scholarly journals Health Facilities’ Readiness to Manage Hypertension and Diabetes Cases at Primary Health Facilities in Bidibidi Refugee Settlement, Yumbe District, Uganda

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Vuchiri Ray Isadru ◽  
Rose Clarke Nanyonga ◽  
John Bosco Alege
Keyword(s):  
Health Services ◽  
Reference Group ◽  
Bachelor's Degree ◽  
Health Facilities ◽  
Chi Square ◽  
Readiness Assessment ◽  
Primary Health ◽  
Trained Staff ◽  
Primary Health Facilities ◽  
Clinical Officers

Background. NCDs are the greatest global contributors to morbidity and mortality and are a major health challenge in the 21st century. The global burden of NCDs remains unacceptably high. Access to care remains a challenge for the majority of persons living with NCDs in sub-Saharan Africa. In Uganda, 55% of refugee households, including those with chronic illnesses, lack access to health services. Of these, 56% are in the West-Nile region where the Bidibidi settlement is located, with 61% of its refugee households in need of health services especially for NCDs (UNHCR, 2019). Data on NCDs in Bidibidi are scarce. Unpublished health facilities’ (HFs) data indicate that cardiovascular diseases (CVDs) (54.3%) and metabolic disorders (20.6%) were the leading causes of consultation for major NCDs (IRC, 2019). No readiness assessment has ever been conducted to inform strategies for the efficient management of NCDs to avert more morbidity, mortality, and the economic burden associated with NCD management or complications among refugees. This study sought to determine the readiness of HFs in managing hypertension (HTN) and diabetes cases at primary health facilities in the Bidibidi refugee settlement, Yumbe district, Uganda. Methods. The study used facility-based, cross-sectional design and quantitative approach to assess readiness for the management of HTN and diabetes. All the 16 HFs at the Health Centre III (HCIII) level in Bidibidi were studied, and a sample size of 148 healthcare workers (HCWs) was determined using Yamane’s formula (1967). Proportionate sample sizes were determined at each HF and the simple random sampling technique was used. HF data were collected using the Service Availability and Readiness Assessment (SARA) checklist and a structured questionnaire used among HCWs. Data were analyzed using SPSS version 20. Univariate analysis involved descriptive statistics; bivariate analysis used chi-square, Fisher’s exact test, and multivariable regression analysis for readiness of HCWs. Results. 16 HCIIIs were studied in five zones and involved 148 HCWs with a mean age of 28 (std ±4) years. The majority 71.6% (106) were aged 20–29 years, 52.7% were females, and 37.8% (56/148) were nurses. Among the 16 HFs, readiness average score was 71.7%. The highest readiness score was 89.5% while the lowest was 52.6%. The 16 HFs had 100% diagnostic equipment, 96% had diagnostics, and 58.8% had essential drugs (low for nifedipine, 37.5%, and metformin, 31.2%). Availability of guidelines for the management of HTN and diabetes was 94%, but only low scores were observed for job aid (12.5%), trained staff (50%), and supervision visits (19%). Only 6.25% of the HFs had all the clinical readiness parameters. On the other hand, only 24% (36) of the HCWs were found to be ready to manage HTN and diabetes cases. Chi-square tests on sex ( p < 0.001 ), education level ( p = 0.002 ), and Fisher’s tests on profession ( p < 0.001 ) established that HCWs with bachelor’s degree (AOR = 3.15, 95% CI: 0.569–17.480) and diploma (AOR = 2.93, 95% CI: 1.22–7.032) were more likely to be ready compared to the reference group (certificate holders). Medical officers (AOR = 4.85, 95% CI: 0.108–217.142) and clinical officers (AOR = 3.79, 95 CI: 0.673–21.336) were more likely to be ready compared to the reference group, and midwives (AOR = 0.12, 95% CI: 0.013–1.097) were less likely to be ready compared to the reference group. In addition, female HCWs were significantly less likely to be ready compared to male HCWs (AOR = 0.19, 95% CI: 0.073–474). Conclusion. HFs readiness was high, but readiness among HCWs was low. HFs had high scores in equipment, diagnostics, and guidelines, but essential drugs, trained staff, and supervision visits as well HCWs had low scores in trainings and supervisions received. Being male, bachelor’s degree holders, diploma holders, medical officers, and clinical officers increased the readiness of the HCWs.

