Patient satisfaction with mobile clinic services in a

remote rural area of Saudi Arabia

 

 ABSTRACT Mobile clinics have been established in Saudi Arabia to facilitate the equitable delivery of primary

health care services in remote and rural areas. A descriptive cross-sectional study was conducted to investigate

the perceived quality of services provided to villages in the Al-Laith region. The majority of the 176 clients

interviewed were satisfied with the working hours and health staff. However, 35.8% viewed the location as

unsatisfactory and 20.5% were dissatisfied with the clinic schedule. Overall satisfaction was very high, although

the mobile clinics were not viewed as substitutes for primary health care centres. Public awareness of the service

needs to be improved and better access and quality of services are important for optimal service provision. 

 

Opini saya:

 Pada jurnal ini dijelaskan mengenai penilaian kepuasaan masyarakat daerah terpencil di Saudi Arabia terhadap pelayanan Mobile clinic.

Mobile clinic yang dimaksud pada jurnal ini adalah pelayanan kesehatan yang diberikan ke daerah terpencil dengan menggunakan mobil yang dilengkapi dengan peralatan medis dan disertai seorang dokter dan perawat. Mobil ini dioperasionalkan di 13 area terpencil di Al-Laith, Saudi Arabia. Lokasi yang dipilih yang berjarak 20-100 km dari pusat pelayanan kesehatan primer. Mobil ini beroperasi satu kali dalam seminggu, dimulai dari pukul 08.00/09.00 - 15.00.

Dari pelayanan mobile clinic yang sudah berjalan tersebut kemudian dinilai sejauh mana kepuasan masyarakat terhadap program tersebut. Masyarakat yang mendatangi pelayanan mobile clinic kemudian diberikan kuesioner terkait kepuasaa terhadap pelayanan. Sebanyak 176 responden menilai terkait lokasi, jadwal (1hari/minggu), jam kerja, pelayanan dokter, dan pelayanan pasien. Sebagian besar masyarakat merasa puas dengan pelayanan dari mobile clinic. Akan tetapi 35,8% dari responden merasa tidak puas dengan lokasi pelayanan dan 20,5% merasa tidak puas dengan jadwal pelayanan.

 

Dengan adanya penilaian ini, saya jadi dapat mengetahui seberapa penting adanya program ini terhadap kesehatan masyarakat di daerah terpencil. program ini sangat bagus dan sangat menarik minat masyarakat desa terpencil untuk lebih peduli terhadap kesehatannya.

Referensi:

1. http://applications.emro.who.int/emhj/V16/10/16_10_2010_1085_1090.pdf?ua=1

Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin

Abstract:

Background - Type 2 diabetes affects approximately 8 percent of adults in the United States. Some risk factors — elevated plasma glucose concentrations in the fasting state and after an oral glucose load, overweight, and a sedentary lifestyle — are potentially reversible. We hypothesized that modifying these factors with a lifestyle-intervention program or the administration of metformin would prevent or delay the development of diabetes.

Methods - We randomly assigned 3234 nondiabetic persons with elevated fasting and post-load plasma glucose concentrations to placebo, metformin (850 mg twice daily), or a lifestyle-modification program with the goals of at least a 7 percent weight loss and at least 150 minutes of physical activity per week. The mean age of the participants was 51 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 34.0; 68 percent were women, and 45 percent were members of minority groups.

Results - The average follow-up was 2.8 years. The incidence of diabetes was 11.0, 7.8, and 4.8 cases per 100 person-years in the placebo, metformin, and lifestyle groups, respectively. The lifestyle intervention reduced the incidence by 58 percent (95 percent confidence interval, 48 to 66 percent) and metformin by 31 percent (95 percent confidence interval, 17 to 43 percent), as compared with placebo; the lifestyle intervention was significantly more effective than metformin. To prevent one case of diabetes during a period of three years, 6.9 persons would have to participate in the lifestyle-intervention program, and 13.9 would have to receive metformin.

