Implementation of National Leprosy Eradication Programme during COVID-19 era: A qualitative research

Introduction: The COVID-19 pandemic imposed new challenge to the implementation of the National Leprosy Eradication Programme. According to national data, after lockdown due to COVID-19, there was a 29% reduction in total leprosy cases reported in the first quarter (April-June) of 2020 in comparison to 2019. Objectives: To explore the difficulties faced by different stakeholders of the National Leprosy Eradication Programme like policy makers, doctors, grass root level health workers as well as leprosy patients during COVID-19 pandemic with respect to programme implementation and access to leprosy care. Materials and Methods: Qualitative research was undertaken including two focus-group-discussions held among six leprosy patients diagnosed after lockdown and nine ASHA workers as well as six in-depth interviews of doctors, leprologists, and programme managers. Ethics committee approval was sought and informed consent was obtained from all participants. All focus-group-discussions were electronically recorded and the in-depth interviews telephonically recorded, transcribed and translated from Bengali-to-English. Transcripts were separately coded by researchers and thematically analysed with the help of Visual-Anthropac software version 1.0. Results: Solitary focus on COVID-19 control, capacity building and information, education and communication, leprosy case search & surveillance, co-infection among health workers, transportation issues were the themes explored from focus-group-discussions of health workers and ASHA workers. Similarly, the present study identified six themes from in-depth interviews of programme manager, leprologists, programme manager as diagnostic difficulty, operational issues, rehabilitation issues, capacity building & information education and communication activities and way forward. Limitations: The research reveals the perceptions of rural population of Eastern India with high leprosy prevalence, which might not be applicable for urban areas or low prevalent districts Conclusion: The solitary focus of the administration towards COVID and shifting the infrastructure and human resource only towards the management of COVID can lead to resurgence of the leprosy. Having an organised framework of operations, catering to the need of the front-line workers in rendering services, utilizing the digital platform and social media, and focusing on rehabilitation would be needed to overcome the crisis

Domains of Adherence and Non-Adherence to Anti-Hypertensive Medications in Hypertensive Patients from Kuala Lumpur: A Qualitative Study

@#Introduction: Previous medication adherence studies primarily focused on the domains of non-adherence in hypertension treatment and less attention has been given on domains that encourage adherence to anti-hypertensive medications. The current study is aimed to identify the domains of adherence and non-adherence to anti-hypertensive medications among hypertensive patients in Kuala Lumpur, Malaysia. Methods: Hypertensive patients from two public health clinics in Kuala Lumpur were invited for in-depth interviews until thematic saturation. Audio recordings from these interviews were transcribed verbatim. Transcripts were then analysed deductively with the guidance of the World Health Organization Medication Adherence Framework to extract the domains of adherence and non-adherence to anti-hypertensive medications. Results: Ten patients who were predominantly Malays and aged 34-73 years old participated the study. Patient-related (encompassing knowledge, attitude, belief and culture, lifestyle, personal barriers, self-efficacy, and cue to action), socioeconomic (encompassing social support), condition-related (encompassing nature of illness and presence of multiple co-morbidities), therapy-related (encompassing experience of receiving treatment, barrier in treatment, and side effects of treatment), and healthcare system (encompassing access to healthcare and healthcare center experience) domains were identified as central to the medication-taking behaviour of hypertensive patients. Conclusion: Sixteen codes of adherence and 22 codes of non-adherence to anti-hypertensive medications were identified, which were distributed across five domains (patient-related, socioeconomic, condition-related, therapy related, and healthcare system domains). These findings can help to inform future development of medication adherence questionnaires, individualised interventions for patients with adherence problems, and targeted health promotion programmes to reduce uncontrolled hypertension.

