scholarly journals Decision space and participation of primary healthcare facility managers in the Ideal Clinic Realisation and Maintenance programme in two South African provinces

2019 ◽  
Vol 35 (3) ◽  
pp. 302-312
Author(s):  
Immaculate Sabelile Muthathi ◽  
Jonathan Levin ◽  
Laetitia C Rispel
Keyword(s):  
Health Sector ◽  
Healthcare Facility ◽  
Essential Medicines ◽  
Health Coverage ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Decision Space ◽  
Cross Sectional ◽  
Critical Areas ◽  
The Ideal

Abstract In South Africa, the introduction of a national health insurance (NHI) system is the most prominent health sector reform planned to achieve universal health coverage in the country. Primary health care (PHC) is the foundation of the proposed NHI system. This study draws on policy implementation theory and Bossert’s notion of decision space to analyse PHC facility managers’ decision space and their participation in the implementation of the Ideal Clinic Realisation and Maintenance (ICRM) programme. We conducted a cross-sectional survey among 127 PHC facility managers in two districts in Gauteng and Mpumalanga provinces. A self-administered questionnaire elicited socio-demographic information, the PHC managers’ participation in the conceptualization and implementation of the ICRM programme, their decision space and an optional open-ended question for further comments. We obtained a 100% response rate. The study found that PHC facility managers reported lack of involvement in the conceptualization of the ICRM programme, high levels of participation in implementation [mean score 5.77 (SD ±0.90), and overall decision space mean score of 2.54 (SD ±0.34)]. However, 17 and 21% of participants reported narrow decision space on the critical areas of the availability of essential medicines and on basic resuscitation equipment respectively. The qualitative data revealed the unintended negative consequences of striving for ‘ideal clinic status’, namely that of creating an illusion of compliance with the ICRM standards. The study findings suggest the need for greater investment in the health workforce, special efforts to involve frontline managers and staff in health reforms, as well as provision of adequate resources, and an enabling practice environment.

scholarly journals Patient Satisfaction with Healthcare at a Tertiary Hospital in Northern Malawi: Results from a Triangulated Cross-sectional Survey

2021 ◽  
Author(s):  
Frank Watson Sinyiza ◽  
Paul Uchizi Kaseka ◽  
Master Rodgers Chisale ◽  
Chikondi Sharon Chimbatata ◽  
Balwani Chingatichifwe Mbakaya ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health Workers ◽  
Health Sector ◽  
Likert Scale ◽  
Tertiary Hospital ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Satisfaction With Services

Abstract BackgroundIn 2016 the Malawi government embarked on several interrelated health sector reforms aimed at improving the quality of health services at all levels of care and attain Universal Health Coverage by 2030. Patient satisfaction with services is an important proxy measure of quality. We assessed patient satisfaction at a tertiary hospital in Northern Malawi to understand the current state in the country. MethodsWe conducted exit interviews with patients aged18 years and above using a 28 statement interviewer administered questionnaire. Patients were asked to express their level of agreement to the statements on a five-point Likert scale – strongly disagree to strongly agree, corresponding to scores of 1 to 5. Overall patient satisfaction was calculated by summing up the scores and diving the sum by the number of statements. Scores >3 constituted satisfaction while scores ≤3 constituted dissatisfaction. Patient self-rated satisfaction was determined from a single statement that asked patients to rate their satisfaction with services on a five-point Likert scale. We also solicited inputs from patients on aspects of hospital care that needed improvement. Responses were reviewed and grouped into themes. Recurring themes are presented according to frequencies.ResultsOverall patient satisfaction was 8.4% (95% CI: 5.2% - 12.9%). Patient self-rated satisfaction was 8.9% (95% CI: 5.5% - 13.4%). Patients raised six major issues that dampened their healthcare seeking experience including health workers reporting late to work, doctors not listening to patients concerns and neither examining them properly nor explaining the diagnosis, shortage of medicines, diagnostics and medical equipment, unprofessional conduct of health workers, poor sanitation and cleanliness, and health workers behaviour of favouring or priotising their relatives and friends over other patients.ConclusionWe found very low levels of patient satisfaction, suggesting that quality of services in the public health sector is still low. It is therefore critical to accelerate and innovate the Ministry of Health’s quality improvement initiatives to attain Malawi’s health goals.

scholarly journals Knowledge Translation in Africa: Are The Structures in Place?

