scholarly journals Understanding the Puzzle of Primary Health-care Use: Evidence from India

2021 ◽  
Author(s):  
Pramod Kumar Sur
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Care Use ◽  
Public Health Care ◽  
Private Health Care ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

In India, households' use of primary health-care services presents a puzzle. Even though most private health-care providers have no formal medical qualifications, a significant fraction of households use fee-charging private health-care services, which are not covered by insurance. Although the absence of public health-care providers could partially explain the high use of the private sector, this cannot be the only explanation. The private share of health-care use is even higher in markets where qualified doctors offer free care through public clinics; despite this free service, the majority of health-care visits are made to providers with no formal medical qualifications. This paper examines the reasons for the existence of this puzzle in India. Combining contemporary household-level data with archival records, I examine the aggressive family planning program implemented during the emergency rule in the 1970s and explore whether the coercion, disinformation, and carelessness involved in implementing the program could partly explain the puzzle. Exploiting the timing of the emergency rule, state-level variation in the number of sterilizations, and an instrumental variable approach, I show that the states heavily affected by the sterilization policy have a lower level of public health-care usage today. I demonstrate the mechanism for this practice by showing that the states heavily affected by forced sterilizations have a lower level of confidence in government hospitals and doctors and a higher level of confidence in private hospitals and doctors in providing good treatment.

scholarly journals Experiences of homosexual patients’ access to primary health care services in Umlazi, KwaZulu-Natal

Curationis ◽  
2015 ◽  
Vol 38 (2) ◽  
Author(s):  
Nokulunga H. Cele ◽  
Maureen N. Sibiya ◽  
Dudu G. Sokhela
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Nursing Education ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Easy Access ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Background: Homosexual patients are affected by social factors in their environment, and as a result may not have easy access to existing health care services. Prejudice against homosexuality and homosexual patients remains a barrier to them seeking appropriate healthcare. The concern is that lesbians and gays might delay or avoid seeking health care when they need it because of past discrimination or perceived homophobia within the health care thereby putting their health at risk.Aim of the study: The aim of the study was to explore and describe the experiences of homosexual patients utilising primary health care (PHC) services in Umlazi in the province ofKwaZulu-Natal (KZN).Method: A qualitative, exploratory, descriptive study was conducted which was contextual innature. Semi-structured interviews were conducted with 12 participants. The findings of this study were analysed using content analysis.Results: Two major themes emerged from the data analysis, namely, prejudice against homosexual patients by health care providers and other patients at the primary health care facilities, and, homophobic behaviour from primary health care personnel.Conclusion: Participants experienced prejudice and homophobic behaviour in the course of utilising PHC clinics in Umlazi, which created a barrier to their utilisation of health services located there. Nursing education institutions, in collaboration with the National Department of Health, should introduce homosexuality and anti-homophobia education programmes during the pre-service and in-service education period. Such programmes will help to familiarise health care providers with the health care needs of homosexual patients and may decrease homophobic attitudes.

scholarly journals Access to Primary Health Care Services for Youth Experiencing Homelessness: “You shouldn’t need a health card to be healthy.”

2019 ◽  
Vol 1 (2) ◽  
pp. 73-92
Author(s):  
Claire Pitcher ◽  
Elizabeth Saewyc ◽  
Annette Browne ◽  
Paddy Rodney
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Homeless Youth ◽  
Care Providers ◽  
Urban Centre ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services

On any given night, thousands of Canadian youth face homelessness in either absolute (living on the street) or relative (couch surfing, staying in emergency shelters) terms.  This study explores influences primary health care access among youth experiencing homelessness in a large Canadian urban centre.  Using a qualitative research design and convenience sampling, 8 youth participated in in-depth individual interviews and 4 clinicians with expertise in working with youth in primary care settings participated in a facilitated solutions-focused dialogue based on findings from the youth interviews.  Data collection occurred from January to November 2016.  Main findings included: (1) Youth experiencing homelessness feel powerless when interacting with health care providers, (2) Health care systems exist as rule-based bureaucracies and (3) Homeless youth are in survival mode when it comes to their health.  The authors offer recommendations to promote more equitable access to primary health care services for homeless youth.

scholarly journals Primary Health Care Services of Urban Villages

2020 ◽  
Author(s):  
Ramonita J. Sencio ◽  
Mauro Allan Padua Amparado
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Health Care Services ◽  
Health Workers ◽  
Care Providers ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Significant Difference

Objectives: The study determined the awareness on Primary Health Care (PHC) services as perceived by the residents and the level of implementation of PHC services as perceived by the Volunteer Health Workers in Bulacao and Pardo, Cebu City, Cebu, Philippines. The findings served as basis for a series of re-orientation seminars on PHC programs. Specifically, the study answered the following questions:1.What is the level of awareness on PHC services as perceived by the residents in terms of:1.1.health education;1.2.locally endemic disease control;1.3.expanded program on immunization;1.4.maternal health, child health and family planning; 1.5.provision of essential drugs;1.6.adequate food and proper nutrition;1.7.control of communicable diseases;1.8.environmental sanitation; and1.9.provision of medical care and emergency treatment?2.What is the level of implementation on PHC services as perceived by Volunteer Health Workers in the same areas?3.Is there a significant difference in the level of awareness and the level of implementation of the PHC programs as perceived by the respondents?4.What problems were encountered by health care providers on the implementation of the PHC programs?5.Based on the findings of the study, what appropriate series of re-orientation seminars can be proposed?Methods:This study utilized the descriptive-evaluative design. The study was conducted in two villages in Cebu City, namely, Bulacao and Pardo. The study includes 379 community residents and 26 volunteer health workers. A researcher-made tool composed of 45 items on the nine components of PHC was used. An interview guide was prepared to gather more information and confirm responses from the tool. Findings and Conclusion:The study revealed that the residents were aware of the PHC services. It also showed that the level of implementation of the volunteer health workers on PHC services was high. There was a significant difference in the perceptions of the residents on the level of awareness and the volunteer health workers’ level of implementation of PHC services. The top three problems encountered by the health care providers were inadequate medicines, inadequate clinic space for consultation, and availability of medical doctors. In conclusion, when the targeted beneficiaries are aware of the primary health care services, the volunteer health workers will feel more determined to perform their roles to render improved primary health care services. Recommended citation:Sencio, Ramonita J. & Amparado, M. A. P. (2010, March). PrimaryHealth Care Services of Urban Villages. 2010 Southwestern University Research Congress, 2(1), 22-24.

