Search results

The purpose of this paper is to review the barriers in the dissemination of effective smoking cessation treatments and services globally. Offering tobacco users help to stop using tobacco is a key demand reduction measure outlined under Article 14 of the World Health Organisation (WHO) Framework Convention on Tobacco Control (FCTC). Implementing Article 14 can reap great dividends for the billion plus tobacco users around the world and their families, friends and societies.

A review of the status of the global implementation of Article 14 using available literature on smoking cessation products, services and national guidelines. Discussing innovative approaches being currently explored in South Asia that can lead to faster adoption and implementation of Article 14 globally.

Major gaps remain in cessation products’ availability and resource allocation for cessation services globally. Current licensed products are falling short on delivering and sustaining smoking cessation. Innovation in cessation products and services needs to build on learnings in nicotine pharmacokinetics, behavioural insights from consumer research and tap into 21st century tools such as mobile based apps. National implementation of FCTC’s Article 14 needs to follow guidelines that encourage integration into existing health programmes and health-care practitioners’ (HCPs) upskilling.

Smoking cessation is a desirable health outcome and nicotine replacement products are a means of achieving cessation through tobacco harm reduction. E-cigarettes are sophisticated nicotine replacement products. Innovation is urgently needed to fill the gaps in smoking cessation products and services, and for converting global policy into local practice. In low- and middle-income countries (LMICs), HCPs’ knowledge, attitudes and practice regarding tobacco use and cessation may hold the key to rapidly scaling up cessation support and delivery to achieve FCTC objectives sooner. Additionally, HCPs can play an important role in offering smoking cessation support in existing national health programmes for TB, cancer screening and maternal and child health. Also, widely prevalent smartphone devices may deliver smoking cessation through telemedicine in LMICs sooner, leapfrogging the hurdles of the existing health-care infrastructure.

Corporate social responsibility (CSR) in India includes education, environment, healthcare and rural development. In post-liberalized India, the healthcare sector (services and facilities) has grown in leaps and bounds over last two decades. The purpose of this paper is to reveal and explain the CSR profile of select healthcare companies of India and reveal gaps and scope of healthcare activities with a special consideration towards maternal health.

Primary data are collected from seven listed companies of Goa state which were willing to participate in the study. In total, 67 companies constituting the Healthcare Sector Index of Standard & Poor of the Bombay Stock Exchange are considered as secondary source. Data of 59 companies that come within the threshold of Companies Act, 2013, are studied. CSR guidelines (with a turnover of Rs 10bn or a market capitalization of Rs 5bn or a net profit of Rs 50m) are taken as an initial frame of reference.

In total, 89.83 per cent of these companies have initiatives related to health care. Structured companies (contribute to the company’s overall mission and goals) with CSR policy have committee size varying from three to five directors with an independent director. During 2016–2017, they were mandated to spend Rs 4.2613bn out of which only 74.59 per cent was spent. Geographical spread of CSR initiatives is skewed, with majority of companies focussing on the states of Maharashtra and Gujarat, whereas the states of Odisha and North-Eastern being neglected. The focus areas of CSR are education, healthcare and rural development. The variation of MMR in different states of India is an indicator for corporate as to which state needs more attention. The corporate sector in India needs to focus on SDG3 target of MMR and move towards a newer dimension and direction.

The originality of this paper lies in the recognition of the initiative of Government of India of weaning out CSR activities outside the purview of business sense and towards instilling a social sense in company behaviour. This is a dimensional and directional change in the evolution of CSR practices in companies and countries. To this end, 59 healthcare sector companies under the threshold of Companies Act 2013 were studied and results were outlined.

Exclusive breastfeeding (EBF) rates continue to be low in Vietnam. This study aimed to determine the factors predicting 6-month EBF among mothers in Ho Chi Minh City, Vietnam.

A cross-sectional study was conducted with 259 mothers of infants aged between six to nine months at well-baby clinics in Ho Chi Minh City. The questionnaires used for data collection included personal background questionnaire, perceived benefits of breastfeeding scale, breastfeeding self-efficacy scale-short form, perceived barriers to breastfeeding scale and the family support of breastfeeding scale. Descriptive statistics, bivariate and multiple logistic regression were used for data analysis.

About 32% of the Vietnamese mothers practiced 6-month EBF. By increasing one unit of perceived benefits of breastfeeding, perceived self-efficacy in breastfeeding and family support, the mothers' likelihood to give 6-month EBF would increase 19% (AOR = 1.19, 95% CI = 1.08, 1.31), 12% (AOR = 1.12, 95% CI = 1.04, 1.19) and 10% (AOR = 1.10, 95% CI = 1.04, 1.16), while previous breastfeeding experience, maternal age and maternal education could not significantly contribute to the 6-month EBF.

This is the first study in Vietnam using a nursing model, the health promotion model, as a framework to identify factors predicting 6-month EBF. An effective program for promoting EBF could be developed by manipulating and tailoring the predicting factors to fit the Vietnamese mothers' needs through a mother class, lactation clinic or individual approach.

The purpose of this study is to identify best practices for innovative primary care models and to describe a potential future primary care (PC) model for Texas to address the burden of chronic disease in a population-based approach.

A systematic literature review was conducted and identified 1,880 published records through PubMed using 26 search terms. After abstract and full-text review, 70 articles remained as potential models.

Although there is already a severe shortage of physicians in Texas, emerging practice patterns and choices among physicians are likely to erode access to primary care services in the state. Health-care leaders are encouraged to consider models such as complex adaptive systems for team-based care, pharmacist hypertension care management program and combined nurse-led care management with group visit structure.

As with any study, this research has its limitations; for example, models that might work in one state, or under a unique state-funded academic medical center, might not be “do-able” in another state within the nuances of a different funding mechanism.