Conclusions - Lifestyle changes and treatment with metformin both reduced the incidence of diabetes in persons at high risk. The lifestyle intervention was more effective than metformin.

My Opinion:

From the article, the hypothesis formed was proven that lifestyle intervention and metformin succeeded in preventing or delaying diabetes in persons with high risk of the disease. This approach is not popular because type 2 diabetes or non-insulin-dependent diabetes mellitus is usually treated for after complications arise. Preventing metabolic diseases through diet and lifestyle has long been advised by health care professionals but prevention with the usage of a drug is not common. This research proved to be effective because it was systematic and intensive. Both lifestyle interventions and metformin groups showed effective results individually.

With the help of dietitians, nutritionists and fitness trainers, I believe a better prevention may be possible for persons with high risk of diabetes. Surveys and screenings can be conducted by family physicians, general physicians, nurses and midwives in the community they are entrusted to serve to identify those with high risk. From the article, persons of age 25 and above with BMI of more than 24 (22 for Asians) were selected.

This approach is very much possible in an Asian setting, more specifically in Yogyakarta city. This is because with the help of the midwives and the primary health centers (Puskesmas), mass screenings can be done thoroughly and prevention be carried out immediately. The people with high risk of diabetes need to be able to prevent diabetes that could lead to many other complications in the future.

The few problems that may arise are:

• Lack of compliance of participants 
• Under-reporting of cases due to distance from the Puskesmas 
• Availability of metformin drugs 
• Accessibility of dietitians, nutritionists and fitness trainers to target groups 

If proper and intensive counselling - as how was conducted in the research - is carried out, the prevention of type 2 diabetes can materialize and in turn reduce the medical costs and increase quality of life. Further researches can be carried out to single out the effect of lifestyle intervention and metformin in preventing diabetes among males and females, different age groups and different economic status groups.

Reference:
http://www.nejm.org/doi/full/10.1056/NEJMoa012512#t=article

Factors Influencing the Success of Rural Cataract Surgery Programs in China: The Study of Hospital Administration and Relative Productivity (SHARP)

Tianyu Liu, Ee Lin Ong, Xixi Yan, Xinxing Guo, Mingguang He, David Friedman,
and Nathan Congdon

Abstract

PURPOSE. To explore factors potentially influencing the success or failure of rural Chinese hospitals in increasing cataract surgical output and quality.

METHODS. Focus groups (FGs, n ¼ 10) were conducted with hospital administrators, doctors, and nurses at 28 county hospitals in Guangdong Province. Discussions explored respondents’ views on increasing surgical volume and quality and improving patient satisfaction. Respondents numerically ranked possible strategies to increase surgical volume and quality and patient satisfaction. FG transcripts were independently coded by two reviewers utilizing the constant comparative method following the grounded theory approach, and numerical responses were scored and ranked.

RESULTS. Ten FGs and 77 ranking questionnaires were completed by 33 administrators, 23 doctors, and 21 nurses. Kappa values for the two coders were greater than 0.7 for all three groups. All groups identified a critical need for enhanced management training for hospital directors. Doctors and nurses suggested reducing surgical fees to enhance uptake, although administrators were resistant to this. Although doctors saw the need to improve equipment, administrators felt current material conditions were adequate. Respondents agreed that patient satisfaction was generally high, and did not view increasing patient satisfaction as a priority.

CONCLUSIONS. Our findings highlight agreements and disagreements among the three stakeholder groups about improving surgical output and quality, which can inform strategies to improve cataract programs in rural China. Respondents’ beliefs about high patient satisfaction are not in accord with other studies in the area, highlighting a potential area for intervention. 

