BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) perform more than the provision of direct care to clients. They are also expected to perform roles as leaders, managers, and collaborators in different settings, especially in areas where there are no physicians. Their continuous professional development must be facilitated to empower them to lead the delivery of health programs and services in pursuit of universal healthcare. This study aims to determine the perceived competencies of public health nurses and describe their training needs.

A descriptive, cross-sectional study was utilized, where an online survey was administered to PHNs across the Philippines to determine their self-perceived competencies and training needs based on the eight domains of core competencies of public health professionals. Descriptive statistics was used to summarize the data.

A total of 330 PHNs answered the survey. The results showed that at baseline, PHNs perceived themselves to be competent (from most to least) in the following: communication, analytical/assessment, community dimensions of practice, policy development/ program planning, leadership and systems thinking, cultural competency skills, public health science, and financial planning and management. In terms of training needs, the enablers mentioned include a supportive work environment that can provide a work schedule that is inclusive of time for professional development and work-life balance; a learning environment where colleagues and supervisors support the need for training and innovation; strong internet connection; and enough equipment to participate and submit deliverables for courses taken.

Filipino public health nurses perceived themselves to be competent in the areas of communication and community practice, but less competent in public health science, and financial planning and management. Future capacity-building programs must be designed to meet this demand. Furthermore, to make training programs truly responsive to the needs of nurses, steps must be taken to promote capacity-building enablers.

The existence of garbage codes in death cause surveillance data sets could influence the accuracy of the death cause statistics, and subsequently affect the precision and effectiveness of public health policy making. International and domestic researchers have studied the characteristics of garbage codes in various death cause data sets from different countries or regions in the world. They proposed several approaches for redistributing garbage codes, such as expert consultancy, fixed proportional reassignment, using the information about death cause chain, building statistical models, and so on. This paper summarizes and compares the principles, applications and limitation of application scenarios of currently common methods for garbage code redistribution in order to provide some references for improving the accuracy and usefulness of the death cause data in China.
Causality ; Cause of Death ; Data Collection ; Humans ; Models, Statistical ; Public Policy

The standardized training for public health physicians plays an important role in exploring the cultivation public health professionals and strengthening the construction of public health service providers. In 2018, the National Health Commission of China launched a pilot program of standardized training for public health physicians in 10 provinces. This paper clarifies the definition of the standardized training for public health physicians, systematically analyzes the status quo of the training in China and other countries, articulates the design and progress of the training in the perspective of Centers for Disease Control and Prevention, and makes some suggestions for the priorities of the pilot training program, so as to provide reference and basis for the better development of the standardized training for public health physicians in China in the future.
China ; Humans ; Physicians ; Pilot Projects ; Policy ; Public Health

Background. The Republic Act 7305 or the Magna Carta of Public Health Workers was enacted in 1992 to address health workers' welfare. However, the implementation of this act was reportedly inconsistent among local government units (LGUs). Objectives. This study was conducted to determine the implementation status of provisions under the law among LGUs. Methods. This is a descriptive case study employing mixed methods. The quantitative data were derived from LGU scorecards, and the qualitative data were obtained from focus group discussions and key informant interviews of mayors, municipal health officers, and budget officers. Results. A total of 1,557 LGU scorecards with 2017 data showed that more than half (52.0%) of LGUs do not provide the full benefits of hazard pay, subsistence allowance, and laundry allowance. Disaggregation by income class showed that the provision of benefits is higher among LGUs with higher income classes (56.10%) compared to LGUs of lower-income classes (38.73%), and this translates to a correlation of income class with the provision of benefits (χ2=59.0, p<0.001). Factors influencing the provision of benefits include the political will of the mayor, the active role of municipal health staff to lobby for their rights, the limited resources of the LGU, the personnel services budget ceiling, the lack of enforcement of the law, and the limiting specifications of the law. Conclusion. This study demonstrated that the Magna Carta benefits for public health workers in municipalities and cities are inadequately implemented. Local governments must enforce public health workers' rights and benefits, but the national government should aid and ensure its unvarying implementation.
Humans ; Public Health ; Public Policy ; Health Policy

