scholarly journals Implementation research on sustainable electrification of rural primary care facilities in Ghana and Uganda

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii124-ii136
Author(s):  
Dena Javadi ◽  
John Ssempebwa ◽  
John Bosco Isunju ◽  
Lucy Yevoo ◽  
Alberta Amu ◽  
...  
Keyword(s):  
Health Services ◽  
Rural Health ◽  
Health Facility ◽  
Health Systems ◽  
Implementation Research ◽  
Health Facilities ◽  
Service Availability ◽  
Community Satisfaction ◽  
Energy Infrastructure ◽  
Implementation Factors

Abstract Access to energy is essential for resilient health systems; however, strengthening energy infrastructure in rural health facilities remains a challenge. In 2015–19, ‘Powering Healthcare’ deployed solar energy solutions to off-grid rural health facilities in Ghana and Uganda to improve the availability of maternal and child health services. To explore the links between health facility electrification and service availability and use, the World Health Organization (WHO), in partnership with Dodowa Health Research Centre and Makerere University School of Public Health, carried out an implementation research study. The objectives of this study were to (1) capture changes in service availability and readiness, (2) describe changes in community satisfaction and use and (3) examine the implementation factors of sustainable electrification that affect these changes. Data were collected through interviews with over 100 key informants, focus group discussions with over 800 community members and health facility assessment checklist adapted from the WHO’s Service Availability and Readiness Assessment tool. Implementation factors were organized using Normalization Process Theory constructs. The study found that access to energy is associated with increased availability of health services, access to communication technologies, appropriate storage of vaccines and medicines, enhanced health worker motivation and increased community satisfaction. Implementation factors associated with improved outcomes include stakeholder engagement activities to promote internalization, provision of materials and information to encourage participation, and establishment of relationships to support integration. Barriers to achieving outcomes are primarily health systems challenges—such as drug stockouts, lack of transportation and poor amenities—that continue to affect service availability, readiness and use, even where access to energy is available. However, through appropriate implementation and integration of sustainable electrification, strengthened energy infrastructure can be leveraged to catalyze investment in other components of functioning health systems. Improving access to energy in health facilities is, therefore, necessary but not sufficient for strengthening health systems.

Predictors of intimate partner violence in patients attending general health services at rural health facilities in Makueni county, Kenya

2020 ◽  
Vol 20 ◽  
pp. 200191
Author(s):  
Victoria Mutiso ◽  
Christine Musyimi ◽  
Tahilia Rebello ◽  
Isaiah Gitonga ◽  
Albert Tele ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Health Services ◽  
Rural Health ◽  
Partner Violence ◽  
General Health ◽  
Intimate Partner ◽  
Health Facilities

scholarly journals PEMAHAMAN TENTANG HAK DAN KEWAJIBAN PESERTA BPJS KESEHATAN DI PUSKESMAS GANDING SUMENEP

2019 ◽  
Vol 4 (2) ◽  
pp. 25-27
Author(s):  
Moh. Jonaidy Prasetiawan ◽  
Dr. Eko Mulyadi ◽  
Sugesti Aliftitah
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Consumer Protection ◽  
Emergency Services ◽  
Health Facilities ◽  
Research Report ◽  
Descriptive Research ◽  
To Come

The large number of BPJS Kesehatan participants who do not understand the rights and responsibilities of BPJS Kesehatan participants, make medical workers in health facilities often conflict with patients and families of patients. This research was conducted to describe the understanding about the rights and obligations of BPJS Kesehatan participants. The method in this research is qulitative descriptive research, this research is intended to investigate the condition, condition or other matters, which result presented in the form of research report. Lack of understanding of BPJS Kesehatan participants due to the absence of clear, correct, detailed and detail information regarding regulations, financing, rights and obligations, sanctions if late dues, health facility destinations, tiered referral, emergency services, how to submit complaints, or concerning health services anything that can and can not be obtained. BPJS Kesehatan socializes passively, which is only doing socialization if invited to come by interested parties. According to Law No. 08 of 1999 on Consumer Protection, BPJS Kesehatan as a business actor is obliged to provide information and socialization that is clear, true and honest about the product of goods or and services to be provided, should not cause the interpretation, must be clear, detailed, and detail. Keyword: Rights, Responsibilities, Socialization, BPJS Kesehatan.

