Community Medicine and Education Journal
CMEJ covers all subjects regarding community medicine and education. The covered research areas as follows community medicine, public health, epidemiology and biostatistics, health policy and administration, public health nutrition, environmental health, occupational health and safety, health promotion, reproductive health, maternal and child health, quality of life, health literacy and communication and their role in developing new healthcare programs, Arts of teaching, Case studies from schools around the world, Change management and education quality, Citizenship education, Classroom management, Computers in educational administration, Differing cultural perceptions of management in education, Distance education and multimedia environments, Early Childhood Education, Economics of education, Educational administration, Education environments (political, social, legal, cultural), Educational leadership, Educational policy and management, Educational systems planning/strategic planning, E-education / E-learning, Entrepreneurial development, Equity and education, Finance and accountability in education, Globalization and education, Human resources management, Individual professional learning portfolio, Information Communication Technologies (ICT) in Education, Special Education and Theories of educational management.
Articles
112 Documents
Sustaining Infection Prevention and Control Post-Accreditation: A Systematic Review and Meta-Analysis of Global Longitudinal Outcomes
Adhika Rahman;
Siswanto Pabidang
Community Medicine and Education Journal Vol. 7 No. 1 (2025): Community Medicine and Education Journal
Publisher : HM Publisher
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DOI: 10.37275/cmej.v7i1.872
Hospital accreditation is globally recognized as a strategic framework for standardizing healthcare quality. However, the long-term efficacy of accreditation in sustaining Infection Prevention and Control (IPC) practices and reducing Healthcare-Associated Infections (HAIs) remains fiercely debated. Most existing literature relies on cross-sectional data, failing to capture the temporal stability of post-accreditation outcomes. A systematic review and meta-analysis were conducted following PRISMA guidelines. We analyzed longitudinal, interrupted time-series, and pre-and-post research articles evaluating IPC compliance and HAI incidence before, during, and after accreditation cycles. Data extraction focused on sample sizes, means, and standard deviations to calculate the Standardized Mean Difference (SMD) using a DerSimonian-Laird random-effects model. Heterogeneity was assessed via the I-squared statistic. Eight longitudinal studies encompassing varying international healthcare contexts were included. The pooled meta-analysis demonstrated a statistically significant, moderate improvement in IPC outcomes post-accreditation, with an overall SMD of 0.52 (95 percent Confidence Interval: 0.38 to 0.66, p < 0.001). Subgroup analyses revealed that structural IPC compliance measures showed higher effect sizes (SMD = 0.58) compared to direct clinical outcomes like HAI incidence density reductions (SMD = 0.42). Moderate heterogeneity was observed (I-squared = 54 percent). In conclusion, hospital accreditation acts as a significant catalyst for improving IPC metrics over time. The moderate effect size on direct clinical outcomes suggests that accreditation provides a structural foundation that must be coupled with continuous quality improvement and strong institutional leadership to prevent post-survey decay.
The Pentahelix Approach to Oral-Systemic Health Integration: A Policy Framework for Academic-Primary Care Partnerships in Transitional Health Systems
Zelka Dapala;
Rachmat Hidayat;
Muhammad Ashraf
Community Medicine and Education Journal Vol. 6 No. 2 (2025): Community Medicine and Education Journal
Publisher : HM Publisher
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DOI: 10.37275/cmej.v6i2.877
The historical bifurcation of dental and medical care pathways imposes a severe epidemiological burden, particularly within transitional health systems confronting a high prevalence of both non-communicable diseases and chronic periodontitis. Bridging this gap requires robust policy frameworks that extend beyond clinical interventions to involve cross-sectoral collaboration. To evaluate the structural efficacy, clinical outcomes, and policy implications of integrating oral-systemic healthcare using a Pentahelix collaborative model between primary healthcare centers and academic dentistry institutions in South Sumatra, Indonesia. A mixed-methods implementation study was conducted over eighteen months across twelve primary care centers in South Sumatra. The intervention utilized the Pentahelix model, integrating government authorities, academic dentistry faculties, health technology industries, community leaders, and local media. Quantitative data included inter-departmental referral completion rates, changes in patient glycemic control (HbA1c), and systemic inflammatory markers (C-Reactive Protein). Qualitative data assessed stakeholder engagement and interprofessional competencies. Implementation of the Pentahelix framework significantly improved medical-dental cross-referral completion rates from a baseline of twelve percent to seventy-six percent. Clinically, patients with comorbid type 2 diabetes and severe periodontitis receiving integrated care demonstrated a mean HbA1c reduction of 0.9% and a significant decrease in serum C-Reactive Protein levels following combined medical and non-surgical periodontal therapy. Furthermore, interprofessional competency scores among participating academic students and primary care staff increased significantly. In conclusion, the Pentahelix model provides a viable, highly effective policy framework for dismantling clinical silos in transitional health systems. By anchoring interprofessional clinical practice within a multi-stakeholder governance structure, health systems can achieve measurable improvements in both population health metrics and health workforce readiness.