| 1. |
- Anderson, Ian, et al.
(författare)
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Indigenous and tribal peoples' health (The Lancet-Lowitja Institute Global Collaboration) : a population study
- 2016
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Ingår i: The Lancet. - : Elsevier. - 0140-6736 .- 1474-547X. ; 388:10040, s. 131-157
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Tidskriftsartikel (refereegranskat)abstract
- Background: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of countries or the range of health indicators. Our objective is to describe the health and social status of Indigenous and tribal peoples relative to benchmark populations from a sample of countries.Methods: Collaborators with expertise in Indigenous health data systems were identified for each country. Data were obtained for population, life expectancy at birth, infant mortality, low and high birthweight, maternal mortality, nutritional status, educational attainment, and economic status. Data sources consisted of governmental data, data from non-governmental organisations such as UNICEF, and other research. Absolute and relative differences were calculated.Findings: Our data (23 countries, 28 populations) provide evidence of poorer health and social outcomes for Indigenous peoples than for non-Indigenous populations. However, this is not uniformly the case, and the size of the rate difference varies. We document poorer outcomes for Indigenous populations for: life expectancy at birth for 16 of 18 populations with a difference greater than 1 year in 15 populations; infant mortality rate for 18 of 19 populations with a rate difference greater than one per 1000 livebirths in 16 populations; maternal mortality in ten populations; low birthweight with the rate difference greater than 2% in three populations; high birthweight with the rate difference greater than 2% in one population; child malnutrition for ten of 16 populations with a difference greater than 10% in five populations; child obesity for eight of 12 populations with a difference greater than 5% in four populations; adult obesity for seven of 13 populations with a difference greater than 10% in four populations; educational attainment for 26 of 27 populations with a difference greater than 1% in 24 populations; and economic status for 15 of 18 populations with a difference greater than 1% in 14 populations.Interpretation: We systematically collated data across a broader sample of countries and indicators than done in previous studies. Taking into account the UN Sustainable Development Goals, we recommend that national governments develop targeted policy responses to Indigenous health, improving access to health services, and Indigenous data within national surveillance systems.
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| 2. |
- Talungchit, Pattarawalai, et al.
(författare)
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Development and Assessment of Indicators for Quality of Care in Severe Preeclampsia/Eclampsia and Postpartum Hemorrhage
- 2013
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Ingår i: Journal for healthcare quality. - : Ovid Technologies (Wolters Kluwer Health). - 1945-1474 .- 1062-2551. ; 35:3, s. 22-34
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Tidskriftsartikel (refereegranskat)abstract
- Severe preeclampsia/eclampsia and postpartum hemorrhage (PPH) are serious obstetric problems worldwide. Quality improvement of care measured by evidence-based indicators is recommended as a recent important strategy; however, the indicators for quality of care of these two conditions have not been established. This study aimed to develop such indicators and assess their validity, reliability, and feasibility at different contextual levels. Of 32 initially valid indicators for care of severe preeclampsia/eclampsia, after two rounds of Delphi technique, 21 and 30 indicators were agreed to be suitable to monitor care at district and referral hospitals. Of 13 initial indicators for PPH, 8 and 13 indicators were selected, respectively. The interrater reliability of indicators varied from 0.28 to 0.63. At least three-fourths of all indicators rated by local doctors and nurses were assessed as feasible in terms of relevance, measurability, and improvability. The process identified reliable and feasible performance indicators to monitor quality of care in severe preeclampsia/eclampsia and PPH for either basic or comprehensive emergency obstetric care (EmOC). The informative applicability of these indicators in clinical practice needs further evaluation.
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| 3. |
- Talungchit, Pattarawalai, et al.
(författare)
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Multifaceted intervention to implement indicators of quality of care for severe pre-eclampsia/eclampsia
- 2014
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Ingår i: International Journal of Gynecology & Obstetrics. - : Wiley. - 0020-7292 .- 1879-3479. ; 124:2, s. 106-111
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To assess the acceptability of implementing indicators of quality of care for severe pre-eclampsia/eclampsia to health providers, and to evaluate the effect of a multifaceted intervention on adherence to these indicators. Methods: A multifaceted approach was used to implement indicators of quality of care for severe pre-eclampsia/eclampsia that were relevant to both district and referral hospitals. Healthcare providers at 9 hospitals in Southern Thailand rated the acceptability and priority of each indicator. In addition, medical records were reviewed before and after the intervention. Results: More than 90% of the indicators were considered to be acceptable by the 145 health providers who participated in the study. After the intervention, adherence to most indicators was significantly increased. However, adherence after the intervention was lower than 80% for one-third of the indicators at district hospitals, compared with less than 10% of the indicators at referral hospitals. Common barriers to indicator implementation were lack of resources and skills, difficulty in making early and accurate diagnoses, and management. Conclusion: The indicators for the quality of care for severe pre-eclampsia/eclampsia were acceptable. Adherence to the indicators increased through a multifaceted intervention; however, the adherence varied considerably depending on the hospital referral level.
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