2020 ◽  
Author(s):  
James Avoka Asamani ◽  
Juliet Nabyonga-Orem
Keyword(s):  
Knowledge Translation ◽  
Health Sector ◽  
Health Coverage ◽  
African Region ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Scientific Publications ◽  
Cross Sectional ◽  
Performance Review ◽  
Sector Performance

Abstract Background: Contextualised evidence to generate local solutions on the progressive path to universal health coverage is important. However, this evidence must be translated into action. Knowledge translation (KT) experts have highlighted plausible mechanisms to foster the uptake of evidence. The objective of this study was to assess the extent to which structures are in place to foster uptake of evidence, in countries of the WHO African Region. Methods: Employing a cross sectional survey we collected data on the availability of structures to foster uptake of evidence into policy in the 35 member states of WHO African region. Data were analysed using a simple counting of the presence or absence of such structures. Results: Less than 50% of countries had evidence collation and synthesis mechanisms. The lack of such mechanisms presents a missed opportunity to identify comprehensive solutions that can respond to heath sector challenges. Close to 50% of countries had KT platforms in place. However, the availability of these was in several forms, as an institution-based platform, as an annual event to disseminate evidence and as a series of conferences at the national. In some countries, KTs were mainstreamed into routine health sector performance review processes. Several challenges impacted the functionality of the KT platforms including inadequate funding and lack of dedicated personnel. Regarding dissemination of evidence, sharing reports, scientific publications and one-off presentations in meetings were the main approaches employed. Conclusion: The availability of KT platforms in the WHO African countries can be described as suboptimal at best and non-existent at the worst. The current structures, where these exist, cannot adequately foster KT. Knowledge translation platforms need to be viewed as sector wide platforms and mainstreamed in routing health sector performance review and policy making processes. Funds for their functionality must be planned for as part of the health sector budget. Dissemination of evidence needs to be viewed differently to embrace the concept of “disseminate for impact”. Further, funding for dissemination activities needs to be planned for as part of the evidence generation plan.

scholarly journals Knowledge translation in Africa: are the structures in place?

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
James Avoka Asamani ◽  
Juliet Nabyonga-Orem
Keyword(s):  
Knowledge Translation ◽  
National Level ◽  
Health Sector ◽  
Health Coverage ◽  
African Region ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Scientific Publications ◽  
Cross Sectional ◽  
Sector Performance

Abstract Background Contextualised evidence to generate local solutions on the progressive path to universal health coverage is essential. However, this evidence must be translated into action. Knowledge translation (KT) experts have highlighted the plausible mechanisms to foster the uptake of evidence. The objective of this study was to assess the extent to which structures are in place to boost uptake of evidence, in countries of the WHO African Region. Methods Employing a cross-sectional survey, we collected data on the availability of structures to foster the uptake of evidence into policy in 35 out of the 47 member states of the WHO African Region. Data were analysed using a simple counting of the presence or absence of such structures. Results Less than half of the countries had evidence collation and synthesis mechanisms. The lack of such mechanisms presents a missed opportunity to identify comprehensive solutions that can respond to health sector challenges. Close to 50% of the countries had KT platforms in place. However, the availability of these was in several forms, as an institution-based platform, as an annual event to disseminate evidence and as a series of conferences at the national level. In some countries, KT was mainstreamed into routine health sector performance review processes. Several challenges impacted the functionality of the KT platforms including inadequate funding and lack of dedicated personnel. Regarding dissemination of evidence, sharing reports, scientific publications and one-off presentations in meetings were the main approaches employed. Conclusion The availability of KT platforms in the WHO African countries can be described as at best and non-existent at the worst. The current structures, where these exist, cannot adequately foster KT. Knowledge translation platforms need to be viewed as sector-wide platforms and mainstreamed in routine health sector performance reviews and policymaking processes. Funds for their functionality must be planned for as part of the health sector budget. Dissemination of evidence needs to be viewed differently to embrace the concept of “disseminate for impact”. Further, funding for dissemination activities needs to be planned for as part of the evidence generation plan.

scholarly journals Knowledge translation in Africa: Are the structures in place?

