scholarly journals The Integral Role of CBOCs in Rural Healthcare: Promises and Challenges

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 119-119
Author(s):  
Camilla Pimentel ◽  
Kathryn Nearing ◽  
Laura Kernan ◽  
Eileen Dryden ◽  
Lauren Moo
Keyword(s):  
Local Community ◽  
Medical Center ◽  
Healthcare Delivery ◽  
Outpatient Services ◽  
Healthcare Delivery System ◽  
Community Based ◽  
Care Services ◽  
Medical Centers ◽  
Integral Role

Abstract Community-based outpatient clinics are critical to extending the geographic reach of VA’s healthcare delivery system. Nationwide, 733 CBOCs provide outpatient care to nearly half of the VA’s patient population. The 13 rural CBOCs in the study sample provide outpatient primary care, mental health care, and a limited number of specialty care services. Located 1–3.5 hours away from their closest VA Medical Center, these CBOCs have a wide—sometimes interstate—service catchment area. To effectively serve increasingly older and medically complex patient populations, they rely heavily on partnerships with larger VA Medical Centers and local community providers for inpatient, residential, and additional outpatient services. CBOCs experience myriad staffing challenges, including staff turnover, “access providers” working at multiple CBOCs, and highly variable training in rural health and geriatrics. While some CBOCs have robust telehealth offerings, others cannot currently grow their telehealth capacity owing to constraints in clinic space and provider schedules.

scholarly journals Exploring general practitioners’ perceptions about the primary care gatekeeper role in Indonesia

2020 ◽  
Author(s):  
Joko Mulyanto ◽  
Yudhi Wibowo ◽  
Dionne S. Kringos
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Work Experience ◽  
Healthcare Delivery ◽  
Care Facility ◽  
Personal Factors ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
And Performance

Abstract Background In the current healthcare delivery system funded by National Health Insurance (NHI) in Indonesia, the gatekeeper role of primary care services is critical to ensuring equal healthcare access for the population. To be effective, gatekeeping relies on the performance of general practitioners (GPs). However, the perceptions held by Indonesian GPs about their gatekeeper role are not yet well documented. This study describes the self-perceived knowledge, attitudes and performance of Indonesian GPs with respect to the gatekeeper role and explores associated factors. Methods We conducted a cross-sectional study of all primary care facilities (N = 75) contracted by the regional NHI office in the Banyumas district. The 73 participating GPs completed a written questionnaire that assessed their knowledge, attitudes and performance in relation to the gatekeeper role. Personal and facility characteristics were analysed in a generalised linear model as possible associating factors.Results GPs scored relatively high in the domains of knowledge and performance but scored lower in their attitudes towards the gatekeeper role of primary care. In the full-adjusted model, no factors were significantly associated with the knowledge score. Work experience as GPs, private or civil service employment status and rural or urban location of the primary care facility were linked to attitude scores. Full- or part-time employment and type of facility were factors associated with the performance score. Conclusion GPs in Indonesia are knowledgeable and report that they adequately perform their function as gatekeepers in primary care. However, their attitudes towards the gatekeeper function are less positive. Attitudes and performance with respect to the primary care gatekeeper role are likely influenced more by contextual factors such as location and type of facility than by personal factors. Efforts to address contextual issues could include improvements in practice standards for privately practising physicians and public information campaigns about gatekeeping regulations. Such efforts will be crucial to improving the gatekeeper role of primary care in Indonesia and assuring efficient access to high-quality care for all.

scholarly journals Tincture of time

2017 ◽  
Vol 1 (3) ◽  
Author(s):  
Erin Nissen Castelloe
Keyword(s):  
Clinical Medicine ◽  
Healthcare Delivery ◽  
Work Situation ◽  
Healthcare Delivery System ◽  
Decision To Leave ◽  
Professional Obligations ◽  
Personal Time ◽  
Personal Experiences ◽  
Do So

