Exploring the Potential of a Multi-Level Approach to Advance the Development of the Medical Tourism Industry in Indonesia

Nowadays, the global medical tourism market size has grown quite rapidly, with a projected increase of 21.1% between 2021 and 2028. This study aimed to explore barriers and potential strategies for the development of medical tourism in Indonesia. A qualitative case study design was employed, where 8 respondents were selected using an expert sampling method from various groups according to the helix framework, including academics, government, professional organizations, the private sector, and the media. Data was collected through document analysis and in-depth interviews, and was analyzed manually using an inductive thematic content analysis approach. Limitations to the development of Indonesian medical tourism are related to regulations concerning medical tourism, the number of health services, distribution, supporting resources, public trust, and competition. At the institutional level, the challenges comprise services and products, hospital facilities, supporting facilities, and marketing processes. Furthermore, at the micro level, the low competency of both health and non-health workers persist as an obstacle. The potential strategy at the macro level include the development of robust marketing and branding strategies, health infrastructure, and resources. At the institutional level, it was necessary to develop related products and services provided, improve quality, and focus on branding and marketing strategies. Additionally, improving human resource skills was needed at the micro level.

Feasibility, acceptance and factors related to the implementation of telemedicine in rural areas: A scoping review protocol

Background

Telemedicine is a quickly developing service that offers more people the access to effective and high-quality healthcare. Societies residing in rural places tend to travel long distances to receive health care, usually have limited access to health care and/or postpone getting health care until a health emergency occurs. However, for telemedicine services to be accessible, a number of prerequisites including the availability of cutting-edge technology and equipment in rural areas must be present.

Objective

This scoping review aims to collect all available data on the viability, acceptability, challenges and facilitators of telemedicine in rural areas.

Methods

PubMed, Scopus and Medical collection of ProQuest are the databases chosen for an electronic search of the literature. Identification of the title and abstract will be followed by an evaluation of the paper's accuracy and eligibility in a two-fold mode; whereas the identification of papers will be openly and completely described using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) flowchart.

Conclusion

This scoping review would be among the first to offer a thorough evaluation of issues related to the viability, acceptance and implementation of telemedicine in rural areas. In order to improve the conditions of supply, demand and other circumstances relevant to the implementation of telemedicine, the results would be helpful in providing direction and recommendations for future developments in the usage of telemedicine, particularly in rural areas.

Determinants of prelacteal feeding practice in Uganda; a population based cross-sectional study using Uganda demographic and health survey data

Background

Breastfeeding has well-established short-term and long-term health benefits for both the mother and infant. Initiating breastfeeding immediately after birth stimulates breast milk production. Prelacteal feeding (PLF) may result in late initiation of breastfeeding, and thus insufficient production of breast milk. This study aimed to identify the determinants of PLF among children under five years in Uganda.

Methods

This cross-sectional study was conducted using the data from the database of Uganda Demographic and Health Survey 2011. The data of 4,774 children/mothers were evaluated in this study.

Results

The prevalence of PLF was 40.3%. The rate of PLF practice was found to be 2.15 times higher in women with moderate economic status and 2.02 times higher in women with high economic status compared to those who have low economic status. The rate of PLF practice was found to be 1.73 times higher in newborns delivered by an unskilled birth attendant and 4.35 times higher in newborns delivered with no birth attendant compared to those infants delivered by a skilled birth attendant. The ratio of PLF practice was found to be 2.49 times higher in multiple births. Mothers who initiated breastfeeding in the first 24 hours after birth had higher odds of PLF. No relationship was found between PLF practice with some sociodemographic characteristics of mother's (age, marital status, educational status, religion, residential location), maternal factors (number of children, antenatal and postnatal care attendance, place of delivery), and characteristics of the newborn infants (sex, type of delivery, birth order number) in the multivariate logistic regression analysis.

Conclusions

All mothers should be informed about the importance of initiation of breastfeeding immediately after delivery, the risks associated with PLF, the optimal practices for breastfeeding, and the presence of a skilled birth attendant at delivery.

The Impact of Large-scale Social Restriction on COVID-19 Incidence: A Case Study of Four Regions in Indonesia

The Indonesian government has chosen to implement large-scale social restrictions, or Pembatasan Sosial Berskala Besar (PSBB), to minimize the spread of COVID-19. PSBB is a government policy aimed at restricting the internal movement of people in a bid to reduce the spread of SARS-CoV-2. This study aims to assess the impact of such large-scale social restriction measures on the incidence of COVID-19 cases in four provinces of Indonesia. Time series analysis was used to describe trends in COVID-19 cases by using surveillance data from the Ministry of Health of Indonesia. Quasi-Poisson regression with an interaction model was used to estimate the incidence rate ratio (IRR), and this was calculated to compare the incidence rate before and during PSBB implementation. The trend in COVID-19 cases in the provinces of West Java, East Java, Banten, and Jakarta has continued to fluctuate. These four provinces have continued to experience a significant increase in the COVID-19 incidence rate ratio after the implementation of the first and second PSBB periods compared to the  period before PSBB implementation. Lack of proper implementation of the large-scale social restrictions has led to PSBB’s ineffectiveness in reducing the number of COVID-19 cases in each of the provinces.