Day 1 :
- Primary Healthcare in Women
Tribhuvan University, Nepal
Background of Study:
Mother’s milk is undoubtedly a great and unique blessing of God that has nourished the
entire needs of newborn and is regarded as the healthiest, the safest, the freshest, the
most accessible and ideal nourishment for a child during the first 2 years of his/her life.
There are numerous health benefits of early initiation of breastfeeding and exclusive breastfeeding on survival, physical and mental growth and development of a
child as well as health and well-being of a mother. Thus the present study highlighted the status of breastfeeding practices and determined the associated factors.
A community based quantitative cross sectional study was conducted in eight wards of Bharatpur Metropolitan, Chitwan Nepal. Systematic random sampling was used to select respondents and sample size for the study was 299. Data were collected through face to face interview using semi-structured questionnaire. The collected data were entered in EPi Data 3.1 and analysis was done in IBM SPSS 20.
The study found that out of 297 respondents, 51.8% (CI: 45.2%-57.8%) had done early initiation of breastfeeding (within 1 hour of birth), 40.1% (CI: 34.5%-45.7%) of respondents had done prelacteal feeding, 12.8% (CI: 9.0%-16.6%) had done exclusive breastfeeding. In multivariate analysis factors religion of respondent (AOR=2.549, CI: 1.17-5.57), and respondent knowledge on early initiation of breastfeeding (AOR=3.95, CI: 2.23-7.00), were significantly associated with early initiation of breastfeeding. In regard to prelacteal feeding age of respondents, (AOR=0.42, CI: 0.21-0.84), economic status (AOR= 0.42, CI: 0.18-0.99), and level of knowledge (AOR= 2.66, CI: 1.52-4.67) were significantly associated with prelacteal feeding. For exclusive breastfeeding respondent knowledge on exclusive breastfeeding (AOR=2.66,
CI:1.52-4.674), sickness of baby up to 0 to 6 months of life (AOR=8.53, CI:2.52-28.84) and mothers participation in household decision making (AOR=6.31, CI:2.184-18.23), were significantly associated with exclusive breastfeeding.
Discussion and Conclusion:
The study revealed that breastfeeding practices were not found good especially prelacteal feeding and exclusive breastfeeding in comparison to early initiation of breastfeeding. The reasons behind the low prevalence were caesarean section, maternal and child health conditions, delay milk secretion, lack of information, baby not able to suck mother's milk and advice of health workers for to fed formula milk mostly in case delivery operating caesarean section.
- Primary Healthcare
Participation of women in the medical profession over several countries worldwide was increased over the past decades. This paper is a part of ongoing studies aiming at addressing the issue of health workforce feminization among doctors in the Sultanate of Oman as well as exploring the health system readiness in dealing with this phenomenon.
Literature in addition to reports and records of the Ministry of Health, Oman (MoH); Sultan Qaboos University (SQU) and Oman Medical Specialty Board were reviewed regarding the gender of the doctors and the medical students.
Results and discussion:
Findings regarding the medical students at the SQU showed higher number of females compared to males (64% females in 2015 compared to 54% in 2009). A similar trend was observed regarding the postgraduates as 61.5% of the graduated residents doctors were females.
As for active workforce, the MoH 2015 report revealed that female doctors represent 42% of the total doctors compared to 27% in 1990. It increased 4% from 1990 to 2000, doubled to 8% from 2000 to 2010. The proportion of specialized female doctors reached 31% in 2015 compared to 21% in 1990. There were also gender variations among specialities. The proportion of female General Practitioners reached 50% in 2015 compared to 30% in 1990 (4% increase every five years).
The feminization phenomenon in Oman is increasing and requires more attention in order to assess the health system readiness of meeting the needs and accommodating the females' as the main care providers. The trend is expected to have important consequences on future planning, given that women doctors differ from men in how they participate in the workforce. It may also potentially contribute to a shortage in supply due to difference in preferences and consequently affect the skill-mix and productivity. The cultural, social context and dimensions need to be explored; and feasible options to be provided for better planning.
Institute of Nursing Suranaree University of Technology.
Dr. Patama Vajamun, R.N. Dr.P.H. (Nursing) Faculty of community health nursing department, Institute of Nursing Suranaree University of Technology
Specialized area: Ophthalmic Nursing Practitioner, elderly care, chronic care, cancer care and palliative care.