scholarly journals Impact of Covid-19 on the Outcomes of Basic Immunization in Health Facilities

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Retno Setyo Iswati ◽  
Indria Nuraini
Keyword(s):  
Significant Relationship ◽  
Immunization Coverage ◽  
Health Facilities ◽  
Children's Health ◽  
Independent Practice ◽  
Chi Square ◽  
Primary Health ◽  
Chi Square Test ◽  
Primary Health Facilities ◽  
The Impact

The purpose of this study was to determine the impact of Covid 19 on basic immunization coverage, oriented to the number of Covid 19 cases mapped in the red, yellow, and green. This research provides the advantage of making a policy to improve children's health during a pandemic, particularly in preventing diseases that can be anticipated by immunization, such as tuberculosis, diphtheria, hepatitis, tetanus, meningitis, polio, and measles. This research can also be used as a basic for immunization in health facilities while still implementing health protocols. This study's results can be implemented in primary health facilities such as the Puskesmas, Posyandu, Poskesdes, or Midwife Independent Practice. This study's results indicate that immunization coverage <95% is mostly found in the red zone area of Pentabio 1 and 2 immunization, as well as measles. Chi-square test found that there was no significant relationship with basic immunization coverage.

scholarly journals “…This facility has all that is Required for Safe Baby Delivery in Case of An Emergency There is a Theater…” Exploring Experiences and Perceptions of Quality of Maternity Care in a Rural Sub-County. A Qualitative Study

2020 ◽  
Author(s):  
Jackline Akinyi Oluoch-Aridi ◽  
Francis Wafula ◽  
Gilbert O Kokwaro ◽  
Mary B Adam
Keyword(s):  
Quality Of Care ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Mortality ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Primary Health ◽  
Delivery Services ◽  
Primary Health Facilities

Abstract Background Maternal mortality still remains a big health system challenge in Kenya. Free maternity policy resulted in an increase in Facility-based delivery. However, this has not been accompanied with a reduction in maternal mortality. This research aims at establishing women’s experiences and perceptions with regard to the quality of maternal health services received at health facilities during delivery. This contextual knowledge will assist policy makers to better understand patterns of health system utilization critical for forging strategies for reducing inequities and providing high quality maternal care.Methods Women aged between 18 and 49 who had recently delivered and were attending six-week immunization clinics were purposively selected at six different health facilities and focus group discussions were conducted with the women. The data was analyzed using thematic content analysis. Verbatim excerpts from the women were provided to illustrate the themes identified. The WHO vision for quality of care was used to assess the themes on experiences of care described by the womenResults Six themes were identified as facilitators to access maternal health services 1) Perceived quality of delivery services 2) Financial access to delivery services 3) Referrals to public tertiary health facilities 4) Social influence 5) operation times at public primary health facilities 6) Distance to the health facility. A few barriers were identified under the perceived quality of services most prominent been the mistreatment of women by night-shift nurses and the operation time at the primary health facilitiesConclusion The findings suggest that the rural women tend to prefer tertiary maternity health facility and there are a number of factors related to quality of care based on their experiences that predispose their choices. Most prominent was the availability of equipment such as theatres for obstetric complications. Another emerging issue was respectful care during maternity services. Auxiliary costs still present a challenge despite the free maternity services. Future studies need to focus on ensuring in depth contextual understanding of women’s perceptions of the experience of care with regard to patient-centered care. Understanding these aspects will help in forging strategies to reduce inequities that are leading to high maternal mortality

scholarly journals Effect of COVID-19 Pandemic on Provision of Sexual and Reproductive Health Services in Primary Health Facilities in Nigeria: a Cross-sectional Study

2021 ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

Abstract BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.

