BACKGROUD

In 1995, RA 7883 was enacted stating the incentives and benefits which can be provided for BHWs. In the advent of the Universal Health Care, the role of the BHWs will be crucial more than ever and to ensure the sustainability of the program is an urgent concern. There is a need to identify the hindrances in the provision of incentives and benefits for the BHWs in coming up with recommendations on how to improve it.

Focus group discussions on selected BHWs and key informant interviews on policy makers and implementors were conducted to assess the reinforcing and hindering factors on the provision of incentives and benefits for the BHWs.

The report outlines key factors affecting BHWs in Oriental Mindoro. While the BHW organization has potential to offer incentives, it needs stronger oversight from the Local Government Unit (LGU) to be effective. NGOs, provide crucial funding for training BHWs in remote areas. Political interference in appointing BHWs, with frequent changes in leadership, disrupts the program's stability. Training opportunities are limited by a lack of funding, leaving many BHWs undertrained. Additionally, local ordinances that offer benefits to BHWs often fail due to unclear policies, changing local leadership, and insufficient budgets.

The BHW program continues to face persistent challenges in the provision of incentives and benefits, largely due to the lack of clear, comprehensive, and enforceable policies and guidelines.

Databases, Bibliographic ; Evidence-based Practice ; Health Services Needs And Demand

Endoscopy ; Health Services Needs and Demand

OBJECTIVES: To discuss the demands and countermeasures for outpatients and emergency patients during the outbreak of coronavirus disease 2019 (COVID-19) in large general hospital. METHODS: By analyzing patients' demands, outpatient service system and emergency system complemented each other with the help of "internet medical" to provide online medical treatment, self-diagnosed pneumonia program, online pharmacies, outpatient appointment and online pre-examination services, open green channels for special patients, and to provide referral services for critical patients. The COVID-19 suspected patients and other common fever patients were separated from other patients. RESULTS: From January 28 to March 1, we have received 26 000 patients online, 1 856 special patients, 2 929 suspected patients and common fever patients including 31 confirmed patients, 0 case of misdiagnosis and cross-infection. CONCLUSIONS Targeting patient's demands and taking appropriate measures are effective on meeting the needs of outpatients' and emergency patients' medical services.
Betacoronavirus ; Coronavirus Infections ; epidemiology ; prevention & control ; Cross Infection ; prevention & control ; Emergency Medical Services ; organization & administration ; Health Services Needs and Demand ; Hospitals, General ; organization & administration ; Humans ; Outpatients ; Pandemics ; prevention & control ; Pneumonia, Viral ; epidemiology ; prevention & control

COVID-19/prevention & control* ; Communicable Disease Control ; General Surgery/organization & administration* ; Guidelines as Topic ; Health Care Rationing ; Health Services Needs and Demand ; Health Workforce ; Humans ; Practice Guidelines as Topic ; SARS-CoV-2 ; Singapore/epidemiology* ; Surgical Procedures, Operative ; Triage