Qualitative Assessment of Adherence to Anti-Tuberculosis Medication Among Active Tuberculosis Patients

Background: Non- adherence is one of the major risk factors for the emergence of MDR and XDR TB. It is also one of the key factors responsible for treatment failure, disease relapse, prolonged infection and death. This study was conducted to explore the various factors contributing to non-adherence to the Anti-TB medication. Methods: A qualitative study was done on Adult Pulmonary and extra pulmonary TB patients who were in course of the treatment. A total of 20 patients were enrolled. Socio 杁emographic details and specific questions regarding TB were collected using a semi-structured questionnaire. In depth telephonic interviews were conducted among all participants. Results: The study participants comprised between 15 to 68 years of age with a mean age of 36 �.9years. Factors influencing non-adherence to medication were grouped under Patient, medication, Socio-economic and Health care related factors, Motive. Almost all patients reported more than one factor. Conclusion: Increasing the awareness of various TB services in the community may increase knowledge and improve attitude among the patients. Providing more information about the effects of medication may reduce the risk of being non adherent. TB anonymous groups can be organized for patients to discuss their challenges while on treatment.

Barriers to Early Diagnosis and Treatment among Breast Cancer Survivors: Qualitative Study in Tertiary Care Hospital, North Karnataka

Introduction: Around the World, Breast cancer has become one of the common cancers among women. Prevalence and mortality of Breast cancer in India are 18 lakh & 12.7 per lakh cases respectively. One of the important reasons behind late presentation & high death rate is the lack of breast cancer awareness. Objectives: To assess the barriers in diagnosis and treatment among breast cancer patients and to explore the perception about cancer prevention among them. Methods: A qualitative study was done among women with confirmed breast cancer who were admitted to KIMS, Hubballi, and Cancer hospital, Navanagar in April 2019. Data collection was done by the In-depth interview method and analyzed as per qualitative study protocol standards. Results: The data was collected among 14 participants. Themes were generated accordingly. The findings showed lack of awareness, myths, financial constraints, negligence were the major barriers to the early presentation of breast cancer. Conclusion: This study showed barriers such as lack of awareness, negligence, fear, financial constraints, myths and misconceptions, social stigma, lack of family support. Measures taken to reduce mortality by early diagnosis and treatment.

Consideraciones metodológicas sobre investigaciones sensibles en metodología cualitativa / Considerações metodológicas sobre investigação sensível em metodologia qualitativa / Methodological considerations for sensitive research on qualitative methodology

Algunos/as autores/as estudian y reconocen la dificultad emocional, por parte de quienes participan en investigaciones científicas, de revivir y relatar historias cuando estas se producen en contextos de violencia sea en el ámbito que sea (escuela, pareja, trabajo, etc.). El presente trabajo expone las dificultades metodológicas surgidas en el marco de una investigación cualitativa sobre la violencia laboral en dos países, Brasil y España. El objetivo de este artículo es ofrecer a la comunidad científica y política un conjunto de estrategias metodológicas para sortear los obstáculos que aparecen en la realización de una investigación con temática sensible. Las conclusiones de este trabajo indican que es necesario revisar las prácticas metodológicas que se llevan a cabo durante el diseño e implementación del estudio, pues esto puede evitar un perjuicio a los/las participantes e investigadores/as...(AU)

Alguns autores estudam e reconhecem a dificuldade emocional, por parte daqueles que participam de pesquisas científicas, de reviver e contar histórias quando estas ocorrem em contextos de violência em qualquer ambiente (escola, casal, trabalho etc.). O presente trabalho expõe as dificuldades metodológicas que surgiram no âmbito de uma pesquisa qualitativa sobre violência no trabalho em dois países, Brasil e Espanha. O objetivo deste artigo é oferecer à comunidade científica e política um conjunto de estratégias metodológicas para superar os obstáculos que surgem na realização de pesquisas sobre temas sensíveis. As conclusões deste trabalho indicam que é necessário rever as práticas metodológicas que são realizadas durante o desenho e implementação do estudo, pois isso pode evitar danos aos participantes e pesquisadores...(AU)

Some authors study and recognize the emotional difficulty, on the part of those who participate in scientific research, of reliving and telling stories when these occur in contexts of violence in any environment (school, couple, work, etc.). The present work exposes the methodological difficulties that arose in the framework of a qualitative research on workplace violence in two countries, Brazil and Spain. The aim of this article is to offer the scientific and political community a set of methodological strategies for overcoming the obstacles that appear in carrying out research on sensitive subjects. The conclusions of this work indicate that it is necessary to review the methodological practices that are carried out during the design and implementation of the study, as this may avoid harm to participants and researchers...(AU)