In this article (part two of a two-article piece), I, Erin Nissen Castelloe, meditate on long-standing frustrations originating from my personal experiences in clinical medicine. My exit from clinical medicine can most succinctly be attributed to burnout, burnout triggered by inadequate time to address my patients’ needs and complete the tasks mandated by the healthcare delivery system in which I worked. Self- and system-imposed pressures to meet my professional obligations led to chronic overwork, reduced personal time, sleep deprivation, exhaustion, and ultimately, recognition that my work situation was unsustainable. For more than ten years, I have questioned my decision to leave clinical medicine, hashing and rehashing the circumstances leading up to it. I am ready to let go of the questions that have haunted me, but I want to do so deliberately, considering them carefully before I release them. Therefore, with high hopes – to understand my past, accept it, and move boldly into my future in medicine – I searched the literature, focusing on burnout in physicians and physicians-in-training; the role of time pressures in burnout; and the value of physicians spending adequate and high-quality time with patients.

scholarly journals A Mixed Questionnaire Study on Prayer as Complementary and Alternative Medicine in Ghana

2021 ◽  
pp. 196-208
Author(s):  
Raphael Nyarkotey Obu ◽  
Lawrencia Aggrey-Bluwey
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Primary Healthcare ◽  
Healthcare Delivery ◽  
Complementary Alternative Medicine ◽  
Naturopathic Medicine ◽  
Medical Centers ◽  
Integral Role ◽  
The Impact ◽  
Complementary And Alternative

Background: Prayer is paramount in the spiritual welfare and development of an individual. Interestingly, prayer is also considered as a form of complementary alternative medicine and is employed in primary healthcare delivery. Aim: The purpose of this study is to investigate the impact of prayer in primary healthcare delivery as a form of complementary healthcare. This study also investigates why patients opt for prayer as an alternative to standard medical care and ultimately to review the scientific aspect of prayer in medicine. Methods: The study incorporates a mixed methods study with integrated data analysis. The respondents in this study were selected practitioners of Naturopathic Medicine with pastoral background, who belong to the Association of Naturopathic Medicine Practitioners in Ghana. Results: Patients and complementary and alternative medicine practitioners alike in Ghana believe that prayer is very important to aid recovery and hence, plays an integral role as complementary medicine in healthcare. Conclusion: This study demonstrates that there is a role of prayer as complementary alternative medicine in primary healthcare delivery. We therefore hold the view that, pastors at the prayer camps should be well educated in basic medical sciences to enable an effective referral pathway to the standard medical centers.

scholarly journals IMPLEMENTASI CORPORATE SOCIAL RESPONSIBILITY (CSR) DALAM MEWUJUDKAN PARIWISATA BERBASIS MASYARAKAT BERKELANJUTAN

2020 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Ni Wayan Juniari ◽  
Luh Putu Mahyuni
Keyword(s):  
Corporate Social Responsibility ◽  
Social Responsibility ◽  
Local Community ◽  
Sustainable Business ◽  
Community Based ◽  
Tourist Destination ◽  
Sustainable Community ◽  
Corporate Social