Opinion:

Some points which are important to make rural cataract surgery successful and can be adopted in Indonesia based on this study below:

1. Provide management training for hospital administrators and increase salary for staff. Doctors and nurses expressed dissatisfaction stemming from factors such as lack of salary incentives and equipment and poor delineation of responsibilities. Given that hospital administrators themselves recognized a need for more management training, cataract surgery programs may improve their effectiveness and sustainability by offering administrative training focused on topics, such as proper staffing and equipment, design and implementation of salary incentives, delineation of responsibilities, and creation of standardized protocols.

2. Reduce surgical fees or make the surgery free for patient

3. Provide OR and peri operative training for nurses.

Our results suggest that nurses could benefit from additional training in three specific areas: OR tasks, basic clinical assessment (e.g., visual acuity measurement), and patient education. 

4. Improve and expand training for surgeons. Although doctors generally praised the quality of current surgery training programs provided by ZOC, they highlighted weaknesses, such as a steep learning curve for doctors without basic surgery skills and lack of hands-on opportunities.

5. Attend to patient satisfaction. Low patient satisfaction with the perceived quality of care has been shown to be a key factor preventing uptake of cataract services in this and other parts of rural China,27 whereas increased patient satisfaction has been associated with increased patient compliance, reduced complaints against the institution, and improved provider morale.

But, further study to adjust the implementation in Indonesia is essential because some limitation of this study. The sample size of the present study was based on a convenience sample from hospitals in Guangdong Province, and therefore generalization of these findings must only be done with care.

Reference:

http://iovs.arvojournals.org/article.aspx?articleid=2188702 (Invest Ophthalmol Vis Sci. 2013;54:266–273) DOI:10.1167/iovs.12-10906

Image:www.thestandard.co.zw

The Health of Trafficked Women: A Survey of Women Entering Posttrafficking Services in Europe

Abstract:
Trained counselors interviewed 192 women who had been trafficked and sexually exploited about abuse and evaluated their physical and mental health status within 14 days of entry into posttrafficking services. Most reported physical or sexual violence while trafficked (95%), pretrafficking abuse (59%), and multiple posttrafficking physical and psychological problems.
Newly identified trafficked women require immediate attention to address posttrauma symptoms and adequate recovery time before making decisions about participating in prosecutorial or immigration proceedings or returning home.

My opinion:
This journal stated that services for such women should be based on good practices used for victims of domestic violence, sexual assault, and torture and for migrants and refugees. These include strategies for crisis intervention, confidentiality, security, shelter, social support, forensics, counseling, and medical cultural competency.

From the data that has been presented, they support that medical care for victims of trafficking is very necessary. It also needs attention there are psychological problems that can hamper the victims to resume their life as usual or return back home. Therefore, in the program, I include counseling as a good media to resolve the issue, either directly or via mobile phone

Reference:
http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2006.108357

Worksite-Based Internet Multimedia Program for Family Caregivers of Persons With Dementia

ABSTRACT

Purpose: Our goal was to evaluate the efficacy of a multimedia support program delivered over the Internet to employed family caregivers of persons with dementia. 

Design and Methods: The evaluation of this program involved 299 employed family caregivers participating in a pretest–posttest randomized clinical trial with a 30-day follow-up and a waitlist control condition. Validated instruments include the Center for Epidemiologic Studies–Depression scale, the State–Trait Anxiety Inventory, the Caregiver Strain scale from Benjamin Rose, and Positive Aspects of Caregiving used in the nationwide REACH study. 

Results: Those who viewed Caregiver’s Friend: Dealing with Dementia 30 days postexposure demonstrated significant improvements in depression, anxiety, level and frequency of stress, caregiver strain, self-efficacy, and intention to seek help, as well as perceptions of positive aspects of caregiving. 

Implications: Interactive multimedia interventions delivered over the Internet appear to be uniquely suited to provide low-cost, effective, convenient, individually tailored programs that present educational information, cognitive and behavioral skills, and affective learning opportunities. This makes Web-based multimedia a promising avenue for work–life balance programs, employee-assistance providers, and organizations interested in improving family caregiver health and well-being.