2020 ◽  
Author(s):  
James Avoka Asamani ◽  
Juliet Nabyonga-Orem
Keyword(s):  
Knowledge Translation ◽  
National Level ◽  
Health Sector ◽  
Health Coverage ◽  
African Region ◽  
African Countries ◽  
Cross Sectional Survey ◽  
Scientific Publications ◽  
Cross Sectional ◽  
Sector Performance

Abstract Background: Contextualised evidence to generate local solutions on the progressive path to universal health coverage is essential. However, this evidence must be translated into action. Knowledge translation (KT) experts have highlighted plausible mechanisms to foster the uptake of evidence. The objective of this study was to assess the extent to which structures are in place to boost uptake of evidence, in countries of the WHO African Region.Methods: Employing a cross-sectional survey, we collected data on the availability of structures to foster the uptake of evidence into policy in 35 out of the 47 member states of the WHO African region. Data were analysed using a simple counting of the presence or absence of such structures.Results: Less than half of the countries had evidence collation and synthesis mechanisms. The lack of such mechanisms presents a missed opportunity to identify comprehensive solutions that can respond to health sector challenges. Close to 50% of countries had KT platforms in place. However, the availability of these was in several forms, as an institution-based platform, as an annual event to disseminate evidence and as a series of conferences at the national level. In some countries, KT was mainstreamed into routine health sector performance review processes. Several challenges impacted the functionality of the KT platforms including, inadequate funding and lack of dedicated personnel. Regarding dissemination of evidence, sharing reports, scientific publications and one-off presentations in meetings were the main approaches employed.Conclusion: The availability of KT platforms in the WHO African countries can be described as suboptimal at best and non-existent at the worst. The current structures, where these exist, cannot adequately foster KT. Knowledge translation platforms need to be viewed as sector-wide platforms and mainstreamed in routine health sector performance reviews and policymaking processes. Funds for their functionality must be planned for as part of the health sector budget. Dissemination of evidence needs to be viewed differently to embrace the concept of “disseminate for impact”. Further, funding for dissemination activities needs to be planned for as part of the evidence generation plan.

PERCEIVED EFFECTS OF STREET HAWKING ON THE WELL-BEING OF CHILDREN IN ANYIGBA, DEKINA LOCAL GOVERNMENT AREA OF KOGI STATE, NIGERIA

2018 ◽  
Vol 8 (1) ◽  
pp. 01-07
Author(s):  
Alfred Eboh
Keyword(s):  
Local Government ◽  
Survey Design ◽  
Sampling Technique ◽  
Well Being ◽  
Local Government Area ◽  
Negative Consequences ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Perceived Effects ◽  
The Government

Background: The hawking of wares by children has been a serious issue confronting the Nigerian society. Children hawk in some of the most horrible conditions conceivable, where they face a serious risk of injury, chronic illness, kidnapping, rape or death. Objective: The focus of this study was to assess the perceived effects of street hawking on the well-being of children in Anyigba, Dekina Local Government Area of Kogi State. Methods: The population of this study consists of parents of the street hawkers in Anyigba while cross-sectional survey design was used through the purposive sampling technique to choose the sample size of one hundred and sixty-two (162) respondents. The validated structured questionnaire and In-Depth Interviews (IDIs) served as the instruments for the data collection respectively. The hypotheses were tested using Chi-Square at a predetermined 0.05 level of significance. The quantitative data were analysed with the aid of the SPSS (version 20). Results: The results indicated among others that street hawking had significant social implications and physical consequences on children's moral behaviour as well as health status in the study area. Conclusion: The study, therefore, concluded that the government of Kogi State should carry out an enlightenment campaign through the media and religious institutions on the negative consequences of street hawking are recommended as panacea. Also, the child right act instrument and its implementation should be strengthened in order to curb street hawking in the study area.

scholarly journals Utilization of key preventive measures for pregnancy complications and malaria among women in Jimma Zone, Ethiopia

