Workplace violence experienced by healthcare providers (HCPs) in Sudan has gone viral, driving many HCPs outside the country. Globally, HCPs have accepted workplace violence as a phenomenon integral to their clinical work, causing an underreporting of incidents. This study reviews the causes and explores solutions for the phenomenon. Search strategies were conducted using internet sources including PubMed, Embase, Google Scholar, and Cochrane. References to Sudan were limited to HCPs in public healthcare facilities. A descriptive analysis was conducted on the global status of workplace violence toward HCPs. Future interventions were examined and discussed considering Sudan\'s circumstances. Results showed the \"pandemic\" nature of the phenomenon. Workplace violence contributes to the deterioration of the quality and efficiency of the healthcare system with consequences for effective healthcare delivery. It is concluded that a multiapproach intervention needs to be integrated to circumvent the standing multifactorial situation. Statutory actions are needed towards the widespread violence and impunity. Workplace organizational procedures are needed to address the patient\'s needs that overwhelm scarce resources. Robust educational efforts are recommended by HCP training bodies, the media, and other stakeholders to improve the doctor/patient relationship.

UNASSIGNED: The coronavirus disease 2019 pandemic has challenged health services worldwide, with a worsening of healthcare workers\' mental health within initial pandemic hotspots. In early 2022, the Omicron variant is spreading rapidly around the world. This study explores the effectiveness and cost-effectiveness of a stepped-care programme of scalable, internet-based psychological interventions for distressed health workers on self-reported anxiety and depression symptoms.
UNASSIGNED: We present the study protocol for a multicentre (two sites), parallel-group (1:1 allocation ratio), analyst-blinded, superiority, randomised controlled trial. Healthcare workers with psychological distress will be allocated either to care as usual only or to care as usual plus a stepped-care programme that includes two scalable psychological interventions developed by the World Health Organization: A guided self-help stress management guide (Doing What Matters in Times of Stress) and a five-session cognitive behavioural intervention (Problem Management Plus). All participants will receive a single-session emotional support intervention, namely psychological first aid. We will include 212 participants. An intention-to-treat analysis using linear mixed models will be conducted to explore the programme\'s effect on anxiety and depression symptoms, as measured by the Patient Health Questionnaire - Anxiety and Depression Scale summary score at 21 weeks from baseline. Secondary outcomes include post-traumatic stress disorder symptoms, resilience, quality of life, cost impact and cost-effectiveness.
UNASSIGNED: This study is the first randomised trial that combines two World Health Organization psychological interventions tailored for health workers into one stepped-care programme. Results will inform occupational and mental health prevention, treatment, and recovery strategies.
UNASSIGNED: ClinicalTrials.gov Identifier: NCT04980326.

UNASSIGNED: India is experiencing a rapid health transition with a rising burden of noncommunicable diseases (NCDs), causing significant morbidity and mortality. Cost-effective interventions for comprehensive NCD management can only be designed after assessing the readiness of various health facilities.
UNASSIGNED: This study aimed to assess the preparedness of healthcare facilities of Manipur in the management of NCDs and to assess the knowledge of doctors regarding NCDs.
UNASSIGNED: A cross-sectional study was conducted in 21 public healthcare facilities in seven districts of Manipur during October 2021. Readiness of these facilities was assessed through observation and interview of doctors and nurses using a checklist adapted from the WHO Package of Essential NCDs. Knowledge of 153 doctors was also assessed using a self-administered, structured questionnaire. Data were entered in SPSS-26 and expressed using descriptive statistics.
UNASSIGNED: General readiness index of primary health centers (PHCs), community health centers (CHCs), district hospitals (DHs), and tertiary care centers (TCCs) was 47%, 66.3%, 73.2%, and 70%, respectively. CHCs were ready in the domains of patient care services (80%), human resources (75%), and advocacy (91.7%). DHs and TCCs were ready in terms of patient care services, human resources, record maintenance, referral system, and advocacy. PHCs were not ready in any of the nine domains. Majority of the doctors (88%) had inadequate knowledge regarding NCDs.
UNASSIGNED: PHCs and CHCs were not adequately prepared, but DHs and TCCs were ready to manage NCDs. More than four-fifth of the doctors had inadequate knowledge. Strengthening PHCs and CHCs and training of healthcare workers are needed for integrated NCD management.

