Refugee health: a new model for delivering primary health care

2010 ◽  
Vol 16 (1) ◽  
pp. 98 ◽  
Author(s):  
Margaret Kay ◽  
Claire Jackson ◽  
Caroline Nicholson
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Community Services ◽  
Primary Health Care System ◽  
Care Providers ◽  
Quality Health Care ◽  
Primary Health ◽  
Quality Health

Providing health care to newly arrived refugees within the primary health care system has proved challenging. The primary health care sector needs enhanced capacity to provide quality health care for this population. The Primary Care Amplification Model has demonstrated its capacity to deliver effective health care to patients with chronic disease such as diabetes. This paper describes the adaption of the model to enhance the delivery of health care to the refugee community. A ‘beacon’ practice with an expanded clinical capacity to deliver health care for refugees has been established. Partnerships link this practice with existing local general practices and community services. Governance involves collaboration between clinical leadership and relevant government and non-government organisations including local refugee communities. Integration with tertiary and community health sectors is facilitated and continuing education of health care providers is an important focus. Early incorporation of research in this model ensures effective feedback to inform providers of current health needs. Although implementation is currently in its formative phase, the Primary Care Amplification Model offers a flexible, yet robust framework to facilitate the delivery of quality health care to refugee patients.

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

scholarly journals Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients

2018 ◽  
Vol 3 ◽  
pp. 9 ◽  
Author(s):  
Victoria Cavero ◽  
Francisco Diez-Canseco ◽  
Mauricio Toyama ◽  
Gustavo Flórez Salcedo ◽  
Alessandra Ipince ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Perceived Need ◽  
Primary Health ◽  
Primary Health Care Providers

Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities.  Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients’ feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases, while psychologists provide one-to-one consultations. Significant limitations in the care provided are discussed.

scholarly journals Two-Phased Strategy for Improvement of Breast Cancer Care in Bangladesh

2018 ◽  
Vol 4 (Supplement 3) ◽  
pp. 40s-40s
Author(s):  
Masuma Sarker ◽  
Nazmul Hoque Masum
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Cancer Care ◽  
Primary Health Care System ◽  
Care Providers ◽  
Breast Cancer Care ◽  
Primary Health ◽  
One Stop

Purpose Bangladesh has a low incidence of breast cancer; however, the incidence is rising rapidly and the mortality rate is significantly higher, which is complicated by limited resources. Hence, a screening and treatment strategy will not be the same as those of high-income countries. Methods We did a literature review, resource evaluation, and finally propose a resource-stratified two-phased implementation strategy to improve breast cancer care in Bangladesh. Results There is a lack of qualitative and quantitative epidemiologic data. According to limited available data, breast cancer demography is different, as almost all patients present in advanced stage and most are premenopausal women. We have identified the three most important factors that affect breast cancer management: social, cultural, and religious barriers to early detection; few treatment facilities, which are concentrated mainly in the capital; and a lack of female health care providers while seeking treatment. We propose a two-phased approach. A female-orientated primary health care system has been successful in Bangladesh in achieving many health goals. In the first phase, we propose involving a female health assistant of the primary health care system to increase awareness, early detection (clinical downstaging), and effective referral of patients with breast cancer. This program can be integrated into existing perinatal care, as a majority of patients with breast cancer are of reproductive age. At the same time, we will modify tertiary health care (THC) to establish a model one-stop breast cancer facility and we propose a single day of a week when female health care providers will be available to provide care. THC providers will conduct outreach programs at the district level. In addition, a population-based epidemiologic study and cancer registry should be started immediately. In the second phase, we aim to establish an effective breast cancer care facility at the secondary health care level, as this is accessible by a large portion of the population. We propose establishing a one-stop breast cancer facility in every district that will be inspired by the THC model clinic. Adequate resources should be allocated to achieve this goal. Conclusion This strategy could be a model for other resource-limited developing countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.

Strategies Used by Interprofessional Teams to Counter Healthcare Marginalization and Engage Complex Patients

2020 ◽  
Vol 30 (7) ◽  
pp. 1058-1071
Author(s):  
Erin Fanning Madden ◽  
Summers Kalishman ◽  
Andrea Zurawski ◽  
Patricia O’Sullivan ◽  
Sanjeev Arora ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Low Income ◽  
Care Providers ◽  
Quality Health Care ◽  
Complex Patients ◽  
Quality Health ◽  
Sociocultural Resources ◽  
Poor Outcomes

Low-income U.S. patients with co-occurring behavioral and physical health conditions often struggle to obtain high-quality health care. The health and sociocultural resources of such “complex” patients are misaligned with expectations in most medical settings, which ask patients to mobilize forms of these assets common among healthier and wealthier populations. Thus, complex patients encounter barriers to engagement with their health behaviors and health care providers, resulting in poor outcomes. But this outcome is not inevitable. This study uses in-depth interviews with two interprofessional primary care teams and surveys of all six teams in a complex patient program to examine strategies for improving patient engagement. Five primary care team strategies are identified. While team member burnout was a common byproduct, professional support offered by the team structure reduced this effect. Team perspectives offer insight into mechanisms of improvement and the professional burdens and benefits of efforts to counter health care marginalization among complex patients.