scholarly journals The Kualitas Pelayanan Berhubungan Dengan Kepuasan Peserta Jkn Di Fasilitas Kesehatan Tingkat Pertama Provinsi Daerah Istimewa Yogyakarta

2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Sri Sularsih Endartiwi ◽  
Pramukti Dian Setianingrum
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Random Sampling ◽  
Health Facilities ◽  
Cross Sectional ◽  
Participant Satisfaction ◽  
Primary Health ◽  
Quality Of Health Services ◽  
Primary Health Facilities

BPJS Health targets participant satisfaction to reach 95%, but until 2017 participant satisfaction reaches 85%. Participants who received service at the primary health facilities based on observations averaged 70%. Based on observations at the primary health facility can be seen that participant satisfaction is 70%. The objective was to evaluate the correlation between the quality services and participant satisfaction on the national health insurance at primary health facilities in the province of Yogyakarta. The type of research was quantitative descriptive with cross sectional design. The research location was primary health facilities that cooperate with BPJS Kesehatan in the Province of Yogyakarta. The study was conducted in July 2018. The number of samples in this study was 850 by proportional random sampling. Data analysis was using the Kendall Tau test. Results showed that the quality of health services both in terms of tangible, reliability, responsiveness, assurance and empathy were related to the satisfaction of BPJS Kesehatan participants in the primary health facilities. The results of bivariate analysis for each variable had a Sig. (2-tailed) 0,000 with a strong relationship. The quality of health services was related to the satisfaction of patients participating in the BPJS Kesehatan in the primary health facilities of the Province of Yogyakarta. Primary health facilities in order to maintain the quality of its health services so that patients participating in the National Health Insurance program remain satisfi ed with the services that have been provided. Abstrak BPJS Kesehatan menargetkan kepuasan peserta mencapai 95%, akan tetapi sampai tahun 2017 ini kepuasan peserta mencapai 85%. Peserta yang mendapatkan pelayanan di fasilitas kesehatan tingkat pertama berdasarkan hasil observasi di puskesmas, dokter keluarga dan klinik pratama rata-rata 70%. Berdasarkan hasil observasi di fasilitas kesehatan tingkat pertama (FKTP) yang bekerja sama dengan BPJS Kesehatan dapat diketahui bahwa kepuasan peserta sebesar 70%. Penelitian bertujuan untuk membuktikan bahwa kualitas pelayanan berhubungan dengan kepuasan peserta Jaminan Kesehatan Nasional (JKN) di Fasilitas Kesehatan Tingkat Pertama Di Provinsi Daerah Istimewa Yogyakarta. Jenis penelitian adalah deskriptif kuantitatif dengan rancangan cross sectional. Lokasi penelitian adalah FKTP yang bekerjasama dengan BPJS Kesehatan di Provinsi Daerah Istimewa Yogyakarta. Penelitian dilakukan pada bulan Juli 2018. Jumlah sampel dalam penelitian ini adalah 850 secara proportional random sampling. Analisis data dilakukan dengan menggunakan uji Kendall Tau. Kualitas pelayanan kesehatan baik dari sudut tangible, reliability, responsiveness, assurance maupun empathy berhubungan dengan kepuasan pasien peserta BPJS Kesehatan di FKTP Provinsi Daerah Istimewa Yogyakarta. Hasil analisis bivariat setiap variabel mempunyai nilai Sig. (2-tailed) 0,000 dengan hubungan yang kuat. Kualitas pelayanan kesehatan (tangible, reliability, responsiveness, assurance dan empathy) berhubungan dengan kepuasan pasien peserta BPJS Kesehatan di FKTP Provinsi Daerah Istimewa Yogyakarta. FKTP di Provinsi Daerah Istimewa Yogyakarta supaya tetap mempertahankan kualitas pelayanan kesehatannya sehingga pasien peserta program Jaminan Kesehatan Nasional (JKN) tetap merasa puas terhadap pelayanan yang sudah diberikan.

scholarly journals The structural quality of maternal health services in primary health care facilities in Tanzania: Findings from a baseline study

