Suchergebnisse

Public health centers (PHCs, hokenjo in Japanese) are local government authorities responsible for public health in Japan. PHCs have an important role in tuberculosis (TB) control. Typically, their responsibilities include 1) the recommendation to admit infectious TB patients to an isolation ward, 2) health checkups with chest X-ray of those in a close contact with infectious TB patients, and 3) public subsidy of medical expenses for TB treatments. Facing the emergence of multi-drug resistant tuberculosis (MDR-TB), the national TB control program was drastically changed; the Japanese version of the Directly Observed Treatment in Short-course (DOTS) strategy was started in 2005. New roles were added to PHCs' responsibilities; 1) active screening of latent TB infection by interferon gamma release assays for those in a close contact with infectious TB patients, 2) community DOTS to promote treatment adherence to outpatients, 3) cohort analysis of outcomes of TB treatment, and 4) national MDR-TB surveillance. These roles are important in preventing MDR-TB and eliminating TB in Japan.

Abstract Background Although Bangladesh has achieved tremendous success in health care over the last four decades, it still lagged behind in the areas of maternal and child malnutrition and primary health care (PHC). To increase access to PHC, the Bangladesh government established approximately 18,000 community clinics (CCs). The purpose of this study was to examine the associations of socioeconomic determinants of women aged 12–49 years with the CCs awareness and visitation. Methods We analyzed secondary data provided by Bangladesh Demographic and Health Survey-2011. A two-stage cluster sampling was used to collect the data. A total of 18,222 ever married women aged 12–49 years were identified from selected households and 17,842 were interviewed. The main outcome measures of our study were awareness and visitation of CCs. Bivariate logistic regression was used to calculate odds ratio (OR) and 95 % confidence interval (CI) to examine the associations between the awareness and visiting CCs with socioeconomic determinants. Results Low prevalence of awareness about CC (18 %) was observed among studied women and only 17 % of them visited CCs. Significant associations (P < 0.05) with CCs awareness and visitation were observed among aged 20–29 years (adjusted OR = 1.18; 95 % CI = 1.03–1.35 and adjusted OR = 1.49; 95 % CI = 1.05–2.11), primary education (adjusted OR = 1.20; 95 % CI = 1.08–1.34 and adjusted OR = 1.37; 95 % CI = 1.05–1.78), and poorest family (adjusted OR = 1.21; 95 % CI = 1.03–1.42 and adjusted OR = 2.36; 95 % CI = 1.56–3.55, respectively), after controlling potential confounders. Conclusions Awareness and visitation of CCs were found to be positively associated with lower economic conditions, young age, and primary education. Awareness and access to CCs might be increased through community activities that involve health care workers. The government should also lower barriers to PHC access through CCs by providing adequate logistics, such as human resources and equipment.