Healthcare facilities are a well-known high-risk environment for transmission of M. tuberculosis, the etiologic agent of tuberculosis (TB) disease. However, the link between M. tuberculosis transmission in healthcare facilities and its role in the general TB epidemic is unknown. We estimated the proportion of overall TB transmission in the general population attributable to healthcare facilities.
We combined data from a prospective, population-based molecular epidemiologic study with a universal electronic medical record (EMR) covering all healthcare facilities in Botswana to identify biologically plausible transmission events occurring at the healthcare facility. Patients with M. tuberculosis isolates of the same genotype visiting the same facility concurrently were considered an overlapping event. We then used TB diagnosis and treatment data to categorize overlapping events into biologically plausible definitions. We calculated the proportion of overall TB cases in the cohort that could be attributable to healthcare facilities.
In total, 1,881 participants had TB genotypic and EMR data suitable for analysis, resulting in 46,853 clinical encounters at 338 healthcare facilities. We identified 326 unique overlapping events involving 370 individual patients; 91 (5%) had biologic plausibility for transmission occurring at a healthcare facility. A sensitivity analysis estimated that 3%-8% of transmission may be attributable to healthcare facilities.
Although effective interventions are critical in reducing individual risk for healthcare workers and patients at healthcare facilities, our findings suggest that development of targeted interventions aimed at community transmission may have a larger impact in reducing TB.

Access to healthcare facilities is an essential measure of the urban development of contemporary cities. Governments often budget huge sums to fulfill the healthcare demands of the population, however neglect to address requirements specific to women. This paper assesses the density, spatial distribution, and services of healthcare facilities to identify care requirements specific to women, and how their needs are-or could be-met. The analysis addresses the research question: What strategies will improve women\'s access to healthcare and satisfy their healthcare requirements? Methods include a case study in the Yuetan Area of Beijing, field investigation, mapping, and questionnaires. The survey was carried out in November 2021 and January 2022 and involved 462 women residents in the Yuetan Area. Results indicate: (i) that, despite the total number of facilities meeting the standards recommended by the WHO, the spatial distribution of healthcare facilities is imbalanced; (ii) women\'s healthcare encompasses both physical and psychological health. Optimizing accessibility to healthcare facilities can positively impact women\'s health and well-being. Conclusions include insights regarding the relationship between access to healthcare facilities women\'s healthcare requirements, as well as proposing strategies for improved healthcare facilities with a focus on an equitable and sympathetic society.

During the COVID-19 pandemic, healthcare facilities worldwide have been overwhelmed by the amount of coronavirus patients needed to be served. Similarly, the U.S. also experienced a shortage of healthcare resources, which led to a reduction in the efficiency of the whole healthcare system. In order to evaluate this from a transportation perspective, it is critical to understand the extent to which healthcare facilities with intensive care unit (ICU) beds are available in both urban and rural areas. As such, this study aims to assess the spatial accessibility of COVID-19 patients to healthcare facilities in the State of Florida. For this purpose, two methods were used: the two-step floating catchment area (2SFCA) and the enhanced two-step floating catchment area (E2SFCA). These methods were applied to identify the high and low access areas in the entire state. Furthermore, a metric, namely the Accessibility Ratio Difference (ARD), was developed to evaluate the spatial access difference between the models. Results revealed that many areas in the northwest and southern Florida have lower access compared to other locations. The residents in central Florida (e.g., Tampa and Orlando cities) had the highest level of accessibility given their higher access ratios. We also observed that the 2SFCA method overestimates the accessibility in the areas with a lower number of ICU beds due to the \"equal access\" assumption of the population within the catchment area. The findings of this study can provide valuable insights and information for state officials and decision makers in the field of public health.

