scholarly journals The effect of the National Essential Medicines Policy on health expenditures and service delivery in Chinese township health centres: evidence from a longitudinal study

BMJ Open ◽  
2014 ◽  
Vol 4 (12) ◽  
pp. e006471 ◽  
Author(s):  
Xin Zhang ◽  
Qunhong Wu ◽  
Guoxiang Liu ◽  
Ye Li ◽  
Lijun Gao ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Service Delivery ◽  
Health Expenditures ◽  
Essential Medicines ◽  
Health Centres ◽  
Essential Medicines Policy

scholarly journals Constructing a malaria-related health service readiness index and assessing its association with child malaria mortality: an analysis of the Burkina Faso 2014 SARA data

2020 ◽  
Author(s):  
Ourohiré Millogo ◽  
Jean Edouard Odilon Doamba ◽  
Ali Sié ◽  
Juerg Utzinger ◽  
penelope vounatsou
Keyword(s):  
Mortality Rate ◽  
Burkina Faso ◽  
Mortality Rates ◽  
Essential Medicines ◽  
Service Availability ◽  
Readiness Assessment ◽  
Malaria Mortality ◽  
Health Centres ◽  
Geostatistical Models ◽  
Facility Readiness

Abstract Abstract Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso. Methods: Data on inpatients visits and malaria-related deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. The analysis was carried out separately for 112 medical centres and 546 peripheral health centres. Results: Malaria mortality rate in medical centres was 4.8 times higher than that of peripheral health centres (3.46% vs. 0.72%, p<0.0001). Essential medicines was the domain with the lowest readiness (only 0.1% of medical centres and 0% of peripheral health centres had the whole set of tracer items of essential medicines). Basic equipment readiness was the highest. The composite readiness score explained 30% and 53% of the original set of items for medical centres and peripheral health centres, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of peripheral health centres, compared to the low readiness group. Medical centres readiness was not related to malaria mortality. The geographical distribution of malaria mortality rate indicate that regions with health facilities with high readiness show lower mortality rates. Conclusion: Performant health services in Burkina Faso are associated with lower malaria mortality rates. Health system readiness should be strengthened in the regions of Sahel, Sud-Ouest and Boucle du Mouhoun. Emphasis should be given to improving the management of essential medicines and to reducing delays of emergency transportation between the different levels of the health system. Keywords: Bayesian geostatistical models, Burkina Faso, Composite readiness index, Malaria, Service Availability and Readiness Assessment

Planning for service delivery at health centres: An experiment

1986 ◽  
Vol 1 (2) ◽  
pp. 39-56 ◽  
Author(s):  
G. Giridhar ◽  
J.K. Satia
Keyword(s):  
Service Delivery ◽  
Health Centres

scholarly journals Association between malaria-related health service readiness and malaria mortality in under 5-year-old children in Burkina Faso

2020 ◽  
Author(s):  
Ourohiré Millogo ◽  
Jean Edouard Odilon Doamba ◽  
Ali Sié ◽  
Juerg Utzinger ◽  
Penelope Vounatsou
Keyword(s):  
Mortality Rate ◽  
Health System ◽  
Burkina Faso ◽  
Health Facility ◽  
Health Centers ◽  
Essential Medicines ◽  
Malaria Mortality ◽  
Medical Centers ◽  
Health Centres ◽  
Facility Readiness

Abstract Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso. Methods: Data on malaria-related visits and deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. The analysis was carried out separately for 112 medical centers and 546 peripheral health centers. Results: Malaria mortality rate in medical centres was 4.8 times higher than that of peripheral health centres (3.46 vs 0.72%, p<0.0001). Essential medicines was the domain with the lowest readiness (only 0.1% of medical centres and 0% of peripheral health centres had the whole set of essential medicines tracer indicators). Basic equipment readiness was the highest. The composite readiness score explained 30% and 53% of the original indicators for medical centers and peripheral health centers, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of peripheral health centers, compared to the low readiness group. Medical centers readiness was not related to malaria mortality. The geographical distribution of malaria mortality rate showed that regions with high mortality rate have also high proportion of health facilities with low readiness and vice versa. Conclusion: Performant health services in Burkina Faso are associated with lower malaria mortality rates. Health system readiness should be strengthened in the regions of Sahel, Sud-Ouest and Boucle du Mouhoun. Emphasis should be given to improving the management of essential medicines and to reducing delays of emergency transportation between the different levels of the health system.

scholarly journals How ready is the system to deliver primary healthcare? Results of a primary health facility assessment in Enugu State, Nigeria