Stroke is the leading cause of death and handicap in Thailand even though the national chronic disease control program was implemented for many years in contrast the problems continuously increasing according to changing to elderly society. Thai VHVs are provided basic health care and health promotion is one of the key success of health care improvement in Thailand. Methodology: 10 VHVs were trained for changing health behaviors of villagers and how to used SUT Stroke Risk Tool (SSRT) to assessed and classified risk factors of target group to guided individuals for changed their significant modifiable health behaviors. 50% of VHVs could encouraged 96% (48) of the risk group changed to healthy behaviors; increase regular exercises, decrease BP, BS, weight, waist, cholesterols, salt, sweet, and alcohol consumption including gave up smoking. Only 4% (2) of them were uncontrolled and referred to the hospital for health check up. It revealed that specific training of VHVs by employed SSRT as a tool could increased healthy behaviors among people who were at risk of stroke in Nonglak village and non of them developed stroke within a year follow up.So that further study may be benefit in general population.
Khlung Community Hospital, Thailand
Ministry of Public Health has prepared a strategy to develop primary care cluster. The main purpose of that was to provide effective public health care in the right size area. Khlung district was a model of community hospital operations in Chanthaburi. During the operation, we has encountered with many problems. Therefore, it was necessary to know the situation of the operation and find a way to develop a new primary care cluster. The purpose of this study was to explore the way to establish the primary care cluster and to propose the operating model for establishing the proper primary care cluster.
The qualitative research conducted in three groups of sample including 5 administrators, 12 practitioners and 8 clients. Focus group discussion and in-depth interview used to collect the data. The research instrument a semi-structured interview questionnaire with 3S model: staff, structure, system and clients. The results reveal as follows: 1) The situation of the establishment of the primary care cluster, we found that the strength of the staff was well preparation of an appropriate portion of a multidisciplinary profession and team work. The development opportunity of the staff was the knowledge and ability in practicing in primary care cluster among staff was limited and there was a little involvement of family and community in health care. The strength of the structure was having a building or place to work and the budget from the community donation. The development opportunity of the structure was one of the health promotion hospital has no car and boat to drive health care team to provide home visit. The strength of the service system was the modification of an appointment scheduling system to see the doctor directly 2 days a week and 24-hour consultation. The development opportunity of the service system was incomplete of basic information of the population and illness information that result to not cover care for all population, registered nurse cannot participate with family physician every time to provide home visit, the clients did not receive the medication prescribed by the family physician as well as the referral of the patients to the regional hospital must be commenced at the community hospital. 2) For the proper model of primary care cluster, the staff should provide a forum for exchange knowledge and experiences such as a case conference among registered nurse, Thai traditional medicine and family physician should be involved in learning and leading the conference. Moreover, the driver position should appoint in family care team. For the structure, it should be cooperated and coordinated with other health promotion hospital in sharing resources. For the system, increasing the number of medication, laboratory examination and referral guideline in order to be the same approach.
- Primary Healthcare-Medical
Songkhla hospital, Thailand
Saowapha Srisai is family physician at Songkhla hospital in Thailand. She enjoys interacting with patients and provide recommendation about how they could take care of themselves. Her passion is in trying to improve prevention and treatment in chronic disease’s patients as well as training medical students to apply their knowledge efficiently. Her main area of expertise include administration MDI and prevention by lowering risk factors.
Chronic Obstructive Pulmonary Disease (COPD) is a common lung disease characterized by airflow limitation. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guideline suggests a short-acting inhaled bronchodilators and anticholinergic inhaled agents as a first line COPD treatment. In spite of its popularity, many COPD patients use inhalers incorrectly. This is a cross-sectional study. The sample includes patients diagnosed with COPD who visit Muangsongkhla hospital (N=92) during 1-31 July 2016. The inhaler technique was directly observed during their visits. Data were analyzed by Program R version 2.13.0. 92 patients diagnosed with COPD were enrolled in this study. Prevalence of the incorrect administration of MDI dispensing a short-acting bronchodilator by COPD patients in primary care setting was 72.8%. Breath-holding for at least 10 seconds after inhalation was found to be the most critical step that was mistaken. Education was found to be significantly associated with the incorrect administration of MDI dispensing a short-acting bronchodilator. Almost three quarters of COPD patients in primary care setting administer short-acting bronchodilator incorrectly. The most important factors associated with incorrect inhaler usage of the MDI are education and income. Therefore, healthcare provider team should carefully provide the instruction for the methods of using MDI administration to COPD patients and reinforce them periodically asking the patients to demonstrate how they administer MDI.