Community-based health services for people with HIV/AIDS: A review from a health service perspective

AIDS Care ◽  
1992 ◽  
Vol 4 (2) ◽  
pp. 203-215 ◽  
Author(s):  
S. Layzell ◽  
M. McCarthy
Keyword(s):  
Health Service ◽  
Health Services ◽  
Community Based ◽  
Service Perspective ◽  
Health Service Perspective ◽  
Hiv Aids

scholarly journals Cost-effectiveness of a domestic violence and abuse training and support programme in primary care in the real world: updated modelling based on an MRC phase IV observational pragmatic implementation study

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e021256 ◽  
Author(s):  
Estela Capelas Barbosa ◽  
Talitha Irene Verhoef ◽  
Steve Morris ◽  
Francesca Solmi ◽  
Medina Johnson ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Service ◽  
Cost Effective ◽  
Uncertainty Interval ◽  
The Uk ◽  
The Cost ◽  
Training And Support ◽  
Domestic Violence And Abuse ◽  
Service Perspective ◽  
Health Service Perspective

ObjectivesTo evaluate the cost-effectiveness of the implementation of the Identification and Referral to Improve Safety (IRIS) programme using up-to-date real-world information on costs and effectiveness from routine clinical practice. A Markov model was constructed to estimate mean costs and quality-adjusted life-years (QALYs) of IRIS versus usual care per woman registered at a general practice from a societal and health service perspective with a 10-year time horizon.Design and settingCost–utility analysis in UK general practices, including data from six sites which have been running IRIS for at least 2 years across England.ParticipantsBased on the Markov model, which uses health states to represent possible outcomes of the intervention, we stipulated a hypothetical cohort of 10 000 women aged 16 years or older.InterventionsThe IRIS trial was a randomised controlled trial that tested the effectiveness of a primary care training and support intervention to improve the response to women experiencing domestic violence and abuse, and found it to be cost-effective. As a result, the IRIS programme has been implemented across the UK, generating data on costs and effectiveness outside a trial context.ResultsThe IRIS programme saved £14 per woman aged 16 years or older registered in general practice (95% uncertainty interval −£151 to £37) and produced QALY gains of 0.001 per woman (95% uncertainty interval −0.005 to 0.006). The incremental net monetary benefit was positive both from a societal and National Health Service perspective (£42 and £22, respectively) and the IRIS programme was cost-effective in 61% of simulations using real-life data when the cost-effectiveness threshold was £20 000 per QALY gained as advised by National Institute for Health and Care Excellence.ConclusionThe IRIS programme is likely to be cost-effective and cost-saving from a societal perspective in the UK and cost-effective from a health service perspective, although there is considerable uncertainty surrounding these results, reflected in the large uncertainty intervals.

scholarly journals Health Service Utilization and Out-Of-Pocket Health Expenditure Among Insured and Uninsured: A Comparative Study in Baglung District, Nepal

2019 ◽  
Author(s):  
Laxman Datt Bhatt ◽  
Shankar Singh Dhami
Keyword(s):  
Health Insurance ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Expenditure ◽  
Health Service Utilization ◽  
Social Health ◽  
Insurance Status ◽  
Community Based ◽  
Health Security

Abstract Background Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias.Method A community based cross-sectional comparative study was conducted in Baglung district of Nepal to find out and compare the health service utilization and direct out-of-pocket health care expenditure among the 225 insured and 225 uninsured households under the national health insurance program of Nepal. Insured households were randomly chosen from study area and uninsured households were selected by using neighborhood method.Result The study focused that insurance status was strongly associated with heath service utilization with odds ratio 1.774 (95% CI = 1.127-2.791, P = 0.013). The study also depicts that insurance status was major determinants of out of pocket health expenditure. The median out-of-pocket health expenditure among insured households Nepalese Rupees 200 while among uninsured was 1225, which was statistically significant (p = <0.001 MW-U test). Among uninsured group, non-dalit were 2.846 times more likely to utilize health services compared to the dalit (p = 0.003) but it was not significant (p = 0.47) among insured group.Conclusion Nepal’s Health Insurance Board is responsible for purchasing the quality health care service and make available at possible nearest point of its member. Our study reveals that Occupation, perceived health status, wealth status played significant role with health service utilization among uninsured group while it was not significant among insured group. Among both insured and uninsured group none of the study variables were found significant with out-of-pocket health expenditure.

scholarly journals MODEL PENGEMBANGAN MASYARAKAT BERBASIS LAYANAN KESEHATAN CUMA-CUMA UNTUK KAUM DHU’AFA Kasus di Pos Sehat Al Ikhwan Parung-Bogor

2014 ◽  
Vol 34 (2) ◽  
pp. 197
Author(s):  
Wati Nilamsari
Keyword(s):  
Health Service ◽  
Community Development ◽  
Health Services ◽  
Local Community ◽  
Research Result ◽  
Healthcare Services ◽  
Development Model ◽  
Community Based ◽  
The Poor

