Legacies of primary health care in an age of health sector reform: Vietnam's commune clinics in transition

Primary Health Care (PHC) is expected to serve as a basis for the country's health sector, of which it is the primary responsibility and priority, as well as the community's overall collective and economic prosperity. Promotion of food supply and proper nutrition are among eight elements of PHC. Protein deficiency is one of the most important health concerns in some parts of the world. A huge numbers of malnourished or hungry people have been reported particularly in the less developed countries. Advantages of aquaculture in nutrition are varied. However, there are some zoonotic microbial illnesses occurred due to consumption of infected seafood. Some of these challenges will be cor- rected by good aquaculture practices. With the right reforms in the aquaculture industry, progress can be made toward solving some of the challenges facing PHC delivery. In this mini-review, the benefits and risks of aquaculture foods in PHC are briefly discussed.

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The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox’s Bazar, Bangladesh

PLoS ONE ◽

10.1371/journal.pone.0253013 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253013

Author(s):

Rosanna Jeffries ◽

Hassan Abdi ◽

Mohammad Ali ◽

Abu Toha Md Rezuanul Haque Bhuiyan ◽

Mohamed El Shazly ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Primary Health Care ◽

Reproductive Health ◽

Health Services ◽

Sexual And Reproductive Health ◽

Health Sector ◽

Advisory Group ◽

Primary Health ◽

Working Groups

On August 25 2017, an unprecedented influx of Rohingya refugees began from Rakhine State in Myanmar into Bangladesh’s district of Cox’s Bazar. The scale and acuteness of this humanitarian crisis was unprecedented and unique globally, requiring strong coordination of a multitude of actors. This paper reflects on the health sector coordination from August 2017 to October 2019, focusing on selected achievements and persisting challenges of the health sector strategic advisory group (HSSAG), and the health sector working groups including epidemiology and case management, sexual and reproductive health, community health, mental health and psychosocial support, and emergency preparedness. In the early days of the response, minimum service standards for primary health care were established, a fundamental initial step which enabled the standardization of services based on critical needs. Similarly, establishing standards for community health outreach was the backbone for capitalizing on this important health workforce. Novel approaches were adopted for infectious disease responses for acute watery diarrhoea and varicella, drawing on inter-sectoral collaborations. Sexual and reproductive health services were prioritized from the initial onset of the crisis and improvements in skilled delivery attendance, gender-based violence services, abortion care and family planning were recorded. Mental health service provision was strengthened through community-based approaches although integration of mental health programmes into primary health care has been limited by availability of specialist psychiatrists. Strong, collaborative and legitimate leadership by the health sector strategic advisory group, drawing on inter-sectoral collaborations and the technical expertise of the different technical working groups, were critical in the response and proved effective, despite the remaining challenges to be addressed. Anticipated reductions in funding as the crisis moves into protracted status threatens the achievements of the health sector in provision of health services to the Rohingya refugees.

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Addressing inequities in access to primary health care: lessons for the training of health care professionals from a regional medical school

Australian Journal of Primary Health ◽

10.1071/py11040 ◽

2011 ◽

Vol 17 (4) ◽

pp. 362 ◽

Cited By ~ 3

Author(s):

Sarah Larkins ◽

Tarun Sen Gupta ◽

Rebecca Evans ◽

Richard Murray ◽

Robyn Preston

Keyword(s):

Health Care ◽

Primary Health Care ◽

Professional Education ◽

Health Care Professionals ◽

Health Care Services ◽

Underserved Populations ◽

Health Sector ◽

Care Services ◽

Primary Health ◽

Primary Health Care Services

Attention to the inequitable distribution and limited access to primary health care resources is key to addressing the priority health needs of underserved populations in rural, remote and outer metropolitan areas. There is little high-quality evidence about improving access to quality primary health care services for underserved groups, particularly in relation to geographic barriers, and limited discussion about the training implications of reforms to improve access. To progress equity in access to primary health care services, health professional education institutions need to work with both the health sector and policy makers to address issues of workforce mix, recruitment and retention, and new models of primary health care delivery. This requires a fundamental shift in focus from these institutions and the health sector, to each view themselves as partners in an integrated teaching, research and service-oriented health system. This paper discusses the challenges and opportunities for primary health care professionals, educators and the health sector in providing quality teaching and clinical experiences for increasing numbers of health professionals as a result of the reform agenda. It then outlines some practical strategies based on theory and evolving experience for dealing with some of these challenges and capitalising on opportunities.

