Covid-19 pandemic and The Nigerian primary healthcare system: The leadership question

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

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A baseline survey of the Primary Healthcare System in South Eastern Nigeria

Health Policy ◽

10.1016/j.healthpol.2005.07.006 ◽

2006 ◽

Vol 77 (2) ◽

pp. 182-201 ◽

Cited By ~ 15

Author(s):

Chinyere Mercellina Chukwuani ◽

Akindeji Olugboji ◽

Edward Erdorga Akuto ◽

Akim Odebunmi ◽

Ezenta Ezeilo ◽

...

Keyword(s):

Healthcare System ◽

Primary Healthcare ◽

Baseline Survey ◽

South Eastern

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Empowering patients, empowering clinicians: How the lessons of HIV can inform chronic disease management across the primary healthcare system

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v18i1.692 ◽

2017 ◽

Vol 18 (1) ◽

Author(s):

Andrea S. Mendelsohn

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Healthcare System ◽

Primary Healthcare ◽

Chronic Disease Management

No abstract available.

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A large outbreak of conjunctivitis on Mayotte Island, France, February to May 2012

Eurosurveillance ◽

10.2807/ese.17.23.20192-en ◽

2012 ◽

Vol 17 (23) ◽

Author(s):

T Lernout ◽

O Maillard ◽

S Boireaux ◽

L Collet ◽

L Filleul

Keyword(s):

Infectious Diseases ◽

Healthcare System ◽

Primary Healthcare ◽

Tropical Climate ◽

Significant Burden ◽

Large Outbreak ◽

Acute Conjunctivitis

From February to May 2012, Mayotte experienced an outbreak of acute conjunctivitis with over 12,000 estimated cases, causing a significant burden on the primary healthcare system. It was most certainly caused by a coxsackievirus, as documented by isolation from a symptomatic traveller from the Comoros Islands in France. Tropical climate and poor hygiene conditions facilitate the spread of infectious diseases on Mayotte and in the region with risk of further exportation to mainland France and Europe.

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Aiming for Health Equity: The role of Public Health Policy and Primary Healthcare Comment on "Universal Health Coverage for Non-Communicable Diseases and Health Equity: Lessons From Australian Primary Healthcare"

International Journal of Health Policy and Management ◽

10.34172/ijhpm.2021.112 ◽

2021 ◽

Author(s):

Bo Burström

Keyword(s):

Public Health ◽

Social Determinants Of Health ◽

Healthcare System ◽

Health Equity ◽

Social Determinants ◽

Primary Healthcare ◽

Communicable Diseases ◽

Determinants Of Health ◽

Non Communicable Diseases

This commentary refers to the article by Fisher et al on lessons from Australian primary healthcare (PHC), which highlights the role of PHC to reduce non-communicable diseases (NCDs) and promote health equity. This commentary discusses important elements and features when aiming for health equity, including going beyond the healthcare system and focusing on the social determinants of health in public health policies, in PHC and in the healthcare system as a whole, to reduce NCDs. A wider biopsychosocial view on health is needed, recognizing the importance of social determinants of health, and inequalities in health. Public funding and universal access to care are important prerequisites, but regulation is needed to ensure equitable access in practice. An example of a PHC reform in Sweden indicates that introducing market solutions in a publicly funded PHC system may not benefit those with greater needs and may reduce the impact of PHC on population health.

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The effectiveness of hypertension management in China: a community-based intervention study

Primary Health Care Research & Development ◽

10.1017/s1463423618000853 ◽

2019 ◽

Vol 20 ◽

Author(s):

Xiaoguo Zheng ◽

Feng Xiao ◽

Ruili Li ◽

Delu Yin ◽

Qianqian Xin ◽

...

