Background Despite significant progress in Nepal’s health indicators over the past three decades,... more Background Despite significant progress in Nepal’s health indicators over the past three decades, regional disparities in public health centre (PHC) provision and accessibility remain severe. It has been reported that rural dwellers prefer and place more trust in outreach centres (ORCs) run by the Dhulikhel Hospital. However, the reasons behind this remain unclear. We aimed to examine the determinants of Nepalese rural dwellers’ choice of first-contact health facility. Methods This was a cross-sectional survey among 1,098 adult rural dwellers in Nepal. The study sample was first divided into PHC and ORC groups, and intergroup differences were tested using Pearson chi-square test and independent sample t-test. Then, binary logistic regression was performed to analyse first-contact health facility decision-making. Results Sex, education level, importance of health care satisfaction, importance of free health care, diagnosis of hypertension, diagnosis of diabetes, insurance coverage, s...
Objective. To assess the effectiveness of a comprehensive blood pressure (BP) control program on ... more Objective. To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru. Methods. A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 – April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention. Results. Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increas...
Design and method: This is qualitative study. Two focus group discussions were held for patients ... more Design and method: This is qualitative study. Two focus group discussions were held for patients from different village in Jatinangor, Sumedang, Indonesia. One session of FGD was held for health professional working in the same area. Results: Due to limited number of physician in Indonesia, hypertensive patients in rural area are diagnosed and treated by nurses and midwives, while those in urban area are managed by doctors, in private and public service. To add the complexity of the problem, severe hypertension is suffered more by patients in rural area. Almost all of the patients do not recall the proper education of drug using, neither the detailed lifestyle modifi cation given by the health provider. Some of them do not even recall any education given. Due to the lack of details, all patients do not practice the proper diet or exercise. Patients in both areas are willing to attend the patient-support meeting to understand more about their disease, but those in urban area need higher level of educator. Health professionals ensure the delivery of offi ce-setting education for every visit, but in public service, where a patient load is always high, they admitted that time was limited. Conclusions: Offi ce-setting education is not effective, limited time and lack of details confounded the patients to follow the instructions. Patient-support group education is preferred.
Korean Journal of Health Education and Promotion, 2019
Objectives: The aim of this study is to analyze the effects of mental health projects of KOICA-Yo... more Objectives: The aim of this study is to analyze the effects of mental health projects of KOICA-Yonsei school health promotion project in Peru. Methods: The project was implemented in Comas and Callao, Lima, Peru from 2014 to 2017 by KOICA-Yonsei School Health project team. The intervention and control schools were four and two, respectively. Difference in differences and logistic regression analysis were performed using the results of Baseline and Endline surveys conducted in 2014 and 2017. Mental health indicators were used for the evaluation of the project in the study. Results: The Difference in Differences analysis showed that the proportion of depression, suicidal thought, being in fight and physical abuse was reduced by 11%, 7.3%, 6.9% and 4.1%, respectively. The logistic regression analysis revealed that there was significant improvement in physical abuse and alcohol consumption. There was significant
reduction in being in the fight, intimidation in last 30 days, physical abuse by friends and alcohol consuming in last 30 days in both intervention and control group. However, the proportion of reduction was higher in the intervention group. Conclusions: The school mental promotion project could be useful intervention for students to improve mental health status. Therefore, it is necessary to develop and implement integrated programs to improve school mental health.
Key words: global health, mental health, Peru, adolescents, DID, KOICA
The objective of this case report is to introduce the development process, structure, characteris... more The objective of this case report is to introduce the development process, structure, characteristics, and effectiveness of the web database (DB) system developed for the hypertension management program in the primary health care setting in the low-income urban areas of Peru. Methods: A Korean research team cooperated with a Peruvian IT startup company to develop a web DB system to improve the data management of the hypertension management program. The entire web application infrastructure was hosted using the Amazon Web Service. Two different web platforms were established for the user groups of health workers and researchers (program managers). Results: A total of 2,827 program participants were registered in the web DB system until December 2017. Health professionals can input the participant data while providing consultation to the program participants, and the data is accumulated in the web DB in real time. Input errors or data loss is prevented by setting restrictions in the data entry system. During the 4-year project period, 7,696 hours of working time and USD 39,536.48 for data management were saved as the result of web DB system utilization. Conclusions: The developed web DB system contributed to improve the health condition of the health program participants by providing necessary information to the health professionals at the right time. This case report could be a reference for other researcher to develop web databases for their own context, especially in developing countries.
Background Despite significant progress in Nepal’s health indicators over the past three decades,... more Background Despite significant progress in Nepal’s health indicators over the past three decades, regional disparities in public health centre (PHC) provision and accessibility remain severe. It has been reported that rural dwellers prefer and place more trust in outreach centres (ORCs) run by the Dhulikhel Hospital. However, the reasons behind this remain unclear. We aimed to examine the determinants of Nepalese rural dwellers’ choice of first-contact health facility. Methods This was a cross-sectional survey among 1,098 adult rural dwellers in Nepal. The study sample was first divided into PHC and ORC groups, and intergroup differences were tested using Pearson chi-square test and independent sample t-test. Then, binary logistic regression was performed to analyse first-contact health facility decision-making. Results Sex, education level, importance of health care satisfaction, importance of free health care, diagnosis of hypertension, diagnosis of diabetes, insurance coverage, s...