scholarly journals Mapping services at two Nairobi County primary health facilities: identifying challenges and opportunities in integrated mental health care as a Universal Health Coverage (UHC) priority

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Manasi Kumar ◽  
Vincent Nyongesa ◽  
Martha Kagoya ◽  
Byamah B. Mutamba ◽  
Beatrice Amugune ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Care Services ◽  
Primary Health

Abstract Introduction There is a need to scale-up mental health service provision in primary health care. The current extent of integration of mental health in primary care is pertinent to promoting and augmenting mental health at this level. We describe a facility mapping exercise conducted in two low-income/primary health facilities in Kenya to identify existing barriers and facilitators in the delivery of mental health services in general and specifically for peripartum adolescents in primary health care as well as available service resources, cadres, and developmental partners on the ground. Method and measures This study utilized a qualitative evidence synthesis through mapping facility-level services and key-stakeholder interviews. Services-related data were collected from two facility in-charges using the Nairobi City County Human Resource Health Strategy record forms. Additionally, we conducted 10 key informant interviews (KIIs) with clinical officers (Clinicians at diploma level), Nurses, Community Health Assistants (CHAs), Prevention of Mother-to-child Transmission of HIV Mentor Mothers (PMTCTMs), around both general and adolescent mental health as well as psychosocial services they offered. Using the World Health Organization Assessments Instrument for Mental Health Systems (WHO-AIMS) as a guideline for the interview, all KII questions were structured to identify the extent of mental health integration in primary health care services. Interview transcripts were then systematically analyzed for common themes and discussed by the first three authors to eliminate discrepancies. Results Our findings show that health care services centered around physical health were offered daily while the mental health services were still vertical, offered weekly through specialist services by the Ministry of Health directly or non-governmental partners. Despite health care workers being aware of the urgent need to integrate mental health services into routine care, they expressed limited knowledge about mental disorders and reported paucity of trained mental health personnel in these sites. Significantly, more funding and resources are needed to provide mental health services, as well as the need for training of general health care providers in the identification and treatment of mental disorders. Our stakeholders underscored the urgency of integrating mental health treatment, prevention, and well-being promotive activities targeting adolescents especially peripartum adolescent girls. Conclusion There is a need for further refining of the integrated care model in mental health services and targeted capacity-building for health care providers to deliver quality services.

Needs assessment for gender sensitive reproductive health services for adolescents

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Fatemeh Rahmanian ◽  
Soheila Nazarpour ◽  
Masoumeh Simbar ◽  
Ali Ramezankhani ◽  
Farid Zayeri
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Health Care Providers ◽  
Health Care Services ◽  
Care Providers ◽  
Reproductive Health Services ◽  
Care Needs ◽  
Reproductive Health Care ◽  
Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

scholarly journals Household preferences and willingness to pay for health insurance in Kampala City: a discrete choice experiment

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Edward Kalyango ◽  
Rornald Muhumuza Kananura ◽  
Elizabeth Ekirapa Kiracho
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Insurance ◽  
Willingness To Pay ◽  
Health Care Providers ◽  
Public Health Care ◽  
Care Providers ◽  
Potential Health ◽  
Kampala City ◽  
Household Preferences

Abstract Introduction Uganda is in discussions to introduce a national health insurance scheme. However, there is a paucity of information on household preferences and willingness to pay for health insurance attributes that may guide the design of an acceptable health insurance scheme. Our study sought to assess household preferences and willingness to pay for health insurance in Kampala city using a discrete choice experiment. Methods This study was conducted from 16th February 2020 to 10th April 2020 on 240 households in the Kawempe division of Kampala city stratified into slum and non-slum communities in order to get a representative sample of the area. We purposively selected the communities that represented slum and non-slum communities and thereafter applied systematic sampling in the selection of the households that participated in the study from each of the communities. Four household and policy-relevant attributes were used in the experimental design of the study. Each respondent attended to 9 binary choice sets of health insurance plans that included one fixed choice set. Data were analyzed using mixed logit models. Results Households in both the non-slum and slum communities had a high preference for health insurance plans that included both private and public health care providers as compared to plans that included public health care providers only (non-slum coefficient β = 0.81, P < 0.05; slum β = 0.87, p < 0.05) and; health insurance plans that covered extended family members as compared to plans that had limitations on the number of family members allowed (non-slum β = 0.44, P < 0.05; slum β = 0.36, p < 0.05). Households in non-slum communities, in particular, had a high preference for health insurance plans that covered chronic illnesses and major surgeries to other plans (0.97 β, P < 0.05). Our findings suggest that location of the household influences willingness to pay with households from non-slum communities willing to pay more for the preferred attributes. Conclusion Potential health insurance schemes should consider including both private and public health care providers and allow more household members to be enrolled in both slum and non-slum communities. However, the inclusion of more HH members should be weighed against the possible depletion of resources and other attributes. Potential health insurance schemes should also prioritize coverage for chronic illnesses and major surgeries in non-slum communities, in particular, to make the scheme attractive and acceptable for these communities.

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