The spread of coronavirus disease 2019 (COVID-19) has led to severe strain on hospital capacity in many countries. We aim to develop a model helping planners assess expected COVID-19 hospital resource utilization based on individual patient characteristics.
We develop a model of patient clinical course based on an advanced multistate survival model. The model predicts the patient\'s disease course in terms of clinical states-critical, severe, or moderate. The model also predicts hospital utilization on the level of entire hospitals or healthcare systems. We cross-validated the model using a nationwide registry following the day-by-day clinical status of all hospitalized COVID-19 patients in Israel from March 1 to May 2, 2020 (n = 2703).
Per-day mean absolute errors for predicted total and critical care hospital bed utilization were 4.72 ± 1.07 and 1.68 ± 0.40, respectively, over cohorts of 330 hospitalized patients; areas under the curve for prediction of critical illness and in-hospital mortality were 0.88 ± 0.04 and 0.96 ± 0.04, respectively. We further present the impact of patient influx scenarios on day-by-day healthcare system utilization. We provide an accompanying R software package.
The proposed model accurately predicts total and critical care hospital utilization. The model enables evaluating impacts of patient influx scenarios on utilization, accounting for the state of currently hospitalized patients and characteristics of incoming patients. We show that accurate hospital load predictions were possible using only a patient\'s age, sex, and day-by-day clinical state (critical, severe, or moderate).
The multistate model we develop is a powerful tool for predicting individual-level patient outcomes and hospital-level utilization.

The Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7) is a water treatment and handwashing with soap intervention for diarrhoea patients and their household members which is initially delivered in a healthcare facility setting. This study evaluated the effectiveness of CHoBI7 program delivery in increasing handwashing with soap in a healthcare facility setting among diarrhoea patients and their household members.
A randomised controlled trial of the CHoBI7 program was conducted among 404 diarrhoea patients and their accompanying household members in healthcare facilities in Dhaka, Bangladesh. The \'Standard Message\' Arm received the standard message given in Bangladesh to diarrhoea patients on the use of oral rehydration solution. The \'Health Facility Visit + Soapy Water\' Arm received the standard message, the CHoBI7 communication module delivered bedside to the patient; and a soapy water bottle in the healthcare facility. The \'Health Facility Visit + Handwashing Station\' Arm received this same intervention plus a small plastic handwashing station. Within 24 h of intervention delivery, three-hour structured observation of handwashing practices at stool/vomit- and food-related events (key events) was conducted in healthcare facilities of diarrhoea patients and their accompanying household members.
Compared to the Standard Message Arm, there was significantly more handwashing with soap at key events in both the Health Facility Visit + Soapy Water Arm (51% vs. 25 %) (Odds Ratio: 3.02; (95% Confidence Interval (CI): 1.41, 6.45) and the Health Facility Visit + Handwashing Station Arm (58% vs. 25%) OR: 4.12; (95% CI: 1.86, 9.14).
These findings demonstrate that delivery of the CHoBI7 communication module and provision of a soapy water bottle to diarrhoea patients and their accompanying household members presents a promising approach to increase handwashing with soap among this high risk population in a healthcare facility setting in Bangladesh.
Le programme (CHoBI7Cholera-Hospital-Based-Intervention-for-7-days) est une intervention de traitement de l\'eau et de lavage des mains avec du savon pour les patients et les membres de leur famille qui est initialement administrée dans un établissement de santé. Cette étude a évalué l\'efficacité du programme CHoBI7 pour augmenter le lavage des mains au savon dans les établissements de santé. MÉTHODES: Un essai contrôlé randomisé du programme CHoBI7 a été mené auprès de 404 patients atteints de diarrhée et des membres de leur famille qui les accompagnent dans des établissements de santé à Dhaka, au Bangladesh. Le bras \"Message standard\" a reçu le message standard donné au Bangladesh aux patients atteints de diarrhée sur l\'utilisation de la solution de réhydratation orale. Le bras \"Visite de l\'établissement de santé + eau savonneuse\" a reçu le message standard, le module de communication CHoBI7 a été délivré au chevet du patient et une bouteille d\'eau savonneuse dans l\'établissement de santé. Le bras \"Visite de l\'établissement de santé + station de lavage des mains\" a reçu la même intervention, ainsi qu\'une petite station de lavage des mains en plastique. Dans les 24 heures suivant l\'intervention, une observation structurée de trois heures des pratiques de lavage des mains lors d\'événements liés aux selles/vomis et à la nourriture (événements clés) a été menée dans les établissements de santé. RÉSULTATS: Par rapport au bras ‘Message standard’, le lavage des mains au savon était significativement plus fréquent lors des événements clés dans le bras ‘Visite de l\'établissement de santé + Station de lavage des mains’ (58% contre 25%) (rapport de cotes (OR): 4,12 ; (intervalle de confiance (IC) de 95%: 1,86-9,14) et dans le bras ‘Visite de l\'établissement de santé + Eau savonneuse’ (51% contre 25%) (OR: 3,02 ; (IC95% : 1,41-6,45).
Ces résultats démontrent que l’implémentation du module CHoBI7 constitue une approche prometteuse pour augmenter le lavage des mains au savon dans un établissement de santé au Bangladesh.

