Managing Health at District Level: A Framework for Enhancing Programme Implementation in India

2021 ◽  
Vol 23 (1) ◽  
pp. 119-128
Author(s):  
Natasha Dawa ◽  
Thelma Narayan ◽  
Jai Prakash Narain
Keyword(s):  
Health Care ◽  
Health Services ◽  
National Health ◽  
Rural Areas ◽  
Social Protection ◽  
Well Being ◽  
District Level ◽  
Access To Health Services ◽  
Programme Implementation ◽  
Quality Health Care

COVID-19 pandemic has brought to the fore the need for a strong health system for the social protection of people and to improve health programme implementation in the coming years. India has made great progress in health over the past 50 years; however, despite the progress made, it is faced with several challenges. While infectious diseases remain an unfinished agenda, chronic non-communicable diseases (NCDs) are rising and are now the leading cause of mortality in the country. This is further compounded by the prevailing inequalities in access to quality health care among population groups including those living in remote rural areas. To achieve Universal Health Coverage and Sustainable Development Goals by 2030, India in 2017 revised its National Health Policy and committed itself to attain the highest possible level of good health and well-being, through preventive and promotive health interventions. While policies are enunciated and plans are formulated, the implementation at ground level is at best tardy and lack lustre As an administrative unit for programme implementation, a district has a key role to play in implementing national programmes and in delivery of basic health services to the people. They are strategically placed to plan, organise and lead efforts meant to deliver primary health care services through better management of existing resources and by fully engaging all relevant stakeholders in contributing towards achievement of national health goals and in responding to a public health emergency such as Covid-19. Planning and managing health problems need an improved and responsive health governance. Strategic planning, monitoring and evaluation require integration and coordination of various health programmes including dealing with health crises, fostering inter-sectoral involvement and engagement of the community as a key actor. Efforts are needed to ensure that services reach the most vulnerable and marginalised sections of the society. Adequate governance support at district level through a whole-of-society approach is essential to bridge the health inequities and ensure equitable access to health services.

scholarly journals Survey on Health, Well-being and Aging. SABE Colombia 2015: Technical report

2019 ◽  
pp. 128-138 ◽  
Author(s):  
Delia Ortega Lenis ◽  
Fabián Méndez
Keyword(s):  
Health Services ◽  
Rural Areas ◽  
Rural Population ◽  
Social Protection ◽  
Survey Methods ◽  
Well Being ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Qualitative Approaches

Introduction: Colombian population is getting old in an accelerated manner, causing economic, social and health services effects. The Ministry of Health and Social Protection in the National System of Population Studies and Surveys for Health implemented the first health, well-being and aging survey- SABE-2015 Colombia- to know the living conditions of people 60 years of age or older. Objective: Describe the design of the method, statistical sampling and quality control of information from the SABE-2015 survey. Methods: A cross-sectional study, with quantitative and qualitative approaches, representative for the population in urban and rural areas aged 60 or over. Information was collected on socioeconomic variables, physical and social environment, behavior, cognition and affection, functionality, mental well-being, health conditions, and the use and access to health services. Results: 23,694 surveys were conducted, 17,189 in urban population (72.5%) and 6,505 in rural population. The percentage of effective national response was 66% in 244 municipalities. Supervision was made in 40% of the surveys and telephone re-contact in 25%. The consistency of 100% surveys was reviewed and double entry was developed in 5% of them. National estimates have a 5% margin error. Conclusion: The SABE Colombia 2015 survey is representative of the main indicators of health, well-being and aging in Colombia. The design allows regional comparisons, between large cities and urban and rural population.

ICTS and Their Role in Health Promotion

2011 ◽  
pp. 1-15 ◽  
Author(s):  
Motshedisi B. Sabone ◽  
Keitshokile D. Mogobe ◽  
Tiny G. Sabone
Keyword(s):  
Health Promotion ◽  
Rural Communities ◽  
Health Services ◽  
Health Information ◽  
Rural Areas ◽  
Well Being ◽  
Specific Reference ◽  
Access To Health Services ◽  
Access To Health ◽  
Level Of Effort

This chapter presents findings of mini-survey that utilized an exploratory descriptive design to examine the accessibility, affordability, acceptability, and utility of ICTs with specific reference to health promotion for selected rural communities. Specifically, the study focused on access to radio, television, mobile phone, and Internet services at a level of effort and cost that is both acceptable to and within the means of a large majority in a given village. The findings indicate that ICTs gadgets explored have opened up possibility for health services and information to reach even people in the rural areas. Ultimately, access affects the general well-being of individuals. One of the major initiatives under the umbrella of health is improving access to health services and information; and this covers among other things, expanding the delivery of health information through the radio and television. This study confirms breakthrough in this respect. Challenges that accompany the use of these ICT gadgets include no connectivity in some areas and lack of training to use them.