2020 ◽  
Vol 35 (Supplement_1) ◽  
pp. i97-i106
Author(s):  
Adanma Ekenna ◽  
Ijeoma Uchenna Itanyi ◽  
Ugochukwu Nwokoro ◽  
Lisa R Hirschhorn ◽  
Benjamin Uzochukwu
Keyword(s):  
Service Delivery ◽  
Urban Health ◽  
Primary Healthcare ◽  
Communicable Disease ◽  
Service Availability ◽  
Facility Assessment ◽  
Primary Health ◽  
Health Centres ◽  
Service Readiness ◽  
Enugu State

Abstract Primary health centres are an effective means of achieving access to primary healthcare (PHC) in low- and middle-income countries. We assessed service availability, service readiness and factors influencing service delivery at public PHC centres in Enugu State, Nigeria. We conducted a cross-sectional study of 60 randomly selected public health centres in Enugu using the World Health Organization’s Service Availability and Readiness Assessment (SARA) survey. The most senior health worker available was interviewed using the SARA questionnaire, and an observational checklist was used for the facility assessment. None of the PHC centres surveyed had all the recommended service domains, but 52 (87%) offered at least half of the recommended service domains. Newborn care and immunization (98.3%) were the most available services across facilities, while mental health was the least available service (36.7%). None of the surveyed facilities had a functional ambulance or access to a computer on the day of the assessment. The specific-service readiness score was lowest in the non-communicable disease (NCD) area (33% in the rural health centres and 29% in the urban health centres) and NCD medicines and supplies. Availability of medicine and supplies was also low in rural PHC centres for the communicable disease area (36%) and maternal health services (38%). Basic equipment was significantly more available in urban health centres (P = 0.02). Urban location of facilities and the presence of a medical officer were found to be associated with having at least 50% of the recommended infrastructure / basic amenities and equipment. Continuing medical education, funding and security were identified by the health workers as key enablers of service delivery. In conclusion, despite a focus on expanding primary care in Enugu State, significant gaps exist that need to be closed for PHC to make significant contributions towards achieving universal healthcare, core to achieving the health-related Sustainable Development Goal agenda.

scholarly journals Rural healthcare providers coping with clinical care delivery challenges: lessons from three health centres in Ghana

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Vitalis Bawontuo ◽  
Augustine Adomah-Afari ◽  
Williams W. Amoah ◽  
Desmond Kuupiel ◽  
Irene Akua Agyepong
Keyword(s):  
Service Delivery ◽  
Coping Strategies ◽  
Knowledge Sharing ◽  
Care Delivery ◽  
Clinical Care ◽  
Health Centre ◽  
Healthcare Providers ◽  
Rural Healthcare ◽  
Quality Healthcare ◽  
Health Centres

Abstract Background Rural settings in low- and middle-income countries are bedeviled with poverty and high disease burden, and lack adequate resources to deliver quality healthcare to the population. Drug shortage and inadequate number and skill-mix of healthcare providers is very common in rural health facilities. Hence, rural healthcare providers have no choice but to be innovative and introduce some strategies to cope with health delivery challenges at the health centre levels. This study explored how and why rural healthcare providers cope with clinical care delivery challenges at the health centre levels in Ghana. Methods This study was a multiple case studies involving three districts: Bongo, Kintampo North, and Juaboso districts. In each case study district, a cross-sectional design was used to explore the research question. Purposive sampling technique was used to select study sites and the study participants. The authors conducted 11 interviews, 9 focus group discussions (involving 61 participants), and 9-week participant observation (in 3 health centres). Transcription of the voice-recordings was done verbatim, cleaned and imported into the Nvivo version 11 platform for analysis. Data was analysed using the inductive content analysis approach. Ethical clearance was granted by the Ethics Review Committee of the Ghana Health Service. Results The study found three main coping strategies (borrowing, knowledge sharing and multi-tasking). First, borrowing arrangements among primary health care institutions help to address the periodic shortage of medical supplies at the health centres. Secondly, knowledge sharing among healthcare providers mitigates skills gap during service delivery; and finally, rural healthcare providers use multi-tasking to avert staff inadequacy challenges during service delivery at the health centre levels. Conclusion Borrowing, knowledge sharing, and multi-tasking are coping strategies that are sustaining and potentially improving health outcomes at the district levels in Ghana. We recommend that health facilities across all levels of care in Ghana and other settings with similar challenges could adopt and modify these strategies in order to ensure quality healthcare delivery amidst delivery challenges.

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