My Opinion :

In this study, the authors stated that compared with the control group, treatment participants reported significantly greater gains with respect to the measures of self-efficacy, intention to get support, and caregiver gain. In addition, the treatment participants reported significantly greater reductions in caregiver stress, caregiver strain, depressive symptomatology, and state anxiety compared with the control participants. This mean that this kind of intervention is efficient. From the efficiency perspective, the author also stated that this program provide a low cost program.

What program I found good in this study is that they make the multimedia tailored program individually for each caregiver, The author also said that this study is successful because of an interactive multimedia program (such as modules about being a caregiver, coping with emotion and common difficulties) presenting materials tailored to the needs of the viewer—as well as the ability of the worksite setting and Internet format to support easy as-needed access. This is a good input for making a such program.

Reference :

https://www.researchgate.net/publication/7441988_Worksite-Based_Internet_Multimedia_Program_for_Family_Caregivers_of_Persons_With_Dementia

Community participation in the prevention and control of dengue: the patio limpio strategy in Mexico

Roberto Tapia-Conyer1 , Jorge Me´ndez-Galva´n2 , Pierre Burciaga-Zu´n˜iga3
full article

Background

Community participation is vital to prevent and control the spread of dengue in Latin America. Initiatives such as the integrated management strategy for dengue prevention and control (IMS-Dengue) and integrated vector management (IVM) incorporate social mobilisation and behavioural change at the community level as part of a wider strategy to control dengue. These strategies aim to improve the efficacy, cost-effectiveness, environmental impact and sustainability of vector control strategies. Community empowerment is a key aspect of the strategy as it allows the local population to drive eradication of the disease in their environment. Through the patio limpio campaign, the concept of community participation has been employed in Mexico to raise awareness of the consequences of dengue. Patio limpio consists of training local people to identify, eliminate, monitor and evaluate vector breeding sites systematically in households under their supervision. A community participation programme in Guerrero State found that approximately 54% were clean and free of breeding sites. Households that were not visited and assessed had a 2.4-times higher risk of developing dengue than those that were. However, after a year, only 30% of trained households had a clean backyard. This emphasises the need for a sustainable process to encourage individuals to maintain efforts in keeping their environment free of dengue.

In order to counter the significant public health burden of dengue in Latin America, the Pan American Health Organization (PAHO) has developed a regional initiative that utilises public participation at community level to encourage behavioural change as part of a wider strategy to control dengue.1 The programme, known as the integrated management strategy for dengue prevention and control (IMS-Dengue), aims to promote the integration of key components to prevent and control dengue, including integrated vector management (IVM) (Fig. 1).2,3 This article discusses how community participation is vital to prevent and control the spread of dengue in Latin America.

Opinion
In this artricle, using Integration Management Strategy for Dengue Prevention and control (IMS-Dengue) and Intergrated Vector Management (IVM). Its key elements are social mobilisation, environmental management, epidemiological and entomological surveillance, and chemical and biological control.
Social mobilisation integrates different members of the community, from householders to political leaders, in order to raise awareness of dengue, deliver resources and services and ensure sustained community participation.
Community empowerment is one of the most important elements of the IVM strategy, allowing the local population, who most suffer the consequences of dengue, to drive eradication of the disease in their environment. Public participation is necessary at a number of stages in the local vector control strategy: in assessing the community’s problems and needs, in implementing activities, and in evaluating and monitoring strategy.

Sustainable programmes and modification of individual behaviour are essential in mosquito-control initiatives. This means that individual households must accept responsibility for the control of mosquitoes in their surroundings. However, to maintain sustainability, such efforts should continue as long as the threat of dengue exists and become culturally embedded. To enable this, capacity-building and training of individuals in surveillance, laboratory diagnosis, case management and vector control are important for effective community interventions to be carried out.
As part of the community mobilisation framework, leadership support from local political, religious and community heads is crucial to engage the local population.  A multidisciplinary approach, for example between vector control personnel, entomologists, anthropologists, epidemiologists and social marketing experts, is also an important aspect of community mobilisation.*

*Parks W, Lloyd L. Planning Social Mobilization and Communication for Dengue Fever Prevention and Control. A Step-by-Step Guide. Geneva, Switzerland: WHO, 2004 [cited 17 December 2011]. Available from: http://whqlibdoc.who.int/ publications/2004/9241591072.pdf.

