Browsing by Author "Oh, J."
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Item COVID-19 and resilience of healthcare systems in ten countries(nature, 2022) Arsenault, C.; Gage, A.; Kim, M.K.; Kapoor, N.R.; Akweongo, P.; Amponsah, F.; Aryal, A.; Asai, D.; Awoonor-Williams, J.K.; Ayele, W.; Bedregal, P.; Doubova, S.V.; Dulal, M.; Gadeka, D.D.; Gordon-Strachan, G.; Mariam, D.H.; Hensman, D.; Joseph, J.P.; Kaewkamjornchai, P.; Eshetu, M.K.; Gelaw, S.K.; Kubota, S.; Leerapan, B.; Margozzini, P.; Mebratie, A.D.; Mehata, S.; Moshabela, M.; Mthethwa, L.; Nega, A.; Oh, J.; Park, S.; Passi-Solar, Á.; Pérez-Cuevas, R.; Phengsavanh, A.; Reddy, T.; Rittiphairoj, T.; Sapag, J.C.; Thermidor, R.; Tlou, B.; Guiñez, F.V.; Bauhoff, S.; Kruk, M.E.Declines in health service use during the Coronavirus Disease 2019 (COVID-19) pandemic could have important effects on population health. In this study, we used an interrupted time series design to assess the immediate effect of the pandemic on 31 health services in two low-income (Ethiopia and Haiti), six middle-income (Ghana, Lao People’s Democratic Republic, Mexico, Nepal, South Africa and Thailand) and high-income (Chile and South Korea) countries. Despite efforts to maintain health services, disruptions of varying magnitude and duration were found in every country, with no clear patterns by country income group or pandemic intensity. Disruptions in health services often preceded COVID-19 waves. Cancer screenings, TB screening and detection and HIV testing were most affected (26–96% declines). Total outpatient visits declined by 9–40% at national levels and remained lower than predicted by the end of 2020. Maternal health services were disrupted in approximately half of the countries, with declines ranging from 5% to 33%. Child vaccinations were disrupted for shorter periods, but we estimate that catch-up campaigns might not have reached all children missed. By contrast, provision of antiretrovirals for HIV was not affected. By the end of 2020, substantial disruptions remained in half of the countries. Preliminary data for 2021 indicate that disruptions likely persisted. Although a portion of the declines observed might result from decreased needs during lockdowns (from fewer infectious illnesses or injuries), a larger share likely reflects a shortfall of health system resilience. Countries must plan to compensate for missed healthcare during the current pandemic and invest in strategies for better health system resilience for future emergencies.Item The "universal" in UHC and Ghana's National Health Insurance Scheme: Policy and implementation challenges and dilemmas of a lower middle income country(BioMed Central Ltd., 2016) Agyepong, I.A.; Abankwah, D.N.Y.; Abroso, A.; Chun, C.; Dodoo, J.N.O.; Lee, S.; Mensah, S.A.; Musah, M.; Twum, A.; Oh, J.; Park, J.; Yang, D.; Yoon, K.; Otoo, N.; Asenso-Boadi, F.Background: Unsafe abortion is an issue of public health concern and contributes significantly to maternal morbidity and mortality globally. Abortion evokes religious, moral, ethical, socio-cultural and medical concerns which mean it is highly stigmatized and this poses a threat to both providers and researchers. This study sought to explore challenges to providing safe abortion services from the perspective of health providers in Ghana. Methods: A descriptive qualitative study using in-depth interviews was conducted. The study was conducted in three (3) hospitals and five (5) health centres in the capital city in Ghana. Participants (n = 36) consisted of obstetrician/gynaecologists, nurse-midwives and pharmacists. Results: Stigma affects provision of safe-abortion services in Ghana in a number of ways. The ambiguities in Ghanaian abortion law and lack of overt institutional support for practitioners increased reluctance to openly provide for fear of stigmatisation and legal threat. Negative provider attitudes that stigmatised women seeking abortion care were frequently driven by socio-cultural and religious norms that highly stigmatise abortion practice. Exposure to higher levels of education, including training overseas, seemed to result in more positive, less stigmatising views towards the need for safe abortion services. Nevertheless, physicians open to practicing abortion were still very concerned about stigma by association. Conclusions: Stigma constitutes an overarching impediment for abortion service provision. It affects health providers providing such services and even researchers who study the subject. Exposure to wider debate and education seem to influence attitudes and values clarification training may prove useful. Proper dissemination of existing guidelines and overt institutional support for provision of safe services also needs to be rolled out.