eMagazine March 2023

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OUR PEOPLE, OUR MISSION Global Health eMagazine March 2023 Highlights Reviews GH Narrative Reflections Hispanic and Latinx Voices Global Local Voices of Ugandan Students Nursing Division Women’s Health Education Innovation and Technology Our Beautiful Planet Art to Remind Us of Who We Can Be two Medicare programs set to expire in October which provided $600 million in additional funding for rural hospitals (H.R.5305, 2021). Another notable past federal intervention took place in 1997 when the Centers for Medicare and Medicaid Services (CMS) established the “critical access” designation for hospitals across the nation. Those that qualified received 101% reimbursement for eligible patients (CMS, 2022). On top of bills and agencies, the National Health Service Corps (NHSC) is a federal program which seeks to provide incentives for newly certified providers to work in rural communities and address the staffing shortage. This wide variety of federal initiatives have sought to address the problem, but not many have made major inroads. At the state level, officials have proposed solutions for this problem and have a different structure than many federal policies. For instance, the Pennsylvania Rural Health Model was launched in January 2017 and uses a different approach for CMS payments. It requires payers to provide eligible hospitals with a fixed amount to cover all hospital care and services while the hospitals, in turn, work on improving quality and efficiency of care. This model also sets a series of metrics to track performance and ensure that participating hospitals meet the necessary standards and continue on a growth trajectory (CMS, 2017). There have been other proposed reforms, one being a Hub and Spoke Model in Georgia but was not as effective as that of Pennsylvania. Future ideas must include components at the federal and state level to generate true impactful reform. The issue of rural hospital closures is one of intricacy with multiple facets. There are several causes that have contributed to this situation, with the pandemic only exacerbating the challenges. Many of the struggles can be narrowed to the way payments are structured with the high number of Medicare and Medicaid patients served. While still important to push for increased staffing through the NHSC or improve health awareness campaigns in rural communities, meaningful reform will only come about through revamping federal payment design. This will lead to consistent revenue for rural hospitals and reduce the number of closures each year. No matter the path, significant reform must be pursued to improve access to healthcare for all Americans. Article of the Month You’re Invited Photo News Calendar Global Health Family Resources Previous Issues of the eMagazine Click here to visit the Nuvance Health Global Health Program COVID-19 Resource Center 24
OUR PEOPLE, OUR MISSION Global Health eMagazine March 2023 Highlights Reviews GH Narrative Reflections Hispanic and Latinx Voices Global Local Voices of Ugandan Students Nursing Division Women’s Health Education Innovation and Technology The Voice of Ugandan Students Section Editor: Joshua Matusuko “NODDING DISEASE” THE MYSTERY DISEASE OF NORTHERN UGANDA Written by Joshua Matusuko Medical student at MaKCHS Nodding syndrome is an unexplained neurologic condition characterized by episodes of repetitive dropping forward of the head, often accompanied by other seizure-like activity, such as convulsions or staring spells. In 1997 and 1998, strange and peculiar symptoms started happening in children that later led to the retrospective diagnosis of the nodding syndrome in the Kitgum and Pader districts of Northern Uganda. Children began suffering seizures, not occasionally, but numerous times a day. Their neck muscles would go temporarily limp, causing their heads to bob. This illness, which later came to be called nodding syndrome, posed many scientific and clinical questions that no doctor could answer. Its origin is unknown, and has devastated many: causing severe developmental delays and psychiatric disturbances. Many died from having seizures that resulted in burns, falls, or drowning. Our Beautiful Planet Art to Remind Us of Who We Can Be Article of the Month You’re Invited Photo News Calendar Global Health Family Resources Previous Issues of the eMagazine Healthcare professionals report nodding syndrome cases in South Sudan, from the states of Western, Central Equatorial as well as southern Tanzania. The Ugandan Students continued on next page >> 25
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