Implementation of a Free Cataract Surgery Program in Rural China

A Community-Based Randomized Interventional Study

Xiu Juan Zhang, MD, PhD,1,* Yuan Bo Liang, MD, PhD,1,* Ying Peng Liu, MD,1,2 Vishal Jhanji, MD,1

David C. Musch, PhD, MPH,3 Yi Peng, MSc, MPH,2 Chong Ren Zheng, MSc, MPH,2 Hui Xi Zhang, MD,4Ping Chen, MD,4 Xin Tang, MD, PhD,5 Dennis S. C. Lam, MD, FRCOphth1,2

Abstract

Purpose: To identify effective methods to increase the number of cataract surgeries in a rural setting in

Pucheng County of Shaanxi Province, northwestern China.

Design: Community-based randomized interventional study.

Participants: Four hundred thirty-two patients 50 years of ageor older with operable cataract who had not undergone surgery 3 months after participation in a cataract outreach screening program.

Methods: Three hundred fifty-five (82.2%) patients eligible for surgery, but not scheduling it on their own,

were contacted and were assigned randomly into 4 groups. Participants in group 1 (n 86) were given informative reminders by telephone or in person by a trained facilitator about undergoing low-cost cataract surgery. Group 2 (n 86) was offered free cataract surgery. Group 3 (n 90) was offered free surgery  and reimbursement of transportation expenses. Group 4 (n 93) was provided with free rides from home to hospital in addition to the reminder and free surgery.

Main Outcome Measures: Number of participants undergoing cataract surgery after interventions.

Results: In total, 94 patients (26.5%) underwent cataract surgery after interventions. In group 1, 13 patients (14.4%) underwent surgery, which was significantly lower than the number in group 2 (n 25 [27.8%]; P 0.027), group 3 (n 28 [31.1%]; P 0.012), and group 4 (n 26 [28%]; P 0.038). There were no significant

differences between groups 2 and 3 (P 0.768) or between groups 2 and 4 (P 0.869).

Conclusions: Provision of free cataract surgery was twice as effective as giving patients an informative reminder when it came to increasing the uptake of cataract surgery. However, offering reimbursement of transportation expenses or provision of free rides had minimal added impact on the response rate of participants to undergo cataract surgery.

Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2013;120:260–265 © 2013 by the American Academy of Ophthalmology.

http://www.cehjournal.org/article/increasing-the-volume-of-cataract-surgery-an-experience-in-rural-china/

Opinion:

This article is informative, because it is emphasized the importance of free cataract surgery compared to reminder and offering information about low cost cataract surgery in rural China. The reimbursement of travel expenses and free ride for patients give minimal added impact. One point that we must consider while offering cataract surgery is it price compares to individual income in rural area. The people in remote area has lower income so economic side of a surgery is one of the main barrier for people in taking cataract surgery. 

Fifteen percent of the participants underwent cataract surgery when they simply were reminded about the availability of low-cost cataract surgery service in or around their residential area. The mean per capita gross domestic product (year 2007) and the annual per capita income in Pucheng County are US$1009/person  and US$375, respectively. Therefore, cataract surgery, even at US$38/surgery, is a considerable economic burden for an individual. This likely is the reason for a statistically significant increase in the proportion of participants (29.1%) who underwent cataract surgery when they were offered a free surgical procedure.

In Indonesia, National Health Coverage (BPJS) give an advantage because people can get cataract surgery service for free. So that one of the strategy which is important to be implemented in Indonesia is expand BPJS participation from people in remote are. Moreover, some people in remote area can not participate in BPJS because of  a administrative problem. The collaboration with organizations, companies or foundations that can provide grant for free cataract surgery is necessary to back up this problem. 

