scholarly journals Effectiveness of an educational manual to promote infant feeding practices in primary health care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G R B Relvas ◽  
G S Buccini ◽  
L Potvin ◽  
S I Venancio
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuing Education ◽  
Infant Feeding ◽  
Primary Healthcare ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Infant Feeding Practices ◽  
Healthcare Teams ◽  
Primary Health

Abstract Background Breastfeeding and adequate complementary feeding in the first years of life provide short- and long-term benefits for child health. However, breastfeeding and adequate complementary feeding prevalence's are low. In Brazil, the Estratégia Amamenta e Alimenta Brasil (EAAB) aims to improve the quality of the assistance provided by primary healthcare teams to ultimately improving infant feeding practices in the Brazilian population. In primary healthcare units, continuing education in breastfeeding and complementary feeding is facilitated by EAAB tutors. A Manual to Support EAAB Tutor (the Manual) was developed following a problem-based learning methodology. This study aimed to evaluate the effectiveness of using the Manual by analyzing exclusive breastfeeding and complementary feeding indicators. Methods A before and after study was conducted at primary healthcare units in Embu das Artes, Brazil. The intervention consisted in the use of the Manual by EAAB tutors who performed some comprehensive training activities with healthcare teams, in a period of 8 months. Subjects consisted of mothers of infants under one year of age attended at primary healthcare units. 561 mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis. Results Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices. Conclusions The Manual is a continuing educational strategy that improved complementary feeding practices in primary health care. Key messages The use of a continuing education strategy grounded on a problem-based learning methodology was effective to produce improvements in complementary feeding practices in primary health care. The 'Manual to Support EAAB Tutor' consists of a tool that has the potential to be adapted for different contexts and easy to disclose to all EAAB tutors in the country.

scholarly journals Effectiveness of an Educational Manual to Promote Infant Feeding Practices in Primary Health Care

2019 ◽  
Vol 40 (4) ◽  
pp. 544-561
Author(s):  
Gláubia Rocha Barbosa Relvas ◽  
Gabriela Buccini ◽  
Louise Potvin ◽  
Sonia Venancio
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Infant Feeding ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Educational Strategy ◽  
Infant Feeding Practices ◽  
Multilevel Regression ◽  
Primary Health ◽  
Before And After

Objective: To test the hypothesis that a continuing educational strategy (ie, “the manual”) in primary health-care improves infant feeding practices among infants under 1 year of age. Methods: A before and after study was conducted at primary health-care units in Embu das Artes, Brazil. The intervention was the use of a manual created to support continuing educational activities on breastfeeding and complementary feeding to be performed by tutors of Estratégia Amamenta e Alimenta Brasil with health-care teams, in a period of 8 months. Five hundred sixty-one mothers before and 598 mothers after intervention were interviewed about breastfeeding and complementary feeding practices. Multivariate analysis was performed using Poisson multilevel regression to test the hypothesis. Results: Lack of minimum food diversity (before 62.9%; after 50.3%) and lack of food adequacy (before 77.5%; after 63.3%) decreased significantly. Regression analysis confirmed that infants after the intervention had lower prevalence of inadequacy of complementary feeding. While the intervention did not show significant association with exclusive breastfeeding, it showed association with the improvement of complementary feeding practices. Conclusions: The manual is a continuing educational strategy that improved complementary feeding practices in primary health care.

scholarly journals Continuing Education in Health: interprofessional practices in the field of Collective Health

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A P N Fornereto ◽  
M N Ogata ◽  
T A Santos ◽  
A B C Franceschini ◽  
MCRLR Pinto ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuing Education ◽  
Technical Assistance ◽  
Health Management ◽  
Multidisciplinary Teams ◽  
Target Area ◽  
Clinic Management ◽  
Primary Health ◽  
Health Support

