scholarly journals The impact of reimbursed user fee exemption of health centre outpatient consultations for the poor in pluralistic health systems: lessons from a quasi-experiment in two rural health districts in Cambodia

2019 ◽  
Vol 34 (10) ◽  
pp. 740-751 ◽  
Author(s):  
Catherine Korachais ◽  
Por Ir ◽  
Elodie Macouillard ◽  
Bruno Meessen
Keyword(s):  
Public Health ◽  
Rural Health ◽  
Health Centre ◽  
User Fees ◽  
Health Seeking ◽  
The Poor ◽  
Health Centres ◽  
The Impact ◽  
Health Districts

Abstract Fees charged at the point of use are a barrier to the health services’ users, especially for the poorest. Two decades ago, Cambodia introduced the so-called health equity fund (HEF) strategy, a waiver scheme which enhances access to public health services for the poor without undermining the economic situation of facilities. Evidence suggests that hospital-based HEF effectively removed financial barriers and reduced out-of-pocket expenditures. There is less evidence on the effectiveness of the HEF when assistance is extended to the primary level of healthcare. This research explores the impact of a HEF extended to health centres in two rural health districts. Two household surveys and 16-month diary data allowed to assess the impact of the intervention on health-seeking behaviours and expenditure of poor households. Though HEF effectively removed user fees at public health facilities, health centre utilization of sick and poor people did not budge much in the intervention district; self-medication and private provider consultations remained the preferred health-seeking behaviours, by far, even if more expensive. Difference-in-difference estimates confirmed that HEF had a slight impact on health-seeking behaviours, but only for the subgroups of HEF beneficiaries living close to the health centre and ready to test their new entitlement. This research reminds on the importance of the context for the effectiveness of any policy: in a highly pluralistic health sector, waiving already low-user fees in public health centres may be insufficient to increase rapidly the use of those facilities and reduce catastrophic spending. In such context, apart from distance to health centres, perceived quality of services at the health centres, which was relatively low compared with other providers, also matters. Although the HEF scheme plays a role in improving perceived and objective quality of care, complementary means are to be deployed.

Relationship between Implementation of Public Health Center Management, Work Commitment and Quality of Medical Services in Public Health Centres, Karangasem, Bali

2016 ◽  
pp. 43 ◽  
Author(s):  
Artini Artini ◽  
I.W. Suarjana ◽  
I.P. Ganda Wijaya
Keyword(s):  
Public Health ◽  
Health Center ◽  
Health Centre ◽  
Health Concern ◽  
Medical Services ◽  
Cross Sectional ◽  
Public Health Center ◽  
The Public ◽  
Health Centres

Background and purpose: Quality of health services in the public health center in Karangasem remain a public health concern. Preliminary findings indicated there was a problem regarding implementation of health center management and working commitment of staff. This study aimed to determine the association between quality of medical services, the implementation of health centre management and working commitment of staff.Methods: Study was cross-sectional among 61 doctors and nurses at 12 public health centres who were selected purposively. Data were collected from February to March 2015 using questionnaires. Data analysis using logistic regression to examine the relationship between the quality of medical services with the implementation of health center management and working commitment of staff.Results: Findings indicated that the quality of medical services, the implementation of health centre management and working commitment of staff were relatively low. The quality of medical services provided was found associated with working commitment of staff (AOR=11.3; 95%C: 1.75-73.06) and not associated with implementation of health center management (AOR=0.9; 95%CI: 0.18-5.24).Conclusion: The quality of medical services provided was found associated with working commitment of staff and not associated with implementation of health center management.

Breast Feeding Practices in Urban and Rural Health Centres: Impact of Baby Friendly Hospital Initiative in Ile-Ife, Nigeria

2000 ◽  
Vol 14 (2) ◽  
pp. 119-125 ◽  
Author(s):  
E.O. Ojofeitimi ◽  
O.A. Esimai ◽  
O.O. Owolabi ◽  
Oluwabusi ◽  
O.F. Olaobaju ◽  
...  
Keyword(s):  
Rural Health ◽  
Breast Feeding ◽  
Rural Areas ◽  
Health Centre ◽  
Feeding Practices ◽  
Educational Status ◽  
Baby Friendly Hospital Initiative ◽  
Rural Health Centres ◽  
Health Centres ◽  
The Impact

