Open Access Review Article

The Cuban Healthcare System: An Insight

Nisha Zahid, Farah Ahmed, Noor Israr, Akhtar Ali, Sidra Farooq, Marium Syed

Asian Journal of Medicine and Health, Page 63-69
DOI: 10.9734/ajmah/2021/v19i130298

All the countries in the world are struggling to improve their healthcare systems regardless of being rich or poor. Talking about Cuba, it represents an example of well-developed healthcare system and policies which is comparable to developed countries of the world. The success of Cuban healthcare system largely depends upon its strong primary health care system, proper immunization, robust public health policies, treating all the population classes equally providing them with free healthcare services. The control of infection spread and non-communicable diseases also contributes to the success of Cuban Healthcare system. We have discussed the Cuban health care system from start till the current situation and also, we performed SWOT analysis to bring the clearer depiction of the Cuban Healthcare System as it highlights the key internal and external issues which are further discussed in detail.

Open Access Original Research Article

A Comparative Assessment of Access to Healthcare of People Living in Ekiti and Kogi States of Nigeria

C. T. Oluwadare, A. A. Olorunfemi, A. S. Atiba, O. A. Ijabadeniyi

Asian Journal of Medicine and Health, Page 7-17
DOI: 10.9734/ajmah/2021/v19i130292

Aim: To undertake a comparative assessment of healthcare access of people in Ekiti and Kogi States of Nigeria. This further provided hard data for health program development towards attainment of universal health coverage and health sustainable development goal.

Study Design: A comparative research design was employed using questionnaire for data collection.

Place and Duration of the Study: The study was conducted in Ekiti and Kogi States of Nigeria representing Southern and Northern parts of the nation. The fieldwork was conducted in October and December 2019.

Methodology: Multistage sampling technique was used starting from random selection of one local government area from each of the three senatorial districts in the two states. From each of the local government areas, five political wards were randomly selected from the existing number of wards. From the selected wards, equal number of 144 sampled respondents were contacted for the structured interviews to make 856 administered copies of questionnaire.

Results: Most of the respondents could identify available health care facilities in their environment. However about 70 percent patronized secondary health facilities in Ekiti State while tertiary health facilities were visited mostly in Kogi State. Costs of health care is higher in Kogi compared to Ekiti State. 49% of Ekiti have a challenge in paying for treatment compared to 69% in Kogi State while from the two states, only about 19% have health insurance coverage. Respondents in Ekiti State experience strike actions of health workers than those in Kogi State. On appropriateness, Ekiti state has better scores while Kogi State has better score in acceptability.

Conclusion: Pronounced challenge to healthcare access is unaffordability of health care as a result of very low health insurance scheme coverage in the two states through Ekiti State has better indicators of quality healthcare.

Open Access Original Research Article

Pattern of Psychoactive Substances Use among Long-Distance Truck Drivers in Nigeria

Mobolaji Usman Dada, Adekunle Olatayo Adeoti, Tobiloba Elebiyo, Banji Ferdinand ` Kumolalo, Adedotun Samuel Ajiboye

Asian Journal of Medicine and Health, Page 18-25
DOI: 10.9734/ajmah/2021/v19i130293

Aims: This study was designed to examine the pattern of psychoactive drugs use among long-distance truck drivers in Ado-Ekiti, Ekiti state, Nigeria.

Study Design: This was a descriptive cross sectional study.

Place and Duration: The study was conducted at the converging motor park for truck drivers in Ado-Ekiti, south-west Nigeria between September and December 2019.

Methods: The pattern of psychoactive drugs use among 306 adult male truck drivers was determined using a semi-structured questionnaire in addition to a sociodemographic questionnaire. Data was analyzed and logistic regression was used to identify significant predictors of illicit drug use.

Results: Among the 306 study participants, 43.7% consumed alcohol.  The major non-prescription drugs used by the truck drivers were cough syrups (67.0%); analgesics (49.3%); cannabis (39.9%); amphetamine/methamphetamine (33.0%) and tranquilizers (32.0%). Opioid analgesics like tramadol (35.1%) and morphine (22.3%) were the commonly used analgesics. The predictor of psychoactive drugs use among the long-distance truck drivers is the co-use of alcohol and tobacco (AOR (1.71) 95% CI (1.24–2.36%).