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N. Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). Conclusion There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.

scholarly journals Effectiveness of Essential Health Care Services Delivery in Nepal

1970 ◽  
Vol 6 (2) ◽  
pp. 74-83 ◽  
Author(s):  
B Devkota
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Services ◽  
Health Facility ◽  
Health Care Services ◽  
Health Facilities ◽  
Care Services ◽  
Services Delivery ◽  
Equity And Efficiency

Background: Ensuring delivery of quality health services in a sustainable and equitable manner is a challenge in Nepal. A host of factors may have impeded the access, quality and utilization of the health services particularly by the marginalized and disadvantaged sections of the population. Review essential health care services (EHCS) provided by the public health facilities, level of progress, effectiveness, sustainability, equity and efficiency, quality of care and inclusion of marginalized and disadvantaged populations in health care servicesMethods: A total of 40 VDCs from 10 districts representing five regions and three eco-zones were covered. Altogether 800 mothers with under two year children, 40 health service providers, 145 key informants and 40 exit clients were interviewed. Forty focused group discussions were also conducted. From each district, health records of one hospital, PHCC, HP, SHP and Ayurvedic health facility each were collected.Results: More than two-third (68.2%) of the mothers received antenatal checks, highest in hills (85%) followed by terai (64.5%) and mountain districts (52.8%).Tetanus vaccine coverage (80.7%) seems higher compared to Nepal Demographic Health Survey 2001 (45%). FP use rate in mountain, hill and terai are 57.6%, 54.1% and 49.7%, higher than in DoHS 2003/2004 statistics, which were 26.8%, 36.4% and 45.3% respectively. Nine out of ten patients visiting the health facilities were outpatients. The coverage of DPT 3, Polio 3, BCG and measles are 92.8%, 93.4%, 95.2% and 90.7% respectively. From the service utilization perspective, disparities in terms of gender, ecological regions, season of the year and health facility were revealed.Conclusion: Health sector services are yet to be made responsive to the ecological and district specific health problems, and be made more inclusive linking with doable safety nets.  Key words: Essential health care services; Effectiveness; Sustainability; Equity and efficiency; Quality of care and inclusion  doi: 10.3126/jnhrc.v6i2.2188Journal of Nepal Health Research Council Vol. 6 No. 2 Issue 13 Oct 2008 Page: 74-83 

scholarly journals Management of chronic lung diseases in Sudan and Tanzania: how ready are the country health systems?

2021 ◽  
Author(s):  
Uzochukwu Egere ◽  
Elizabeth Shayo ◽  
Nyanda Ntinginya ◽  
Rashid Osman ◽  
Bandar Noory ◽  
...  
Keyword(s):  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Lung Diseases ◽  
Health Centre ◽  
Sub Saharan Africa ◽  
World Health ◽  
Service Availability ◽  
Chronic Lung Diseases ◽  
Service Readiness

Abstract BackgroundChronic Lung Diseases (CLDs), responsible for 4 million deaths globally every year, are increasingly important in low- and middle-income countries where most of the global mortality due to CLDs currently occurs. As existing health systems in resource-poor contexts, especially sub-Saharan Africa (SSA), are not generally oriented to provide quality care for chronic diseases, a first step in re-imagining them is to critically consider readiness for service delivery across all aspects of the existing system. MethodsWe conducted a mixed-methods assessment of CLD service readiness in 18 purposively selected health facilities in two differing SSA health system contexts, Tanzania and Sudan. We used the World Health Organization’s (WHO) Service Availability and Readiness Assessment checklist, qualitative interviews of key health system stakeholders, health facility registers review and assessed clinicians’ capacity to manage CLD using patient vignettes. CLD service readiness was scored as a composite of availability of service-specific tracer items from the WHO service availability checklist in three domains: staff training and guidelines, diagnostics and equipment, and basic medicines. Qualitative data were analysed using the same domains.ResultsOne health facility in Tanzania and five in Sudan, attained a CLD readiness score of ≥50% for CLD care. Scores ranged from 14.9% in a dispensary to 53.3% in a health centre in Tanzania, and from 36.4% to 86.4% in Sudan. The least available tracer items across both countries were trained human resources and guidelines, and peak flow meters. Only two facilities had COPD guidelines. Patient vignette analysis revealed significant gaps in clinicians’ capacity to manage CLD. Key informants identified low prioritization as key barrier to CLD care. Conclusion: Gaps in service availability and readiness for CLD care in Tanzania and Sudan threaten attainment of universal health coverage in these settings. Detailed assessments by health systems researchers in discussion with stakeholders at all levels of the health system can identify critical blockages to reimagining CLD service provision with people-centred, integrated approaches at its heart.