scholarly journals Community oriented primary care in Tshwane District, South Africa: Assessing the first phase of implementation

2013 ◽  
Vol 5 (1) ◽  
Author(s):  
Hans-Friedemann Kinkel ◽  
Tessa Marcus ◽  
Shehla Memon ◽  
Nomonde Bam ◽  
Jannie Hugo
Keyword(s):  
South Africa ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Sector ◽  
Political Commitment ◽  
Care Providers ◽  
Primary Health

Background: Re-engineering primary health care is a cornerstone of the health sector reforminitiated nationally in South Africa in 2009. Using the concept of ward based NGO-run healthposts, Tshwane District, Gauteng, began implementing community oriented primary care (COPC) through ward based outreach teams (WBOT) in seven wards during 2011.Objectives: This study sought to gain insight into how primary health care providers understood and perceived the first phase of implementing COPC in the Tshwane district.Method: Qualitative research was performed through focus group interviews with staff of the seven health posts during September 2011 and October 2011. It explored primary health careproviders’ understanding, perception and experience of COPC.Results: Participants raised organisational, workplace and community relationship issues in the discussions. Organisationally, these related to the process of initiating and setting up COPC and the relationship between governmental and nongovernmental organisations. Issues that arose around the workplace related to the job situation and employment status and remuneration of health post staff. Community related issues centred on the role and relationship between service providers and their communities.Conclusion: COPC touched a responsive nerve in the health care system, both nationallyand locally. It was seen as an effective way to respond to South Africa’s crisis of health care. Initiating the reform was inevitably a complex process. In this initial phase of implementing COPC the political commitment of governmental and nongovernmental organisations was evident. What still had to be worked through was how the collaboration would materialise in practice on the ground.

scholarly journals Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients

2018 ◽  
Vol 3 ◽  
pp. 9 ◽  
Author(s):  
Victoria Cavero ◽  
Francisco Diez-Canseco ◽  
Mauricio Toyama ◽  
Gustavo Flórez Salcedo ◽  
Alessandra Ipince ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Perceived Need ◽  
Primary Health ◽  
Primary Health Care Providers

Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities.  Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients’ feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases, while psychologists provide one-to-one consultations. Significant limitations in the care provided are discussed.

scholarly journals Erythematous plaques of the vulvo-perineal region

2021 ◽  
Vol 16 (3) ◽  
pp. 101-103
Author(s):  
Qin Jian Low ◽  
Tzyy Huei Lim ◽  
Shu Ann Hon ◽  
Seng Wee Cheo ◽  
Noranizah Wagino ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Health ◽  
Primary Health Care Providers ◽  
Slow Evolution ◽  
Skin Conditions

Skin conditions are a common reason for consulting primary health care. The public frequently expects their primary health care providers to be able to recognise and treat common skin conditions with confidence. Primary care providers must be able to identify ‘red flag’ skin conditions that require dermatology referral. However, diagnosis is often delayed due to the non-specific clinical presentation, low incidence, slow evolution and long-term history of such lesions. We report the case of a patient with extramammary Paget’s disease that presented to her primary care provider and subsequently underwent a wide local excision.

'I demand to be treated as the person I am': experiences of accessing primary health care for Australian adults who identify as gay, lesbian, bisexual, transgender or queer

Sexual Health ◽  
2014 ◽  
Vol 11 (3) ◽  
pp. 258 ◽  
Author(s):  
Chee S. Koh ◽  
Melissa Kang ◽  
Tim Usherwood
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Sexual Identity ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Free Text ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Background Individuals who identify as gay, lesbian, bisexual, transgender or queer (GLBTQ) suffer higher rates of illness and morbidity compared with the general population but may experience significant barriers to accessing primary health care. Method: We used an online questionnaire to explore GLBTQ adults’ experiences of accessing primary health care in Australia. We developed the questionnaire in consultation with individuals who belonged to or worked closely with the GLBTQ community. Questions were open-ended and sought information about four topic areas: sexual identity and its meaning, utilisation of primary health care services, disclosure of sexual identity to primary care providers and experiences of accessing primary health care. Data were analysed by coding free-text responses into themes. Results: Ninety-nine valid responses were received. Participants were 18–60+ years old (modal age group: 20–29 years); 70% lived in cities. Of these, 49% identified as gay, 35% as lesbian, 13% as bisexual, 8% as queer and 3% as transgender. Some participants indicated more than one identity. GLBTQ-identifying adults often divided care, seeking different primary care services for different health concerns. Themes in relation to disclosure of sexual identity were: taking a rights-based position, experiences of homophobia and clinical context. Themes about access to primary health care were: diversity and heterogeneity, real or perceived discrimination, visual symbols and respect. Conclusion: Despite diversity, GLBTQ adults experience many barriers to accessing health care due to sexual identity. General practitioners and other primary health care providers have a role in ensuring equitable access to health care.

Sign in / Sign up

Export Citation Format

Share Document