Browsing by Author "Czabanowska, Katarzyna"

Now showing 1 - 6 of 6
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    Exploring the Influence of Sociodemographic Characteristics on the Utilization of Maternal Health Services: A Study on Community Health Centers Setting in Province of Jambi, Indonesia
    (MDPI, 2022-07-11) Herwansyah, Herwansyah; Czabanowska, Katarzyna; Kalaitzi, Stavroula; Schröder-Bäck, Peter; Health Policy and Management, Richard M. Fairbanks School of Public Health
    The Maternal Mortality Ratio in Indonesia has remained high, making it a national priority. The low utilization of maternal health services at community health centers is considered to be one of the reasons for poor maternal health status. This study aims to assess the influence of sociodemographic factors on utilization of maternal health services. The analysis was completed using binary and logistic regression to examine the association between sociodemographic variables and maternal health services utilization. A total of 436 women participated in the survey. In the multivariable analysis, age, education, ethnicity, parity status, distance to health centers and insurance ownership were associated with the utilization of maternal health services. Ethnicity (OR, 2.1; 95% confidence interval, 1.4-3.3) and distance to the CHC (OR, 0.5; 95% confidence interval, 0.3-0.8) were significantly associated with ANC visits. The association between parity and place of delivery was statistically significant (OR, 0.8; 95% confidence interval, 0.5-1.4). A positive association between basic health insurance ownership and PNC services was reported (OR, 0.3; 95% confidence interval, 0.1-0.6). Several sociodemographic factors were positively associated with the utilization of maternal health services at the CHCs. The required measures to improve the utilization of maternal health services at the CHCs level have to take into consideration the sociodemographic factors of reproductive age women.
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    Global health leadership: Recall the past to better understand the present
    (2020) Kalaitzi, Stavroula; Czabanowska, Katarzyna; Babich, Suzanne; Health Policy and Management, School of Public Health
    The COVID-19 pandemic makes us reflect on the lessons learnt from history, which witnessed the loss of lives, opportunities and leadership. The authors attempt to discuss the implications of the past on dealing with the contemporary health crisis. The scale and unpredictability of the coronavirus have shaken our systems and access to them in a significant way. Regardless of gender, race, ethnicity, religion, or age, health care leaders at every level of health system including frontline health care professionals such as nurses, physicians and medical rescuers are confronted with the unprecedented situations that require values-driven, ethical approaches. A once-in-a-hundred-years pandemic offers an opportunity for health leaders to reconsider and refresh the values and priorities they espouse, renew a commitment to strive for a more humanized approach to the pandemic, solidarity, equality and democracy and, of course, shared, scientific knowledge. As we learn from history, humanity will celebrate a victory against current and future pandemics.
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    Leadership Changes to Support Healthcare Providers with Long COVID Care
    (2025-04) Weideman, Angela Katherine; Czabanowska, Katarzyna; Bigatti, Silvia; Modji, Komi
    Objective: To explore how public health leaders and long COVID stakeholders from the Midwest United States can best support healthcare providers in providing long COVID care and how they can help ease the burdens of such care. Data sources and study setting: Qualitative interviews with 34 long COVID stakeholders from the Midwest region of the United States, from 15 different stakeholder groups, were collected from December 2024 to February 2025. Study Design: The research design was a qualitative study in which key informant interviews were conducted with stakeholders of long COVID using a semi-structured interview. Data collection: Semi-structured, one-on-one interviews were conducted virtually using Microsoft teams, and interviews were audio recorded and transcribed using Microsoft teams. Interviews were then coded using NVivo for inductive coding, used to identify and describe themes. Principal findings: The challenges identified related to diagnosis, access to care, provider concern, communication, and treatment. Stakeholders identified that they have impact and influence related to helping patients get to diagnosis and treatment more quickly, setting or supporting policies, making long COVID a priority in their organizations, making it easier for people to access long COVID care, and to support the people who are giving long COVID care. Numerous strategies were offered by stakeholders for supporting healthcare providers who are providing long COVID care. These include better characterization of the disease, increased treatment options, increased prevention efforts, advocacy, communication strategies, support for providers, collaboration with stakeholders, policy development, and learning from the success of advancement of care for other chronic conditions. Conclusion: Long COVID is a novel condition that requires change leadership support especially in the areas of diagnosis, access to care, communication, treatment, and provider knowledge and relations. It will take a multidisciplinary approach from a variety of stakeholders to create and implement a plan to support healthcare professionals who provide long COVID care. If these changes can be implemented and maintained, those who are suffering with long COVID symptoms can get to diagnosis and treatment more quickly and receive better quality care and treatment. This will have a positive impact on long COVID patients, their family members, employers, schools, medical professionals, health systems, governments, and the economy.