scholarly journals Perceptions on adolescents’ friendly health services concepts and the use of health services by adolescents in Kavango region, Namibia

2021 ◽  
Vol 8 (4) ◽  
pp. 1632
Author(s):  
Taimi Amakali-Nauiseb ◽  
Joan M. Kloppers
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Health Facilities ◽  
Drop Out ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Qualitative Approaches ◽  
School Drop Out ◽  
Transition Into Adulthood ◽  
Use Of Health Services

Background: The objective of this study was to determine the perceptions on adolescents’ friendly health services concepts and the use of health services by adolescents in Kavango region, Namibia.Methods: A cross-sectional analytical study was conducted using mixed methods - quantitative and qualitative approaches among 350 school learners and 150 school drop-out adolescents. In total a sample of 540 was utilized. The stratified random sampling techniques were used in the selections of the circuit and the schools. Structured questionnaires were used in face-to-face interviews, and in depth interviews were conducted among the key informants (25 teachers) and as well with 15 school learners.Results: Illustrated the following: there was a statistically highly significant association between adequate confidentiality, last visit at the health facility and both sexually transmitted infections and visited health facility (p=0.004 respectively). A statistically significant association was found between all visits to health facilities, pamphlets and talks on contraceptives; visit to health facilities, comfortable and contraceptives talks (p=0.001 respectively). Additionally, there was a statistically significant association respectively between both contraceptives used and number of times services sought and between services, pamphlets and contraceptives with a (p 0.010<0.05).Conclusions: The youth need health services that are sensitive to their unique stage of biological, cognitive, and psychosocial transition into adulthood. Health services that are more accessible and acceptable to adolescents and made more youth-friendly.  

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to provide geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of key items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8 - 26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores with regard to; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher level HFs were statistically significantly friendlier than lower level HFs (p= 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p=0.025). Conclusion There is low readiness of public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for old people if the 2020 global healthy ageing goal is to be met.

scholarly journals Consumer choice of health facility among the lowest socioeconomic group in newly established demand-side health-financing scheme in Khyber Pakhtunkhwa, Pakistan

2021 ◽  
Author(s):  
Sidra Malik ◽  
Naveed Sadiq ◽  
Saeed Anwar ◽  
Umair Qazi
Keyword(s):  
Health Services ◽  
Private Sector ◽  
Health Facility ◽  
Consumer Choice ◽  
Geographic Location ◽  
Health Facilities ◽  
Health Protection ◽  
Social Health ◽  
Socioeconomic Group ◽  
The Social

Background: The Social Health Protection Initiative was introduced initially in Pakistan in Khyber Pakhtunkhwa Province. The initiative aimed to provide the lowest socioeconomic group of the population with in-patient healthcare services, which otherwise would be financially hard to obtain. It is one of the flagship projects of the Provincial Government to contribute towards the United Nations Sustainable Development Goals and universal health coverage. Aims: To assess consumer choice of health facility and its determinants for public versus private sector health facilities by people enrolled in Social Health Protection Initiative. Methods: We used secondary data of availed health services from February 2016 to September 2017 under the Social Health Protection Initiative. A proxy outcome variable, visit to health facility, was used to determine consumer choice between public and private sector health facilities. The treatment group (health services received by beneficiaries) was used as an independent variable controlled for age groups, cost groups, and geographic location of health facilities. All statistical analyses were performed by SPSS version 20. Results: Most beneficiaries chose private over public health facilities (90.25%). However, adjusted odds of visiting a public sector health facility for surgical and gynaecological services were 0.12 [95% confidence interval (CI): 0.10–0.16] and 0.11 (95% CI: 0.09–0.14) respectively, when compared to medical services. Conclusion: Social Health Protection Initiative beneficiaries have lesser odds of visiting a public hospital over a private one. The choice may be affected by factors such as age of the beneficiary, cost of health services, and geographic location of health facilities.

