Journal of Preventive Medicine and Hygiene (JPMH)
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Breaking the Stalemate: How Italy\u27s Non-Medical Health Professions Are Trapped by Redundant Roles and Ineffective Degrees
Full text linkThis letter addresses the critical issues affecting non-medical health professions in Italy, highlighting the inefficacy of master\u27s degrees and the proliferation of redundant professional roles. Despite advanced training, these professionals often experience stagnant career progression and limited autonomy due to overlapping roles and resistance from the medical community. The letter also underscores the lack of European harmonization in educational standards, which exacerbates these challenges. To improve the system, the letter advocates for reducing role overlaps, reforming advanced education, and promoting greater autonomy for non-medical health professionals to ensure patient-centered care
Assessment of “Quality of Life” of Parents and Siblings of Intellectually Disabled Children residing at one of Metropolitan cities at Western India: Quality of Life of Families of Intellectually Disabled Children: A Cross-Sectional Study
No full textIntroduction: Intellectual disability is a permanent disability and raising such a child may lead to varied physical, social, emotional response from caregivers. Data of Quality of life of family members of such children is underexplored. Objectives: To measure quality of life of family members of intellectually disabled children. Methodology: A total of 253 parents and 195 siblings eligible and giving consent to participate in the study were interviewed from 382 students enrolled across multiple schools located at one of the Metropolitan cities in Western India. Result: Areas like Social aspect, Physical care, Embarrassment & Sibling effect were more affected unfavorably amongst Parents. However Positive impact was seen amongst 62.8% Parents. Functional impairment was observed in 80% of siblings. Conclusion: Quality of life of Parents was affected but more functional impairment was observed amongst siblings of intellectually disabled children
A hard-to-heal wound: a case study on the collaboration between nonprofit and Public Health Sector in South Italy
Full text linkThis paper presents a case study of the barriers to care faced by a 44-year-old patient from Ivory Coast who has been living in Italy for 15 years. The patient visited his general practitioner (GP) in his neighborhood in southern Italy, seeking treatment for a workplace complex hand injury for which parenteral antibiotic therapy was recommended. During the medical examination, the physician also diagnosed the patient with diabetes mellitus and prescribed specialist examinations (i.e., diabetology, physiatry, surgery). Even if the patient was regularly residing in Italy, he encountered difficulties in navigating the health system to obtain the recommended services (i.e., administration of parenteral antibiotic therapy, serial dressings for the wound, booking several medical appointments). The local office of the Italian non-governmental organization EMERGENCY (EMR) stepped in to support the patient in facilitating the health system navigation, and collaborated with his GP on a diagnostic and therapeutic strategy. The course was regular and the patient did not develop any complications (i.e., gangrene, sepsis). The synergy between EMR, the patient, and his GP has resulted in (1) an effective clinical pathway, (2) reduced barriers to access, and (3) increased patient empowerment. However, this approach proved to be extremely resource-intensive. Organizing these resources with more planning and forethought would have granted many more patients access to care. Were the SSN to provide this type of comprehensive healthcare to every patient, regardless of the presence of NGOs, there would be better outcomes for marginalized health seekers, and resources would be used more efficiently and sustainably
Basing patient safety education on real student experience: development of a multinational simulation scenario
Full text linkIntroduction
Implicit learning during clinical placements includes patient safety issues. Simulation scenarios offer ways to improve the learning process and students’ awareness of patient safety. The aim of this study was to develop a prototype simulation scenario based on real student experiences.
Methods
This was a mixed-method study using a multi-phase design. Nursing students’ experiences of workplace events they identified as possible threats to patient safety were collected between 2017 and 2019. These experiences were used to develop an interprofessional scenario about patient safety.
Results
A range of scenario materials were produced including a video. Participation in the scenario video had positive impacts including: “feeling safer” while performing nursing activities and more timely detection and reporting of errors. Nursing students reported that participation in the scenario taught important lessons about patient safety, communication, listening to patients and healthcare collaboration.
Conclusions
The role-playing methodology of the scenario provided opportunities for reflection on patient safety and improved interprofessional understanding and communication in an emotionally safe environment
Social and Behavioral Determinants of Dental Care Utilization among Homeless Pregnant Women in the United States: Dental Care Utilization and Oral Health in Pregnant Women
No full textIntroduction: Despite modest research on oral health care during pregnancy, there is a dearth of evidence describing dental care among pregnant women experiencing homelessness. The purpose of this study was to examine associations between dental care utilization and social and behavioral determinants of health among United States (US) pregnant women who experienced homelessness relative to those who did not.
