Increasing Access to Primary Health Care for 'Marginalized' People: Lessons from Two Urban Aboriginal Health Centres

2010 ◽  
Author(s):  
Sabrina Wong ◽  
Annette J. Browne
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Aboriginal Health ◽  
Primary Health ◽  
Health Centres

scholarly journals Quality of Health Assistants in primary Health centres in Rural Maharashtra, India

2013 ◽  
Vol 6 ◽  
pp. HSI.S11226
Author(s):  
Enakshi Ganguly ◽  
Bishan S. Garg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Primary Health Care System ◽  
Job Descriptions ◽  
Continuous Training ◽  
Primary Health ◽  
Primary Health Centres ◽  
Quality Assurance Mechanism ◽  
Health Centres

Introduction Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs) and to assess their quality using this tool. Methodology Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs) was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality.

scholarly journals Setting the scene for an ARI control programme: is it worthwhile in Saudi Arabia?

1999 ◽  
Vol 5 (1) ◽  
pp. 111-117
Author(s):  
T. A. Khoja ◽  
K. K. Al Mohammad ◽  
K. M. Aziz
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Primary Health Care ◽  
Respiratory Infections ◽  
Diagnostic Procedures ◽  
Control Programme ◽  
Acute Respiratory Infections ◽  
Survey Questionnaire ◽  
Primary Health ◽  
Health Centres

Baseline data on acute respiratory infections [ARI] were collected by a survey questionnaire distributed to physicians of 10% of the health centres randomly selected from each of the five provinces of Saudi Arabia. The physicians estimated that ARI was the cause of sickness in 50% of ill children < 5 years in 1995. None of the physicians had had any training in ARI and they were not aware of any national protocol or programme. Physicians’ responses indicated an over-use of antibiotics and diagnostic procedures. A national protocol for diagnosis and treatment of ARI has been prepared and distributed and leaders of primary health care and 55 national trainers have been trained

Community Health and General Practice: The Impact of Different Cultures on the Integration of Primary Care

2001 ◽  
Vol 7 (1) ◽  
pp. 65 ◽  
Author(s):  
Hal Swerissen ◽  
Jenny Macmillan ◽  
Catuscia Biuso ◽  
Linda Tilgner
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Community Health ◽  
Community Health Centres ◽  
Care Services ◽  
Primary Health ◽  
Health Centres ◽  
The Relationship

This study examined the existing relationship between community health centres and General Practice Divisions in the State of Victoria, including the nature of joint working arrangements and the identification of barriers to greater collaboration. Improved integration of primary health care services has been advocated to improve consumer and population health outcomes and to reduce inappropriate use of acute and extended care services. General practitioners (GPs) and community health centres are two key providers of primary health care with potential for greater integration. The current study conducted telephone interviews with 20 community health centre CEOs and 18 Executive Officers of divisions, which were matched according to catchment boundaries. Results suggest, while some joint planning is occurring, especially on committees, working parties and projects, there is an overall low level of satisfaction with the relationship between community health centres and GPs and GP divisions. Major barriers to greater integration are the financial or business interests of GPs and misunderstanding and differences in perceived roles and ideology between GPs and community health centres. Improved communication, greater contact and referral and follow-up procedures are identified as a means of improving the relationship between GPs, GP divisions and community health centres. Community health centres and general practitioners (GPs) are key providers of primary care (Australian Community Health Association, 1990).

An analysis of the Primary Health Care Access Program in the Northern Territory: A major Aboriginal health policy reform

2004 ◽  
Vol 10 (3) ◽  
pp. 89 ◽  
Author(s):  
Clive Rosewarne ◽  
John Boffa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Access ◽  
Aboriginal Health ◽  
Northern Territory ◽  
Care Access ◽  
Health Policy Reform ◽  
Funding Model ◽  
Primary Health ◽  
Access Program

This paper describes the development of and lessons learned in implementing the Primary Health Care Access Program (PHCAP) in the Northern Territory. The implementation of the PHCAP is a major Aboriginal health policy reform. PHCAP provides an opportunity for Aboriginal people to gain access to properly resourced comprehensive primary health care (PHC) services. PHCAP is described in its unique funding model that attempts to address tensions within the federal governance system. In this paper we argue that access to PHC services is a key determinant of health and that funding of PHC services has been inadequate and inequitable throughout the Northern Territory. The implementation of PHCAP is reforming the existing health system and leading to the establishment of new PHC services. We analyse the barriers encountered in this process. The PHCAP funding model is analysed for its adequacy and design strength to address federal relations. We consider issues of workforce shortage that will limit our capacity to implement the program and the need for effective regional PHC support services. We conclude that the basic funding model within PHCAP - a grant payment plus access to the Medicare Benefits Schedule and Pharmaceutical Benefits Scheme - is the best possible way to fund comprehensive PHC at the present time, and call for bipartisan party commitment to fully realise the potential of this program to address Aboriginal health inequalities.

