Школа громадського здоров’я

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Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population
(2024) Mazhnaya, Alyona; Geurts, Brogan; Brigida, Krestina; Bakieva, Shokhista; Sadirova, Shakhlo; Witzigmann, Annika; Musabaev, Erkin; Brandl, Michael; Weishaar, Heide; Dudareva, Sandra; El Bcheraoui, Charbel
Introduction In the World Health Organization European Region, an estimated 14 million people live with a chronic hepatitis B virus infection (HBV), and 12 million are affected by a hepatitis C virus infection (HCV). Uzbekistan bears a major burden of HBV and has one of the highest HCV prevalence in the region. Following a presidential decree in May 2022, significant funds were allocated to the viral hepatitis (VH) elimination program in Uzbekistan. The program expands VH testing to reach 500,000 people annually during 2022–2025 as part of the VH elimination strategy that includes the provision of free testing and affordable treatment. Exploring the existing barriers and facilitators to VH testing is pivotal for informing these interventions. Methods This study uses a cross-sectional qualitative design to identify and explore the barriers and facilitators to VH testing among the general population in Uzbekistan. We collected data during October-November 2022 through semi-structured interviews with 12 key informants (KIs) and 7 focus group discussions with two target populations: the general population and healthcare workers (HCW) in Tashkent, Uzbekistan. Results Following the capability-opportunity-motivation-behavior model (COM-B model) as a framework for the analysis, we identified major capability barriers to VH testing primarily linked to low health literacy and limited knowledge about VH types, symptoms, transmission, testing and treatment. Physical opportunity barriers included the time and financial costs associated with testing, diagnostics, and treatment. Sociocultural opportunity barriers involved anticipated negative reactions and stigmatization, particularly affecting women. Motivational barriers included a reluctance to be tested when asymptomatic and a general fear of receiving positive test results. The involvement of healthcare workers in promoting VH awareness and motivating the general population emerged as a facilitator. Conclusions A multi-pronged approach is recommended to achieve VH testing goals among the general population, focusing on raising awareness and health literacy and creating an enabling environment that ensures easy accessibility and minimizing VH testing-associated costs.
Bridging gaps: improving the access of primary health care in rural Ukraine through mobile health units
(2024) Suzyma, Valentyna; Yurochko, Tetiana
Rural healthcare is an integral part of the Ukrainian healthcare system. However, access to healthcare for the rural population is uneven due to poor development of medical infrastructure and staffing. The problem of access to medical care in rural areas has been exacerbated by the full-scale war. The objective: to study and analyze the current state of accessibility of primary health care in rural areas in Ukraine, followed by a discussion of promising areas for the introduction of mobile health units as a tool for implementing the "Medical Guarantees" program in hard-to-reach regions of Ukraine. Materials and methods. The study included data from official statistical reports, regulatory documents and scientific sources. The methodology includes bibliosemantic, medical and statistical methods and the method of structural logical analysis. Results. It has been established that the low level of access to primary health care for the rural population of Ukraine has been significantly exacerbated by the devastating impact of the war on medical and transport infrastructure, especially in the frontline and recently de-occupied rural areas, and by migration processes. The situation is complicated by the fact that most patients in rural areas are elderly people who are physically unable to use public transportation, even if it is available. The analysis of international practice has shown that mobile health units can be introduced into the public healthcare system as a temporary measure to meet the urgent needs of the Ukrainian population, especially in rural areas. Integration of mobile health units into the state program "Medical Guarantees" can effectively address the urgent health care needs to increase access to health care for the rural population of Ukraine. State regulation of the division of these units will eliminate problems such as duplication and uneven service delivery and will create a transparent system of remuneration for the staff included in these units. Conclusions. The results of the study suggest that the practice of mobile medical units should be introduced as a tool for implementing the "Medical Guarantees" program for regions/locations of Ukraine with low access to medical infrastructure, namely remote rural areas and areas that have been devastated by the war. Mobile medical units will ensure the stability of access to primary health care services and contribute to improving the health of the population.
Current challenges in accessibility to ophthalmological care in Ukraine
(2024) Skrypnikova, Olena; Yurochko, Tetiana
Aim: The purpose of the study is to identify challenges in the organization and access to ophthalmic services through the analysis of expert opinion of practitioners and government officials. Materials and Methods: Materials developed during expert interviews with practitioners and government officials were used in the study. We also used materials worked out within the project ID 22120107 supported by Visegrád Fund. Conclusions: Despite all the challenges in access to high-quality ophthalmology services, practitioners and government officials have common opinions on how to improve the organization of eye services, how to make care more inclusive and effective, so that the development of blindness and visual impairment does not cause a burden on the state and society.