Reference:

http://www.sciencedirect.com/science/article/pii/S0161642012007518

Sex Trafficking in Nepal: A Review of Intervention and Prevention Programs

Abstract:
Trafficking of girls and women for the purpose of sexual exploitation is a problem worldwide, particularly in South Asia. This review focuses on Nepal-to-India sex trafficking with an examination of current anti-trafficking intervention and prevention programs. The activities of both governmental agencies and nongovernment organizations are described and critically analyzed. Suggestions for evaluating and improving interventions, and thereby reducing the trafficking of girls and women, are discussed.

My opinion:
Antitrafficking programs in the Nepalese context can be divided into prevention programs, indirect prevention, remediation, and advocacy. Prevention programs include direct education about trafficking and/or safe migration practices, “awareness raising” programs, and patrolling the country’s borders. Indirect prevention includes women’s rights programs, microcredit lending, and education programs for women or formal schooling for girls. Remediation includes efforts toward the care and support of trafficking survivors, programs for their rehabilitation, and attempts to reintegrate them into their communities. Advocacy includes prosecution of traffickers and the enforcement of laws against trafficking.

Anti-trafficking program conducted in Nepal can be a reference for me in making my program, the activities carried out by NGOs in Nepal are fairly easy to implement. Prevention activities in Nepal include awareness raising and social mobilization, such as increased community surveillance, as well as improved opportunities for livelihood and the interception of suspected trafficking victims at border checkpoints. These are executed through rallies, seminars, street theater performances, prevention camps, community support groups, and peer education. Maiti Nepal sets up “prevention homes” for women who are thought to be at high risk for trafficking. Women live in the home for a period of 4 to 6 months, during which time they receive counseling, skills training, health care education, and information on trafficking and sexually transmitted infections, including HIV.

Reference:
http://vaw.sagepub.com/content/17/5/651.full.pdf

Adolescents’ Sexuality and School-Based Sex Education in South Korea

Abstract

The aim of this study was to assess adolescents’ sexuality and to gather student opinions on current school-based sex education in South Korea. A self-administered questionnaire survey was conducted in Seoul, Incheon, and Kyunggi Province to assess the status and needs of high school sexuality education. Survey data was obtained from 1,130 senior high school students.

The rates of sexual intercourse for boys and girls were 33.1% and 13.2% respectively. Boys were more likely to be sexually involved (p = .000) and experienced earlier at first sexual intercourse than girls (p = .006). Among students who had sexual intercourse, only 20.3% (21.1% of boys and 19.1% of girls) used contraceptives at first sexual intercourse. The proportion of respondents who had had sexual intercourse was higher among those with poor self-perceived academic performance (p = .000). The proportion was also higher among those with a boy or girl friend (p = .000). Other risk-taking behaviors such as smoking and drinking were associated with sexual activity (p =.000).

This study found that most students were not satisfied with sex education because of teachers’ lack of information and skills in delivering it. Most teachers providing sex education were not qualified and/or trained. They should receive adequate training and guidelines for the training. Training should also give teachers time to practice and become comfortable in delivering it.

Opini

Jurnal ini bertujuan mengetahui kebutuhan / needs dari para remaja, khususnya yang bersekolah di SMA, di Korea Selatan, akan pendidikan seks berbasis sekolah. Situasi di Korea Selatan adalah para remaja banyak yang sudah aktif secara seksual dan tren usianya semakin hari semakin muda. Peran orang tua dan guru di sekolah sangat penting dalam mendidik para remaja agar mereka menunda hubungan seksual sebelum benar-benar siap dalam hubungan yang dewasa. Para orang tua cenderung malu bila membicarakan hal-hal terkait seks dengan anak-anak mereka, akibatnya para remaja cenderung mencari informasi sendiri dan mencoba-coba dengan teman-teman mereka. Maka, sekolah memegang peran penting dalam pendidikan seks.