Abstract Family Health Support Centres (NASFs, in Portuguese) aim to develop interprofessional practices anchored in the assumptions of Primary Health Care, guided by the criteria of shared care specific professional interventions, management processes, interdisciplinarity, intersectoriality, Continuing Education in Health and health promotion. This health management methodology (Matrix Support) still represents a challenge to workers and managers, as it switches the logic of clinical thought from individual-centred, ambulatory and disciplinary care to collective, territory and interdisciplinary care. This study might illustrate and allow sharing of experiences about a work management format for multidisciplinary teams in Primary Health Care. A partnership between the University and the state health department was established in order to elaborate a collaborative, educational and supportive action. We formed a group of workers in the target area (24 municipalities and 18 teams) who had a focus on Continuing Education in Health using Institutional Analysis as theoretical reference. The main goal of the action was to provide spaces to share experiences and learning in the perspective of Continuing Education in Health. How does Continuing Education in Health support interprofessional practices in the field of Collective Health? Among the main results, we list: reflection about organisation practices of multiprofessional work, reflection about care practices and clinic management in the technical-assistance and pedagogic perspectives of Matrix Support; encouragement to improve the services offered in this level of care and their relationship with other points of the network. This experience showed us the importance of three main aspects: Continuing Education in Health, as a strategy of critical analysis about work and workers; the partnership and integration between teaching and service; and interprofessional formation processes (necessary to NASF and Collective Health). Key messages Continuing Education in Health is a strategy to deal with challenges and possibilities of interprofessional practices in the field of Collective Health. Enabling experiences and providing spaces for health professionals to share experience and learning.

scholarly journals Primary care organizational model mix and avoidable hospitalization: an ecological study in Portugal

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pinto ◽  
J V Santos ◽  
M Lobo ◽  
J Viana ◽  
J Souza ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Pay For Performance ◽  
Care Quality ◽  
Organizational Model ◽  
Avoidable Hospitalizations ◽  
Primary Health ◽  
Age And Sex

Abstract Background In Portugal, there are different organizational models in primary health care (PHC), mainly regarding the payment scheme. USF-B is the only type with financial incentives to the professional (pay-for-performance). Our goal was to assess the relationship between groups of primary healthcare centres (ACES) with higher proportion of patients within USF-B model and the rate of avoidable hospitalizations, as proxy of primary care quality. Methods We conducted a cross-sectional study considering the 55 ACES from mainland Portugal, in 2017. We used data from public hospitalizations to calculate the prevention quality indicator (avoidable hospitalizations) adjusted for age and sex, using direct standardization. The main independent variable was the proportion of patients in one ACES registered in the USF-B model. Unemployment rate, proportion of patients with family doctor and presence of Local Health Unit (different organization model) within ACES were also considered. The association was assessed by means of a linear regression model. Results Age-sex adjusted PQI value varied between 490 and 1715 hospitalizations per 100,000 inhabitants across ACES. We observed a significant effect of the proportion of patients within USF-B in the crude PQI rate (p = 0.001). However, using the age-sex adjusted PQI, there was not a statistical significant association (p = 0.504). This last model was also adjusted for confounding variables and the association remains non-significant (p = 0.865). Conclusions Our findings suggest that, when adjusting for age and sex, there is no evidence that ACES with more patients enrolled in a pay-for-performance model is associated with higher quality of PHC (using avoidable hospitalizations as proxy). Further studies addressing individual data should be performed. This work was financed by FEDER funds through the COMPETE 2020 - POCI, and by Portuguese funds through FCT in the framework of the project POCI-01-0145-FEDER-030766 “1st.IndiQare”. Key messages Adjusting PQI to sex and age seems to influence its value more than the type of organizational model of primary health care. Groups of primary healthcare centres with more units under the pay-for-performance scheme was not associated with different rate of avoidable hospitalizations.

scholarly journals Infant Feeding Practices in Kaski District, Pokhara

2012 ◽  
Vol 32 (1) ◽  
pp. 23-27
Author(s):  
S Basnet ◽  
E Gauchan ◽  
K Malla ◽  
T Malla ◽  
DP Koirala ◽  
...  
Keyword(s):  
Infant Feeding ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Economic Factors ◽  
Infant Feeding Practices ◽  
Factors Associated ◽  
Awareness Campaigns ◽  
Prelacteal Feeds ◽  
Initiation Of Breastfeeding ◽  
Socio Economic Factors

