scholarly journals Quality of child healthcare at primary healthcare facilities: a national assessment of the Integrated Management of Childhood Illnesses in Afghanistan

2016 ◽  
Author(s):  
Ghulam Farooq Mansoor ◽  
Paata Chikvaidze ◽  
Sherin Varkey ◽  
Ariel Higgins-Steele ◽  
Najibullah Safi ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Integrated Management ◽  
National Assessment ◽  
Healthcare Facilities ◽  
Childhood Illnesses ◽  
Child Healthcare

scholarly journals Effects of Training Health Workers in Integrated Management of Childhood Illness on Quality of Care for Under-5 Children in Primary Healthcare Facilities in Afghanistan

2019 ◽  
Vol 9 (1) ◽  
pp. 17-26
Author(s):  
Essa Tawfiq ◽  
Sayed Ali Shah Alawi ◽  
Kayhan Natiq
Keyword(s):  
Quality Of Care ◽  
Physical Examination ◽  
Primary Healthcare ◽  
Health Workers ◽  
Integrated Management ◽  
Quality Care ◽  
Medical Advice ◽  
Healthcare Facilities ◽  
Training Courses

Background: Training courses in integrated management of childhood illness (IMCI) have been conducted for health workers for nearly one and half decades in Afghanistan. The objective of the training courses is to improve quality of care in terms of health workers communication skills and clinical performance when they provide health services for under-5 children in public healthcare facilities. This paper presents our findings on the effects of IMCI training courses on quality of care in public primary healthcare facilities in Afghanistan. Methods: We used a cross-sectional post-intervention design with regression-adjusted difference-in-differences (DiD) analysis, and included 2 groups of health workers (treatment and control). The treatment group were those who have received training in IMCI recently (in the last 12 months), and the control group were those who have never received training in IMCI. The assessment method was direct observation of health workers during patient-provider interaction. We used data, collected over a period of 3 years (2015–2017) from primary healthcare facilities, and investigated training effects on quality of care. The outcome variables were 4 indices of quality care related to history taking, information sharing, counseling/medical advice, and physical examination. Each index was formed as a composite score, composed of several inter-related tasks of quality of care carried out by health workers during patient-provider interaction for under-5 children. Results: Data were collected from 733 primary healthcare facilities with 5818 patients. Quality of care was assessed at the level of patient-provider interaction. Findings from the regression-adjusted DiD multivariate analysis showed significant effects of IMCI training on 2 indices of quality care in 2016, and on 4 indices of quality care in 2017. In 2016 two indices of quality care showed improvement. There was an increase of 8.1% in counseling/medical advice index, and 8.7% in physical examination index. In 2017, there was an increase of 5.7% in history taking index, 8.0% in information sharing index, 10.9% in counseling/medical advice index, and 17.2% in physical examination index. Conclusion: Conducting regular IMCI training courses for health workers can improve quality of care for under-5 children in primary healthcare facilities in Afghanistan. Findings from our study have the potential to influence policy and strategic decisions on IMCI programs in developing countries.

scholarly journals A comparison of the levels of satisfaction with the medical services provided by primary healthcare centers in selected communes in Lubelskie Voivodeship

2016 ◽  
Vol 126 (1) ◽  
pp. 8-12
Author(s):  
Daria Przybylska ◽  
Piotr Przybylski ◽  
Bartłomiej Drop ◽  
Krzysztof Czarnocki ◽  
Wojciech Przybylski ◽  
...  
Keyword(s):  
Family Medicine ◽  
Primary Healthcare ◽  
The Elderly ◽  
Healthcare Services ◽  
Medical Services ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Primary Type ◽  
Primary Healthcare Centers

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.

scholarly journals Integrated Management of Childhood Illnesses (IMCI): a mixed-methods study on implementation, knowledge and resource availability in Malawi

2021 ◽  
Vol 5 (1) ◽  
pp. e001044
Author(s):  
Kim Kilov ◽  
Helena Hildenwall ◽  
Albert Dube ◽  
Beatiwel Zadutsa ◽  
Lumbani Banda ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Mixed Methods ◽  
Resource Availability ◽  
Quantitative Data ◽  
Integrated Management ◽  
Knowledge Score ◽  
Holistic Approach ◽  
Mixed Methods Study ◽  
Childhood Illnesses