ICTS and Their Role in Health Promotion

2012 ◽  
pp. 211-224
Author(s):  
Motshedisi B. Sabone ◽  
Keitshokile D. Mogobe ◽  
Tiny G. Sabone
Keyword(s):  
Health Promotion ◽  
Rural Communities ◽  
Health Services ◽  
Health Information ◽  
Rural Areas ◽  
Well Being ◽  
Specific Reference ◽  
Access To Health Services ◽  
Access To Health ◽  
Level Of Effort

This chapter presents findings of mini-survey that utilized an exploratory descriptive design to examine the accessibility, affordability, acceptability, and utility of ICTs with specific reference to health promotion for selected rural communities. Specifically, the study focused on access to radio, television, mobile phone, and Internet services at a level of effort and cost that is both acceptable to and within the means of a large majority in a given village. The findings indicate that ICTs gadgets explored have opened up possibility for health services and information to reach even people in the rural areas. Ultimately, access affects the general well-being of individuals. One of the major initiatives under the umbrella of health is improving access to health services and information; and this covers among other things, expanding the delivery of health information through the radio and television. This study confirms breakthrough in this respect. Challenges that accompany the use of these ICT gadgets include no connectivity in some areas and lack of training to use them.

scholarly journals “The Message Is You Don’t Exist”: Exploring Lived Experiences of Rural Lesbian, Gay, Bisexual, Transgender, Queer/Questioning (LGBTQ) People Utilizing Health care Services

2021 ◽  
Vol 7 ◽  
pp. 237796082110511
Author(s):  
Nadine R. Henriquez ◽  
Nora Ahmad
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Lived Experiences ◽  
Health Care Services ◽  
Care Delivery ◽  
Well Being ◽  
Minority Population ◽  
Physical And Mental Health ◽  
Access To Health Services ◽  
Care Services

Background Lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) people experience significant health inequities with well-documented negative health impacts due to their status as a sexual and gender minority population. Insensitive or discriminatory attitudes toward LGBTQ people within the health care system have negatively impacted access to health services and the overall physical and mental health and well-being of this at risk population. Few studies of LGBTQ populations in rural areas have been conducted, with even fewer in the Canadian context. Rural areas often create greater visibility for LGBTQ persons, contain fewer supports and alternatives in the face of discrimination, and are often are less accepting of LGBTQ populations due to increased stigma and social isolation. Objective The purpose of this study is to examine the lived experiences of LGBTQ people utilizing health care services in rural Manitoba. Method 12 individuals who self-identified as LGBTQ who had accessed health care services in Manitoba were recruited. Using qualitative methodology, interviews were recorded and analyzed for themes. Results Analysis revealed themes including stigma and discrimination, judgments and assumptions, gender identities, lack of knowledge, limited access/systemic barriers, rural considerations, and recommendations for changes to address the gaps in health care services and barriers to access. Conclusions This study of the LGBTQ community provides an expression of their opinions and experiences, but also provides a voice to this underserved population. The findings of this study provide a better understanding of the unique health needs and experiences of LGBTQ people in rural Manitoba, creating opportunities for meaningful change in health care delivery

scholarly journals PUBLIC INVESTMENT ON HEALTH SERVICES AND ITS DETERMINANTS IN MIZORAM: AN EMPIRICAL ANALYSIS

2020 ◽  
pp. 21-26
Author(s):  
Dr.Lalfakawmi
Keyword(s):  
Economic Growth ◽  
Health Care ◽  
Human Capital ◽  
Health Services ◽  
Poverty Reduction ◽  
Universal Access ◽  
Public Investment ◽  
Well Being ◽  
Access To Health Services ◽  
The Government

The health of human capital generates both higher income and individual well-being. Improved health generates economic growth and poverty reduction in the long- run. Good health is universally acknowledge being of intrinsic value and, therefore, constitutes an integral element of development. The expenditure on health is revealed as a kind of investment in human capital. Government has almost exclusive responsibility for providing public goods that create large positive externalities. Despite differences of opinion about the role of the government in health care, it seems that there is unanimity of view that universal access and equity are dependent on the government financial support of basic health care. The access to health services has to be need and state specific, depending on the socio-economic conditions, health outcomes and administrative capacity. Attempt is made in this paper to analyze the growth of public investment on health services and its determinants in Mizoram. The study shows that there has been commendable growth of public investment on health services, both in current and constant prices. It is further observed that there is more than proportional increase of public health expenditures with respect to population, while it is almost proportional to total budget of the state, and less than proportional to GSDP. KEYWORDS: health services, economic growth, public investment/expenditure, determinants.

scholarly journals Community monitoring: A strategy to watch out for

2013 ◽  
Vol 6 ◽  
Author(s):  
Saurabh RamBihariLal Shrivastava ◽  
Prateek Saurabh Shrivastava ◽  
Jegadeesh Ramasamy
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Rural Areas ◽  
Universal Access ◽  
Current Status ◽  
Community Based ◽  
Quality Health Care ◽  
Community Ownership ◽  
Community Monitoring