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Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

International Journal of Health Services ◽

10.2190/hs.38.4.g ◽

2008 ◽

Vol 38 (4) ◽

pp. 697-715 ◽

Cited By ~ 15

Author(s):

Göran Dahlgren

Keyword(s):

Health Care ◽

Quality Of Care ◽

Primary Health Care ◽

Low Income ◽

Health Sector ◽

High Income ◽

Public Hospitals ◽

Primary Health ◽

Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

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Dynamics surrounding the Implementation of the Primary Health Care Approach in Zimbabwe’s Rural Areas: The Case of Mt Darwin District

International Journal of Clinical Inventions and Medical Science ◽

10.36079/lamintang.ijcims-0301.162 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1-17

Author(s):

Alouis Chilunjika ◽

Sharon R.T. Muzvidziwa-Chilunjika

Keyword(s):

Health Care ◽

Primary Health Care ◽

Rural Areas ◽

Health Sector ◽

Health Service Delivery ◽

Face To Face ◽

Primary Health ◽

Care Approach ◽

Health Related ◽

Research Findings

This research studied the implementation of the Primary Health Care approach to health service delivery in Zimbabwe’s rural areas from 2009 to 2012. The approach was launched in response to the Alma-Alta Declaration in 1978 which sought to end the inequalities in health care provision around the globe and was first adopted and implemented in 1982 in Zimbabwe. The approach almost collapsed due to the economic meltdown in the past decade but the period 2009 to 2013 marked a new economic paradigm in Zimbabwe which saw the economy being dollarized which subsequently led to the revival and the resuscitation of the health sector. It is therefore to explore the progress and the dynamics surrounding the implementation of the PHC at Mt Darwin Hospital in light of the dollarized economy. The study explores the dynamics surrounding the implementation of PHC at Mt Darwin District Hospital by particular attention to the following key elements: promotion of nutrition, sanitation, maternal and child care, immunization, treatment of common diseases and provision of essential drugs. Qualitative techniques such as face to face interviews with key informants and documentary research were used to generate data. The research findings revealed that PHC is a powerful tool in delivering health services in Mt Darwin. However, lack of material, financial and human resources have hindered the proper implementation of the PHC approach in Mt Darwin district. The study recommends multi sectoral collaboration in solving health related issues.

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Supporting Primary Health Care in Mongolia: Experiences, Lessons Learned, and Future Directions

10.22617/wps210020-2 ◽

2021 ◽

Author(s):

Altantuya Jigjidsuren ◽

Bayar Oyun ◽

Najibullah Habib

Keyword(s):

Health Care ◽

Primary Health Care ◽

Human Resources ◽

Health Sector ◽

Asian Development Bank ◽

Lessons Learned ◽

Development Bank ◽

Future Directions ◽

Health Sector Reforms ◽

Primary Health

ince the early 1990s, the Asian Development Bank (ADB) has broadly supported health sector reforms in Mongolia. This paper describes primary health care (PHC) in Mongolia and ADB support in its reform. It highlights results achieved and the lessons drawn that could be useful for future programs in Mongolia and other countries. PHC reform in Mongolia aimed at facilitating a shift from hospital-based curative services toward preventive approaches. It included introducing new management models based on public–private partnerships, increasing the range of services, applying more effective financing methods, building human resources, and creating better infrastructure. The paper outlines remaining challenges and future directions for ADB support to PHC reform in the country.

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Exercício da prática odontológica na atenção primária à saúde durante o enfrentamento à COVID-19: revisão narrativa de literatura

Journal of Dentistry & Public Health ◽

10.17267/2596-3368dentistry.v11i2.3126 ◽

2020 ◽

Vol 11 (2) ◽

pp. 188

Author(s):

Síntique Lopes ◽

Marcela Moreira ◽

Maria Cangussu

Keyword(s):