This study investigates how patients and medical staff assess the physical environments of two recently built hospitals in Sulaimani City to understand the extent to which indoor environmental factors influence the creation of an optimal healing environment.
A contemporary healing environment may be recognized by the quality of an indoor environment in positively influencing patients\' psychological comfort and supporting their recovery.
Post-occupancy evaluations were conducted in Shar General Hospital and Faruk Medical City wards. A 43-item questionnaire was distributed to 312 patients, doctors, and nurses to gather their perspectives. In total, 175 valid questionnaires were retrieved.
The results show that the quality of the indoor environments met patients\' psychological needs and expectations, and as a result, they were generally satisfied with the indoor healing environments. The findings from the patient and medical staff surveys suggest three essential factors in creating a healing environment, which are (1) Interior appearance, (2) Privacy, and (3) Comfort and control. Significant negative correlations of some demographic characteristics, such as educational attainment and age, with patient satisfaction were observed.
This study shows that exploring patients\' and medical staff\'s experiences can reveal factors that positively influence patients\' satisfaction levels, which may vary depending on their sociocultural perspectives and personal characteristics. Additionally, the findings emphasize the role of the tested factors in increasing patients\' satisfaction levels, optimizing healing environments, and informing design decisions.

BACKGROUND: While there has been a trend for greater number of women to deliver at health facilities across Tanzania, mothers and their family members continue to face mistreatment with respectful maternity care during childbirth being violated. The objective of this study was to describe the experience of mothers and fathers in relation to (mis) treatment during childbirth in Tanzania.
METHODS: Using a qualitative descriptive design, 12 semi-structured interviews and four focus group discussions were held with mothers and fathers who were attending a postnatal clinic in the Lake Zone region of Tanzania. Mothers\' age ranged from 20 to 45 years whereas fathers\' age ranged from 25 to 60 years. Data were analyzed using a priori coding based on Bohren\'s et al. typology of the mistreatment of women during childbirth.
RESULTS: Mothers reported facing mistreatment and disrespectful maternity care through verbal abuse (harsh or rude language and judgmental or accusatory comments), failure to meet professional standards of care (refused pain relief, unconsented surgical operations, neglect, abandonment or long delays, and skilled attendant absent at time of delivery), poor rapport between women and providers (poor communication, lack of supportive care, denied husbands presence at birth, denied mobility, denied safe traditional practices, no respect for their preferred birth positions), and health system conditions and constraints (poor physical condition of facilities, supply constraints, bribery and extortion, unclear fee structures). Despite some poor care, some mothers also reported positive birthing experiences and respectful maternity care by having a skilled attendant assistance at delivery, having good communication from nurses, receiving supportive care from nurses and privacy during delivery.
CONCLUSIONS: Despite the increasing number of deliveries occurring in the hospital, there continue to be challenges in providing respectful maternity care. Humanizing birth care in Tanzania continues to have a long way to go, however, there is evidence that changes are occurring as mothers notice and report positive changes in delivery care practices.