Kementerian Pendidikan Korsel sudah menawarkan banyak usaha untuk program pendidikan seks berbasis sekolah sejak tahun 1980-an. Mereka merekomendasikan sekolah-sekolah untuk mengalokasikan 10-12 jam untuk pendidikan seks dalam satu minggu setiap tahun.  Kenyataannya banyak sekolah-sekolah yang tidak melaksanakan rekomendasi, bahkan tidak mengadakan pendidikan seks, sesuai anjuran dari Kementerian Pendidikan Korsel.

Dari hasil survei yang dilakukan kepada 1.130 remaja di tingkat SMA di Korea Selatan, baik remaja laki-laki maupun perempuan lebih banyak menggunakan video untuk memuaskan rasa ingin tahu mereka terhadap seks, dibanding media lain seperti komik, majalah, film, dan internet. Hal ini dapat menimbulkan persepsi yang keliru dan bersifat kurang informatif.

Dari 1.130 responden remaja, 961 orang telah menerima pendidikan seks berbasis sekolah. Hanya 4,8% dari mereka yang mengaku terpuaskan oleh pendidikan seks yang telah diberikan. Alasan terkuat adalah materi yang diberikan kurang informatif (tidak sesuai yang ingin diketahui), diikuti dengan alasan-alasan lain seperti tenaga pengajar yang menyampaikan materi kurang terlatih, materi yang diberikan kurang banyak,  metode pengajaran kurang interaktif, waktu yang dialokasikan kurang, dan tidak ada ketertarikan untuk belajar di pendidikan seks lebih lanjut. Topik terkuat yang ingin dibahas dalam pendidikan seks adalah kontrasepsi (cara mendapatkan dan penggunaannya), diikuti oleh penyakit menular seksual, HIV/AIDS, perilaku seksual (termasuk homoseksualitas), kehamilan tak diinginkan (termasuk aborsi), membina hubungan dengan calon pasangan, dan faktor sosial (termasuk peran dan kesetaraan gender).

95% responden setuju bahwa pendidikan seks berbasis sekolah sangat penting. 91,4% responden setuju bahwa pendidikan seks harus ditawarkan di sekolah. 68,5% responden setuju bahwa pendidikan seks di sekolah bersifat wajib. 74,6% responden setuju bahwa pendidikan seks dimulai sejak SD.

Jurnal ini menilai keberhasilan program pendidikan seks berbasis sekolah yang telah direkomendasikan oleh Kementerian Pendidikan Korea Selatan. Program yang dijalankan tidak menemui kebutuhan dari sasaran program (siswa-siswi SMA di Korea Selatan).  Hal ini disebabkan karena faktor materi yang diberikan dan tenaga pengajar yang menyampaikan materi. Dari hasil penilaian ini bisa dirancang program lain, atau memperbaiki program yang sudah ada yang bisa memenuhi kebutuhan dari sasaran program.   

Situasi di Korea Selatan tidak berbeda jauh dengan di Indonesia, di mana banyak remaja SMA yang sudah aktif secara seksual dan minimnya pengetahuan para remaja tentang seks. Program pendidikan seks berbasis sekolah akan lebih berjalan sesuai harapan bila materinya sudah diperbaharui  (sesuai dengan yang ingin diketahui para siswa) dan tenaga pengajarnya kompeten (tidak canggung atau monoton dalam menyampaikan materi).

Referensi

Sohn, Ae-Ree; Han, Hee-Jeong. 2002. Adolescents’ Sexuality and School-Based Sex Education in South Korea. Korean Journal of Health Education and Promotion. Volume 19. Issue 4. pp.45-60. Available at www.koreascience.or.kr/article/ArticleFullRecord.jsp?cn=BGGJBY_2002_v19n4_45 [Accessed on August 30^th 2016]

Can the ubiquitous power of mobile phones be used to improve health outcomes in developing countries?