Results of this research provide a model for implementing IPCM for the state of Texas first and will guide IPCM planning and implementation in other states.

This study is “land grant-centric” and focused on carrying out the mission of a major, top-tier research university with an emerging college of medicine at an academic medical center.

Health in low-income countries has become associated with the provision of minimum guaranteed public health services though Essential Health Packages (EHPs). How far do EHPs deliver the human right to health for all? This study addresses this question through qualitative research into access to health care for vulnerable communities, using Malawi as a case study. This study shows that there are significant accountability gaps and perceptions of weak service provision in Malawi’s EHP in relation to some particularly marginalised (and stigmatised) groups that limit the right to health and the promise of “health for all”.

This study extends the body of qualitative work on EHPs in general and on Malawi in particular by exploring the perceptions of key stakeholders in relation to inclusivity and the delivery of health policies to particularly vulnerable groups. To do so, this study adopted an approach based on interpretive epistemologies (Scott, 2014). This study conducted largely unstructured interviews with a range of health stakeholders, speaking to stakeholders individually, rather than through focus groups due to the potentially sensitive nature of the topic.

The findings of this study are as follows: limited inclusion of civil society actors and local communities; local communities and local policymakers feel frustration with the gap between the promises of consultation in the EHP and the reality, and the difficulties of not having effective channels of communication; and exclusionary health practices for particularly vulnerable groups.

There are limitations based on the qualitative methodology, and in terms of the particularly vulnerable groups – the authors studied two such groups (people with disabilities and those who identify as LBTQ) but a wider survey of vulnerable groups is needed to extend and confirm the findings.

Greater attention to the health rights of vulnerable groups would improve access and services, even in the context of resource restrictions. This study suggests that a deeper engagement with human rights-based approaches would pay dividends in terms of increasing access to health in Malawi, even within the constraints of the EHP process. Furthermore, without this, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

Without addressing these issues, there is the risk that discrimination and exclusion will become more embedded in health policies, rather than progressively minimised.

This paper makes an important contribution to the growing literatures on EHP in sub-Saharan Africa and Malawi in particular and to the importance of listening to stakeholder perceptions. It provides original data on stakeholder perspectives of the challenges associated with universalising health care in resource-constrained countries. To the best of the authors’ knowledge, it is one of the first papers to focus on the rights of disabled and LBTQ people in relation to EHPs.

The purpose of this paper is to investigate the trend of life expectancy in Bangladesh and find the effect of eliminating the causes of diseases on life expectancy statistics.

Data consisted of 1,530 deaths in 2000, 1,582 deaths in 2004 and 1,514 deaths in 2008 that were collected from the Health and Demographic Surveillance System of International Centre for Diarrheal Disease Research, Bangladesh. Trends in life expectancy after eliminating the cause of diseases were examined by a Single Decrement Life table.

The expectation of life for both male and female presented differing patterns. Results showed that life expectancies were greatly reduced in the presence of all groups of non-communicable diseases (NCDs) in the community, whilst life expectancies were significantly improved if all NCDs within all disease groups were completely eliminated. The life expectancies in the presence of NCDs showed lowest expected years among all the present diseases groups and the life expectancies eliminating NCDs showed highest expected years among all the eliminating diseases groups. The results indicated that 10.99 years of life would be added to life expectancy at birth for the male population and 8.82 years for the female population in 2008 if NCDs were eliminated.

The findings of this study provide useful information which could contribute to a more effective allocation of targeted funding for developing public health programs. Lowering mortality by eliminating major groups of diseases results in higher life expectancy ratings. Specifically, the relative impacts of eliminating cardiovascular diseases and respiratory diseases, as compared with eliminating neoplasms.

This study aims to deepen the understanding of the challenges and implications entailed by deploying mobile clinics in conflict zones to reach populations affected by violence and cut off from health-care services.

This research combines an integrated literature review and an instrumental case study. The literature review comprises two targeted reviews to provide insights: one on conflict zones and one on mobile clinics. The case study describes the process and challenges faced throughout a mobile clinic deployment during and after the Iraq War. The data was gathered using mixed methods over a two-year period (2017–2018).

Armed conflicts directly impact the populations’ health and access to health care. Mobile clinic deployments are often used and recommended to provide health-care access to vulnerable populations cut off from health-care services. However, there is a dearth of peer-reviewed literature documenting decision support tools for mobile clinic deployments.

This study highlights the gaps in the literature and provides direction for future research to support the development of valuable insights and decision support tools for practitioners.

Personalized medicine (PM) encompasses a set of procedures, technologies and medications; the term became more prominent from the 2000s onwards and stems from the mapping of the human genome. The purposes of this study were to analyse the development stage of the process of technological innovation for PM and the obstacles that prevent PM from being adopted in the public health system in Brazil.

As a research method, this paper opts for a case study carried out at the Hospital das Clínicas, which belongs to São Paulo Medical School. In total, 22 in-depth interviews were carried out at the hospital to identify current practices in PM, future prospects and barriers imposed to the adoption of PM technologies in public health.

Personalized or precision medicine is already a reality for a small portion of the Brazilian population and is gradually gaining ground in public health care. One finding is that such changes are occurring in a disjointed manner in an incomplete and under development health innovation system. The analysis pointed out that the obstacles identified in Brazil are the same as those faced by high-income countries such as regulation, lack of clinical studies and need to adapt clinical studies to PM. They appear in all stages of the innovation cycle, from research to widespread use.

The research method was a case study, so the findings cannot be extrapolated to other contexts. A limited number of professionals were interviewed, their opinions may not reflect those of their organizations.

There are several studies that discuss how health-care systems in high-income countries could incorporate these new technologies, but only a few focuses on low or middle-income countries such as Brazil.