Consideraciones Metodológicas sobre Investigaciones Sensibles en Metodología Cualitativa / Considerações Metodológicas sobre Investigação Sensível em Metodologia Qualitativa / Methodological Considerations for Sensitive Research on Qualitative Methodology

Algunos/as autores/as estudian y reconocen la dificultad emocional, por parte de quienes participan en investigaciones científicas, de revivir y relatar historias cuando estas se producen en contextos de violencia sea en el ámbito que sea (escuela, pareja, trabajo, etc.). El presente trabajo expone las dificultades metodológicas surgidas en el marco de una investigación cualitativa sobre la violencia laboral en dos países, Brasil y España. El objetivo de este artículo es ofrecer a la comunidad científica y política un conjunto de estrategias metodológicas para sortear los obstáculos que aparecen en la realización de una investigación con temática sensible. Las conclusiones de este trabajo indican que es necesario revisar las prácticas metodológicas que se llevan a cabo durante el diseño e implementación del estudio, pues esto puede evitar un perjuicio a los/las participantes e investigadores/as.

Alguns autores estudam e reconhecem a dificuldade emocional, por parte daqueles que participam de pesquisas científicas, de reviver e contar histórias quando estas ocorrem em contextos de violência em qualquer ambiente (escola, casal, trabalho etc.). O presente trabalho expõe as dificuldades metodológicas que surgiram no âmbito de uma pesquisa qualitativa sobre violência no trabalho em dois países, Brasil e Espanha. O objetivo deste artigo é oferecer à comunidade científica e política um conjunto de estratégias metodológicas para superar os obstáculos que surgem na realização de pesquisas sobre temas sensíveis. As conclusões deste trabalho indicam que é necessário rever as práticas metodológicas que são realizadas durante o desenho e implementação do estudo, pois isso pode evitar danos aos participantes e pesquisadores.

Some authors study and recognize the emotional difficulty, on the part of those who participate in scientific research, of reliving and telling stories when these occur in contexts of violence in any environment (school, couple, work, etc.). The present work exposes the methodological difficulties that arose in the framework of a qualitative research on workplace violence in two countries, Brazil and Spain. The aim of this article is to offer the scientific and political community a set of methodological strategies for overcoming the obstacles that appear in carrying out research on sensitive subjects. The conclusions of this work indicate that it is necessary to review the methodological practices that are carried out during the design and implementation of the study, as this may avoid harm to participants and researchers.

Demographic And Socioeconomic Profile Of Female Domestic Workers In An Urban Slum Of Central Delhi– A Mixed Method Study.

Background: Labour pool engaged in informal or the unorganised sector is stillamong the least investigated employment conditions in ambit of public health research. Present study aimed to assess the living conditions and physical health profile of female domestic workers in an urban slum of central Delhi. Methods: A pretested questionnaire was used in a house to house survey of an urban slum to interview 100 women working as domestic help assessing their socio–demography and working conditions. Besides, in depth interviews were performed for key informants (n=10) to get detailed assessment of working conditions. Results:A large proportion of female domestic workers in the study sample were in late thirties. Although majority were literate but found it as most apt job. Majority were currently married and supporting families ranging from 2–15 members. In about 15% of the families they were the only ead winner of the family.Majority were migrants in Delhi from other northern states of India and few were cross border migrants. Majority of the subjects live in insanitary environment. Job security and job satisfaction are very low. Often at times they are subjected to long working hours and excessively arduous tasks. Discussion: Participants in our study were all from low socioeconomic status living and working in deplorable situation. Conclusion:More research in this issue as any other occupation in formal or informal sector is recommended.

The Perception of Laymen and Experts Toward Mobile Applications for Self-monitoring of Diet Based on in-depth Interviews and Focus Group Interviews / 대한지역사회영양학회지

OBJECTIVES: We conducted a qualitative study to explore the feasibility of mobile applications for self-monitoring of diet. METHODS: We conducted in-depth and focus group interviews with eight laymen who had used mobile dietary applications and eight experts. Interviews were audio-recorded and analyzed using an open coding method. RESULTS: The qualitative data of our study revealed two key themes: (1) perceptions, opinions and attitudes towards mobile applications of self-monitoring of diet and (2) future directions to improve mobile applications. CONCLUSIONS: Our qualitative study suggested the potential use of mobile applications as a food-tracking and dietary monitoring tool and the need for improved mobile applications for self-monitoring of diet. The results of our study may provide insights into how to technically improve mobile applications for self-monitoring of diet, how to utilize dietary data generated through mobile applications, and how to improve individual's health though mobile applications.