The Big Data Research Committee of the Korean Society of Gastroenterology conducted activities and researches with three goals. First, it provides the basis for proper and cost-effective treatment of digestive diseases in Korea. Second, it carries out population-level global research by establishing a system of big data analysis related to gastroenterology. Third, it provides the members of the Korean Society of Gastroenterology with the opportunity to plan and assess the public interest related to big data. The studies published by the committee members in this paper were carried out under these objectives, and the findings are believed to have achieved the public interest goals that may be helpful in the current medical and health policy. The construction of the big data infrastructure for digestive drugs is also underway, and we expect to see meaningful results pertaining to important digestive drugs. Research using public health medical big data, such as the National Health Insurance Corporation data base, should ultimately provide a basis for reflecting public messages and policies for the public. To this end, it is necessary for Korean researchers to lead efforts to lower the barriers and to approach relevant information and opportunities using big data research.
Committee Membership ; Gastroenterology ; Health Policy ; Korea ; National Health Programs ; Public Health ; Statistics as Topic

BACKGROUND: Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS).METHODS: We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression.RESULTS: Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102–3.017). The most suitable cutoff point for MHI by Youden’s index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%).CONCLUSION: Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.
Climate ; Daegu ; Heat Stroke ; Hot Temperature ; Humans ; Incidence ; Korea ; Logistic Models ; Meteorology ; Odds Ratio ; Public Policy ; Sensitivity and Specificity

OBJECTIVES: This study evaluated dietary intakes of total fat and fatty acids among the Korean adult population. METHODS: This cross-sectional study used the 2016–2017 Korea National Health and Nutrition Examination Survey data. A total of 10,772 subjects aged ≥19 y for which dietary data were available were selected. Data pertaining to energy and nutrient intakes were obtained by a 24-h recall method. Total fat and fatty acids intakes were evaluated based on the Acceptable Macronutrient Distribution Ranges (AMDR) of 2015 Dietary Reference Intakes for Koreans by sex and age groups. All statistical analyses accounted for the complex sampling design effect and sampling weights. RESULTS: The mean intakes of energy and total fat were 1,952 kcal (95% CI: 1928–1977) and 46.1 g (45.2–47.1), respectively, and about 21% of the energy was obtained from fat in this study population (21.7% in men and 20.2% in women). The mean percentages of energy from saturated, monounsaturated, and polyunsaturated fatty acids were 6.4%, 6.7%, and 5.2%, respectively. About 18% of adults exceeded the AMDR for fat (30% of energy), whereas 37.6% exceeded the AMDR for saturated fatty acids (7% of energy). The proportions of subjects who consumed more than the AMDR for fat and saturated fatty acids decreased across age groups in both sexes. Among young adults (19–29 y), about 63% of the subjects obtained ≥7% of their energy from saturated fatty acids. About 61% of older adults obtained less than 15% of their energy from total fat. CONCLUSIONS: Increased intake of fat energy was prominent in saturated fatty acids. Our findings suggest current information on total fat and fatty acids intakes in Korean adults and can be used to provide dietary guidelines for the improvement of public health.
Adult ; Cross-Sectional Studies ; Dietary Fats ; Fatty Acids ; Fatty Acids, Unsaturated ; Humans ; Korea ; Male ; Methods ; Nutrition Policy ; Nutrition Surveys ; Public Health ; Recommended Dietary Allowances ; Weights and Measures ; Young Adult