Primary Health Care Under Pressure: A Case Study of Amalgamation in Victoria

1996 ◽  
Vol 2 (3) ◽  
pp. 38 ◽  
Author(s):  
Brigid McCoppin ◽  
Christine Birrell
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Policy ◽  
Care Policy ◽  
Community Health Centres ◽  
Primary Health ◽  
Health Centres ◽  
Common Response ◽  
Future Demands

Amalgamation of community health centres has become a fairly common response to Victorian government changes in primary health care policy (both Labor and Coalition). This is a study of one such amalgamation and of its effects. The amalgamation brought staff and management many difficulties of adjustment, but it has produced a larger organisation which, while it has some residual problems, appears well fitted to withstand the pressure of today's policy directions and to meet future demands.

scholarly journals Continuity of nursing care in Finnish primary health care settings: A 15-year follow-up

2018 ◽  
Vol 7 (1) ◽  
pp. 11 ◽  
Author(s):  
Risto Raivio ◽  
Eija Paavilainen ◽  
Kari J. Mattila
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuity Of Care ◽  
Nursing Care ◽  
Health Centre ◽  
University Hospital ◽  
Primary Health ◽  
Patient Reported ◽  
Health Centres

Objective: Continuity is an essential part of high-quality nursing care. This study is the first systematic follow-up of Finnish primary health care patients assessing continuity of health centre nursing staff. The aim was to ascertain how longitudinal interpersonal continuity of care is related to patients’ characteristics, their consultation experiences, and how continuity had changed over the 15-year study period.Methods: A questionnaire survey was conducted among patients attending the health centres in the Tampere University Hospital catchment area from 1998 to 2013. A total of 157,549 patients responded out of 363,464 in almost 60 health centres. We analysed the opinions of patients (n = 47,470) who had visited a nurse during the survey weeks. Opinions on the continuity of care were assessed with the question: “When visiting the health centre, do you usually see the same nurse”, the alternatives being “yes” or “no”. A binary logistic regression model was used.Results: Almost two thirds of the respondents had met the same nurse when visiting their health care centre. Longitudinal interpersonal continuity of care decreased by 15 percentage (67%-52%) during the study years. Continuity was connected to patient-related items such as a visit in the preceding 12 months (OR 1.32, 95% CI 1.17-1.49) and non-urgency of the visit (OR 1.44, 95% CI 1.27-1.63). The most prominent factor contributing to the sense of continuity of care was how attentively nurses had listened to their patients’ problems and shown an interest in them and a willingness to answer their questions (OR 1.31, 95% CI 1.120-1.43).Conclusions: In the past 15 years patient-reported longitudinal interpersonal continuity of nursing care has declined. However continuity of care proved to enhance the experienced quality of primary health care. Continuity was best realized in nursing care when nurses had listened to their patients’ problems, showed interest toward them and a willingness to answer their questions.

scholarly journals Experiences of primary health care nurses regarding the provision of free health care services in the Northern region of the Limpopo Province

Curationis ◽  
2005 ◽  
Vol 28 (1) ◽  
Author(s):  
VO Netshandama ◽  
L Nemathaga ◽  
SN Shai-Mahoko
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Northern Region ◽  
Limpopo Province ◽  
Care Services ◽  
Primary Health ◽  
Health Centres ◽  
Free Health Care ◽  
Primary Health Care Nurses

The purpose of the study was to explore the experiences of primary health care nurses working in the clinics and health centres involved in the provision of free health care services. The research design followed was exploratory, descriptive and qualitative. The population of the study included all primary health care nurses working at the clinics and health centres in the Vhembe (northern) region of the Limpopo Province. The sampling method used was purposive for the samples of both the clinics and the nurses. The inclusion criteria for the nurses included experience of two or more years in providing primary health care. The inclusion criteria for the selection of clinics included being a busy clinic (a minimum of 2000 patients per month) with a staff establishment of four or more primary health care nurses. In conducting this research, ethical principles were taken into account. Data was collected from 23 participants in the Northern Region. The research question read as follows: What are your experiences regarding the provision of free health care services? An open coding method consisting of eight steps provided by Tesch's (1990:140-145) eight-step method of analysing data was used. The research findings revealed that the primary health care nurses working in the clinics experience feelings of failure to provide adequate primary health care services due to the increased workload, misuse of the service, and fear associated with lack of security in the clinics and health centres. The conclusions drawn from this research are that on the one hand a poor mechanism exists for the monitoring of the implementation of free health services, and on another hand, there has been misuse of the facilities by the community. The concept “free health care service” has been misinterpreted.

scholarly journals Community participation in health service reform: the development of an innovative remote Aboriginal primary health-care service

2015 ◽  
Vol 21 (4) ◽  
pp. 409 ◽  
Author(s):  
Carole Reeve ◽  
John Humphreys ◽  
John Wakerman ◽  
Vicki Carroll ◽  
Maureen Carter ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Service ◽  
Care Service ◽  
Health Care Service ◽  
Aboriginal Health ◽  
Primary Health Care Service ◽  
Disadvantaged Area ◽  
Primary Health ◽  
Comprehensive Primary Health Care

The aim of this study was to describe the reorientation of a remote primary health-care service, in the Kimberley region of Australia, its impact on access to services and the factors instrumental in bringing about change. A unique community-initiated health service partnership was developed between a community-controlled Aboriginal health organisation, a government hospital and a population health unit, in order to overcome the challenges of delivering primary health care to a dispersed, highly disadvantaged Aboriginal population in a very remote area. The shared goals and clear delineation of responsibilities achieved through the partnership reoriented an essentially acute hospital-based service to a prevention-focussed comprehensive primary health-care service, with a focus on systematic screening for chronic disease, interdisciplinary follow up, health promotion, community advocacy and primary prevention. This formal partnership enabled the primary health-care service to meet the major challenges of providing a sustainable, prevention-focussed service in a very remote and socially disadvantaged area.

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