Methods: This was a cross-sectional study that used data from the 2012-2018 Pregnancy Risk Assessment Monitoring System (PRAMS). The sample consisted of 5,939 homeless and 209,942 non-homeless women. Bivariable and multivariable analyses were conducted to determine associations between dental health-related measures and social, medical, and behavioral determinants of health based on whether a woman experienced homelessness 12 months prior to birth.
Results: In this sample, 41.2% of homeless women saw a dentist for a problem while this was true for only 19.1% of women who were not homeless. Approximately 36.4% of women who experienced homelessness did not have their teeth cleaned before pregnancy compared to 25.7% of women who were not homeless. Lack of preventive care, smoking, older age, and experiencing multiple stressors during pregnancy were positively associated with seeing a dentist during pregnancy for both groups of women.
Conclusions: The results indicate the need for healthcare providers and policy officials to develop targeted interventions and policies to ensure that dental care is readily accessible for all pregnant women and especially those who are homeless
Achieving Health Equity in Decentralized Healthcare: An Innovative Approach to Preventive Care in Southern Italy
Full text linkIntroduction: This report evaluates the Italian Ministry of Health’s Decree No. 77 of 23 May 2022, aimed at standardizing preventive healthcare nationwide. It highlights regional disparities in healthcare access and explores innovative approaches, including Regulation 13/2023 of the Apulia Region (Southern Italy), to improve health outcomes. Methods: The report compares the healthcare management systems of northern and southern Italy, focusing on vaccination rates, chronic disease management, and the integration of environmental health. It examines the Apulian regulatory model, emphasizing environmental determinants such as air quality monitoring and predictive analytics to mitigate climate-related health risks. Additionally, comparisons are made with decentralized healthcare systems in Spain, Germany, Canada, and the United Kingdom. Results: The Apulia model led to significant health improvements, including a 25% reduction in waterborne diseases and a 12% reduction in heatwave-related hospitalizations. Multidisciplinary collaboration and community engagement enhanced policy effectiveness and public confidence. Conclusions: This report underscores the importance of balancing national health guidelines with regional autonomy to address health inequalities. The Apulia model demonstrates the need for integrating environmental health factors and offers a replicable framework to improve health equity and resilience. Recommendations include strengthening administrative capacity, fostering inter-regional collaboration, and promoting innovative regional healthcare approaches
Attitude and Practices Towards Breast Cancer Among Undergraduate Female Pharmacy Students in Pakistan
Full text linkBackground: Lack of knowledge, attitude and perception towards breast cancer still a major public health issue disease in many developed and under-developed countries including Pakistan. In 2024 in Pakistan, one in every 8 females is affected by Breast Cancer.
Objective: To determine the awareness, attitude, and practices of Pharmacy (Pharm-D) students towards Breast Cancer (BC) and their correlation with participants’ age and level of study.
Methodology: A cross-sectional study was conducted on 401 female students of Pharmacy from December 2023 to March 2024, using a self-administered questionnaire assessing awareness, attitude, and practices towards BC. For sample size calculation, Raosoft® online sample size calculator with a 5.0% margin of error and a 95.0% confidence interval was used. The respondents were sampled via convenience sampling.
Results: Our sample included 401 participants. The majority gained knowledge about BC from the media (69.8%). About 73.4% of participants did not participate in breast self-examination (BSE), and about 41.3% of them believed they were not at risk. About 92.6% of participants didn’t undergo clinical breast examination (CBE). Nearly half of the participants (44.9%) agreed that BC is more common in older women. About four-fifths of the respondents (79.3%) agreed that regular examination can reduce the risk of BC.