Peningkatan kunjungan wisatawan ke suatu destinasi wisata selain membawa manfaat positif juga meninggalkan dampak negatif. Peran manajer sangat signifikan untuk memastikan operasional perusahaan pengelola destinasi wisata dapat mendukung perekonomian masyarakat lokal dan tidak merusak lingkungan, sehingga terwujud praktik bisnis berkelanjutan. Penelitian ini bertujuan mengeksplorasi bagaimana corporate social responsibility (CSR) dipraktikkan untuk dapat mewujudkan pariwisata berbasis masyarakat berkelanjutan. Untuk mencapai tujuan penelitian, penelitian kualitatif dengan pendekatan studi kasus dilakukan di kawasan wisata Monkey Forest Ubud, Gianyar, Bali. Berlandaskan pada konsep CSR dan pariwisata berbasis masyarakat, data dikumpulkan melalui wawancara kemudian dianalisis secara kualitatif dengan bantuan software NVivo12. Penelitian ini mengindikasikan bahwa Monkey Forest Ubud mengimplementasikan berbagai bentuk CSR yang memungkinkan masyarakat lokal berpartisipasi penuh dalam operasional kawasan wisata dan memperoleh manfaatnya secara langsung. Penelitian ini memberikan inspirasi mengenai bagaimana suatu destinasi/kawasan wisata dapat mengimplementasikan CSR untuk memastikan terwujudnya bisnis berkelanjutan dan pada saat bersamaan berkontribusi bagi pengembangan pariwisata berbasis masyarakat berkelanjutan.   Increasing tourist arrivals in a touristic area, besides bringing positive impacts also leaving negative footprints. The role of managers is significant to ensure that the business operational supports the local community and preserve the environment, so as sustainable business can be attained. This study aims at exploring how corporate social responsibility (CSR) is practiced to develop sustainable community-based tourism. To address the research objective, a qualitative case study was conducted at Ubud Monkey Forest, Gianyar, Bali. Guided by the concept of CSR and community-based tourism, data was collected through interviews and analyzed qualitatively with the help of NVivo12 software. This research indicates that Ubud Monkey Forest implements various CSR activities that allow the local community to participate in the operational of the forest and obtain the benefits from the operational. This research exemplifies how a tourist destination could implement CSR to ensure business sustainability and at the same time contribute to the development of sustainable community-based tourism.

scholarly journals Metodologie, percorsi operativi e strumenti per lo sviluppo delle cooperative di comunità nelle aree interne italiane

2020 ◽  
Keyword(s):  
Local Community ◽  
Social Economic ◽  
Well Being ◽  
Local Communities ◽  
Policy Support ◽  
Community Based ◽  
Research Project ◽  
Environmental Vulnerability ◽  
Present Essay

The present essay includes the main results of the research project on community-based cooperatives, promoted in 2018 by Fondosviluppo and FEDAM, and implemented by researchers of University of Molise. The volume highlights the potential and the modes of operating of community-based cooperatives, which carry out a mix of productive and socially useful activities for local community well-being. The research, through a new methodological and operational path, reaches the following results: a) devise a strategy to detect the degree of social, economic and environmental vulnerability levels of Italian inner areas; b) outline the needs of local communities; c) define the role of community-based cooperatives in bridging regional gaps, also identifying their possible policy support.

scholarly journals Peran Kelompok Masyarakat dalam Rehabilitasi Ekosistem Mangrove di Pesisir Kota Semarang

2018 ◽  
Vol 6 (2) ◽  
pp. 100 ◽  
Author(s):  
Nana Kariada Tri Martuti ◽  
Sri Mulyani Endang Susilowati ◽  
Wahid Akhsin Budi Nur Sidiq ◽  
Ditha Prasisca Mutiatari
Keyword(s):  
Environmental Quality ◽  
Coastal Area ◽  
Wave Breaking ◽  
Local Community ◽  
Analysis Method ◽  
Community Based ◽  
Interactive Analysis ◽  
Community Based Programs

The coastal area of Semarang City has a strategic function for regional economic development. Due to land use change, the environmental quality of coastal area is damaged and declining. The environmental quality decline has affected the socio-economic quality of local community. This research aims to investigate the role of local community in sustainable environmental management in Semarang City coastal area. The study takes place in two kelurahans, namely Tugurejo and Mangunharjo, and applies a descriptive qualitative approach to figure out the local community role in the coastal environment rehabilitation. Data collection through a preliminary survey supported with a satellite imagery study covers up an appropriate ecosystem with the research substance. Then the following data analysis and interpretation uses Miles and Huberman interactive analysis method. The results show the significant role of the local community in coastal area quality management and improvement in Semarang City more effectively and efficiently. This relates to their active interactions in various community-based programs including wave-breaking instrument building and mangrove nursery and planting.

scholarly journals The Role of Local Leadership in Community- Based Rural Homestay in Malaysia