BackgroundThe introduction of the WHO’s Integrated Management of Childhood Illnesses (IMCI) guidelines in the mid-1990s contributed to global reductions in under-five mortality. However, issues in quality of care have been reported. We aimed to determine resource availability and healthcare worker knowledge of IMCI guidelines in two districts in Malawi.MethodsWe conducted a mixed-methods study, including health facility audits to record availability and functionality of essential IMCI equipment and availability of IMCI drugs, healthcare provider survey and focus group discussions (FGDs) with facility staff. The study was conducted between January and April 2019 in Mchinji (central region) and Zomba (southern region) districts. Quantitative data were described using proportions and χ2 tests; linear regression was conducted to explore factors associated with IMCI knowledge. Qualitative data were analysed using a pragmatic framework approach. Qualitative and quantitative data were analysed and presented separately.ResultsForty-seven health facilities and 531 healthcare workers were included. Lumefantrine-Artemether and cotrimoxazole were the most available drugs (98% and 96%); while amoxicillin tablets and salbutamol nebuliser solution were the least available (28% and 36%). Respiratory rate timers were the least available piece of equipment, with only 8 (17%) facilities having a functional device. The mean IMCI knowledge score was 3.96 out of 10, and there was a statistically significant association between knowledge and having received refresher training (coeff: 0.42; 95% CI 0.01 to 0.82). Four themes were identified in the FGDs: IMCI implementation and practice, barriers to IMCI, benefits of IMCI and sustainability.ConclusionWe found key gaps in IMCI implementation; however, these were not homogenous across facilities, suggesting opportunities to learn from locally adapted IMCI best practices. Improving on-going mentorship, training and supervision should be explored to improve quality of care, and programming which moves away from vertical financing with short-term support, to a more holistic approach with embedded sustainability may address the balance of resources for different conditions.

scholarly journals The experience, results, and possible perspectives of organizing the optimally accessible primary medical care for the rural population of Zaporizhzhia region

2021 ◽  
Vol 14 (3) ◽  
pp. 369-373
Author(s):  
O. H. Aleksieiev ◽  
V. V. Taranov ◽  
V. P. Petrykhin
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Rural Population ◽  
Healthcare Facility ◽  
Service Area ◽  
Healthcare Facilities ◽  
Care Facilities

Nowadays, the assessment of the activity of the domestic healthcare system is an important and actual issue, especially against the background the active reformation of this industry. One of the important elements of the assessment is studying the availability of primary healthcare to the rural population. The aim of this work is to study the territorial accessibility of primary healthcare, the adequacy and effectiveness of the principles of forming a network of primary care facilities in the rural areas of Zaporizhzhia region that enables to address issues and optimize the location of primary care facilities in the rural areas. Materials and methods. The materials of the research were the data of the official statistical reports for the past 20 years, which characterize the state of health and the degree of medical care accessibility to the rural population. During the research, the technique of complex social and hygienic research was applied, with the use of historical, sociological, sanitary and statistical methods, organizational experiment and others. Results. The article presents the main results of studying the current state of primary healthcare organization for the rural population of Zaporіzhzhia region against the background of active reforming processes. According to the research results, the main elements forming the system of accessibility are territorial, medical, social and economic. The main factors of impact on territorial accessibility are identified. These are: the nature of the settlement of rural residents (density, compactness, service-area radius, the proportion of the rural population, the distance between villages, the distance from a household to a healthcare facility); quality of roads; transport connections between settlements and healthcare facilities; availability of communication means. Conclusions. As a result of the research, the following conclusions were drawn. Such factors as population density, compactness of its location, service-area radius, distance between villages, distance from a household to a healthcare facility, condition and quality of roads, transport connections between settlements and healthcare facilities are important during forming or improving the network of healthcare facilities in rural areas. These factors must be considered for the rational placement of primary care facilities in rural areas.  

scholarly journals Family and provider perceptions of quality of care in the management of sick young infants in primary healthcare settings in four counties of Kenya

2021 ◽  
Vol 10 (3) ◽  
pp. e001125
Author(s):  
Samuel Mbugua ◽  
Jesse Gitaka ◽  
Tabither Gitau ◽  
George Odwe ◽  
Peter Mwaura ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Primary Healthcare ◽  
Young Infant ◽  
Infant Care ◽  
Health Providers ◽  
Provider Attitudes ◽  
Healthcare Facilities ◽  
Healthcare Settings ◽  
Young Infants

BackgroundUnderstanding the perceptions of quality of care given to sick young infants in primary healthcare settings is key for developing strategies for effective uptake and utilisation of possible severe bacterial infection guidelines. The purpose of this study is to assess families and providers’ perceptions of care given to sick young infants at primary healthcare facilities in four diverse counties in Kenya.MethodsA cross-sectional qualitative design involving 37 in-depth interviews and 39 focus group discussions with very young (15–18 years), young (19–24 years) and older (25–45 years) caregivers of young infants aged 0–59 days; and key informant interviews with community-based and facility-based front-line health providers (14) in primary healthcare facilities. Qualitative data were captured using audio tapes and field notes, transcribed, translated and exported into QSR NVivo V.12 for analysis. A thematic framework approach was adopted to classify and analyse data.ResultsPerceived care given to sick young infants was described around six domains of the WHO framework for the quality of maternal and newborn healthcare: evidence-based practices for routine and emergency care; functional referral systems; effective communication; respect and preservation of dignity; availability of competent, motivated human resources; and availability of physical resources. Views of caregivers and providers regarding sick young infant care in primary healthcare settings were similar across the four sites. Main hindrance to sick young infant care includes stockout of essential drugs, limited infrastructure, lack of functional referral system, inadequate providers which led to delays in receiving treatment, inadequate provider skills and poor provider attitudes. Despite these challenges, motivation and teamwork of health providers were key tenets in care provision.ConclusionThe findings underscore the need to prioritise improving quality of sick young infant services at primary healthcare settings by building capacity of providers through training, ensuring continuous supply of essential medicines and equipment and improving infrastructure including referral.