The Perception of Laymen and Experts Toward Mobile Applications for Self-monitoring of Diet Based on in-depth Interviews and Focus Group Interviews / 대한지역사회영양학회지

OBJECTIVES: We conducted a qualitative study to explore the feasibility of mobile applications for self-monitoring of diet. METHODS: We conducted in-depth and focus group interviews with eight laymen who had used mobile dietary applications and eight experts. Interviews were audio-recorded and analyzed using an open coding method. RESULTS: The qualitative data of our study revealed two key themes: (1) perceptions, opinions and attitudes towards mobile applications of self-monitoring of diet and (2) future directions to improve mobile applications. CONCLUSIONS: Our qualitative study suggested the potential use of mobile applications as a food-tracking and dietary monitoring tool and the need for improved mobile applications for self-monitoring of diet. The results of our study may provide insights into how to technically improve mobile applications for self-monitoring of diet, how to utilize dietary data generated through mobile applications, and how to improve individual's health though mobile applications.

What We Need To Solve The Urgent Crisis Of And How To Develop Sustainable Long Term Care In Thailand: Policy Makers’ Perspectives

@#Thailand’s growing aging population who have increased longevity has resulted in an upsurge in disability and the expectation of chronic diseases. The demand for increased care challenges the government to develop treatment and long-term management procedures. This study explores the following two objectives: 1) identifying policies for intervention that improve the quality of life of the elderly; and 2) developing a sustainable and feasible ten-year delivery system for Long Term Care (LTC). We conducted comprehensive interviews with 8 male and 3 female policy makers on LTC development for the elderly in Thailand and analyzed these transcripts by using NVivo 8 data analysis. Two independent investigations that contain thematic codes have been developed from the transcript subset’s first set. Six of the identified issues – care services imbalance, poor management, skill search, health workforce scarcity, regulations, and information system problems – are considered urgent and require a solution. The surveys reiterate that an LTC scheme will become family- and community-based in a decade. The improvements in the quality of life for elderly patients with long-term conditions are accomplished through integrated services, regulatory system consolidation, an LTC workforce, infrastructure delivery, and investment in elderly health groups. LTC must use an all-inclusive societal policy.

Factors Affecting the Insured Organizations Participation in Decision Making Process in Health Insurance Policy Committee / 보건행정학회지

BACKGROUND: Due to the asymmetry of information and knowledge and the power of bureaucrats and medical professionals, it is not easy for citizens to participate in health care policy making. This study analyzes the case of the insured organization participating in the Health Insurance Policy Committee (HIPC) and provides a basis for discussing methods and conditions for better public participation. METHODS: Qualitative analysis was conducted using the in-depth interviews with the participants and document data such as materials for HIPC meetings. Semi-structured interviews were conducted with purposively sampled six participants from organizations representing the insured in HIPC. The meanings related to the factors affecting participation were found and categorized into major categories. RESULTS: The main factors affecting participating in the decision making process were trust and cooperation among the participants, structure and procedure of governance, representation and expertise of participants, and contents of issues. Due to limited cooperation, participants lacked influence in important decisions. There was an imbalance in power due to unreasonable procedures and criteria for governance. As the materials for meetings were provided inappropriate manner, it was difficult for participants to understand the contents and comments on the meeting. Due to weak accountability structure, opinions from external stakeholders have not been well received. The participation was made depending on the expertise of individual members. The degree of influence was different depending on the contents of the issues. CONCLUSION: In order to meet the values of democracy and realize the participation that the insured can demonstrate influence, it is necessary to have a fair and reasonable procedure and a sufficient learning environment. More deliberative structure which reflects citizen's public perspective is required, rather than current negotiating structure of HIPC.