Objective To investigate the demand for scientific information among cervical cancer patients and to evaluate the quality of the relevant information available for these patients.Methods The demand for medical science information among patients with cervical cancer was investigated via questionnaire.The Discernn scoring system was used to score the cervical cancer science articles retrieved by Baidu and Sogou.A model was established to analyse the reading difficulty of these articles.Results Nearly half(53.6%)of the respondents searched for online science information at least weekly.The main target readings were the etiology and risk factors of diseases,symptoms,treatment options,adverse reactions of treatments,and prognosis.Most respondents(96.4%)thought that the network science information was reliable.Of the 104 search results included in the sample bank,13(12.5%)met the inclusion criteria,91(87.5%)were not selected,including 32 duplicates(30.8%),6 non-text webpages(5.8%),18 short texts(less than 300 Chinese characters)(17.3%),7 advertisements(6.7%),3 news articles(2.9%),22 forum posts(21.2%),and 3 academic articles(2.9%).According to the Discern scoring system,the reliability(=0.728, <0.001),the quality of treatment-related information(=0.431, <0.001),and the overall scores(=0.559,<0.001)of the enrolled 13 publications were consistent,as evaluated by two professional physicians.The mean overall score was 3.A lower score(less than 3)in the reliability assessment was due to the source of the content,generation methods,sponsors,citations,and the undefined parts.During the evaluation of treatment information,the average score was below 3 for each item.Analysis of the reading difficulty showed that,among these 13 articles,4 were at postgraduate thesis level(level 5),4 at undergraduate thesis level(level 4),0 at high school textbook level(level 3),and 8 was higher than middle school level(≥level 3).Eight articles(61.5%)were suitable for readers with an education background of higher middle school and only 5 articles(38.5%)were suitable for readers with an education background of middle school or lower(≤ level 2).Conclusions The vast majority of patients with cervical cancer search for clinical information through the Internet and trust their reliability.Chinese search engines have lower detection rates for high-quality medical science articles.The currently available high-quality medical science articles are small in number and difficult to read.More physicians are urged to write easy-to-read high-quality articles for these patients.
Female ; Health Services Needs and Demand ; Humans ; Information Seeking Behavior ; Internet ; Reproducibility of Results ; Search Engine ; Surveys and Questionnaires ; Uterine Cervical Neoplasms

PURPOSE: Emotional intelligence is a factor affecting the health of individuals, and happiness is another factor affecting it. Medical students' health can greatly affect a community's health due to the important role of medical students in maintaining and improving it. Accordingly, we aimed to study the relationship between emotional intelligence and happiness among the students of the Shiraz Medical School. METHODS: This study is an analytical, cross-sectional study. The target population of this study was the medical students who began studying in the medical school and the international branch of Shiraz University of Medical Sciences from September 2014 to September 2017. The sample size was 300 students who were selected by a systematic sampling method. The instruments for collecting information in this study were Oxford Happiness Inventory and Siberia Schering's Emotional Intelligence Questionnaire. The significance level of the tests was set at 0.05. RESULTS: The mean age of 292 responded participants were 20.73 with standard deviation of ±1.81 emotional intelligence (p < 0.001), level of stress (p < 0.001), and grade (p=0.03) and type of personality (p < 0.001) can explain the changes in the happiness level and they were significant effective factors in the regression modeling. CONCLUSION: Emotional intelligence was a predictive factor for happiness in medical students. Students with higher emotional intelligence felt healthier. And happiness in extroverted students was higher than introverted ones. It is suggested that the results of this study should be confirmed with prospective studies.
Cross-Sectional Studies ; Emotional Intelligence ; Happiness ; Health Services Needs and Demand ; Humans ; Iran ; Methods ; Prospective Studies ; Sample Size ; Schools, Medical ; Siberia ; Students, Medical

PURPOSE: Though regular surveillance of hepatocellular carcinoma (HCC) for high-risk patients is widely recommended, its rate and effectiveness are not clear. The aim of this study is to investigate the actual rate of HCC surveillance and its related factors and to clarify its impact on survival in a Korean HCC cohort. MATERIALS AND METHODS: From 2012 to 2015, 319 newly diagnosed HCC patients were prospectively enrolled at a tertiary hospital. Patient interviews based on a structured questionnaire survey were conducted. Surveillance was defined as liver imaging test ≥ 2 times with at least 3-month interval within 2 years prior to HCC diagnosis. RESULTS: Surveillance rate was 39.8%. Of the HCC patients with high-risk factors, only 182 (57.1%) had knowledge for the need for regular surveillance, and 141 (44.2%) had the accurate information about the method (ultrasound-based study). Surveillance group showed a higher proportion of early HCC (p < 0.001) and a longer overall survival (p < 0.001) compared to non-surveillance group. The multivariable Cox regression analysis indicated Child-Pugh class A, history of anti-viral therapy, low serum α-fetoprotein level, non-advanced Barcelona Clinic Liver Cancer stage as independent predictors of overall survival, while regular surveillance was not (p=0.436). CONCLUSION: Less than half of the newly diagnosed Korean HCC patients were under surveillance and the accurate perception for the need of HCC surveillance was insufficient. Of those under surveillance, most patients were diagnosed with early stage HCC, which led to the improved survival. Comprehensive efforts to optimize the surveillance program for the target population are warranted.
Carcinoma, Hepatocellular ; Cohort Studies ; Diagnosis ; Health Services Needs and Demand ; Humans ; Korea ; Liver ; Liver Cirrhosis ; Liver Neoplasms ; Mass Screening ; Methods ; Prospective Studies ; Tertiary Care Centers