Conclusion: There is a high rate of psychoactive drugs use among truck drivers. There is an urgent need to educate the truck drivers on the adverse implications of illicit drug use and the need to abstain for better health promotion.

Open Access Original Research Article

Electrophysiological Detection of Asymptomatic Neuropathy in Alcohol Dependence Syndrome Patients- A Cross Sectional Observational Study

Arvind Visweshwar, Mohamed Hanifah, . Murugesan, . Avudaiappan, Arun Prakash

Asian Journal of Medicine and Health, Page 26-31
DOI: 10.9734/ajmah/2021/v19i130294

Aim: To detect the prevalence of asymptomatic neuropathy using nerve conduction study among alcohol dependence syndrome patients and to investigate the existence or not of correlation between duration, quantity of alcohol consumption and neuropathy.

Study Design: Observational cross-sectional study.

Place and Duration of Study: Department of General Medicine and Department of Psychiatry, Mahatma Gandhi Medical College and Research Institute, Pondicherry, affiliated to Sri Balaji Vidyapeeth (Deemed to be) University, India between February 2019 and August 2020.

Methods: Alcohol dependence syndrome patients, asymptomatic for neuropathy were prospectively included and, patients who were symptomatic and had other comorbid conditions that can cause neuropathy were excluded. Patients were then submitted to nerve conduction studies. In patients who had neuropathy, duration and quantity of alcohol consumption were compared for correlation.

Results: This study included 65 male patients who were mostly middle aged heavy drinkers of alcohol. 73.8% (n=48) had neuropathy. Our research showed longer the duration, larger the quantity of alcohol consumption, and higher the Cut-Annoyed-Guilty-Eye (CAGE score), more were the prevalence of neuropathy. This research also used Severity Of Alcohol Dependence Questionnaire (SAD-Q) scoring for screening alcohol dependence which showed patients with neuropathy were moderate drinkers. We did not find correlation with age of patients and neuropathy.

Conclusion: This research results like correlation of prevalence of neuropathy and duration of alcohol consumption and quantity of alcohol consumption were in contrast with previous studies on alcoholic neuropathy. This research used SAD-Q scoring for dependence, future researches can throw light on usage of SAD-Q score in asymptomatic neuropathy and the correlation of neuropathy with alcohol consumption.

Open Access Original Research Article

Assessment of the Knowledge and Practice of Handwashing among Healthcare Workers in a Tertiary Hospital in Ekiti, Southwestern Nigeria

Oluwalana Timothy Oyekale, Samsudeen Adeniran Adegbile, Oluwatosin Bola Ojo, Damilola Esther Oguntunmbi, Oluwatoyin Ige Oyekale

Asian Journal of Medicine and Health, Page 32-44
DOI: 10.9734/ajmah/2021/v19i130295

Background: The most common means of transmission of Healthcare-Associated Infections (HAIs) is the contaminated hand of Healthcare Workers (HCWs), proper handwashing by HCWs is the best method of halting this transmission, however, there is poor adherence to the practice of the simple handwashing procedure in many health facilities.

Aims: To assess the knowledge and practice of proper handwashing, to identify the factors impeding adherence to its good practice among HCWs and to identify the handwashing and hand drying facilities available to these HCWs.

Study Design: This is a descriptive cross-sectional study.

Place and Duration of Study: The study was carried out at Federal Teaching Hospital, Ido-Ekiti (FETHI), Southwestern Nigeria between July 2020 and December 2020.

Methods: The study involved 328 randomly selected HCWs. Data was collected using pretested self administered questionnaires, entered into Microsoft Excel 2016 and analyzed by SPSS version 23.

Results: Only 31.10% of respondents had good knowledge of handwashing while 80.18% had good practice of handwashing. Longer stay in service and being a doctor or nurse were associated with good knowledge and good practice of handwashing. Only 16.46% of respondents had previous training on handwashing within 3 years prior to this study. Previous training on handwashing was associated with good knowledge of handwashing (P=.001). Up to 68.60% of respondents used stored water and soap for handwashing. The most common hand drying facility reported in the study was common towel, no respondent ever used paper towel. The most common reason given for poor adherence to handwashing practices was the busy schedule.