Qualitative Study for Medication Use among the Hearing Impaired in Korea

OBJECTIVE: Because of communication difficulties, the hearing-impaired face many disadvantages throughout their lives. One of those is limited access to health care services, particularly medication service. Though they suffer from problems related to taking medication properly, there have been few studies on their actual condition of medication use in Korea. This study is to investigate any obstacles to properly taking medications and, therefore, to suggest preliminary evidence for policy measures to improve safe medication use among the hearing-impaired. METHODS: Study participants consisted of hearing-impaired individuals living in Seoul. We also interviewed two sign language interpreters in order to illuminate health care state of the hearing-impaired. In-depth interview for each study participant was recorded and was translated into a written script for analysis. RESULTS: Study participants were comprised of four women (66.6%) and two men (33.3%). There were one participants in 20's, two participants in 30's, one 40's, and two 50's. Sign language interpreters were all women. One was in her 30's and the other was in her 40's. Communication difficulties have been found to be key barrier to use medication safely. A negative image of pharmacists also hinders safe medication usage, lowering access to local pharmacy and leading discretional self-medication. This article provides pharmacists with solutions to promote adherence in this population. CONCLUSION: The hearing-impaired had limited access to medication-related information as well as using services in a hospital and local pharmacy due to their disability. Institutional improvement for safe medication usage among the hearing-impaired is necessary.

Qualitative and quantitative research of preventive medicine's clinical internship / 中华医学教育探索杂志

Objective To provide improvement measures and recommendations to improve preven-tive medicine's clinical internship. Methods 88 third-year students and 82 fifth-year students of preventive medicine in Sichuan University were surveyed. Then 81 valid questionnaires of the third grade and 79 valid questionnaires of the fifth grade were input into EpiData, and SPSS 17.0 was used to analyze the data. Then, in-depth interviews were conducted among 6 employees and 2 professional teachers of the employing units, and the interview records were organized to form an interview summary. Results The third-year preventive medicine students who are preparing to take part in the clinical internship know little about the clinical in-ternship, which accounts for only 0％and 92.59％(75) think that the internship content should be different with the clinical medicine, in the meantime 44.44％ (36) think chief resident should be the internship teacher. For the fifth-year preventive medicine students who have finished the clinical internship, only 3.80％(3) is very satisfied with clinical internship;84.81％(67) are considered to take into account the pro-fessional characteristics of the clinical practice; meanwhile, the satisfaction of the knowledge or the ability learned from the clinical internship as well as the help in the post-graduation job is only 8.86％ (7); the employer's and professional teachers consider that the related clinical internship program of the preventive medicine student should be suitable for prevention medical students , and at the same time , preventive medicine students should focus on learning clinical knowledge related to disease prevention. Conclusion The clinical internship of preventive medicine needs further improvements, such as adjusting practice con-tents, learning teacher, management methods to form a clinical practice system characterized by preventive medicine so as to meet the needs of employers and students.

Características de la comunicación en empresas ecuatorianas: una primera aproximación / Features of communication in Ecuadorian companies: A first approximation

Resumen El tema de investigación nace de los datos obtenidos en una investigación anterior sobre clima organizacional realizada por los mismos autores, donde el factor «Comunicación¼ fue el más llamativo. En el presente estudio se determina el proceso de comunicación de las empresas afiliadas a la Cámara Nacional del Calzado (CALTU), provincia de Tungurahua (Ecuador). Es una investigación de tipo exploratorio, descriptivo, cualitativo, fenomenológico, inductivo, hermenéutico-dialéctico, no experimental, transversal. Se aplican entrevistas en profundidad a los gerentes/propietarios de las empresas de calzado. El procesamiento de datos se realiza a través del software Atlas.ti, herramienta informática que facilita el análisis cualitativo de datos textuales. El análisis metodológico de los resultados se apoya en la teoría fundamentada, cuyo principio básico es la construcción de teoría partiendo directamente de los datos obtenidos, y no de supuestos a priori, de otras investigaciones o de marcos existentes. Se concluye que los entrevistados entienden la comunicación organizacional básicamente como la comunicación con el trabajador. Y la comunicación técnica es más fluida que la comunicación personal: existe apertura para la comunicación ascendente y para las sugerencias del personal, siempre y cuando la comunicación se relacione con la información necesaria para la ejecución de las tareas.