2019 ◽  
Author(s):  
Ntuli A. Kapologwe ◽  
Albino Kalolo ◽  
Naomi H. Isanzu ◽  
Josephine Borghi ◽  
Stephen M. Kibusi
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Services ◽  
Maternal Death ◽  
Maternal Health Services ◽  
Health Facilities ◽  
Structural Quality ◽  
Primary Health ◽  
Primary Health Facilities

AbstractBackgroundStructural quality of maternal health services remains a key indicator of highly performing health care system. Evidence attest to the fact that introduction of the new interventions in the health care system does not necessarily lead into improvement of the target outcome, such as quality of health services delivered. This study aimed at assessing the structural quality of maternal health services prior to introduction of Direct Health Facility Financing (DHFF) program.MethodsThis was a cross-sectional study, conducted in 42 public primary health facilities between January and mid February 2018. Observational were used to collect the data from health facilities. The collected information was on privacy, hygiene and sanitation, obstetric emergences, sterilization, maternal death audit reviews and waste management. Collected data were analyzed by using SPSS.ResultsAll 42 (100%) primary health facilities that were assessed were public primary health facilities, of which 14 (33.3%) were health centers and 28 were dispensaries. The furthest primary health facilities from the district head office were 140 Kms and the nearest 2 Kms. Focusing on; - privacy, hygiene and sanitation, obstetric emergences, sterilization, maternal death audit reviews and waste management assessed eight areas of Structural qualities. Majority (68.9%) of Health Centers has less than 39 skilled staff while some of them they have up to 129 health service providers and majority (92.8%) of Dispensaries have less than 15 staff and some have 1 staff.By comparing Dispensary and Health center performances on structural quality indicated relatively low differences among the attributes assessed. Specifically, they did not show statistical significant differences except for obstetric emergencies (p < .005), sterilization (p=. 034) and overall structural quality (p=. 018). With regard to rural-urban performance on structural quality, there was no statistical significant difference on total performance. Similarly, there was no significant differences between rural and urban health facilities on other assessed attributes of structural quality (p >.05) except for sterilization in which urban facilities performed significantly higher than the rural facilities [M=41.2, SD=27.7, 61.3, SD=28.4, respectively (p= .028)]. On the other hand, marginal differences were observed on individual assessed attributes. For examples, rural facilities performed relatively higher than urban ones on privacy (41.2 and 32.0), maternal death reviews (31.4 and 30.7) and waste management (49.0 and 47.3) respectively.ConclusionGenerally facilities performed low on the structural quality indicators of maternal health services provision however; they had high performance on sterilization and emergence obstetric care.

scholarly journals The Direct Health Facility Financing Impact on Financial Management in Kaliua District Council, Tabora Tanzania

2021 ◽  
Vol 7 (1) ◽  
pp. 1
Author(s):  
Batamaga Akimu Kajuni ◽  
Deogratias Faustine Mpenzi
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Financial Management ◽  
Planning Process ◽  
Health Facilities ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Primary Health ◽  
District Council ◽  
Primary Health Facilities

This study assessed the implementation of Direct Health Facility Financing (DHFF) on financial management among primary health facilities of Kaliua District Council. The assessment conducted because Kaliua District is the one among 184 councils where the government introduced DHFF; the study adopted case study design whereby, both qualitative and quantitative approaches were used. A structured questionnaire, Interview, FDGs, Documentary review were used in obtaining data which were classified into planning process, rate of fund utilization, adherence to financial management guidelines and perceptions of employees on fund utilization which were administered to 238 respondents who sampled through simple random and purposeful sampling techniques. Data analysed using excel and SPSS for quantitative data and content analysis for qualitative data.Study revealed that, planning process work in excellent way (72.9%); utilization capacity of funds disbursed has been acknowledged at 70%; Fund utilization perceived positively impacting on the quality of health services delivery like availability of medicines and medical equipment in health facilities unlike the time before DHFF. Financial and procurement guidelines to some extent are adhered for about 50%. However, study observed some problems like lack of funds to facilitate HFGCs’ activities, late disbursement of funds that affected utilization. Conclusively based on findings, financial management at health facilities is effective as it attributed to significantly positive impacts on general improvement of health services delivery in public primary health facilities.