The present study was carried out to assess the impact of the Baby Friendly Hospital Initiative (BFHI) on breast feeding practices. The variables used to evaluate the BFHI centre included time of initiation of breastfeeding (BF) after delivery, intended duration of BF, adoption of exclusive breastfeeding (EBF) in relation to educational status, location of health centre, and knowledge and practice of positioning the child at the breast. Observation, questionnaire and interview techniques were employed to collect the data among 217 and 214 nursing mothers (NMs) from Urban and Rural Health Centres. Of the 228 NMs who initiated BF within 30 minutes after delivery, 140 (61 %) were from a designated BFHI Centre and 88 (39%) were from an undesignated BFHI rural health centre. There was a significant relationship between the practice of EBF and designation of BFHI centre (P = 0.0001). The higher the level of education of the NMs, the higher the present of NMs subscribing to EBF (P = 0.0001). The present study has also confirmed that EBF which was once considered to be less than 3%, has increased significantly to 61 %. The success was not unconnected with the inauguration of BFHI. The BFHI is recording huge success in the urban area but the impact is still to be felt in the rural areas.

scholarly journals Knowledge and practices regarding malaria and the National Treatment Guidelines among public health workers in Equatorial Guinea

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Marta Blanco ◽  
Pablo Suárez-Sanchez ◽  
Belén García ◽  
Jesús Nzang ◽  
Policarpo Ncogo ◽  
...  
Keyword(s):  
Public Health ◽  
Treatment Guidelines ◽  
Health Workers ◽  
Health Centre ◽  
Regional Hospital ◽  
Malaria Treatment ◽  
Diagnosis And Treatment ◽  
Equatorial Guinea ◽  
Public Health Facilities ◽  
Health Centres

Abstract Background In 2018, an estimated 228 million cases of malaria occurred worldwide. Countries are far from having achieved reasonable levels of national protocol compliance among health workers. Lack of awareness of treatment protocols and treatment resistance by prescribers threatens to undermine progress when it comes to reducing the prevalence of this disease. This study sought to evaluate the degree of knowledge and practices regarding malaria diagnosis and treatment amongst prescribers working at the public health facilities of Bata, Equatorial Guinea. Methods A cross-sectional survey was conducted in October-December 2017 amongst all public health professionals who attended patients under the age of 15 years, with suspected malaria in the Bata District of Equatorial Guinea. Practitioners were asked about their practices and knowledge of malaria and the National Malaria Treatment Guidelines. A bivariate analysis and a logistic regression model were used to determine factors associated with their knowledge. Results Among the 44 practitioners interviewed, 59.1% worked at a Health Centre and 40.9% at the District Hospital of Bata. Important differences in knowledge and practices between hospital and health centre workers were found. Clinical diagnosis was more frequently by practitioners at the health centres (p = 0.059), while microscopy confirmation was more frequent at regional hospital (100%). Intramuscular artemether was the anti-malarial most administrated at the health centres (50.0%), while artemether-lumefantrine was the treatment most used at the regional hospital (66.7%). Most practitioners working at public health facilities (63.6%) have a low level of knowledge regarding the National Malaria Treatment Guidelines. While knowledge regarding malaria, the National Malaria Treatment Guidelines and treatment resistances is low, it was higher amongst hospital workers than amongst practitioners at health centres. Conclusions It is essential to reinforce practitioners’ knowledge, treatment and diagnosis practices and use of the National Malaria Treatment Guidelines in order to improve malaria case management and disease control in the region. A specific malaria training programme ensuring ongoing updates training is necessary in order to ensure that greater experience does not entail obsolete knowledge and, consequently, inadequate diagnosis and treatment practices.

scholarly journals Second Year Nursing Students’ Experiences of Clinical Placement in a Rural Health Centre

2018 ◽  
Vol 3 (2) ◽  
pp. 107
Author(s):  
Vistolina Nuuyoma ◽  
Daniel Opotamutale Ashipala
Keyword(s):  
Nursing Education ◽  
Nursing Students ◽  
Rural Health ◽  
Positive Impact ◽  
Health Centre ◽  
Learning Context ◽  
Rural Health Centre ◽  
Satellite Campus ◽  
Health Centres ◽  
Second Year

