Urbanisation and health services: developing a new model of primary health care in Goma (Democratic Republic of Congo)

2019 ◽  
pp. 1-5 ◽  
Author(s):  
Jean-Bosco Kahindo Mbeva ◽  
Simbi Ahadi ◽  
Mara Vitale ◽  
Mitangala Ndeba Prudence ◽  
Yves Coppieters ◽  
...  
2020 ◽  
Author(s):  
Mutume Vivalya ◽  
Jimmy BEN FORRY ◽  
Okesina AKEEM AYODEJI ◽  
Kalima Nzanzu Adelard ◽  
Paluku Mwalitsa Jean-Paul ◽  
...  

UNSTRUCTURED The COVID-19 pandemic has led to the resolution of a total lockdown both developed and developing countries. The lock-down has worsened the prevailing economic crisis, affected the health and political system, exacerbated unemployment levels and cost of managing health conditions in African settings and especially the Democratic Republic of Congo; which tends to have detrimental effects on the mental health of the affected population. Also, it is extremely expensive to access professional health care services. We ought to provide insight into policy-relevant approaches including integrative community based organization, digital heath, systematic screening of mental health problems in primary health care, given that failure to treat those who are emotionally affected will result in long-term social and economic outcomes and costs to society. The primary health workers should be trained on mental health care delivered through the internet and digital support. Helping affected community by COVID-19 to feel mentally better will require the integration of online telehealth among primary health care for the online mental health screening and psychotherapy centred on a supportive therapy strategy, anger/stress management, and the establishing of integrative community based organisation. Any partners during the COVID-19 should plan for the workshop on online mental health services and training to allow its integration and the reportage from patient’s home to the health centres and hospitals.


2020 ◽  
pp. 35-43
Author(s):  
Alexey Smyshlyaev ◽  
Maria Sadovskaya

Optimization of the activities of medical organizations providing primary health care requires the development of new organizational and functional models. The introduction of new approaches to organizing the activities of medical organizations is primarily a step towards patients. The new model is a patient-oriented medical organization, the management of which is based on the use of a process-oriented approach and «lean» technologies. Since 2019, within the framework of the federal project «Development of a primary health care system,» a project has been launched to introduce the «New Model of a Medical Organization Providing Primary Health Care». The implementation of the project is scheduled for 2019-2024 inclusive. The creation and replication of the «new model» is planned for the participation of all subjects of the Russian Federation. The introduction of lean technology methods in the work of medical organizations has reduced the waiting time for doctors, optimized the burden on doctors, reduced the time for obtaining research results, streamlining the process of moving a patient within a medical organization. The creation of an effective quality management system in medical organizations is achieved through the phased implementation of lean-technology.


2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.


1997 ◽  
Vol 2 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Rosemare Troskie

The Reconstruction and Development Plan as well as the National Health Plan of the ANC supports the reorganisation of health services. OpsommingDie Heropbou en Ontwikkelingsprogram sowel as die Nasionale Gesondheidsplan van die ANC staan die herorganisasie van gesondheidsdienste voor. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.


Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.


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