scholarly journals Improving Tanzanian childbirth service quality

2018 ◽  
Vol 31 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Jennie Jaribu ◽  
Suzanne Penfold ◽  
Cathy Green ◽  
Fatuma Manzi ◽  
Joanna Schellenberg
Keyword(s):  
Health Facility ◽  
Low Income ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Rural District ◽  
Local Data ◽  
Content Type ◽  
Primary Health ◽  
Primary Health Facilities ◽  
Childbirth Care

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

scholarly journals Heterogeneity in Average Cost per Patient with type 2 Diabetes at Primary Health Facilities in Mexico: Comparing Comprehensive Diabetes Management Medical Offices with General Practice

2020 ◽  
Author(s):  
M. Arantxa Colchero ◽  
Rousellinne Gómez ◽  
Ruy López-Ridaura ◽  
Daniel López-Hernández ◽  
Iyari Sánchez-Díaz ◽  
...  
Keyword(s):  
General Practice ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Unit Cost ◽  
Health Facilities ◽  
Patient Knowledge ◽  
Factors Associated ◽  
Unit Costs ◽  
Primary Health ◽  
Primary Health Facilities

Abstract Background. Despite the high health and financial burden imposed by diabetes in Mexico, few studies have estimated the cost per patient treated. The objective of this study was to estimate the average annual cost per patient (unit cost) with diabetes among 60 primary health facilities in Mexico comparing comprehensive diabetes management medical offices (MIDE) and those from general practice (Non-MIDE). Methods. We described the variation in unit costs across these two types of medical offices and explored factors associated. Unit costs were the sum of staff, medications, laboratory tests, and equipment. We show descriptive statistics to analyze the heterogeneity of unit costs, and the distribution of total costs by input and the distribution of staff costs by personnel all by medical office. We estimated a multivariate linear regression model to explore factors associated with the unit costs. Results. Unit costs vary from $267.2 USD in Non-MIDE offices to $410.6 for MIDE. Unit costs were negatively associated with scale, Non-MIDE offices, medical competence, patient knowledge of diabetes and positively associated with comorbidities. Conclusions. Results from this study might help design more efficient programs for diabetes care in primary health facilities to reduce the burden of diabetes in the system. Investing in staff training and educational interventions to increase patient knowledge of diabetes could be promising interventions to reduce diabetes care costs in primary care settings.

scholarly journals The Nutritional Status of Adult Antiretroviral Therapy Recipients with a Recent HIV Diagnosis; A Cross-Sectional Study in Primary Health Facilities in Gauteng, South Africa

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 290
Author(s):  
Khabo Mahlangu ◽  
Perpetua Modjadji ◽  
Sphiwe Madiba
Keyword(s):  
South Africa ◽  
Antiretroviral Therapy ◽  
Nutritional Status ◽  
Health Facilities ◽  
The Body ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

The study determined the nutritional status of adult antiretroviral therapy (ART) recipients, and investigated the association between the duration on ART and the nutritional status. This study was based in primary health facilities in Gauteng, South Africa. The data collected included sociodemographic variables; the duration of the treatment; and the body mass index (BMI), classified as undernutrition (<18.5 kg/m2), normal (18.5–24.9 kg/m2), or overweight/obesity (≥25 kg/m2). ART recipients (n = 480) had a mean age of 35 (± 8.4SD) years. All had taken ART for six months or more (range 6–48 months). The data were analyzed using STATA 13.0. The overall prevalence of overweight/obesity was 39%, it was higher in females (46%) than in males (30%), 26% were overweight, and 13% were obese. Underweight was 13%, and was higher in males (18%) than females (9%). Being overweight was more likely in those aged ≥35 years and those in smaller households. Being obese was less likely in males, in the employed, and in those with a higher income, but was more likely in those with a longer duration on ART. Abdominal obesity was high, but less likely in males. Interventions to prevent overweight/obesity should be integrated into routine HIV care, while at the same time addressing the burden of undernutrition among ART recipients.

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