BackgroundRegulation of private health care providers (PHPs) in middle-income countries can be challenging. Mandatory safety and quality standards for PHPs have been in place in the Republic of Srpska since 2012, but not all PHPs have adopted them yet. Adoption rates have differed among different types of providers. We studied three predominant types of PHPs to determine why the rate of adoption of the standards varies among them.MethodsThis study used a mixed methods approach, which allowed the integration of both quantitative and qualitative data, to develop an explanatory case study. The case study covered three types of private PHPs: pharmacies, dental practices and specialist practices. Primary data were collected through face-to-face semi-structured in-depth interviews and a self-administered postal survey of private health care providers. Our study’s theoretical framework was based on the diffusion of innovation theory.ResultsThe rate of adoption of mandatory standards varied among different types of PHP mainly due to four factors: (1) level of concern about negative financial consequences, such as the risk of fines or of losing contracts with the Health Insurance Fund of the Republic of Srpska; (2) availability of information on the standards and implementation process; (3) level of the relevant professional association’s support for the introduction of standards; and (4) provider’s perceptions of the relevant health chamber’s attitude toward the standards. Opinions conveyed to PHPs by peers slightly negatively influenced adoption of the standards at the attitude-forming stage. Perceived gains in professional status did not have a major influence on the decision to adopt standards. All three types of PHPs perceived the same disadvantages of the introduction of safety and quality standards: associated expense, increased administrative burden and disruption of service provision.ConclusionsWhen introducing mandatory quality and safety standards for PHPs, national health authorities need to: ensure adequate availability of information on the relative advantages of adhering to standards; support the introduction of standards with relevant incentives and penalties; and work in partnership with relevant professional associations and health chambers to get their buy-in for regulation of quality and safety of health services.Electronic supplementary materialThe online version of this article (10.1186/s12939-018-0806-0) contains supplementary material, which is available to authorized users.
Induced abortion is an important aspect of sexual and reproductive health, with potentially negative impact on physical and emotional health of women. The aim of this paper is to investigate the presence of abortion in our society, characteristics of women who had induced abortion and its impact on mental health. The results presented in this paper are part of the bigger study "Health Status, Health Needs and Utilization of Health Services", which was carried out in Republic of Srpska during 2010. Survey covered 1042 women age from 18 to 49. A standardized set of instruments in the field of sexual-reproductive and mental health (NHS, EUROHIS, ECHIM) was applied. Results indicate that 28.8 % of women had induced abortion, while nearly half of them (48.2%) had more than one abortion in their life. Induced abortion is more common among women over 38 years who already have children (97.1%) and live in rural parts of country (61.7%). Abortion is mostly preferred method of birth control among married woman (88.6%), woman with secondary school (64.5%), but is equally present among employed or unemployed woman and housewife's (around 1/3). There was a statistically significant but low correlation between current life satisfaction, mental health and induced abortion (F=8.0, p=0.000; Wilks' lambda =0.97; partial Eta-squared=0.03). More precisely, women who have had abortions have expressed higher levels of stress, lower levels of vitality, and were less satisfied with present life compared to those who did not have an abortion. High rates of induced abortion are present in Balkans countries for a long time (Rasevic, 1994: 86; Rasevic, 2011: 3). Higher rates of abortion, compared to the European Union and western neighbors, raises the question of presence of "abortion culture" (Rasevic and Sedlecki, 2011: 4). Abortion culture is the conse-quence of frequent use of traditional method of contraception (coitus interruptus) in combination with low availability of counseling and family planning. Lot of scientific rigorous studies indicate a specific connection between abortion and mental health without supporting attitudes which claim that abortion has a strong impact on mental health (Coleman, 2011: 183), as well as attitudes that deny any effect of abortion on mental health (APA, 2008). The results point the importance of promoting greater sexual-reproductive rights, free and responsible family planning and greater availability of contraceptives as safer methods of birth control.
