk assessment, the hazard quotient and cancer risk values were 11-18 and 46-600 times higher than the recommended values of US-EPA (i.e., 1.00 and 10(-6), respectively). In addition to As, various water quality parameters (e.g., electrical conductivity, Na, Ca, Cl(-), NO₃(-), SO₄(2-), Fe, Mn, Pb) also enhanced the health risk. The results show that consumption of As-contaminated groundwater poses an emerging health threat to the communities in the study area, and hence needs urgent remedial and management measures.
| S-EPMC4626974 | biostudies-literature
Project description:BackgroundHospitals are the biggest users of the health system budgets. Policymakers are interested in improving hospital efficiency while maintaining their performance during the economic crisis. This study aims at analysing the hospitals' policy solutions during the economic crisis using the resilience system capacities framework.MethodThis study is a systematic review. The search strategy was implemented on the Web of Science, PubMed, Embase, Scopus databases, and Econbiz search portal. Data were extracted and analysed through the comparative table of resilience system capacities framework and the World Health Organization (WHO) health system's six building blocks (i.e., leadership and governance, service delivery, health workforce, health systems financing, health information systems, and medicines and equipment).FindingsAfter the screening, 78 studies across 36 countries were reviewed. The economic crisis and adopted policies had a destructive effect on hospital contribution in achieving Universal Health Coverage (UHC). The short-term absorptive capacity policies were the most frequent policies against the economic crisis. Moreover, the least frequent and most effective policies were adaptive policies. Transformative policies mainly focused on moving from hospital-based to integrated and community-based services. The strength of primary care and community-based services, types and combination of hospital financing systems, hospital performance before the crisis, hospital managers' competencies, and regional, specialties, and ownership differences between hospitals can affect the nature and success of adopted policies.ConclusionThe focus of countries on short-term policies and undermining necessary contextual factors, prioritizing efficiency over quality, and ignoring the interrelation of policies compromised hospital contribution in UHC.
| S-EPMC9339182 | biostudies-literature
Project description:BackgroundDisrespect, abuse, discrimination, and lack of emotional support characterize intrapartum care in the health systems of many low- and middle-income countries. Although the World Health Organization (WHO) provides frameworks and guidelines to address this issue, no operational model exists that effectively incorporates WHO intrapartum care guidelines into routine public health services. We aimed to develop and pilot-test a theory-driven, service-delivery intervention package linking dignified care with perinatal mental health to promote psychosocially supportive and respectful maternity care (S-RMC) in public health facilities in Sindh, Pakistan.MethodsUsing a mixed-method, pre-post design, the study was implemented in 6 secondary-level public health facilities in 2 rural districts of Southern Sindh, Pakistan. Its development was guided by the COM-B framework and informed by a literature review, formative research, and consultative sessions with implementers. The intervention was implemented in March-September 2021 and compared women's experiences of S-RMC during childbirth at baseline (n=313) and endline (n=314). We used descriptive statistics and linear regression techniques for analysis.ResultsA substantial reduction was observed in the cumulative level of overall mistreatment from baseline to endline, yielding a relative change of 50% (P<.001). Similar change was evident across different types of mistreatment: physical abuse (75%), verbal abuse (72%), ineffective communication (60%), nonconfidential care (78%), health system conditions and constraints (25%), noninclusive care (28%), lack of supportive care (52%), and stigma and discrimination (82%). Furthermore, we observed a significant reduction in the proportion of women experiencing symptoms of anxiety and depression before and after the intervention.ConclusionThis intervention built the capacity of maternity teams while improving accountability, health information systems, and governance measures. Given its promise to promote supportive and respectful childbirth in public health facilities, a large-scale effectiveness evaluation across diverse settings is warranted.
| S-EPMC10285721 | biostudies-literature