Conclusion: The practice of BSE by the Pharm.D students is lagging. There were notable gaps in CBE by pharmacy students due to the belief that breast cancer predominantly affects older women. Therefore, it is important to make future pharmacists aware of practicing BSE and CBE regularly
A Field Report from War-Torn Remote Villages in South-Eastern Ukraine: Enhancing Healthcare Access Through a Community-Oriented Primary Care Model
Full text linkThe ongoing conflict in Ukraine has severely disrupted healthcare infrastructure, displaced medical personnel and restricted access to care, prompting an unprecedented international support. Since October 2023, the non-governmental organization EMERGENCY has conducted a field assessment to identify critical barriers to healthcare delivery in remote villages of Donetsk to inform an effective intervention. The assessment revealed that many health needs, particularly those related to chronic diseases and mental health, were pre-existing but had been exacerbated by the war, resulting in a secondary surge of unmet needs in rural communities facing growing barriers to basic care. In response, a Community Health Worker (CHW)-led intervention was developed to bridge gaps between communities and health services. Locally recruited CHWs conduct door-to-door assessments, monitor treatment adherence for chronic diseases, address mental health needs, arrange home-based care for bedridden individuals, deliver health education sessions, and facilitate timely referrals in close collaboration with nurse-led clinics. To strengthen resilience, CHWs are trained in basic emergency and disaster preparedness, including life support skills, improving community-level readiness for health emergencies. To address sustainability challenges, the intervention is integrated into Ukraine’s primary care network, and provides CHWs with ongoing training and compensation through regular contracts. Aligned with national health priorities and the Health Cluster’s strategy, the model targets marginalized groups, engages communities, and strengthens local health systems, ensuring efficient use of resources and continuity of care. This report outlines a scalable, context-sensitive approach to enhancing healthcare access in conflict settings, with relevance for other humanitarian contexts
Mapping the social networks of key actors in the development of health technology assessment in Iran
Full text linkBackground: Health Technology Assessment (HTA) plays a crucial role in informing health policy and ensuring the effective allocation of resources. In Iran, the development and implementation of HTA involve various key actors with differing levels of influence, interest, and support. Understanding the social networks and power dynamics among these actors is essential for optimizing HTA processes.
Methods: This study employed Social Network Analysis (SNA) to map the relationships and interactions among 27 identified stakeholders involved in HTA development in Iran. Data were collected through an online questionnaire distributed to 83 participants, assessing five dimensions: power, position, interest, influence, and support. Network metrics, including degree centrality, closeness centrality, betweenness centrality, and eigenvector centrality, were calculated to evaluate the roles and connections of each actor.
Results: The analysis revealed that the Ministry of Health and Medical Education, Food and Drug Administration, Insurance Organizations, and the Islamic Consultative Assembly (Parliament) are the most influential actors in the HTA network. The Plan and Budget Organization and National Institute of Health Research emerged as key connectors with high centrality metrics. Despite this, the network exhibited limited connectivity and sparse interactions among some actors, notably the Chamber of Commerce.
Conclusion: The study highlights the central roles of key institutions in HTA development while identifying gaps in stakeholder communication and connectivity. Enhancing collaboration and addressing these gaps are critical for improving HTA processes in Iran. Strengthening central coordination and stakeholder engagement will facilitate more effective HTA implementation and informed health policy decisions
Policy brief: addressing the shortage of human resources in the Iranian health system
Full text linkBackground: This policy brief addresses the critical shortage of human resources in the Iranian healthcare system, which significantly hampers healthcare access, quality, and patient outcomes. The ongoing mismatch between the supply of healthcare professionals and the growing demand due to population increases and the rising burden of chronic diseases necessitates urgent action. Despite efforts to expand the healthcare workforce, challenges such as geographic maldistribution, migration of healthcare workers abroad, inadequate training opportunities, and limited support systems persist, further exacerbating the crisis.
Introduction: The current landscape reveals an uneven distribution of healthcare professionals, with urban areas benefiting disproportionately compared to rural regions. As a result, many communities face difficulties accessing essential healthcare services. Additionally, the migration of skilled professionals seeking better opportunities overseas undermines the existing workforce, leading to further gaps in care delivery. These shortages directly affect healthcare quality, resulting in longer wait times, decreased patient satisfaction, and poorer health outcomes. Furthermore, the strain on remaining healthcare workers contributes to burnout, compromising their well-being and the effectiveness of care provided.
Materials and Methods: To address these challenges, this policy brief presents evidence-based recommendations aimed at enhancing the capacity and effectiveness of the healthcare workforce. Key policy options include: Implementing strategies to incentivize the placement of healthcare workers in underserved areas, establishing centralized data systems for workforce management, and developing rural placement programs. Improving salary structures, working conditions, and career development opportunities to retain healthcare workers and reduce migration, along with promoting work-life balance. Increasing investments in medical and nursing education, expanding specialized training opportunities, and establishing continuing education frameworks to ensure ongoing skill development. Exploring innovative models that allow for task-shifting, enabling non-physician health workers to perform essential tasks, thereby optimizing the use of available human resources. Encouraging collaboration with the private sector and NGOs to expand training capacities and provide healthcare services in underserved regions. Promoting digital health tools and telemedicine to extend healthcare access, especially in remote areas.
Discussion: The brief outlines a phased implementation strategy that includes both short-term actions, such as pilot projects and capacity-building initiatives, and long-term structural reforms aimed at sustaining a robust healthcare workforce.
Conclusion: Addressing the human resource shortage in Iran\u27s healthcare system is vital for improving healthcare access and outcomes, requiring immediate and comprehensive policy action to foster a resilient healthcare environment for all citizens