<p>This paper is a research result examining the development model of community-based free health services to the poor (dhuafa) at Pos Sehat Al Ikhwan, Parung-Bogor. The writer used the Rothman and Glen’s theory to analize the case. This study used the local community development model. It is aimed to build the economic autonomy of community, in which they could determine and meet their own needs by using creative and operative processes. Having completed the mentoring process conducted by Da'wah and Communication Faculty, “Pos Sehat Al Ikhwan” attempts to maintain the continuity of health services for the dhu'afa in Bojong Indah, Parung, Bogor by strengthening network of the similar healthcare services being performed by advanced institutions to support the operational of “Pos Sehat”. Some of those are the health service of At Taqwa Mosque, and free health services of Dompet Dhu'afa which is until now still help advocating the “Pos Sehat Al Ikhwan” through connecting the Dompet Dhuafa donors with the “Pos Sehat Al-Ikhwan”.</p><p align="center"><strong>***</strong></p><p>Paper ini merupakan hasil penelitian yang mengkaji tentang Model Pengembangan Masyarakat berbasis layanan kesehatan Cuma-Cuma untuk kaum Dhuafa, dengan mengangkat kasus yang terjadi di Pos Sehat Al Ikhwan, Parung-Bogor. Analisis mengenai model pengembangan masyarakat pada  layanan Kesehatan Pos Sehat Al Ikhwan menggunakan teori dari Rothman dan kawan-kawan maupun Glen. Penelitian ini merupakan model pengembangan masyarakat lokal. Model ini bertujuan untuk membangun kemandirian masyarakat, dimana masyarakat sendiri yang mendefinisikan dan memenuhi kebutuhan mereka sendiri dengan menggunakan proses-proses yang kratif dan operatif. Upaya yang dilakukan oleh Pos Sehat Al Ikhwan untuk menjaga keberlangsungan layanan kesehatan untuk kaum dhu’afa di Desa Bojong Indah, Parung, Bogor setelah selesainya proses pendampingan yang dilakukan oleh Fakultas Dakwah dan Komunikasi yaitu dengan memperkuat jaringan pada layanan kesehatan mandiri yang dilakukan oleh lembaga yang sudah maju untuk mendukung operasional Pos sehat, antara lain dengan Layanan Kesehatan Masjid At Taqwa Bintaro, dan juga Layanan Kesehatan Cuma-Cuma Dompet Dhua’afa yang hingga sekarang melakukan pendampingan pada pos sehat Al Ikhwan melaui mekanisme menghubungkan donatur Dompet Dhuafa dengan pos sehat Al Ikhwan.</p>

scholarly journals Pemanfaatan Pelayanan Kesehatan oleh Perempuan Terinfeksi HIV/AIDS

2013 ◽  
Vol 8 (1) ◽  
pp. 33 ◽  
Author(s):  
Rialike Burhan
Keyword(s):  
Social Support ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Predisposing Factors ◽  
Research Approach ◽  
Enabling Factors ◽  
Living With Hiv ◽  
Hiv Aids

Perempuan terinfeksi human immunodeficiency virus dan acquired immune deficiency syndrome (HIV/AIDS) mempunyai permasalahan yang kompleks sehubungan dengan penyakit dan statusnya, sehingga mereka mempunyai kebutuhan yang khusus. Kebutuhan perawatan, dukungan dan pengobatan tersebut dapat diperoleh dengan mengakses pelayanan kesehatan yang tersedia untuk dapat mengoptimalkan kesehatan mereka sehingga dapat meningkatkan kualitas hidup. Tujuan penelitian ini untuk menganalisis hubungan faktor predisposisi yang meliputi pengetahuan, sikap, stigma, faktor pemungkin yang meliputi jarak ke pelayanan kesehatan dan faktor penguat berupa dukungan sosial dengan pemanfaatan pelayanan kesehatan pada perempuan terinfeksi HIV/AIDS. Rancangan penelitian menggunakan pendekatan potong lintang. Penelitian dilaksanakan di Kelompok Dukungan Sebaya Female Plus Kota Bandung pada bulan Juni sampai Juli 2012. Sampel penelitian berjumlah 40 orang perempuan terinfeksi HIV/AIDS. Data di analisis secara univariat, bivariat, dan multivariat. Hasil penelitian ini didapatkan bahwa terdapat hubungan yang signifikan secara statistik yaitu usia, pendidikan, status perkawinan, status pekerjaan, faktor predisposisi (pengetahuan, sikap, stigma), faktor penguat (dukungan sosial), dan faktor pemungkin yaitu jarak ke pelayanan kesehatan tidak berhubungan dengan pemanfaatan pelayanan kesehatan. Pengetahuan merupakan faktor penentu dalam pemanfaatan pelayanan kesehatan berpeluang 60,1 kali untuk memanfaatkan pelayanan kesehatan.Women living with HIV/AIDS have a complex problems who connection with the disease and her status, because they have special needs, for care, support and treatment can be obtained by accessing the health services available to optimize their health so as to improve the quality of life. The purpose of this study was to analyze the correlation between three factors, predisposing factors (knowledge, attitudes, stigma), enabling factors (distance to health services), and reinforcing factors (social support) with health service utilization.This type of research was analytic with cross-sectional research approach. The research was implemented in Female Plus Peer Support Group Bandung from June until July 2012. The sample in this study were 40 women living with HIV/AIDS. Data analysis using univariate, bivariate, and multivariate. The results obtained that there were significant relationship is age, education, marital status, work, predisposing factors (knowledge, attitude, stigma), reinforcing factor (social support), and enabling factors (distance to health services were not correlated with health service utilization). Knowledge was the determinant factor to health service utilization in 60,1 times the chance to utilize health services.