Introduction: In nursing education, it is expected that students take theoretical and practical courses. Practical components are an integral part of learning in nurses’ training, which is effected through placement of students in different clinical settings. In Namibia, hospitals, clinics and health centres are popularly utilized as a clinical environment for placing nursing students at all levels of studies. However, little is known on how students experience the placement at the health centres. In 2016 Nursing students from a satellite campus were placed at a health centre.Methods: The study followed qualitative research principles, and it was explorative, descriptive and contextual in nature. Data were collected from reflections submitted by second year nursing students from a UNAM satellite campus upon completion of their two weeks placement at a health centre in 2016. Data were analyzed using content analysis as a data analysis strategy. Trustworthiness of this study was ensured by applying the criteria of Lincoln and Guba, namely: credibility, transferability, dependability, and confirmability of the study.Results: The five themes that emerged from the study are: ‘interpersonal factors’, ‘students’ reactions to the learning context’, ‘enablers of students’ learning at a rural health centre’, ‘challenges experienced by students’, and ‘recommendations made by students on learning in a rural health centre’.Conclusion: It is evident that good interpersonal interaction between nursing staff, students and patients appear to have a positive impact on learning. Students reflected on limited supply of equipment, and limited cases available as challenges experienced during their placement. Furthermore, students made suggestions to improve placements in a rural health centre.

scholarly journals Perilaku caring perawat terhadap kepuasan pasien di UPT Puskesmas rawat inap

2020 ◽  
Vol 14 (3) ◽  
pp. 486-493
Author(s):  
Triyoso Triyoso ◽  
Martina Sari
Keyword(s):  
Public Health ◽  
Patient Satisfaction ◽  
Health Center ◽  
Health Centre ◽  
P Value ◽  
Public Health Centre ◽  
Caring Behaviors ◽  
Caring Behavior ◽  
Nurse Caring ◽  
The Impact

Nurse caring behaviors and patient satisfaction: The impact of patients experience at Bukit Kemuning inpatient public health centreBackground: The results of the pre-survey conducted on January - 2019 based on the medical records of the Bukit Kemuning Inpatient Health Center in North Lampung recorded in 2018 had of 279 inpatients. Base on evaluation in Bukit Kemuning Inpatient Health Center, the Minimum Service Standards (MSS) achievement scored of 67.29% describes the service quality is still suboptimal.Purpose: Knowing relationship between nurses' caring behavior towards patient satisfaction in Bukit Kemuning Inpatient Health Centre North Lampung RegencyMethod: A quantitative cross-sectional approach, the population of all outpatient who had experienced hospitalization at Bukit Kemuning Inpatient Health Center, with a sample of 282 respondent. The variables of this study were nurse caring behavior and patient satisfaction. The research conducted at the Bukit Kemuning Inpatient Health Center UPT North Lampung Regency. data collection using a questionnaire. Data analysis was univariate and bivariate (chi square).Results: Knowing the respondents' statement that nurses' shown caring behavior in a poor category of 162 (57.4%), patients unsatisfied of 140 (49.4%), There is a relationship between Nurse caring behaviors and patient satisfaction at Bukit Kemuning inpatient public health centre North Lampung Regency (p-value = 0.000 OR = 4.659)Conclusion: There is a correlation between Nurse caring behaviors and patient satisfaction: The impact of patients experience at Bukit Kemuning inpatient public health centre, for the Health Center management to consider for nurses' staff for conducting caring behavior training and improve health services.Keywords: Nurses; Caring behavior; Patient; SatisfactionPendahuluan: Standar kepuasan pasien di pelayanan kesehatan ditetapkan secara nasional oleh Departemen Kesehatan. Hasil pra survey yang dilakukan tanggal 5 – 9 Januari 2019  berdasarkan data rekam medis Puskesmas Rawat Inap Bukit Kemuning  Kabupaten Lampung Utara  tercatat tahun 2018 jumlah pasien yang melakukan kunjungan rawat jalan sebesar 11.169 orang dan rawat inap sebanyak 279 orang. Puskesmas Rawat Inap Bukit Kemuning  Kabupaten Lampung Utara  Standar SPM > 90 % dengan hasil capaian hanya 67, 29% sehingga dapat menggambarkan mutu pelayanan masih belum optimal.Tujuan : Diketahui  hubungan perilaku caring perawat terhadap kepuasan pasien di UPT Puskesmas Rawat Inap Bukit Kemuning  Kabupaten Lampung Utara  tahun 2019Metode: Penelitian kuantitatif pendekatan Cross Sectional, populasi seluruh pengunjung Puskesmas, dengan sampel berjumlah 282 orang Objek dalam penelitian ini adalah perilaku caring perawat dan kepuasan pasien. Penelitian dilakukan di UPT Puskesmas Rawat Inap Bukit Kemuning  Kabupaten Lampung Utara. bulan Januari – Juni  2019 . pengumpulan data menggunakan kuesioner. Analisis data secara univariat dan bivariat (chi square).Hasil: Diketahui pernyataan responden tentang perawat yang menunjukkan perilaku caring kategori buruk, sebesar 162 (57,4%) responden, kepuasan keluarga pasien kurang puas, sebesar 140 (49,4%) responden, Ada  hubungan antara perilaku caring perawat terhadap tingkat kepuasan keluarga pasien di UPT Puskesmas Rawat Inap Bukit Kemuning  Kabupaten Lampung Utara  tahun 2019 (p-value=0,000,0,05, OR=4,659)Simpulan: Ada  hubungan antara perilaku caring perawat terhadap tingkat kepuasan keluarga pasien di UPT Puskesmas Rawat Inap Bukit Kemuning  Kabupaten Lampung Utara  tahun 2019, bagi pihak manajemen Puskesmas sebagai bahan pertimbangan untuk mengadakan pelatihan perilaku caring perawat guna meningkatkan pelayanan pasien.