2018 ◽  
Vol 2 (4) ◽  
pp. 65-71
Author(s):  
SITI AISAH ABAS ◽  
NORHAZLIZA ABD HALIM
Keyword(s):  
Local Community ◽  
Focal Point ◽  
Value Added ◽  
Community Empowerment ◽  
Community Based ◽  
Local Participation ◽  
Local Leadership ◽  
Local Product ◽  
Conceptual Research

This conceptual research intended to highlight the emergent concept of local leadership in Community-Based Rural Homestay (CBRH) in Malaysia. In addition, the development and progress of local participation in CBRH also become the focal point to be discussed. Undeniably, Community-Based Rural Homestay become a vehichle and development for local community to enhance their socioeconomy through engagement as homestay operators. Ministry of Tourism and Culture put a lot effort to improve infrastructure and facilities in every homestay providers to boost up tourist arrival. Apart of being source of income to local community, CBRH also offers various local product, quality rural experience and culture preservation and conservation for tourist.  Thus, CBRH programme has proved as a platform for local community empowerment and distributed benefir as individual or collective basis. Most of the homestay operator motivated to participate in this programme due to value-added to their source of income and medium for them to promote their local culture to tourist. However, incompetent leaders to lead the CBRH initiatives become a challenge to homestay operator as they need a proactive leaders to drive and facilitate them in order to handle tourist and homestay operation.

scholarly journals Women and Batik Conservation on Muria Slopes: A Study of Female Batik Crafters in Kudus

2018 ◽  
Vol 1 (1) ◽  
pp. 33-42
Author(s):  
Zaimatus Sa’diyah
Keyword(s):  
Local Community ◽  
Public Awareness ◽  
Environmental Conservation ◽  
Development Programs ◽  
Human Beings ◽  
Community Based ◽  
Critical Attention ◽  
Youth Community ◽  
And Training

The worsening condition of nature calls the critical attention of human beings to look for primary keys to deal with. Struggling with the same issue, the local government of Kudus promotes community-based development programs that concern with introducing environmental conservation and education, besides cultural understanding programs, which emphasizes local community awareness in environmentally friendly tourism hosting and management. The youth community is invited to join workshops and training to enrich the skills in some handy craft production, networking and society management, particularly related to batik. “Komunitas Batik Manjing Werni” (KBMW) is one of the community-based development centers that concerns in promoting a unique batik motif. This article aims to describe the role of female crafters of natural motif batik in batik conservation on Muria slope. The main objective is to identify how these female crafters in KBMW contribute to build public awareness around Muria slope conservation through religious teachings and education. The data in this descriptive-qualitative research were obtained through observation, documentation and interviews with key persons in KBMW, people living around KBMW and Kudus regency tourism office.

scholarly journals “The Skill Is Using Your Big Head Over Your Little Head”

2013 ◽  
Vol 7 (4_suppl) ◽  
pp. 31S-42S ◽  
Author(s):  
Lisa Bowleg ◽  
Meaghan Mingo ◽  
Jenné S. Massie
Keyword(s):  
Hiv Prevention ◽  
Low Income ◽  
Urban Areas ◽  
Local Community ◽  
Development Program ◽  
Community Based ◽  
Prevention Messages ◽  
Community Based Organization ◽  
Hiv Aids

Although the disproportionate toll of HIV/AIDS among Black heterosexuals, particularly in low-income U.S. urban areas is well documented, Black heterosexual men are rarely the explicit focus of HIV prevention messages, research, and interventions. We conducted 4 focus groups with 28 Black men, aged 19 to 51 years, who were enrolled in the workforce and fatherhood development program of a local community-based organization to examine (a) the priority and role of HIV/AIDS in their lives and (b) their HIV prevention needs. Although none articulated HIV as a top life priority, respondents nonetheless prioritized educating their children about HIV prevention and protecting their main partners from HIV if they had other sexual partners. Analyses demonstrated that participants said they wanted and needed: to learn how to talk to partners about HIV testing and use condoms when tempted not to do so, and more discussion-oriented educational opportunities to learn and exchange prevention strategies.

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