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    Physician Compensation Models and Quality of Healthcare Services in the United Arab Emirates
    (2023) Elrefaey, Mahmoud; Tierney, William Michael; Babich, Suzanne M.; Czabanowska, Katarzyna
    Physicians working in different healthcare systems receive financial compensation by means of several structures (e.g., the salaried model, the fee-for-service model, and the revenue-share model) depending on how and where they practice. Most research on the relationships, if any, between physicians' compensation models and the outcomes of healthcare services has been conducted in North America and Europe, but no equivalent research has been conducted in the United Arab Emirates (UAE). The purpose of my exploratory qualitative research study was to address two open-ended research questions: 1) what are the perceptions of hospital stakeholders about the idiographic effects of different physician payment models on quality of healthcare services in the hospital? 2) What changes might be implemented to physician payment models to improve healthcare services in the hospital? I audio-recorded semi-structured interviews with a purposive sample of N = 17 stakeholders at one private sector hospital in UAE. The heterogenous or maximum variation sample included five hospital leaders, two financial or insurance managers, five physicians, two nurses, and three patients. I conducted a qualitative analysis and identified ten primary semantic themes by deductive reasoning to address the first research question. I based four semantic themes on a template extracted from the literature, specifically: 1) Physician Payment Models Implemented at the Hospital; 2) Environmental Context for Payment Models; 3) Stakeholders Affected by Payment Models; 4) Misuse of Payment models. I underpinned six semantic themes by the dimensions of healthcare quality proposed by the Institute of Medicine, specifically: 5) Payment Models and Safe Care; 6) Payment Models and Effectiveness of Care; 7) Payment Models and Patient-Centered Care; 8) Payment Models and Timely Care; 9) Payment Models and Efficiency of Care; 10) and Payment Models and Equity of Care. Subsequently, I synthesized the semantic themes and identified two latent themes by inductive reasoning, specifically: 1) Relationships between Physicians' Compensation Models and Healthcare Services; and 2) Proposed Changes to Physician Compensation Models. I propose innovative changes underpinned by Kotter's Management Change Theory and Roger's Theory of Diffusion of Innovations. I recommend future confirmatory research using a quantitative correlational design to validate these themes.
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    Stroke Training, Research, and Education Toward Capacity With Hydroxyurea (Stretch)
    (2024-05) Latham, Teresa Smith; Czabanowska, Katarzyna; Babich, Suzanne M.; Ware, Russell E.; Yego-Kosgei, Faith
    Background and Purpose: Sickle cell anemia (SCA) is an inherited hematological disease characterized by chronic pain, susceptibility to infections, and significant morbidity and mortality, particularly among children living in resource-limited settings. Stroke is a complication of SCA that can be prevented through transcranial Doppler (TCD) ultrasonography, a screening tool that identifies children at risk, and treatment with hydroxyurea. This study will inform how public health leaders can mitigate stroke risk among children with SCA in sub-Saharan Africa and how TCD screening fits into a larger context of providing safe, effective care. Methods: Stroke Training, Research, and Education Toward Capacity with Hydroxyurea (STRETCH) utilized a qualitative design that included semi-structured interviews with TCD examiners and stakeholders. There were 17 interviews with TCD examiners who participated in a training and supervision program, TCD trainers, and clinical care providers from 6 countries across sub-Saharan Africa. Interviews were coded and analyzed for themes that were used to identify effective training and program strategies, and to develop a capacity-building model for resource-limited settings. Results: Participants reported satisfaction with the training program, noting that in-person training with sub-Saharan Africa-based examiners was preferable to initial training using a web-based platform, and that ongoing training, supervision, and technical support through collaboration between US-based and Africa-based teams was conducive to skill development. Participants described the major clinical and socioeconomic impact of SCA on children, families and communities and emphasized the role of hydroxyurea in preventing complications and decreasing burden on health systems. Results indicate a call to action for improved education for clinicians, families, and community leaders and stakeholder support for health policy to facilitate access to hydroxyurea. Conclusion: The complexities of healthcare infrastructure and the morbidity and mortality associated with SCA in resource-limited settings warrant a multifaceted approach to capacity building. The STRETCH model integrates education, policy development, and access to hydroxyurea as a holistic approach that leverages geographical partnerships and builds on existing resources in sub-Saharan Africa. By simultaneously addressing education, policy, and access barriers, public health leaders can work collaboratively toward building sustainable capacity that improves outcomes for children with SCA in these settings.
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    The utilization of maternal health services at primary healthcare setting in Southeast Asian Countries: A systematic review of the literature
    (Elsevier, 2022) Herwansyah, Herwansyah; Czabanowska, Katarzyna; Kalaitzi, Stavroula; Schröder-Bäck, Peter; Community and Global Health, Richard M. Fairbanks School of Public Health
    The reduction of Maternal Mortality Ratio (MMR) remains a global health issue. Although major progress has been achieved in the past 15 years, the ratio is still high, especially in Low Middle-Income Countries. In the Southeast Asian region, most of the countries have not reached the Sustainable Development Goals target yet. Although the countries have several similarities in many aspects, such as community characteristics, cultural context, health systems, and geographical proximity, the MMR in the region presents interesting variations. The scope of this systematic review is to explore published literature on the utilization of maternal health services at the community healthcare centre setting in Southeast Asian countries. The databases PubMed, Web of Science, and Google Scholar were searched systematically to identify quantitative, qualitative and mixed methods studies published in 2000–2020. A total of 1876 records were found, out of which 353 full text were screened. Finally, 27 studies on utilization of maternal health services met the inclusion criteria and were selected for analysis from seven Southeast Asian countries: Cambodia, Indonesia, Lao PDR, Myanmar, The Philippines, Timor Leste and Vietnam. Most of the articles focused on the utilization of maternal health services at primary health care setting. Several themes on maternal health services utilization in the countries emerged, including cultural and socioeconomic factors contributed to the utilization of maternal health services, factors associated with the low utilization of ANC, determinants affected place of delivery and delivery assistance choice. The utilization of maternal health services at primary healthcare setting in seven Southeast Asian countries was identified in a small number of studies. Sociocultural barriers and disparities of health services provision are the major factors associated with low utilization of the services. Further research on strengthening the role of primary healthcare in maternal health services provision is required.