scholarly journals The effect of training in Integrated Management of Childhood Illness (IMCI) on the performance and healthcare quality of pediatric healthcare workers: a systematic review

2008 ◽  
Vol 8 (2) ◽  
pp. 151-162 ◽  
Author(s):  
João Joaquim Freitas do Amaral ◽  
Cesar Gomes Victora
Keyword(s):  
Systematic Review ◽  
Healthcare Workers ◽  
Integrated Management ◽  
Childhood Illness ◽  
World Health ◽  
Control Group ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Health Organization

OBJECTIVES: to analyze the effect of training in Integrated Management of Childhood Illness (IMCI) on the quality of case management by healthcare workers based on a systematic review of the literature. METHODS: the authors searched the databases MEDLINE, LILACS, PAHO and WHOLIS for the search terms Integrated Management of Childhood Illness (IMCI), and analyzed documents published by Pan American Health Organization, World Health Organization and the Brazilian Ministry of Health between January 1993 and July 2006. The quality of the methodology was assessed using the criteria developed by Downs and Black. RESULTS: thirty-five papers were reviewed. Twelve of these validated the IMCI algorithm and found the sensitivity to be high and the specificity to be over 80% for major illnesses. Twenty-three papers assessed the performance of healthcare workers, eight of these with no control group. The present study shows clear evidence of improvement in the performance of healthcare workers employed at healthcare facilities with IMCI. The main methodological weaknesses of the study were lack of control of confounding factors and lack of information regarding statistical power. CONCLUSIONS: the performance of healthcare workers tends to improve at public healthcare facilities when IMCI is introduced.

Quality of care and cost of prescriptions for diabetes and hypertension at primary healthcare facilities in the Cape Town Metropole

2015 ◽  
Vol 57 (3) ◽  
pp. 187-193 ◽  
Author(s):  
A Isaacs ◽  
N Manga ◽  
C Le Grange ◽  
DA Hellenberg ◽  
V Titus ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Primary Healthcare ◽  
Cape Town ◽  
Healthcare Facilities

scholarly journals Integrating eye health training into the primary child healthcare programme in Tanzania: a pre-training and post-training study

2020 ◽  
Vol 4 (1) ◽  
pp. e000629
Author(s):  
Aeesha N J Malik ◽  
Mlika Mafwiri ◽  
Clare Gilbert ◽  
Min J Kim ◽  
Joanna Schellenberg
Keyword(s):  
Primary Healthcare ◽  
Healthcare Workers ◽  
Integrated Management ◽  
Multiple Choice Questions ◽  
Eye Care ◽  
Post Intervention ◽  
Ministry Of Health ◽  
Training Study ◽  
Healthcare Facilities ◽  
Eye Health

ObjectivesTo evaluate a primary child eye care training module for use in the WHO/UNICEF Integrated Management of Newborn and Childhood Illness (IMNCI) programme by primary healthcare workers.DesignPre-training and post-training study.SettingPrimary healthcare facilities in a semirural district, central Tanzania.Participants54 primary healthcare workers selected by the Ministry of Health were trained during routine IMNCI training. All these healthcare workers were assessed pre-intervention and post-intervention. A subgroup of 40 were also assessed 6 months after the completion of training.InterventionTraining in an IMNCI eye module, developed for child primary healthcare workers with the Tanzania Ministry of Health and eye care experts.Main outcome measuresKnowledge, skills and attitudes were assessed using multiple choice questions, case studies and a self-assessment of skills using a Likert scale before and immediately after training, and 6 months later. A total score was derived. At 6 months, attitudes were assessed in semistructured interviews.Results69% PHWs trained were nurses. The baseline (before training) score was 29.9 (95% CI 27.5 to 32.4) and increased by 11.2 points (95% CI 8.3 to 14) immediately after training, and by 12.4 points (95% CI 9.2 to 15.6) at 6 months post the training. Therefore, the post-training scores increased and there was no evident difference in scores from immediately after training to 6 months later. Self-assessed confidence in skills decreased from 9/18 (95% CI 9 to 10) to 6/18 (95% CI 6 to 7). At 6 months, the module was reported as easy to understand and use, with challenges including difficulties in examining children’s eyes and poor referral systems.ConclusionsThe module increased knowledge of child eye health in primary healthcare workers, which was maintained, and was acceptable. The module has since been included into the national IMNCI health policy in Tanzania.

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