scholarly journals The prevalence of scabies in Monrovia, Liberia: a population-based survey

2020 ◽  
Author(s):  
Shelui Collinson ◽  
Joseph Timothy ◽  
Samuel K Zayay ◽  
Karsor K Kollie ◽  
Eglantine Lebas ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Of Life ◽  
Health Problem ◽  
Public Health Problem ◽  
Sub Saharan Africa ◽  
Quality Data ◽  
Local Health ◽  
Sub Saharan ◽  
The Impact

AbstractBackgroundScabies is known to be a public health problem in many settings but the majority of recent data is from rural settings in the Pacific. There is a need for high quality data from sub-Saharan Africa and peri-Urban settings to inform scale up of scabies control efforts. There have been anecdotal reports of scabies being a public health problem in Liberia but robust data are lacking.MethodsWe conducted a cross-sectional cluster-randomised prevalence survey for scabies in a peri-urban community in Monrovia, Liberia in February-March 2020. Participants underwent a standardised examination conducted by trained local health care workers. Health related quality of life (HRQoL) was assessed using age-appropriate dermatology life quality indices (DLQIs). Prevalence estimates were calculated accounting for clustering at community and household levels and associations with key demographic variables assessed through multivariable random-effects logistic regression.Results1,318 participants from 477 households were surveyed. The prevalence of scabies prevalence was 9.3% (95% CI: 6.5-13.2%), across 75 (19.7%) households; impetigo or infected scabies prevalence was 0.8% (95% CI: 0.4-1.9%). The majority (52%) of scabies cases were classified as severe. Scabies prevalence was lower in females and higher in the youngest age group; no associations were found with other collected demographic or socio-economic variables. DLQI scores indicated a very or extremely large effect on HRQoL in 29% of adults and 18% of children diagnosed with scabies.ConclusionsOur study indicates a substantial burden of scabies in this peri-Urban population in Liberia. This was associated with significant impact on quality of life, highlighting the need for action to control scabies in this population. Further work is needed to assess the impact of interventions in this context on both the prevalence of scabies and quality of life.Plain English summaryScabies is an infestation with a microscopic mite which affects many people living in low-resource tropical countries. It causes intense itching, which can lead to complications through bacterial infection and poor quality of life. To help develop global scabies control programmes, we need a better understanding of how common it is across different tropical settings. We conducted a survey to assess the burden of scabies and bacterial skin infection in a random sample of people living in a community in Monrovia, Liberia. Information about participants and their household were collected and their skin was examined; those with skin conditions were asked about its impact on quality of life.We examined 1,318 participants and found that almost 10% of people had scanies. Scabies was more common in young children, and was more common in male children than female children. We found that there was a large impact on quality of life due mostly to the itching that scabies causes and to people feeling embarrassed or sad because of their skin condition. This scabies survey is one of the first conducted across all age groups in recent years in sub-Saharan Africa and indicates a substantial burden and impact on quality of life. More work is needed to understand how common scabies is in different settings and the impact that different treatment strategies may have.

scholarly journals Does Motivation Contribute on Health Care Provision?