India’s National Rural Health Mission (NRHM) was launched in 2005 on a nationwide scale with a vision to provide universal access to equitable, affordable and quality health care. In particular, it aims to meet the health needs of the poor and vulnerable in mostly rural areas, such as women, children and the elderly. The Mission is distinguished by in-built flexible mechanisms, so that local needs and priorities can be identified and addressed and local initiatives promoted. Central to these mechanisms is the role of community ownership and participation in management, which is seen as an important prerequisite within the NRHM. This article explores the development and use of community-based monitoring (CBM), which involves drawing in, activating, motivating and capacity building so that the community and its representatives can directly give feedback about the functioning of public health services, including input to improving planning of those services. The focus of this monitoring process is mainly on ‘fact finding’ and ‘learning lessons for improvement' rather than on ‘fault finding’. This article describes the objectives and stages of CBM and also discusses its current status and challenges. The most important reasons for the success of CBM are strong civil society engagement, the involvement of public health personnel as well as the community as principal stakeholders, adequate geographic representation and the crucial role played by the Monitoring and Planning Committees. Community-based monitoring of health services is a key strategy of the NRHM to ensure that services reach those for whom they are intended. This framework is consistent with the ‘Right to Health Care’ approach since it places health rights of the community at the centre of the process. It also seeks to address gaps in the implementation of various programs, thereby enhancing transparency down to the grassroots level. Keywords: Community, community mobilisation, community monitoring, community ownership and participation in management, health care, public health

scholarly journals Socio-demographic profile of child and adolescent users of oral health services in Victoria, Australia

2014 ◽  
Vol 30 (9) ◽  
pp. 1903-1911 ◽  
Author(s):  
J Rodrigo ◽  
Hanny Calache ◽  
Martin Whelan
Keyword(s):  
Health Care ◽  
Oral Health ◽  
Health Services ◽  
Health Care Services ◽  
Social Inequalities ◽  
Secondary Analysis ◽  
Well Being ◽  
Oral Health Care ◽  
Sample Mean ◽  
Oral Health Services

The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Telemedicine during COVID-19: India embracing the change

2021 ◽  
Vol 8 (4) ◽  
pp. 262-264
Author(s):  
Manoj Pathak ◽  
Srishti Rai
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Provider ◽  
Care Provider ◽  
Adult Literacy ◽  
Rural Areas ◽  
Vital Role ◽  
Literacy Rate ◽  
Psychological Counselling ◽  
Standards Of Practice

Telemedicine has been around for decades but it has taken foreground in health services recently. When COVID-19 cases started to be reported in the country it brought with itself panic and chaos. At all India level, the adult literacy rate is 77.7%, this could also be linked to unawareness related to the disease in rural areas. The sudden countrywide lockdown imposed was of no help and further worsened the situation for economically weaker section of the society. During the struggle of our nation to overcome the COVID-19 Telemedicine has indeed played a vital role. People in fear of contacting the disease and due to nationwide lockdown were unable to reach their health care provider. People with pre-existing conditions that needs regular monitoring, pregnancy related queries, queries on new symptoms, psychological counselling and many more could not wait for the COVID-19 to be over before they get any help on the issues.­­ Telemedicine shall continue developing and be used in a multitude of settings by more health-care doctors and patients, and these standards of practice will be a crucial driver within this evolution.

scholarly journals Use of and access to health services in Brazil, 2013 National Health Survey

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Sheila Rizzato Stopa ◽  
Deborah Carvalho Malta ◽  
Camila Nascimento Monteiro ◽  
Célia Landmann Szwarcwald ◽  
Moisés Goldbaum ◽  
...  
Keyword(s):  
Health Services ◽  
National Health ◽  
Health Survey ◽  
National Health Survey ◽  
Brazilian Population ◽  
Access To Health Services ◽  
Level Of Education ◽  
Head Of Household ◽  
Access To Health ◽  
Use Of Health Services

ABSTRACT OBJECTIVE To analyze the use of health services in the Brazilian population by sociodemographic factors, according to data from the 2013 Brazilian National Health Survey. METHODS The study analyzed data from 205,000 Brazilian citizens in all age groups who participated in the Brazilian National Health Survey, a cross-sectional study carried out in 2013. Prevalence and confidence intervals were estimated for indicators related to access to and use of health services according to age group, level of education of head of household, and Brazilian macroregions. RESULTS Among individuals who sought health services in the two weeks prior to the survey, 95.3% (95%CI 94.9–95.8) received care in their first visit. Percentages were higher in the following groups: 60 years of age and over; head of household with complete tertiary education; living in the South and Southeast regions. In addition, 82.5% (95%CI 81.2–83.7) of individuals who received health care and prescriptions were able to obtain all the necessary medicines, 1/3 of them from SUS. Less than half the Brazilian population (44.4%; 95%CI 43.8–45.1) visited a dentist in the 12 months prior to the survey, with smaller percentages among the following groups: 60 years of age or older; head of household with no education or up to incomplete elementary; living in the North region of Brazil. CONCLUSIONS People living in the South and Southeast regions still have greater access to health services, as do those whose head of household has a higher level of education. The (re)formulation of health policies to reduce disparities should consider differences encountered between regions and social levels.

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