scholarly journals Resilience of health systems in conflict affected governorates of Iraq, 2014–2018

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Shaimaa Ibrahim ◽  
Sara Al-Dahir ◽  
Taha Al Mulla ◽  
Faris Lami ◽  
S. M. Moazzem Hossain ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Services ◽  
Health Facility ◽  
Health Systems ◽  
Health Workers ◽  
Communicable Disease ◽  
The Public ◽  
Health Facility Survey ◽  
Initial Shock ◽  
Facility Survey

Abstract Objectives The objective of this study was to assess the resilience of health systems in four governorates affected by conflict from 2014 to 2018, and to convey recommendations. Methods Health managers from Al Anbar, Ninawa, Salah al-Din, and Kirkuk governorates discussed resilience factors of Primary Health Care services affected by the 2014–2017 ISIS insurgency in focus groups, and general discussions. Additional information was gathered from key informants and a UNICEF health facility survey. Three specific aspects were examined: (1) meeting health needs in the immediate crisis response, (2) adaptation of services, (3) restructuring and recovery measures. Data from a MoH/UNICEF national health facility survey in 2017 were analyzed for functionality. Results There were many common themes across the four governorates, with local variations. (1) Absorption The shock to the public sector health services by the ISIS invasion caught health services in the four governorates unprepared, with limited abilities to continue to provide services. Private pharmacies and private clinics in some places withstood the initial shock better than the public sector. (2) Adaptation After the initial shock, many health facilities adapted by focusing on urgent needs for injury and communicable disease care. In most locations, maternal, neonatal, and child health (MNCH) preventive and promotive PHC services stopped. Ill persons would sometimes consult health workers in their houses at night for security reasons. (3) Restructuring or transformative activities In most areas, health services recovery was continuing in 2020. Some heavily damaged facilities are still functioning, but below pre-crisis level. Rebuilding lost community trust in the public sector is proving difficult. Conclusion Health services generally had little preparation for and limited resilience to the ISIS influx. Governorates are still restructuring services after the liberation from ISIS in 2017. Disaster planning was identified by all participants as a missing component, as everyone anticipated future similar emergencies.

HARMONISASI POLA PENGELOLAAN KEUANGAN FASKES DI LINGKUNGAN KEMENTERIAN PERTAHANAN DAN TNI DENGAN UU NO. 44 TAHUN 2009 tentang RUMAH SAKIT

2019 ◽  
Vol 19 (2) ◽  
pp. 182
Author(s):  
Sutarno Sutarno
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Social Security ◽  
Health Facility ◽  
Health Facilities ◽  
Fundamental Change ◽  
Legal Research ◽  
Legal Rules ◽  
The Social ◽  
The Government

<em>Since the enactment of Law Number 24 of 2011 concerning the Social Security Organizing Agency, there has been a very fundamental change in terms of Health Services. Health facilities within the Ministry of Defense and TNI which also affect budget governance. This legal research is a normative law with sources of primary and secondary legal materials that aim to review and analyze the legal rules regarding the management of income income received by Health Facilities within the Ministry of Defense and the TNI based on Law Number 44 of 2009; and reviewing and analyzing conflicting norms for the use of the TNI Health Facility as of the enactment of Law Number 24 of 2011 concerning the Health Insurance Administering Body. The results showed that the TNI Hospital which is a health facility owned by the Government should be subject to the rules contained in RI Law No. 44 of 2009 concerning Hospitals.</em>

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