Keyword(s):

Blood Pressure ◽

Healthcare System ◽

Primary Healthcare ◽

Rural Areas ◽

Urban Areas ◽

Blood Pressure Reduction ◽

Hypertension Management ◽

Hypertension Control ◽

Community Based ◽

One Year

Abstract Aim: This study aimed to evaluate the effectiveness of hypertension management and analyse the factors associated with blood pressure reduction within China’s primary healthcare system. Background: Hypertension is one of the leading risk factors for global disease burden and is strongly associated with cardiovascular diseases. In China, hypertension is a serious public health problem, but few studies have evaluated the effectiveness of hypertension management in China’s primary healthcare system. Methods: The study sites were 24 primary healthcare institutions, selected using multistage stratified random sampling method. In each institution, hypertension patients aged at least 35 years who agreed to participate and had no disabilities or mental health problems were enrolled for hypertension management. Participants received comprehensive interventions in the primary healthcare system via a team. After a one-year intervention, data from 6575 hypertension patients were analysed to check the effectiveness of hypertension management and examined factors associated with hypertension control. Findings: There was an overall mean reduction of 4.5 mmHg in systolic blood pressure (SBP) and 1.9 mmHg in diastolic blood pressure (DBP). The blood pressure reduction after one year was greater in rural patients than in urban patients, 6.6 mmHg versus 3.4 mmHg for SBP and 2.6 mmHg versus 1.6 mmHg for DBP, respectively. The hypertension control rate also increased more in rural areas (22.1%) than in urban areas (10.6%) after the one-year intervention. Age, body mass index, region and being in an urban area had a significant negative association with the reduction of SBP (P < 0.05). Education level and baseline SBP showed a significant positive association (P < 0.05). Conclusions: Community-based hypertension management by general practitioners was feasible and effective. The effectiveness of hypertension management in rural areas was greater than in urban areas. Intervention strategies should pay more attention to patients in rural areas and western China.

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Weaknesses and Challenges of Primary Healthcare System in Iran: A Review

The International Journal of Health Planning and Management ◽

10.1002/hpm.1105 ◽

2011 ◽

Vol 27 (2) ◽

pp. e121-e131 ◽

Cited By ~ 20

Author(s):

Mahmoud Nekoei Moghadam ◽

Vahideh Sadeghi ◽

Sahar Parva

Keyword(s):

Healthcare System ◽

Primary Healthcare

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Can Primary Medical Institutions Lead to Worse Health Status for Patients with Noncommunicable Diseases Compared with High-Level Hospitals? A Follow-Up Observation Study in China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16081336 ◽

2019 ◽

Vol 16 (8) ◽

pp. 1336 ◽

Cited By ~ 2

Author(s):

Yadong Niu ◽

Ting Ye ◽

Yan Zhang ◽

Liang Zhang

Keyword(s):

Health Status ◽

Healthcare System ◽

Growth Curve ◽

Primary Healthcare ◽

Utility Score ◽

Growth Curve Model ◽

Observation Study ◽

Medical Institutions ◽

Curve Model ◽

High Level

The weak primary healthcare system in China brings challenges to the national strategy of primary medical institutions providing general health needs for patients with non-communicable diseases (NCDs). It is necessary to explore the potential discrepancies in health status for patients with NCDs if they go to primary medical institutions rather than high-level hospitals. Data was obtained from Surveillance of Health-seeking Behavior in Hubei Province. Respondents were investigated six times to collect information on health service utilization and health-related quality of life (HRQoL). Ninety-two hypertension patients who went to medical institutions of the same level were included. HRQoL was measured by the Chinese version of EQ-5D-3L. A multilevel growth curve model was applied to analyze whether provider level could influence HRQoL. The utility score and visual analogue scale (VAS) of patients varied insignificantly over six months (p > 0.05). A growth curve model showed that comorbidity was the only factor significantly influencing utility score (p = 0.019). Time and comorbidity were the only influencing factors of VAS (p < 0.05). Our findings indicated that the level of healthcare provider had no significant impact on the health status of patients with NCDs. As such, this study concludes that the primary healthcare system in China is qualified to be the health gatekeeper for NCDs patients.

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