Background: Children in developing countries are prone to infectious diseases due to insufficient and inappropriate feeding practices. Socio-demographic and socio-economic factors directly and indirectly play a role in influencing infant feeding practices.  This study was conducted to assess the socio-demographic and economic factors associated with initiation of breastfeeding, complimentary feeding, and the various prelacteal feeds practiced in Kaski, Pokhara. Materials and Methods: In this prospective study, interviews were conducted to 500 mothers at Manipal Teaching Hospital who brought their child for treatment. The interviews were conducted in a questionnaire format relating to their demographic and financial statuses. Results: A total of 500 mothers were questioned, out of which 86.6% gave their child breastmilk as its first food. 47% initiated breastfeeding within half an hour of child’s birth. 86% gave Jaulo as the first complementary food to their children. About 26% of the mothers gave complementary feeding to their children before the recommended time of 6 months. Conclusion: Initiation of breastfeeding after life and complementary feeding practices overall has improved from previous studies. There is still need of making awareness campaigns and such in order to further improve this trend. Key words: Breastfeeding; Complimentary feeding; Malnourishment DOI: http://dx.doi.org/10.3126/jnps.v32i1.5339     J. Nepal Paediatr. Soc. Vol.32(1) 2012 23-27

scholarly journals CONTINUING EDUCATION AND HUMANIZATION IN THE TRANSFORMATION OF PRIMARY HEALTH CARE PRACTICES

2019 ◽  
Vol 23 ◽  
Author(s):  
Maria Tereza Soares Rezende Lopes ◽  
Célia Maria Gomes Labegalini ◽  
Maria Elisabeth Kleba da Silva ◽  
Vanessa Denardi Antoniassi Baldissera
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuing Education ◽  
Primary Health ◽  
Health Care Practices ◽  
Care Practices

scholarly journals Psychological trauma and access to primary healthcare for people from refugee and asylum-seeker backgrounds: a mixed methods systematic review

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Clemence Due ◽  
Erin Green ◽  
Anna Ziersch
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Primary Health Care ◽  
General Population ◽  
Primary Healthcare ◽  
Asylum Seeker ◽  
Psychological Trauma ◽  
Service Access ◽  
Primary Health ◽  
The Relationship

Abstract Background Several reviews have found that psychological trauma affects access to health care services, including mental health care, in the general population. People from refugee and asylum seeker backgrounds are more likely to have a mental illness than the general population, and experience a broad range of barriers and facilitators to service access. However, to date there has been no comprehensive consideration of the potential effect of psychological trauma on access to primary health care within this population. Methods This paper provides a mixed-methods systematic review of literature which included any consideration of the relationship between psychological trauma and access to primary health care. A systematic search of Medline, PsychInfo, Scopus, Web of Science, Embase, CINAHL and Cochrane Library was conducted. Study eligibility criteria were empirical, peer-reviewed studies that considered the relationship between psychological trauma and access to, or use of, primary healthcare in resettlement countries for refugees (including asylum seekers). Papers were required to be written in English and published between 1998 and August 2019. Quality was assessed using the Multi-Methods Appraisal Tool. The search identified a total of 14 eligible studies (11 quantitative and 3 qualitative) which had explored this relationship in refugee and asylum seeker populations. Results Overall, synthesis of findings indicated variable results with respect to the impact of psychological trauma on service access. Specifically, the review found that while rates of psychological trauma were high. Key themes were that while general health care access was comparable or greater than the general population, rates of mental healthcare specifically were low. In addition, included papers identified a range of barriers to service access—particularly somatisation, stigma and healthcare provide knowledge about psychological trauma. Conclusions While there is a critical need for more research in this area, the study points to several key recommendations including training of general practitioners in relation to psychological trauma, ensuring culturally responsive services, and the use of interpreters. Finally, due to the levels of somatisation found in some studies, ensuring general practitioners understand the somatic element of psychological trauma—particularly within some groups of people from refugee backgrounds—is important.

