This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the author's institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. b s t r a c tBackground: The burgeoning health burden in Indonesia requires strengthening primary care services through interprofessional collaboration. Purpose: to explore factors contributing to interprofessional collaboration within health centres Indonesia. Methods: Eight focus group discussions involving a range of health professionals from health centres were conducted in four districts in East Java, Indonesia. Thematic analysis was used to generate findings. Results: Collaborative practices in Indonesian health centres are directly affected by health professional interactions (personnel level) e hierarchy and lack of role understanding have been reported as barriers to the interactions. These factors are in turn affected by health centre's environment (organisational level) and the Government legislation/policy (health system). The health centre's environment included organisation's culture, team management, physical space, as well as communication and coordination mechanisms. Conclusions: Factors contributing to collaborative practices in this setting were complex and intertwined. Structuring collective actions or strategies would be required to address the identified collaborative issues.
Objectives This study aimed to define the problems of the current use of the e-Catalogue and the national formulary (NF)—two elements of medicine pricing and reimbursement policies in Indonesia for achieving universal health coverage (UHC)—by examining the knowledge and attitudes of stakeholders. Specifically, to investigate (1) the perceived challenges involved in the further implementation of the e-Catalogue and the NF, (2) reasons of prescribing medicines not listed in the NF, and (3) possible improvements in the acceptance and use of the e-Catalogue and the NF. Methods Semi-structured interviews were conducted with stakeholders (policymakers, healthcare providers, a pharmaceutical industry representative, and experienced patients) to collect the qualitative data. The data was analysed using directed content analysis, following the guidelines of the COnsolidated criteria for REporting Qualitative studies (COREQ) in reporting the findings. Results Interestingly, 20 of 45 participants decided to withdraw from the interview due to their lack of knowledge of the e-Catalogue and the NF. All 25 stakeholders who fully participated in this research were in favor of the e-Catalogue and the NF. However, interviewees identified a range of challenges. A major challenge was the lack of harmonization between the lists of medicines in the e-Catalogue and the NF. Several system and personal reasons for prescribing medicines not listed in the NF were identified. Important reasons were a lack of incentives for physicians as well as a lack of transparent and evidence-based methods of selection for the medicines to be listed in the NF. Conclusions The e-Catalogue and the NF have not been fully utilized for achieving UHC in Indonesia. Some possible improvements suggested were harmonization of medicines listed in the e-Catalogue and the NF, restructuring incentive programs for prescribing NF medicines, and increasing the transparency and evidence-based approach for selection of medicines listed in the e-Catalogue and the NF.
Over a 10 year + follow-up period Asian subjects had a higher risk of stroke than CHD. Contrary to CVD prevention in Western countries, strategies should also consider stroke instead of CHD only.
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