BACKGROUND: The objectives of the study are to find out the effect of the implementing reform in three Central Asian countries, identify its impact on health status and health care delivery systems. This study address to identify strong and weak points of the health systems and provide a recommendation for further health care organization. METHODS: A comparative analysis was conducted to evaluate the effects of implemented policy on health care system efficiency and equity. Secondary data were collected on selected health indicators using information from the World Health Organization Global Health Expenditure Database, European Health Information Platform, and World Bank Open Data. RESULTS: In terms of population status, countries achieved relatively good results. Infant mortality and under-5 mortality rate decreased in all countries; also, life expectancy increased, and it was more than 70 years. Regulations of the health systems are still highly centralized, and the Ministry of Health is the main organ responsible for national health policy developing and implementation. Among the three countries, only Kyrgyzstan was successful in introducing a national health system. Distribution of health expenditure between public expenditure and out-of-pocket payments was decreased, and out-of-pocket payments were less the 50% of total health expenditure in all countries, in 2014. CONCLUSION: After independent, all three countries implemented a certain number of the policy reform, mostly it was directed to move away from the old the Soviet system. Subsequent reform should be focused on evidence-based decision making and strengthening of primary health care in terms of new public health concepts.
Asian Continental Ancestry Group ; Decision Making ; Delivery of Health Care ; Global Health ; Health Expenditures ; Health Policy ; Humans ; Infant ; Infant Mortality ; Kazakhstan ; Kyrgyzstan ; Life Expectancy ; Mortality ; Primary Health Care ; Public Health ; Social Control, Formal ; United Nations ; Uzbekistan ; World Health Organization

BACKGROUND: In order to provide essential scientific evidence on the population's health status and social health determinants as well as the current capacity of the health care system in Vietnam to health policy makers and managers, Vietnam Ministry of Health, Hanoi University of Public Health, Hanoi Medical University, and Ho Chi Minh University of Medicine and Pharmacy collaborated with Seoul National University (Korea) and conducted a health system survey in the Quoc Oai district (of Hanoi capital) that represented northern rural Vietnam. METHODS: The study design was a cross-sectional study. The survey covered different topics (more than 200 questions) and was administered in three separate questionnaires: 1) Basic information of all household members; 2) Household characteristics; and 3) Individual characteristics. Socio-demographic characteristics among the households and individuals were collected from 2,400 households sampled by multi-stage cluster sampling method: more than 200 questions. RESULTS: The household size of Quoc Oai was larger than the national average and there was no significant difference in gender composition. In addition, the proportions of pre-elderly, age 55–64, and elderly group (65 years old and over) were higher than the national population statistics. In this context, demographic transition has begun in Quoc Oai. CONCLUSION: This study design description provides the basic information about a baseline survey of a future prospective cohort (as a part of a collaborative project on strengthening the health system in Vietnam) to the prospective data user of this survey.
Aged ; Cohort Studies ; Cross-Sectional Studies ; Delivery of Health Care ; Family Characteristics ; Health Policy ; Humans ; Methods ; Pharmacy ; Population Characteristics ; Population Dynamics ; Prospective Studies ; Public Health ; Seoul ; Surveys and Questionnaires ; Vietnam

OBJECTIVES: The lowest-low fertility status of Korea has continued for the past 17 years despite governmental efforts to encourage childbirth. As the number of working women has increased, their residence patterns have changed; however, the impact of this factor has yet to be explored. Therefore, this study was conducted to investigate the effects of residence patterns relative to the workplace on the total fertility rate of working women.METHODS: Information on eligibility and healthcare utilization was obtained from the National Health Information Database between 2011 and 2015. The study participants were working women aged 15-49 years. We classified their residence relative to their workplace into 3 patterns: same municipality, same province, and different province. The total fertility rate was calculated and logistic regression was performed of childbirth according to residence pattern, adjusting for age, insurance contribution quartile, size of the workplace, year of birth, and province of residence.RESULTS: The total fertility rates of working women from 2011 to 2015 were 1.091, 1.139, 1.048, 1.073, and 1.103, respectively. The total fertility rate by residence pattern was highest in women residing in the same municipality as their workplace. After adjustment, the odds of childbirth in women from the same municipality and the same province were 21.6% and 16.0% higher than those of women residing in a different province, respectively.CONCLUSIONS: The total fertility rate was higher among women living near their workplace. Therefore, effective policy measures should be taken to promote the proximity of working women's workplace and residence.
Birth Rate ; Delivery of Health Care ; Female ; Fertility ; Humans ; Insurance ; Korea ; Logistic Models ; Parturition ; Public Policy ; Women, Working