Postpartum depression guidelines for public health practitioners: Putting primary health care into action

2005 ◽  
Author(s):  
Peggy Strass
Author(s):  
Syed M. Ali ◽  
Satwinder Rehal

Background: In resource-limited settings, national tuberculosis (TB) control programmes are highly dependent on external funds, which may pose a challenge to programme sustainability. There is a recognized need for developing guidance around sustainable programming of current TB control initiatives. Aims: The aim of this study was to explore public health practitioners’ perspectives on the sustainability of TB control initiatives in Pakistan at the primary health care (PHC) level. Methods: Guided by an interpretive epistemology, online in-depth interviews were conducted with 10 public health practitioners who had experience as resource planners in the TB control programme in Pakistan. Thematic content analysis was employed to the textual data as the analytical approach. Results: Three themes were inductively derived from the thematic analysis: community involvement, stakeholder engagement and efficient use of the PHC system. Community involvement was a determinant in sustaining TB control initiatives. This was attributed to the nature of the disease and prevalent health seeking behaviour. Stakeholder engagement was associated with funding arrangements between public and private partners and considered important in how new initiatives can be made part of the routine structure. Overall, having an efficient PHC system was deemed critical in sustaining current TB control initiatives at the PHC level in Pakistan. Conclusion: Fostering an enabling operational environment through regulations, supporting the utilization of existing resources, expanding the network of providers, inclusive planning, increasing spending on research and cost–effective testing are pivotal for sustaining the TB control initiatives.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solomon Nyame ◽  
Edward Adiibokah ◽  
Yasmin Mohammed ◽  
Victor C. Doku ◽  
Caleb Othieno ◽  
...  

Abstract Background In low- and middle-income countries, the paucity of conventional health services means that many people with mental health problems rely on traditional health practitioners (THPs). This paper examines the possibility of forging partnerships at the Primary Health Care (PHC) level in two geopolitical regions of Ghana, to maximize the benefits to both health systems. Methods The study was a qualitative cross-sectional survey. Eight (8) focus group discussions (FGDs) were conducted between February and April 2014. The views of THPs, PHC providers, service users (i.e. patients) and their caregivers, on the perceived benefits, barriers and facilitators of forging partnerships were examined. A thematic framework approach was employed for analysis. Results The study revealed that underlying the widespread approval of forging partnerships, there were mutual undertones of suspicion. While PHC providers were mainly concerned that THPs may incur harms to service users (e.g., through delays in care pathways and human rights abuses), service users and their caregivers highlighted the failure of conventional medical care to meet their healthcare needs. There are practical challenges to these collaborations, including the lack of options to adequately deal with human rights issues such as some patients being chained and exposed to the vagaries of the weather at THPs. There is also the issue of the frequent shortage of psychotropic medication at PHCs. Conclusion Addressing these barriers could enhance partnerships. There is also a need to educate all providers, which should include sessions clarifying the potential value of such partnerships.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tingting Zhang ◽  
Xingrong Shen ◽  
Rong Liu ◽  
Linhai Zhao ◽  
Debin Wang ◽  
...  

Abstract Background In China, the primary health care (PHC) system has been designated responsible for control and prevention of COVID-19, but not treatment. Suspected COVID-19 cases presenting to PHC facilities must be transferred to specialist fever clinics. This study aims to understand the impact of COVID-19 on PHC delivery and on antibiotic prescribing at a community level in rural areas of central China. Methods Qualitative semi-structured interviews were conducted with 18 PHC practitioners and seven patients recruited from two township health centres and nine village clinics in two rural residential areas of Anhui province. Interviews were transcribed verbatim and analysed thematically. Results PHC practitioners reported a major shift in their work away from seeing and treating patients (due to government-mandated referral to specialist Covid clinics) to focus on the key public health roles of tracing, screening and educating in rural areas. The additional work, risk, and financial pressure that PHC practitioners faced, placed considerable strain on them, particularly those working in village clinics. Face to face PHC provision was reduced and there was no substitution with consultations by phone or app, which practitioners attributed to the fact that most of their patients were elderly and not willing or able to switch. Practitioners saw COVID-19 as outside of their area of expertise and very different to the non-COVID-19 respiratory tract infections that they frequently treated pre-pandemic. They reported that antibiotic prescribing was reduced overall because far fewer patients were attending rural PHC facilities, but otherwise their antibiotic prescribing practices remained unchanged. Conclusions The COVID-19 pandemic had considerable impact on PHC in rural China. Practitioners took on substantial additional workload as part of epidemic control and fewer patients were seen in PHC. The reduction in patients seen and treated in PHC led to a reduction in antibiotic prescribing, although clinical practice remains unchanged. Since COVID-19 epidemic control work has been designated as a long-term task in China, rural PHC clinics now face the challenge of how to balance their principal clinical and increased public health roles and, in the case of the village clinics, remain financially viable.


Author(s):  
Joanne Stares ◽  
Jenny Sutherland

ABSTRACT ObjectivesUnderlying the delivery of services by the universal Canadian health care system are a number of rich secondary administrative health data sets which contain information on persons who are registered for care and details on their contacts with the system. These datasets are powerful sources of information for investigation of non-notifiable diseases and as an adjunct to traditional communicable disease surveillance. However, there are gaps between public health practitioners, access to these data, and access to experts in the use of these secondary data. The data linkage requires in-depth knowledge of these data including usages, limitations and data quality issues and also the skills to extract data to support secondary usage. OLAP reports have been developed to support operation needs but not on advanced analytics reports for surveillance and cohort study. To fill these gaps, we developed a set of web-based modular, parameterized, extraction and reporting tools for the purpose of: 1) decreasing the time and resources necessary to fill general secondary data requests for public health audiences; 2) quickly providing information from descriptive analysis of secondary data to public health practitioners; 3) informing the development of data feeds for continued enhanced surveillance or further data access requests; 4) assisting in preliminary stages of epidemiological investigations of non-notifiable diseases; and, 5) facilitating access to information from secondary data for evidence-based decision making in public health. ApproachWe intend to present these tools by case study of their application to small area analysis of secondary data in the context of air quality concerns. Data sources include individuals registered for health care coverage in BC, hospital separations, physician consultations, chronic disease registries, and drugs dispensation. Data sets contain complete information from 1992. Data were extracted and analyzed to describe the occurrence of health service utilization for cardiovascular and respiratory morbidity. Analysis was undertaken for BC residents in areas identified by local public health as priorities for monitoring. Health outcomes were directly standardized by age and compared to provincial trends by use of the comparative morbidity figure. ResultsResults will include descriptive epidemiological analysis of secondary data relating to respiratory and cardiovascular morbidity in the context of air quality concerns, summary of next steps, as well as an assessment of tool performance. ConclusionsWhere adopted tools such as these can make information from secondary data more accessible to support public health practice, particularly in regions with low analytical or epidemiological capacity.


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