2018 ◽  
Vol 8 (2) ◽  
pp. 315
Author(s):  
Elizabeth Landa
Keyword(s):  
Public Health ◽  
Social Security ◽  
Working Condition ◽  
Health Centre ◽  
Team Work ◽  
Social Security Fund ◽  
Customer Care ◽  
Significant Difference ◽  
Health Centres ◽  
Security Fund

This study aimed to examine the contribution of employee motivation on provision of customer care in public health centres, in Morogoro Municipality. Data were collected from four selected public health institutions namely Morogoro General Hospital, Nunge Health Centre, Mafiga Health Centre and Kingolwila Health Centre respectively. The sample of 124 respondents were used, that is; employees and heads of the health centres. Collected data were coded using SPSS, where frequencies, percentages and chi-square were employed. The study identified that career development, training, appreciation, recognition, membership to the Social Security Fund, team work, working condition, paid leave, housing allowances and acting allowance were, the motivation schemes provided to public health employees. However public health workers are motivated by being a member on social security fund, medical cover, supervision, and job security. The result shows that there is significant difference between the employee who are motivated and those who are not motivated with regard to their provision of customer care to patients. The study concludes that most of the employees are not motivated by the existing motivation schemes which consequences lower their ability to provide the appropriate health services. The study recommends that strategies for improving motivation of employee to improve customer care include increase salary, improve working condition, pay housing allowance to all employees, allowance such as leave, overtime should be paid on time, promotion should be made in appropriate time and fair.

scholarly journals Understanding equity of institutional delivery in public health centre by level of care in India: an assessment using benefit incidence analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sanjay K. Mohanty ◽  
Radhe Shyam Mishra ◽  
Suyash Mishra ◽  
Soumendu Sen
Keyword(s):  
Public Health ◽  
Concentration Index ◽  
Institutional Delivery ◽  
Health Centre ◽  
Secondary Level ◽  
Wealth Quintile ◽  
Level Of Care ◽  
Public Subsidy ◽  
Health Centres ◽  
Incidence Analysis

Abstract Background The National Health Mission (NHM), the largest ever publicly funded health programme worldwide, used over half of the national health budget in India and primarily aimed to improve maternal and child health in the country. Though large scale public health investment has improved the health care utilization and health outcomes across states and socio-economic groups in India, little is known on the equity concern of NHM. In this context, this paper examines the utilization pattern and net benefit of public subsidy for institutional delivery by the level of care in India. Methods Data from the most recent round of the National Family Health Survey (NFHS 4), conducted during 2015–16, was used in the study. A total of 148,645 last birth delivered in a health centre during the 5 years preceding the survey were used for the analyses. Out-of-pocket (OOP) payment on delivery care was taken as the dependent variable and was analysed by primary care and secondary level of care. Benefits Incidence Analysis (BIA), descriptive statistics, concentration index (CI), and concentration curve (CC) were used to do the analysis. Results Institutional delivery from the public health centres in India is pro-poor and has a strong economic gradient. However, about 28% mothers from richest wealth quintile did not pay for delivery in public health centres compared to 16% among the poorest wealth quintile. Benefit incidence analyses suggests a pro-poor distribution of institutional delivery both at primary and secondary level of care. In 2015–16, at the primary level, about 32.29% of subsidies were used by the poorest, 27.22% by poorer, 20.39% by middle, 13.36% by richer and 6.73% by the richest wealth quintile. The pattern at the secondary level was similar, though the magnitude was lower. The concentration index of institutional delivery in public health centres was − 0.161 [95% CI, − 0.158, − 0.165] compared to 0.296 [95% CI, 0.289, 0.303] from private health centres. Conclusion Provision and use of public subsidy for institutional delivery in public health centres is pro-poor in India. Improving the quality of service in primary health centres is recommended to increase utilisation and reduce OOP payment for health care in India.

Sign in / Sign up

Export Citation Format

Share Document