scholarly journals Evaluation of ConPrim: A three-part model for continuing education in primary health care

2016 ◽  
Vol 46 ◽  
pp. 115-120 ◽  
Author(s):  
Erika Berggren ◽  
Peter Strang ◽  
Ylva Orrevall ◽  
Ann Ödlund Olin ◽  
Hanna Sandelowsky ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Continuing Education ◽  
Primary Health ◽  
Part Model

scholarly journals Determinants of child wasting in Bhutan. Insights from nationally representative data

2016 ◽  
Vol 20 (2) ◽  
pp. 315-324 ◽  
Author(s):  
Víctor M Aguayo ◽  
Nina Badgaiyan ◽  
Laigden Dzed
Keyword(s):  
Infant Feeding ◽  
Complementary Feeding ◽  
Feeding Practices ◽  
Western Region ◽  
Infant Feeding Practices ◽  
Very Young Children ◽  
Multiple Indicator ◽  
The Western Region ◽  
Nationally Representative ◽  
Prelacteal Feeds

AbstractObjectiveTo characterize the epidemiology of wasting and identify the main predictors of wasting, severe wasting and poor weight-for-height in children.DesignWe analysed a nationally representative sample of 2028 children (Multiple Indicator Survey, 2010).SettingRoyal Kingdom of Bhutan.SubjectsChildren aged 0–23 months.ResultsWasting prevalence was significantly higher among infants aged 0–11 months than among children aged 12–23 months (12·0 v. 6·7 %; P=0·004) and among boys than girls (11·0 v. 7·5 %; P=0·04). Children from the Western region had 63 % higher odds of being wasted than children from the Central/Eastern regions (adjusted OR (AOR)=1·63; 95 % CI 1·14, 2·34). Poor feeding practices were among the most significant predictors of wasting and severe wasting. Children who were given prelacteal feeds in the first days of life had 2·5 times higher odds of being severely wasted than those who were not (AOR=2·49; 95 % CI 1·19, 5·19); inadequate complementary feeding in children aged 0–23 months was associated with 58 % higher odds of being wasted (AOR=1·58; 95 % CI 1·02, 2·47) and 2·3 times higher odds of being severely wasted (AOR=2·28; 95 % CI 1·13, 4·58). The association of poor infant feeding practices with wasting and severe wasting was particularly significant in infants (0–11 months).ConclusionsProgrammes for the detection and treatment of severely wasted children need to prioritize very young children (0–11 months), particularly in the Western region. Programmes for the prevention of wasting need to prioritize the improvement of complementary foods and feeding practices in children aged 6–23 months.

Surviving or thriving in the primary health care research workforce: the Australian experience

2017 ◽  
Vol 23 (2) ◽  
pp. 183
Author(s):  
Jodie Oliver-Baxter ◽  
Lynsey Brown ◽  
Ellen McIntyre
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Healthcare ◽  
Health Care Research ◽  
Healthcare Research ◽  
Full Time ◽  
Policy And Practice ◽  
Primary Health ◽  
Research Workforce

Primary healthcare research strives for high-quality, priority-driven research to inform policy and practice. This relies on a robust and sustainable workforce to tackle complex problems faced in primary health care locally and globally. The current study investigated characteristics, experiences and career paths of the Australian primary healthcare research workforce. Thirty-seven former Research Higher Degree students from University Departments of General Practice and Rural Health completed a survey. Number of provisions for researchers and career path clarity were associated with job satisfaction. Motivators to stay in research included job satisfaction, research in role descriptions, and identification of problems requiring change. Barriers related to funding, time, and other work roles taking priority were identified. Comparisons were made between participants self-identifying as working in primary healthcare research (‘stayers’; n=22) and those no longer part of this workforce (‘leavers’; n=15). Leavers were more likely to be in permanent full-time work whereas stayers had experienced more career progression and mentoring. This study raises challenges faced by primary healthcare researchers and will inform strategies for supporting the sustainability of this workforce.

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