Uvod. Anemija je važan javnozdravstveni problem prepoznat širom svijetabilo da se javlja izolovano ili udružena sa ostalim oblicima malnutricije.U 2016. godini prevalenca anemije u svijetu je kod žena u reproduktivnojdobi iznosila 32,0% odnosno postojala je kod 613 miliona žena starosti 15-49 godina. Cilj rada je bio utvrditi prevalencu anemije kod osoba ženskogpola u reproduktivnoj dobi (>15≤49 godina) u Republici Srpskoj i utvrditipovezanost između prehrambenih navika i prevalence anemije.Metode. Istraživanje je provedeno kao studija presjeka. Uzorak je dizajnirankao dvoetapni stratifikovani slučajni uzorak, sa popisnim krugovimaodabranim u prvoj etapi i domaćinstvima u drugoj etapi. Istraživanjem jeobuhvaćeno 1539 osoba ženskog pola starosti od 15 do 49 godina. Za ispitivanjeosnovnih sociodemografskih karakteristika uzorka i navika u ishraniispitanica korišćeni su za to posebno kreirani upitnici. Za mjerenje koncentracijehemoglobina u krvi korišćen je Photometer, HemoCue Hb 301/SET.Rezultati. Prevalenca anemije kod žena u reproduktivnoj dobi u RepubliciSrpskoj iznosi 11,8% i svrstava Republiku Srpsku u zemlje sa niskomprevalencom. Anemija se statistički značajno češće javlja (p<0,001) u starosnojkategoriji od 36 do 49 godina i na geografskom području Doboja iIstočnog Sarajeva (p=0,002). Analizom navika u ishrani, sa posebnim osvrtomna unos namirnica sa hem i non-hem željezom, dokazano je da osobebez anemije unose statistički značajno više namirnica sa hem željezom(p=0,009). Utvrđena je slaba, ali statistički značajna veza između upotrebesuplemenata željeza i odsustva anemije (r= -0,064, p=0,013).Zaključak. Republika Srpska spada u zemlje sa niskim opterećenjem anemijom,ali je neophodno nastaviti sa aktivnostima usmjerenim na unapređenjeishrane svih kategorija stanovništva, a posebno voditi računa o unosunamirnica sa hem željezom.
Social support appears to be related to mental status and self-perceived health.The results are intertwined with different age groups and they can provide baseline for further analysis of causal relationship between social support and mental and physical health among different age categories. Detecting a link among social support, mental and physical health could provide insight into the mechanisms of social support influencing health status and behaviour.
Osnovni cilj ovog rada je ispitati odnos između prihvatanja i pripisivanja kolektivne krivice i spremnosti na pomirenje među stanovništvom srpske etničke pripadnosti u Bosni i Hercegovini. Ispitaćemo koji faktori doprinose spremnosti na pomirenje sa osvrtom na karakteristike i razlike prisutne među mlađom generacijom koja je rođena i odrasla neposredno nakon posljednjih ratnih dešavanja u Bosni i Hercegovini u podjeljenim etničkim sredinama te starijom generacijom koja je odrasla u etnički heterogenim sredinama, a zatim preživjela rat tokom devedesetih. Istraživanjem je obuhvaćeno 406 ispitanika koji su ujednačeni prema dvije starosne kategorije (203 osobe mlađe generacije i 203 osobe starije generacije). Ispitivanje je sprovedeno među stanovništvom srpske etničke pripadnosti na području grada Banja Luka tokom novembra i decembra mjeseca 2014. godine. Primjenjeno je nekoliko standardizovanih mjernih skala: Skala kolektivne krivice (dvije podskale: Prihvatanje kolektivne krivice i Pripisivanje kolektivne krivice), Skala spremnosti za pomirenje, Skala identifikacije sa etničkom grupom, Skala stresnog ratnog iskustva. Rezultati dobijeni primjenom višestruke regresione analize ukazuju da varijable pol, identifikacija sa etničkom grupom, pripisivanje i prihvatanje kolektivne krivice te stresno ratno iskustvo objašnjavaju 41.5% varijanse spremnosti za pomirenje kod mlađe i 15.1% varijanse spremnosti na pomirenje kod starije generacije ispitanika. Prisutna je negativna povezanosti pripisivanja kolektivne krivice i pozitivna povezanosti prihvatanja kolektivne krivice sa spremnošću na pomirenje kod obe generacije ispitanika. Dobijeni rezultati potvrđuju rezultate prethodnih studija koje su utvrdile da prihvatanje kolektivne krivce podstiče spremnost na izvinjenje i reparaciju.
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