Effect on maternal and child health services in Rwanda of payment to primary health-care providers for performance: an impact evaluation

The Lancet ◽  
2011 ◽  
Vol 377 (9775) ◽  
pp. 1421-1428 ◽  
Author(s):  
Paulin Basinga ◽  
Paul J Gertler ◽  
Agnes Binagwaho ◽  
Agnes LB Soucat ◽  
Jennifer Sturdy ◽  
...  
2018 ◽  
Vol 2 (3) ◽  
pp. 1-10
Author(s):  
Lim Shiang Cheng ◽  
Jens Aagaard-Hansen ◽  
Feisul Idzwan Mustapha ◽  
Ulla Bjerre-Christensen

Introduction: Studies from many parts of the world have explored factors associated with poor diabetes self-management including Diabetes Self-Management Education (DSME). Research Methodology: This study was conducted among 162 diabetes patients at primary healthcare clinics in Malaysia using semi-structured exit-interviews to explore their perceptions, attitudes and practices in relation to self-care and encounters with primary health care providers. Results and Discussion: Generally, the patients had limited knowledge, lack of motivation and encountered difficulties in diabetes self-management. The DSME was inadequate due to limited time allocated for consultations with doctors, language barriers and the lack of interpersonal and communication skills of HCPs. Conclusion: In view of the positive effects of quality DSME on the health outcomes and quality of life among diabetes patients, it is important for the primary healthcare clinics in Malaysia to strengthen the diabetes services through training in communication of all HCPs, awareness of language difference and task shifting.


Objectives: The primary objective of this study is to assess three domains - the knowledge, attitude and practice related to the Intrauterine Contraceptive Device (IUCD) among primary health care providers (physicians and nurses) in Oman. The secondary objective is to compare the IUCD-related knowledge, attitude and practice of health care providers in primary health care between physicians and nurses. Methods: A descriptive cross-sectional survey was conducted in primary health care centers in Muscat region of Oman from May, 2014 until September, 2015. The survey was a self-administered questionnaire contained questions to assess factual knowledge, attitudes and practice of IUCD. The questionnaire was distributed to female health care providers only. Data was collected by researchers and analyzed using SPSS version 20. Results: Total 269 primary health care providers completed the questionnaire. 109 (40.52%) participants had good and 131 (48.70%) had average actual knowledge related to IUCD. The main reasons providers cited for not recommending the IUCD were concerns about the side effects; 174 (64.68%) mentioned that it causes bleeding and 127 (47.21%) reported that it needs service provider. Only 140 (52.43%) of the providers would routinely recommend IUCD to their clients. Conclusion: Future educational programs for health care providers should address the educational needs in the identified areas including misconceptions with regards to IUCD failure rate and side effects. Future training programs are also required to increase the technical competence of insertion and confidence in handling the side effects of IUCD.


PEDIATRICS ◽  
1981 ◽  
Vol 67 (1) ◽  
pp. 47-52
Author(s):  
Henry K. Silver ◽  
John E. Ott ◽  
Claibourne I. Dungy ◽  
Louis L. Fine ◽  
Virginia M. Moore ◽  
...  

More than 20 studies have been carried out of child health associates to assess their knowledge, training, and practice; their ability to interpret and integrate data; their cognitive knowledge and psychomotor and interpersonal skills; and their competence and effectiveness as primary health care providers. The results of the assessment and evaluation studies of child health associates indicate that they can determine the health status and manage the health care of patients in ambulatory settings and in the newborn nursery with a degree of skill and competence approaching that of pediatricians. Child health associates can provide comprehensive primary health care for more than 90% of children seen in these settings. The high degree of acceptance of child health associates by families and their demonstrated proficiency and cost-effectiveness document that they can be an important source of primary health care for most children.


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