Conclusion: Hospital managers must prioritize the regular provision of handwashing and hand drying facilities for their centre, in addition to organizing regular hand hygiene training for HCWs, to improve their knowledge and practice of handwashing and thus reduce the rate of HAIs

Open Access Original Research Article

Water Treatment for Hemodialysis in Benghazi Medical Center (BMC)

Asmaa A. Alfarisi, Hadir Gawili, Areej O. AlFerjany, Soha B. AlTalhi, Aisha A. Gandrah, Nora M. Bushaala

Asian Journal of Medicine and Health, Page 48-62
DOI: 10.9734/ajmah/2021/v19i130297

Background: A single 4-hour dialysis treatment can require up to 400 liters of water per week for dialysis patients compare that with healthy person who drinks less than 15 liters of water per week. Therefore, it is clearly important to know and monitor the chemical and microbiological purity of the dialysis water.

Aims: Determine the physicochemical and bacteriological characteristics of water used by hemodialysis services Isolate and identify fungi present in water systems of hemodialysis units in Benghazi Medical center (BMC) in Benghazi, Libya.

Methods: Analysis study carried out in hemodialysis unit in BMC collected samples from each places (A & B) sections.

Results: Six samples that target to chemical analysis and 32 samples for microbiological test, Chemical parameters of study area A and B for drinking and dialysis water were within international standards, but there was a minute of Calcium elevation in area B that was 3.3mg/l. No contamination with bacteria observed in all samples in section (A), the counts of yeasts and filamentous fungi investigated in the tap water, in the treated water, and dialysis machine in section B and Penicillium spp was the most frequent fungi.

Conclusions: Our study demonstrated that the tap and dialysis water success to meet the all-chemical and microbiological requirements in (A) area inside hospital of Benghazi center. In generally to prevent the risk of contaminants for hemodialysis patients need to a high water quality management program and development of water treatment system in hemodialysis centers.

Open Access Short Communication

The Justinianic Plague’s Origins and Consequences

Georgiana Bianca Constantin, Ionuţ Căluian

Asian Journal of Medicine and Health, Page 45-47
DOI: 10.9734/ajmah/2021/v19i130296

The bubonic plague is an extremely old disease (apparentely from the late Neolitic era). The so-called “Justinianic plague” of the sixth century was the first well-attested outbreak of bubonic plague in the history of the Mediterranean world. It was thought that the Justinianic Plague, along with barbarian invasions, contributed directly to the so-called “Fall of the Roman Empire.”

Open Access Opinion Article

Universal Health Coverage- A Case Study of Indian Healthcare System during COVID-19 Pandemic

Rashika Nandwani

Asian Journal of Medicine and Health, Page 1-6
DOI: 10.9734/ajmah/2021/v19i130291

Aim: The main purpose of this paper is to look at the Indian healthcare system during the COVID-19 pandemic and how COVID-19 acts as barrier and also presents some opportunities towards the road of Universal Health Coverage (UHC).

Background: COVID-19 has exposed the vulnerability of health systems across the world and India is no exception. The World Health Organization (WHO) has kept the definition of UHC very flexible and has left on the country which is implementing it as to how much of the population and which services should be included in the scheme. 

Discussion: India already has a unique flagship program Ayushman Bharat where it is trying to cover her most vulnerable population against catastrophic expenditure of health. This paper further investigates the progress of India towards UHC and how COVID-19 is acting as an impediment for India to progress towards it. On the other hand, it also poses some opportunities which had not been explored in the past. Health Systems Strengthening is the path towards the achievement of UHC and due to COVID-19, India has touched upon all the six building blocks which are needed to strengthen our system towards the achievement of UHC.

Recommendations and Conclusion: It recommends that Indian system should be more proactive than reactive; it also suggests following a systems-based approach and to not target the problem in silos. It also suggests increasing the government funding as well as establishment of proper public health cadre. To conclude, this paper also suggests that the government should include outpatient expenses into their scheme, and they should also concentrate towards building adequate infrastructure in order to face future pandemics like COVID-19.