Abstract

Background - The ongoing policy debate about the value of communications technology in promoting development objectives is diverse. Some view computer/web/phone communications technology as insufficient to solve development problems while others view communications technology as assisting all sections of the population. This paper looks at evidence to support or refute the idea that fixed and mobile telephones is, or could be, an effective healthcare intervention in developing countries.

Methods - A Web-based and library database search was undertaken including the following databases: MEDLINE, CINAHL, (nursing & allied health), Evidence Based Medicine (EBM), POPLINE, BIOSIS, and Web of Science, AIDSearch (MEDLINE AIDS/HIV Subset, AIDSTRIALS & AIDSDRUGS) databases.

Results - Evidence can be found to both support and refute the proposition that fixed and mobile telephones is, or could be, an effective healthcare intervention in developing countries. It is difficult to generalize because of the different outcome measurements and the small number of controlled studies. There is almost no literature on using mobile telephones as a healthcare intervention for HIV, TB, malaria, and chronic conditions in developing countries. Clinical outcomes are rarely measured. Convincing evidence regarding the overall cost-effectiveness of mobile phone " telemedicine" is still limited and good-quality studies are rare. Evidence of the cost effectiveness of such interventions to improve adherence to medicines is also quite weak.

Conclusion - The developed world model of personal ownership of a phone may not be appropriate to the developing world in which shared mobile telephone use is important. Sharing may be a serious drawback to use of mobile telephones as a healthcare intervention in terms of stigma and privacy, but its magnitude is unknown. One advantage, however, of telephones with respect to adherence to medicine in chronic care models is its ability to create a multi-way interaction between patient and provider(s) and thus facilitate the dynamic nature of this relationship. Regulatory reforms required for proper operation of basic and value-added telecommunications services are a priority if mobile telecommunications are to be used for healthcare initiatives.

My Opinion:

With the rise in science & technology, information lies at our fingertips. A patient may be more up to date on the latest treatment around the globe compared to their family doctor. This perk can actually be used to benefit doctors. The one way to do so is the use of mobile phones for telemedicine as mentioned in the article. There are many pros and cons to this approach and they vary from one social demographic to another.

I will be looking at the benefits (or detriment) of telemedicine. In Canada, patients were assigned to telephone groups and told to report their blood glucose levels. They also received counselling every week as to how much to adjust their insulin and food duration. Significant improvement was seen in the treatment group after 12 weeks. In the United States, voice-interactive telephone system that required patients to daily self-measure glucose levels or report hypoglycemic symptoms. After 12 months, the yearly prevalence of diabetes-related crises or hypoglycemia decreased and a concomitant statistical significant decrease in type 2 diabetic HbA1c was observed. Similar results were observed in proactive telephone intervention for type 1 diabetes in the United States. In the Spanish island of Tenerife, 75% expressed that they were more comfortable in sending their data via the mobile phone SMS. A 3 month research in Korea showed improvement in HbA1c levels as well. However not all approaches proved to bear fruits. A 1 year study carried out in Finland among type 1 diabetic patients proved not beneficial to all due to low measurement activity and was suggested to be limited to those having high motivation to use telemedicine.

For an Asian setting, it has been proven to be effective in South Korea. Large, urban cities with fast internet connectivity will be the most suitable hub for such an approach. Educated patients will be able to benefit much from this method and in the process ease the work of doctors in monitoring their patients. However, for a setting like the city of Yogyakarta, diabetes is seen in all age groups and in all demographic levels. For patients without a mobile phone or patients who do not know how to use one, telemedicine may be difficult and would require patients to regularly come for check ups to their local primary health centers or secondary hospitals.

Nevertheless, telemedicine does have a lot of prospect and should be mastered by general physicians to benefit their line of work in the near future.

Reference:

http://globalizationandhealth.biomedcentral.com/articles/10.1186/1744-8603-2-9