Digital solutions for the development of corporate health programs
(2023) Aleksandrenko, Hlib; Shevchenko, Maryna
Introduction. The article examines the relevance and importance of the health status of employees in modern society. Considering the rapid development of digital technologies, the expediency of their use to improve health and well-being at workplaces is being investigated. Purpose. The purpose of the article is to analyze the current state of development of digital technologies for corporate health programs, as well as to present the results of the developed and implemented digital tool for the implementation of the corporate health program. Materials and methods. The research materials are: 1) regulatory and legal support for the regulation of corporate health of employees of enterprises; 2) information resources of foreign companies that use scientific and practical achievements in the field of digital technology development to preserve and strengthen the corporate health of enterprise employees. In the process of carrying out the research, the following scientific methods were used: theoretical generalization (to characterize corporate health programs and digital applications for tracking the individual corporate health of employees); formalization, analysis and synthesis (to build a model of strengthening corporate health); logical generalization of results (formulation of conclusions). Results. One of the modern trends in the field of personnel management (or, as we call it now, human resources or HR) is the implementation of a holistic approach to the well-being of employees. Companies offer innovative programs to ensure financial well-being, mental health, a healthy lifestyle (in particular, nutrition, physical activity), stress management, etc. It has been becoming a part of both the employer's corporate social responsibility and a strategy crafted to ensure the maintenance of a positive HR brand, attract and retain talents, and increase the level of employee engagement as well as efficiency. It has been confirmed by the results of the Deloitte study. The developed and implemented model of the corporate health program, one of the components of which is the use of digital tools in the form of an automated system of interaction, ensured effective communication and feedback with program participants and prompt response to their needs. Automated distribution of information, support, and personalization were carried out thanks to the proposed algorithm and the possibility of customization through the personal account of each program participant. Thus, we were able to provide a personalized approach to each of them. Discussion. The predicted economic efficiency of this program is estimated for the company's management at approximately $51,000 per year. It has been established that strategies, conditions, or activities carried out in the work environment can motivate employees to make changes that will not only have a positive effect on their health and well-being but also allow for increased productivity at the workplace.
Environmental competencies for healthcare management at a 2nd education level as a component of strategic management
(2024) Turianytsia, Solomiia; Yurochko, Tetiana; Balashov, Kostyantyn; Hulchiy, Olesya
Aim: To present the results of the analysis of educational standards and curricula of the second educational level of training of specialists, who may be managers of healthcare, on the content of the environmental component as an element of strategic management. Materials and Methods: Content analysis 24 educational standards of the Ministry of Education and Science of Ukraine for 6 fields of knowledge and 200 master’s curricula from 87 institutions of higher education of Ukraine. Conclusions: There is a distribution of basic leadership and management competencies both by types of these competencies and between specialties. The requirements for the inclusion of the environmental component in the framework documents are poorly expressed. The content of environmental issues in the curricula is insufficient.
How much can we learn from each other? Polish and Hungarian good practices in financing ophthalmology care as a proposal for implementation in Ukraine
(2024) Więckowska, Barbara; Byszek, Katarzyna; Rękas, Marek; Yurochko, Tetiana; Shevchenko, Maryna; Skrypnikova, Olena; Dozsa, Csaba; Toth, Melanie
The article aims to compare payment schemes for cataract, glaucoma, vitrectomy, cornea transplantations, DME, and AMD across Hungary, Poland, and Ukraine, and to identify implementable practices in Ukraine within the context of ongoing healthcare reforms.
Organization of ophthalmological care in Ukraine
(2023) Skrypnikova, Olena; Yurochko, Tetiana
The aim: To consider the organization of ophthalmological care in Ukraine for cataract and glaucoma and +nd out whether it is appropriate to implement advanced good practices of reference countries for Ukraine. Materials and methods: The method of desk review was used, supported by secondary analysis of data, in particular legislative acts. The research included conducting expert interviews with ophthalmologist of the public and private sectors, heads of public healthcare institutions, and management of the National Health Service of Ukraine. We also used materials on good practices from partners within the project ID 22120107 supported by Visegrád Fund. Results: Since the burden of ophthalmological pathologies is increasing and processes of reforming the health care system are taking place, changes in the organization and +nancing of ophthalmological services are taking place. Within the framework of the partner project, "Access to healthcare services in the context of +nancing mechanisms. The case of ophthalmology" identi+ed good practices in the organization of ophthalmological care in the context of improving access to services and improving quality. The results of interviews with key stakeholders led to the fact that the respondents generally support all the good practices proposed by the partner countries and indicate their arguments why the proposed practices are (not)appropriate to implement in Ukraine. Conclusions: The organization and +nancing of healthcare in Ukraine still require the study and implementation of good practices so that patients can have access to quality services and treatment.
Using a chatbot as a digital tool at the primary health care level
(2024) Aleksandrenko, Hlib; Shevchenko, Maryna
Aim: To analyze the feasibility of utilizing a digital tool such as a chatbot at the primary health care level as part of a health program. Materials and Methods: With the involvement of a general practitioner and the use of a digital tool, a chatbot, a three-month health program was conducted for employees of an IT company. The chatbot was used to collect information, monitor the health status of participants and provide personalized health recommendations. To evaluate the program’s effectiveness survey was conducted to compare participants answers before and after using standardized evaluation scales. A questionnaire based on the Evaluation and Management Services Guide was created to collect medical information on the health status of participants before and after the program. Results: After the program, the average total score of participants’ health complaints and symptoms decreased (from 27.1 to 16.1, p=0.019). The average severity of the chief complaint on a scale of 0 to 10 decreased from 5.08 to 2.27, or by 55.3% (p=0.00676). The frequency of individual complaints such as eye pain, decreased concentration, increased fatigue and irritability also dropped. Conclusions: The chatbot enabled the primary care physician to respond promptly to participants’ health complaints. The results demonstrated the potential of chatbots as innovative and accessible digital tools at the primary health care level for providing recommendations, monitoring health, and contacting a primary care physician in a timely manner.

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