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mariame Ouedraogo ◽  
Jaameeta Kurji ◽  
Lakew Abebe ◽  
Ronald Labonté ◽  
Sudhakar Morankar ◽  
...  
Keyword(s):  
Health Services ◽  
Pregnant Women ◽  
Malaria Infection ◽  
Preventive Measures ◽  
Health Sector ◽  
Maternal Health Services ◽  
Cross Sectional Survey ◽  
Wealth Status ◽  
Cross Sectional ◽  
Jimma Zone

Abstract Background In Ethiopia, malaria infections and other complications during pregnancy contribute to the high burden of maternal morbidity and mortality. Preventive measures are available, however little is known about the factors influencing the uptake of maternal health services and interventions by pregnant women in Ethiopia. Methods We analyzed data from a community-based cross-sectional survey conducted in 2016 in three rural districts of Jimma Zone, Ethiopia, with 3784 women who had a pregnancy outcome in the year preceding the survey. We used multivariable logistic regression models accounting for clustering to identify the determinants of antenatal care (ANC) attendance and insecticide-treated net (ITN) ownership and use, and the prevalence and predictors of malaria infection among pregnant women. Results Eighty-four percent of interviewed women reported receiving at least one ANC visit during their last pregnancy, while 47% reported attending four or more ANC visits. Common reasons for not attending ANC included women’s lack of awareness of its importance (48%), distance to health facility (23%) and unavailability of transportation (14%). Important determinants of ANC attendance included higher education level and wealth status, woman’s ability to make healthcare decisions, and pregnancy intendedness. An estimated 48% of women reported owning an ITN during their last pregnancy. Of these, 55% reported to have always slept under it during their last pregnancy. Analysis revealed that the odds of owning and using ITNs were respectively 2.07 (95% CI: 1.62–2.63) and 1.73 (95% CI: 1.32–2.27) times higher among women who attended at least one ANC visit. The self-reported prevalence of malaria infection during pregnancy was low (1.4%) across the three districts. We found that young, uneducated, and unemployed women presented higher odds of malaria infection during their last pregnancy. Conclusion ANC and ITN uptake during pregnancy in Jimma Zone fall below the respective targets of 95 and 90% set in the Ethiopian Health Sector Transformation Plan for 2020, suggesting that more intensive programmatic efforts still need to be directed towards improving access to these health services. Reaching ANC non-users and ITN ownership and use as part of ANC services could be emphasized to address these gaps.

Evaluation of health system in Iraq from people's point of view: a comparative study of two different eras

2021 ◽  
Vol 4 (2) ◽  
pp. 380-387
Author(s):  
Saad Ahmed Ali Jadoo ◽  
Adil H. Alhusseiny ◽  
Shukr Mahmood Yaseen ◽  
Mustafa Ali Mustafa Al-Samarrai ◽  
Anmar Shukur Mahmood
Keyword(s):  
Health System ◽  
Health Sector ◽  
Health Resources ◽  
Sampling Technique ◽  
Point Of View ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Current Health ◽  
Multi Stage ◽  
Geographical Regions

Background: Since the 2003 United States–British Coalition military invasion, Iraq has been in a state of continuous deterioration at all levels, including the health sector. This study aimed to elicit the viewpoints of the Iraqi people on the current health system, focusing on many provided health services and assessing whether the public prefers the current health system or that was provided before the invasion. Methods: A cross-sectional survey designed to explore the Iraqi people’s opinions on their health system. A self-administered questionnaire using a multi-stage sampling technique was distributed in five geographical regions in Iraq to collect the data from the head of household between 1st October and 31st of December 2019. Multiple logistic regressions were recruited to determine the significant contributing variables in this study. Results: A total of 365 heads of households (response rate: 71.7%) with the mean age of 48.36 + 11.92 years (ranged 35-78) included in the study. Most of the respondents (61.4%) complained of healthcare inaccessibility, 59.7% believed that health resources were not available, 53.7% claimed a deterioration in the quality of care, and 62.2% believed that the political / media position did not contribute to positive changes during the past two decades. Indeed, most respondents (66.0%) believe that the current healthcare system is worse than before. In the multivariate analysis, there was a statistically significant relationship between the characteristics and opinions of the respondents. Young age group (p = 0.003), men (p = < 0.001), unmarried (p = 0.001), high educated (p = < 0.001), rural resident (p = < 0.001), unemployed (p = 0.003), monthly income of less than USD 400 (p = < 0.001), consider themselves to be unhealthy (p = 0.001),  and those who think that people are unhappy now than two decades ago (p = 0.012) have a more negative opinion of the health system. Conclusions: Most Iraqis surveyed expressed disappointment from the health system after the 2003 US-led invasion. The current health system is faltering at all levels and does not meet the citizens' basic needs. Health Transformation Program (HTP) has become inevitable to develop an accessible, affordable, high-quality, efficient, and effective health system.