Abstract The research topic arises from the data obtained in an earlier research on Organizational Climate conducted by the same authors, where the «Communication¼ factor was the most striking. In the present study, the communication process of the companies affiliated to the National Shoe Chamber (CALTU), Tungurahua, Ecuador, is determined. It is an investigation of type: exploratory, descriptive, qualitative, phenomenological, inductive, hermeneutic-dialectical, non-experimental, transversal. In-depth interviews are conducted with managers/owners of footwear companies. The data processing is done through Atlas.ti software, a computer tool that facilitates the qualitative analysis of textual data. The methodological analysis of the results is based on the Grounded Theory, whose fundamental principle is the construction of theory starting directly from the data obtained, and not from a priori assumptions, from other research or from existing frameworks. It concludes that interviewees understand organizational communication basically as communication with the worker. And technical communication is more fluid than personal communication: there is openness to the upward communication and to the suggestions of the staff, as long as the communication is related to the information necessary for the execution of the tasks.

Qualitative Study on Improvement of Operating System and Tailored Nutrition Education Program for Marriage Immigrants to Korea: Program Providers' Perspective / 대한지역사회영양학회지

OBJECTIVES: The purpose of this study is to analyze the current status of nutrition education programs for multicultural families and to provide policy suggestions for improvement. METHODS: In-depth interviews of a total of 21 multicultural experts were conducted; 15 people were interviewed individually, while 6 people were interviewed in groups of three. RESULTS: In-depth interviews revealed various problems related to the operation of nutrition education programs. The causes of problems were analyzed and categorized as four factors: systemic, practical, environmental and cultural. As for the systematic factors, insufficient linkage between related organizations and duplicate performance of several projects were identified as concerns Establishment of a control tower and strengthening the linkage among the related organizations may be needed to address this concern. With regard to practical factors, the study identified that language barriers, and lack of nutritional education media and tools translated into multicultural languages were limiting factors. These limitations the development of nutrition education materials that aretranslated into multiple languages, implementation of education programs that are different from the Korean education, and by providing interpreters. As for the environmental factors, low educational level and poor nutritional knowledge of multicultural women made it difficult for them to understand the contents of the education. Demonstration, practical training and urgent education on pregnancy and childbirth nutrition were identified as needs to address these concerns. Withregard to cultural factors, food culture conflict with Korean families, and difficulties in home practices were detected as concerns. Participants in the study suggested that getting education with family and facilitation of weekend and nighttime programs health of this community. CONCLUSIONS: Further studies are needed to adopt more effective and efficient nutrition intervention to promote the healthy eating of the married immigrant women based on the study results.

Health Group and Disease Group's Perceptions of Health and Health-related Quality of Life: a Focus Group Study and In-depth Interviews

BACKGROUND: This study aimed to understand and explore perception of healthy adults and chronically ill adults on health and health-related quality of life (HRQoL). METHODS: Data were collected by open questions using a focus group discussion for healthy adults (N=6) and in-depth interviews for chronically ill adults (N=6). Previously developed 34 HRQoL items also were offered and participants were asked to select the five most important HRQoL items among them. RESULTS: Findings were elicited along the following themes: health, HRQoL, health maintenance strategies, and elements affecting health. The definition on "being healthy" by healthy participants had a variety of standards and required several conditions to be fulfilled. Whereas chronically ill adults have more flexible perception about the coexistence of health and disease. Health dimensions were thought to affect each other, and physical and mental health dimension were selected as the most important items. As for the five most important HRQoL items, both group participants selected mental health dimension than physical or social health dimensions. Health maintenance strategies were similar in both groups except more healthcare service use in chronically ill adults. CONCLUSIONS: This study shows the difference of perception on health and HRQoL between health group and disease group in Korea. It can be used for developing the HRQoL assessment tool reflecting the perception of Korean people.