scholarly journals Promotion of Mental Health Rehabilitation in China: Community- Based Mental-Health Services

2020 ◽  
Vol 1 (2) ◽  
pp. 21-27
Author(s):  
Y. Zhu ◽  
X. Li ◽  
M. Zhao
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
National Standards ◽  
Chinese Government ◽  
Public Health Services ◽  
Community Based ◽  
The 1960S

Community-based mental health services are important for the treatment and recovery of patients with mental health disorders. The Chinese government has made the establishment of a highly efficient community-based health service an enduring priority. Since the 1960s, community-based mental health services have been developed in many Chinese cities and provinces. National policies, including mental health regulations and five-year national mental health working plans, have been issued to support the development of quality of mental health services. The accessibility and efficiency of community-based mental health services are now highly promoted to community residents. According to the National Standards for Primary Public Health Services, community-based mental health services are one of the most important components of primary public health services. They are mainly provided via Community Health Service Centres (CHCs), by a combination of general practitioners, public health physicians, nurses and social workers. Patients receive individualized and continuous health services according to their rehabilitation status. These services include regular physical examination, health education, rehabilitation guidance, social function rehabilitation training, vocational training and referral services; family members also receive care and psychological support. Future work will focus on expanding mental health service coverage and usage, increasing awareness of mental health and decreasing stigma, and strengthening service capability to establish an integrated model to enhance the overall efficiency of mental health services.

scholarly journals Facilitators to Accessibility of HIV/AIDS-Related Health Services among Transgender Women Living with HIV in Yogyakarta, Indonesia

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Nelsensius Klau Fauk ◽  
Maria Silvia Merry ◽  
Theodorus Asa Siri ◽  
Fabiola Tazrina Tazir ◽  
Mitra Andhini Sigilipoe ◽  
...  
Keyword(s):  
Social Support ◽  
Health Service ◽  
Health Services ◽  
Transgender Women ◽  
Hiv Positive ◽  
Snowball Sampling ◽  
Framework Analysis ◽  
Enabling Factors ◽  
Constructive Feedback ◽  
Hiv Aids

The study aimed to explore facilitators or enabling factors that enhance accessibility (defined as the opportunity to be able to use) to HIV/AIDS-related health services among HIV positive transgender women, also known as Waria in Yogyakarta, Indonesia. A qualitative study employing one-on-one in-depth interviews was conducted from December 2017 to February 2018. Participants were HIV positive Waria recruited using purposive and snowball sampling techniques. Data were analysed using the framework analysis for qualitative research. The findings showed that participants’ knowledge of HIV/AIDS and the availability of HIV/AIDS-related health services were enablers to the services accessibility. Emotional support from fellow Waria displayed in various ways, such as kind and caring attention, attentive listening, and encouraging words, was an important social support that played a role in supporting Waria’s accessibility to the services. HIV/AIDS-related health service information shared personally or jointly by fellow Waria and instrumental support including helping each other to collect antiretroviral (ARV) from hospitals or community health centres, contacting ambulance in emergency situations, accompanying each other to health service facilities, and helping those without the health insurance to receive free health services were also the social support enabling accessibility to the services among the study participants. Appraisal support such as providing constructive feedback and affirmation was another enabling factor to Waria’s accessibility to the services. The findings indicate the needs to broadly disseminate information and educate Waria populations and their significant others about HIV/AIDS and related health services to raise their awareness of HIV/AIDS and acceptance of HIV/AIDS positive individuals. Educating and broadly disseminating this information in other settings in the country will also increase accessibility to the HIV/AIDS services among Waria, their families, and communities addressing the currently existing inequities in health. The findings also reinforce the importance of the establishment of Waria peer-support groups within Waria communities and the involvement of Waria in HIV/AIDS activities and programs, which may increase their awareness of HIV/AIDS, and accessibility to HIV/AIDS-related health services.

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