Objective. To assess the effectiveness of a comprehensive blood pressure (BP) control program on ... more Objective. To assess the effectiveness of a comprehensive blood pressure (BP) control program on improving lifestyle indicators, BP levels, and laboratory examination results among people living in low-income urban areas of Peru. Methods. A prospective before-and-after study design was applied to 1 271 participants with hypertension or pre-hypertension. The intervention was implemented for 2 years, from May 2015 – April 2017, in three health centers in Lima (2 in Comas and 1 in Callao). The changes in participants over the study period were compared. All participants were provided with individualized consultations, group health education sessions, regular group meetings to improve self-management, and text messages providing health education. Paired t- and chi-square tests were used to determine the significance of the changes in indicators before and after the intervention. Results. Lifestyle behaviors, such as weight and blood pressure monitoring, reduced salt consumption, increas...
Design and method: This is qualitative study. Two focus group discussions were held for patients ... more Design and method: This is qualitative study. Two focus group discussions were held for patients from different village in Jatinangor, Sumedang, Indonesia. One session of FGD was held for health professional working in the same area. Results: Due to limited number of physician in Indonesia, hypertensive patients in rural area are diagnosed and treated by nurses and midwives, while those in urban area are managed by doctors, in private and public service. To add the complexity of the problem, severe hypertension is suffered more by patients in rural area. Almost all of the patients do not recall the proper education of drug using, neither the detailed lifestyle modifi cation given by the health provider. Some of them do not even recall any education given. Due to the lack of details, all patients do not practice the proper diet or exercise. Patients in both areas are willing to attend the patient-support meeting to understand more about their disease, but those in urban area need higher level of educator. Health professionals ensure the delivery of offi ce-setting education for every visit, but in public service, where a patient load is always high, they admitted that time was limited. Conclusions: Offi ce-setting education is not effective, limited time and lack of details confounded the patients to follow the instructions. Patient-support group education is preferred.
Korean Journal of Health Education and Promotion, 2019
Objectives: The aim of this study is to analyze the effects of mental health projects of KOICA-Yo... more Objectives: The aim of this study is to analyze the effects of mental health projects of KOICA-Yonsei school health promotion project in Peru. Methods: The project was implemented in Comas and Callao, Lima, Peru from 2014 to 2017 by KOICA-Yonsei School Health project team. The intervention and control schools were four and two, respectively. Difference in differences and logistic regression analysis were performed using the results of Baseline and Endline surveys conducted in 2014 and 2017. Mental health indicators were used for the evaluation of the project in the study. Results: The Difference in Differences analysis showed that the proportion of depression, suicidal thought, being in fight and physical abuse was reduced by 11%, 7.3%, 6.9% and 4.1%, respectively. The logistic regression analysis revealed that there was significant improvement in physical abuse and alcohol consumption. There was significant
reduction in being in the fight, intimidation in last 30 days, physical abuse by friends and alcohol consuming in last 30 days in both intervention and control group. However, the proportion of reduction was higher in the intervention group. Conclusions: The school mental promotion project could be useful intervention for students to improve mental health status. Therefore, it is necessary to develop and implement integrated programs to improve school mental health.
Key words: global health, mental health, Peru, adolescents, DID, KOICA
The objective of this case report is to introduce the development process, structure, characteris... more The objective of this case report is to introduce the development process, structure, characteristics, and effectiveness of the web database (DB) system developed for the hypertension management program in the primary health care setting in the low-income urban areas of Peru. Methods: A Korean research team cooperated with a Peruvian IT startup company to develop a web DB system to improve the data management of the hypertension management program. The entire web application infrastructure was hosted using the Amazon Web Service. Two different web platforms were established for the user groups of health workers and researchers (program managers). Results: A total of 2,827 program participants were registered in the web DB system until December 2017. Health professionals can input the participant data while providing consultation to the program participants, and the data is accumulated in the web DB in real time. Input errors or data loss is prevented by setting restrictions in the data entry system. During the 4-year project period, 7,696 hours of working time and USD 39,536.48 for data management were saved as the result of web DB system utilization. Conclusions: The developed web DB system contributed to improve the health condition of the health program participants by providing necessary information to the health professionals at the right time. This case report could be a reference for other researcher to develop web databases for their own context, especially in developing countries.
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reduction in being in the fight, intimidation in last 30 days, physical abuse by friends and alcohol consuming in last 30 days in both intervention and control group. However, the proportion of reduction was higher in the intervention group. Conclusions: The school mental promotion project could be useful intervention for students to improve mental health status. Therefore, it is necessary to develop and implement integrated programs to improve school mental health.
Key words: global health, mental health, Peru, adolescents, DID, KOICA
reduction in being in the fight, intimidation in last 30 days, physical abuse by friends and alcohol consuming in last 30 days in both intervention and control group. However, the proportion of reduction was higher in the intervention group. Conclusions: The school mental promotion project could be useful intervention for students to improve mental health status. Therefore, it is necessary to develop and implement integrated programs to improve school mental health.
Key words: global health, mental health, Peru, adolescents, DID, KOICA