Qualitative Study for Medication Use among Visually Impaired in Korea

OBJECTIVE: The visually impaired have limited access to health care services and related information, and thus, they can have serious hurdles against properly taking medications. Despite that it is important to improve self-care ability of the visually impaired for correct medication use, there have been few studies investigating their needs for health care services in Korea, particularly focusing on proper medication usage. This study is to explore safety-related issues regarding mediation usage among the visually impaired based on in-depth interview. We particularly focus on any obstacles for safe use of medicines including experience on medication-related adverse effects in order to provide preliminary evidence for policy measures to improve proper medication use among the visually impaired. METHODS: Study sample was visually impaired individuals who resided in Seoul area and were registered in the National Association of Visually Impaired. The association helped the process of recruiting the study participants. In-depth interview for each study participants was conducted. Each interview was recorded and later converted into a written script to extract core contents for the analysis. RESULTS: The study participants comprised of three women (42.9%) and four men (57.1%). One was in his 20's, and there were four participants in 30's and two in 40's. Fully impaired participants were majority (5 out of 7). Limitation to physical access to health care providers and health information were the key factors to hamper safe medication utilization among the study participants. Difficulty reading medication information and may take the wrong medication or incorrect doses of medication, resulting in serious consequences, including overdose or inadequate treatment of health problems. Visually impaired patients report increased anxiety related to medication management and must rely on others to obtain necessary drug information. Pharmacists have a unique opportunity to pursue accurate medication adherence in this special population. This article reviews literature illustrating how severe medication mismanagement can occur in the visually impaired elderly and presents resources and solutions for pharmacists to take a larger role in adherence management in this population. CONCLUSION: The visually impaired had difficulties reading medication information and identifying medicines, and took incorrect doses of medications. Public support for safe medication use and medication management among the visually impaired is necessary.

The status and barriers of health foundation development:A case study of four foundations in Beijing / 中国卫生政策研究

For attracting more social charity funding into the health field, in-depth interviews are conducted into four health foundations in Beijing, presenting three aspects of existing problems and obstacles in the foundations devel-opment in this article. Firstly, the foundations have low effect in fundraising, poor information publication, little com-munication between other facilities and vague mechanism in donation. Secondly, the social public has erroneous views leading to deviant behavior. Finally, some annual inspection standards of the foundation are not suitable for the health field. Based on the above analysis, suggestions about how to improve transparency and fundraising ability in foundations and change the public erroneous views in donation are proposed. The governments might be suggested to get more relax-ed on the annual inspection standards of the foundations, and build an information platform in healthcare field as well.

Why is Perinatal Mortality Higher among Women Delivered at Health Facility in Rural Northwest Ehiopia? A Qualitative Study.

This study investigated the reasons for high perinatal deaths among newborns delivered in health facilities in rural northwest Ethiopia. Qualitative in-depth interviews were conducted with 11 survivors of obstetric complications and 11 normal home deliveries. The interviews were audio recorded and transcribed verbatim. Open code qualitative 3.6 software was used for managing data and analysis. The primary reasons attributed to high mortality among health-facility-delivered babies were delay in recognizing danger signs of labor and delay in decision to seek care. Most women arrive to health institutions late with seriously complicated labor. Lack of transport, finance, and perceived poor quality of services are additional reasons to delayed seeking of health care during labor. Increasing public education on danger signs of labour, improving quality of emergency obstetric care in the nearby health facilities, and facilitating affordable referral mechanisms are critical to enhance prompt household decisionmaking and decreasing perinatal deaths in rural communities.

Study on the cognition status of implementing case-based payment policy among healthcare providers:A case in Chengdu, Sichuan Province / 中国卫生政策研究

Objective:To understand the implementation status of case-based payment among healthcare provid-ers and their cognition on the matter. Methods:Semi-structured interview was conducted on 30 purposely selected staff from 9 hospitals in Chengdu. Results:After one-year implementation of case-based payment, hospitals at different level carried out the policy vigorously:executed corresponding expense control measures and management. Neverthe-less, the proportion of cases that were paid with case-based payment was low, moreover the inclusion criteria for case was of disunity and the formulation of the expense standard was ambiguous to some extent. Conclusion:Certain achievements were accompanied with problems, so it is essential to refine reimbursement standards, improve case-based payment, make clear the inclusion criteria for case and extend the covering range of case-based payment in Chengdu. In addition, the medical insurance agency should strengthen the supervision of healthcare providers,and guide them to set up effective incentive mechanism.