Health Care ◽

Primary Health Care ◽

Literature Review ◽

Health Sector ◽

Working Process ◽

Eligibility Criteria ◽

Multiprofessional Team ◽

Primary Health ◽

The Face ◽

Online Library

INTRODUCTION: Coronavirus Disease 2019 - COVID-19, whose etiological agent is the SARS-CoV-2 virus, promoted global alert in 2020. In this context, in Brazil, the health sector, especially Primary Health Care (PHC), has been imbued with adaptations with a view to containing the disease. Among the professional actions in this scenario, dentistry stands out as a participant of the multiprofessional team in the fight against COVID-19. OBJECTIVE: to present narrative review of the literature about the practice of dental in PHC in face of COVID-19. METHODS: This is a literature review, whose search was made through the retrospective analysis of government regulations/protocols on the subject, as well as through the electronic databases Pubmed/MEDLINE, Scielo, Wiley Online Library and LILACS. The descriptors previously consulted in MeSH were: "dentistry"; "oral health"; "public health"; primary health care; COVID-19". It should be noted that the studies were selected from the titles and abstracts, later read in full, and those that met the eligibility criteria were considered. LITERATURE REVIEW: To understand the working process of the dentist, the epidemiological aspects, diagnosis and treatment of COVID-19 were understood, as well as the admission of the risk character of dentistry for this health context. For this purpose, it was also considered the legitimacy of PHC as a potency in containing the expansion of the current pandemic. CONCLUSION: Changes were suggested to the exercise of dental practice in the face of the pandemic caused by SARS-CoV-2. However, further research will be needed to ascertain their impact on population care.

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Workload Assessment of Medical Doctors at Primary Health Care Centers in the Duhok Governorate

10.21203/rs.3.rs-915782/v1 ◽

2021 ◽

Author(s):

Samim Ahmed Al-Dabbagh ◽

Hushyar Musa Sulaiman ◽

Nazik Abdulrahman Abdulkarim

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Sector ◽

Health Care Facilities ◽

Medical Doctors ◽

Cross Sectional ◽

Primary Health ◽

Physician Shortages ◽

Primary Health Care Centers ◽

Health Care Centers

Abstract Background: A shortage in human resources, particularly physicians, has become a challenge confronting health authorities in the Duhok governorate, as these resources are the key input for delivering health care. It has become necessary to identify the most appropriate scientifically sound method for having adequate staffing levels. This study aimed to forecast the required number of physicians to cope with the current workload at the main primary health care centers in the Duhok governorate.Methods: A cross-sectional study was adopted to collect data for one full year. Data collection included both primary and secondary data sources. A semi-structured questionnaire was developed to obtain information every month from health centers on activities related to training and leaves. Data analysis was performed using Workload Indicators of Staffing Need software.Results: Sixty-one primary health care centers met the final criteria for analysis. The study revealed physician shortages and inequity in the distribution of staffing. In these centers, 145 physicians lacked an adequate delivery of health services based on the workload imposed on them. The 'workload indicators of staffing need' ratio was 0.33, indicating high work pressure on medical doctors. Some centers offered more health care than others but had fewer doctors based on the current staffing practices. Conclusions: This study pointed out the importance for the public health sector and academic medical institutions to use Workload Indicators of Staffing Needs software in health policy administration to restructure their efforts to address the physician shortages and distribution imbalances at primary health care facilities.

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Influence of Interpersonal Processes on the Performance of Primary Health Care Organizations

Sustainability ◽

10.3390/su132112243 ◽

2021 ◽

Vol 13 (21) ◽

pp. 12243

Author(s):

Duško Čučković ◽

Ilija Ćosić ◽

Milan Delić ◽

Miroslav Miškić ◽

Slavica Ranisavljev Kovačev

Keyword(s):

Health Care ◽

Primary Health Care ◽

Structural Equation ◽

Health Sector ◽

Medical Personnel ◽

Equation Modeling ◽

Interpersonal Processes ◽

Patient Centeredness ◽

Education Of Patients ◽

Primary Health

Processes in the health sector include diagnostics, treatment, rehabilitation, prevention, education of patients, and all other interactions between qualified medical personnel and patients. Interpersonal processes pertain to the psychosocial aspect of said activities and include variables that describe communication, continuity, patient awareness, and the degree of patient involvement and influence the performance of health institutions in primary health care (PHC). The dimensions of importance for researching the influence of indicators of interpersonal processes on the performance of PHC organizations were identified, taking into account the underlying theory and specifics and characteristics of PHC. This paper studies the influence that patient-centeredness, as a dominant dimension that encompasses interpersonal processes, has on effectiveness, i.e., outcomes presented through health-related quality of life (HRQOL). Data on the factors of importance for this research subject were collected in the Republic of Serbia, while data analysis was carried out using partial least squares structural equation modeling (PLS-SEM). The research results show a complex relationship between indicators of interpersonal processes, highlight the importance of this group of processes for increasing the effectiveness of PHC organizations, and demonstrate the influence of interpersonal processes on the performance of PHC organizations.

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