Nonalcoholic fatty liver disease (NAFLD), together with metabolic syndrome and obesity, has shown a rapid increase in prevalence worldwide and is emerging as a major cause of chronic liver disease and liver transplantation. Among the various phenotypes of NAFLD, nonalcoholic steatohepatitis (NASH) is highly likely to progress to development of end-stage liver disease and cardiometabolic disease, resulting in liver-related and non-liver–related mortality. Nonetheless, there is no standardized pharmacotherapy against NASH and many drugs are under development in ongoing clinical trials. To develop a successful anti-NASH drug, it is necessary to select an appropriate target population and treatment outcomes depending on whether the mode of action is anti-metabolic, anti-inflammatory or anti-fibrotic. Recently, innovative surrogate markers have been investigated to replace hard outcomes such as liver histology and mortality and reduce the clinical trial duration. Currently, several drugs with fast track designation are being tested in phase III clinical trials, and many other drugs have moved into phase II clinical trials. Both lean NAFLD and typical obese NAFLD have been extensively studied and genetic variants such as PNPLA3 and TM6SF2 have been identified as significant risk factors for lean NAFLD. In the near future, noninvasive biomarkers and effective targeted therapies for NASH and associated fibrosis are required to develop precision medicine and tailored therapy according to various phenotypes of NAFLD.
Biomarkers ; Drug Therapy ; Fibrosis ; Health Services Needs and Demand ; Liver ; Liver Diseases ; Liver Transplantation ; Mortality ; Non-alcoholic Fatty Liver Disease ; Obesity ; Phenotype ; Precision Medicine ; Prevalence ; Risk Factors

OBJECTIVES: In South Korea, there are two nationwide health surveys conducted by the Korea Centers for Disease Control and Prevention: the Korea Community Health Survey (KCHS) and Korea National Health and Nutrition Examination Survey (KNHANES). The two surveys are directly comparable, as they have the same target population with some common items, and because both surveys are used in various analyses, identifying the similarities and disparities between the two surveys would promote their appropriate use. Therefore, this study aimed to compare the estimates of six variables in KCHS and eight variables in KNHANES over a six-year period and compare time series stability of region-specific and sex- and age-specific subgroup estimates. METHODS: Data from adults aged 19 years or older in the 2010-2015 KCHS and KNHANES were examined to analyze the differences of estimates and 95% confidence interval for self-rated health, current smoking rate, monthly drinking rate, hypertension diagnosis rate, diabetes diagnosis rate, obesity prevalence, hypertension prevalence, and diabetes prevalence. The variables were then clustered into subgroups by city as well as sex and age to assess the time series stability of the estimates based on mean square error. RESULTS: With the exception of self-rated health, the estimates taken based on questionnaires, namely current smoking rate, monthly drinking rate, hypertension diagnosis rate, and diabetes diagnosis rate, only differed by less than 1.0%p for both KCHS and KNHANES. However, for KNHANES, estimates taken from physical examination data, namely obesity prevalence, hypertension prevalence, and diabetes prevalence, differed by 1.9-8.4%p, which was greater than the gap in the estimates taken from questionnaires. KCHS had a greater time series stability for subgroup estimates than KNHANES. CONCLUSIONS: When using the data from KCHS and KNHANES, the data should be selected and used based on the purpose of analysis and policy and in consideration of the various differences between the two data.
Adult ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Drinking ; Health Services Needs and Demand ; Health Surveys ; Humans ; Hypertension ; Korea ; Nutrition Surveys ; Obesity ; Physical Examination ; Prevalence ; Smoke ; Smoking