scholarly journals Nurses' knowledge of universal health coverage for inclusive and sustainable elderly care services

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Fabian Ling Ngai Tung ◽  
Vincent Chun Man Yan ◽  
Winnie Ling Yin Tai ◽  
Jing Han Chen ◽  
Joanne Wai-yee Chung ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Elderly Care ◽  
Healthcare Policy ◽  
Health Coverage ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Care Services ◽  
Universal Health ◽  
Nurses Knowledge

Objectives: to explore nurses' knowledge of universal health coverage (UHC) for inclusive and sustainable development of elderly care services. Method: this was a cross-sectional survey. A convenience sample of 326 currently practicing enrolled nurses (EN) or registered nurses (RN) was recruited. Respondents completed a questionnaire which was based on the implementation strategies advocated by the WHO Global Forum for Governmental Chief Nursing Officers and Midwives (GCNOMs). Questions covered the government initiative, healthcare financing policy, human resources policy, and the respondents' perception of importance and contribution of nurses in achieving UHC in elderly care services. Results: the knowledge of nurses about UHC in elderly care services was fairly satisfactory. Nurses in both clinical practice and management perceived themselves as having more contribution and importance than those in education. They were relatively indifferent to healthcare policy and politics. Conclusion: the survey uncovered a considerable knowledge gap in nurses' knowledge of UHC in elderly care services, and shed light on the need for nurses to be more attuned to healthcare policy. The educational curriculum for nurses should be strengthened to include studies in public policy and advocacy. Nurses can make a difference through their participation in the development and implementation of UHC in healthcare services.

scholarly journals Essential Medicines at the National Level: The Global Asthma Network’s Essential Asthma Medicines Survey 2014

2019 ◽  
Vol 16 (4) ◽  
pp. 605 ◽  
Author(s):  
Karen Bissell ◽  
Philippa Ellwood ◽  
Eamon Ellwood ◽  
Chen-Yuan Chiang ◽  
Guy Marks ◽  
...  
Keyword(s):  
Inhaled Corticosteroids ◽  
Communicable Disease ◽  
Action Plan ◽  
National Level ◽  
Essential Medicines ◽  
World Health ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Middle Income ◽  
Poor Access

Patients with asthma need uninterrupted supplies of affordable, quality-assured essential medicines. However, access in many low- and middle-income countries (LMICs) is limited. The World Health Organization (WHO) Non-Communicable Disease (NCD) Global Action Plan 2013–2020 sets an 80% target for essential NCD medicines’ availability. Poor access is partly due to medicines not being included on the national Essential Medicines Lists (EML) and/or National Reimbursement Lists (NRL) which guide the provision of free/subsidised medicines. We aimed to determine how many countries have essential asthma medicines on their EML and NRL, which essential asthma medicines, and whether surveys might monitor progress. A cross-sectional survey in 2013–2015 of Global Asthma Network principal investigators generated 111/120 (93%) responses—41 high-income countries and territories (HICs); 70 LMICs. Patients in HICs with NRL are best served (91% HICs included ICS (inhaled corticosteroids) and salbutamol). Patients in the 24 (34%) LMICs with no NRL and the 14 (30%) LMICs with an NRL, however no ICS are likely to have very poor access to affordable, quality-assured ICS. Many LMICs do not have essential asthma medicines on their EML or NRL. Technical guidance and advocacy for policy change is required. Improving access to these medicines will improve the health system’s capacity to address NCDs.

Sign in / Sign up

Export Citation Format

Share Document