scholarly journals Assesing Health Services in Colombia: Development of a Conceptual Framework and Measurement tools based on primary data

SAGE Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 215824402110168
Author(s):  
Marcela Arrivillaga
Keyword(s):  
Health Care ◽  
Health Services ◽  
Conceptual Framework ◽  
Health Care Services ◽  
Health Services Accessibility ◽  
Primary Data ◽  
Health Coverage ◽  
Care Services ◽  
Concept Of Health ◽  
Measurement Tools

Colombia has a mixed public-private health care system, and although official data indicate more than 95% of health coverage, research in this field has demonstrated the persistence of barriers to accessing health care services. This study aimed to analyze the conceptual framework of health services accessibility and develop measurement tools for its assessment using primary data and also to propose a method for ascertaining health services accessibility and availability using a territory-based approach. A mixed method study with concurrent design was carried out in four phases between 2014 and 2017. The starting points were a review of the literature and a documentary research that identified five conceptual frameworks for health services accessibility published between 1970 and 2013. It was found that the theoretical concept of health services availability has not been clear; the literature does not define it explicitly and does not differentiate it from the concept of health coverage. As a result, two measurement tools were developed: a Health Care Services Accessibility Household Survey and a Health Care Services Availability Questionnaire. These tools and the proposed method for ascertaining health services accessibility can be useful for government, institutions, and social and scientific organizations to monitor progress in guaranteeing the fundamental human right to health, declared in the Health Organic Law issued in 2015 in Colombia.

scholarly journals Assessing health services accessibility in Colombia: Beyond universal health coverage

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Arrivillaga
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Right To Health ◽  
Primary Data ◽  
Pilot Test ◽  
Health Coverage ◽  
Human Right ◽  
Care Services ◽  
Universal Health

Abstract Background Colombia has an insurance-based, private and public health care system, with the intermediation of health insurance agencies that control the resources. At present, the Universal Health Coverage (UHC) is around 97%. However, there is wide scientific evidence that criticizes the structure and operation of the system due to the persistent differences between the UHC indicator and real accessibility to health services. This study aimed to analyze the concept of accessibility of health services in order to design and validate alternatives instruments for its assessment beyond UHC. Methods A mixed methods approach with concurrent design in three phases was conducted between 2014 and 2017: 1) systematic review of literature and documentary research; 2) design, content validation with experts and pilot test of instruments to assess health care accessibility and 3) definition of a route to assess accessibility. Results The reviewed literature revealed five conceptual logics to define accessibility: decent minimum of health care, health care market, factors and multicausality, needs and, social justice and human right to health. A Household Survey on Accessibility to Health Care Services and a Health Care Services Availability Questionnaire was designed and validated with experts and pilot test in representative samples of households and care centers in three cities in Colombia was conducted. Those instruments were designed under the conceptual logic of human right to health. Finally, an alternative route to assess accessibility in Colombia was proposed. Conclusions The route for assessing accessibility with primary data, territorial approach and without intermediation of health insurance agencies allow obtaining an overview of the real situation beyond the UHC indicator. The instruments included in this assessing process can be useful to monitor progress in guaranteeing the human right to health, declared in Colombia and other countries. Key messages The UHC indicator is not enough to assess real accessibility to health services. This study presents an alternative route and two validated instruments for its assessment with primary data and territory-based approach, applicable to countries with public-private health systems.

scholarly journals Telemedicine: Bridging the Gap between Refugee Health and Health Services Accessibility in Hamilton, Ontario

Refuge ◽  
2016 ◽  
Vol 32 (3) ◽  
pp. 108-118 ◽  
Author(s):  
Anthony Robert Sandre ◽  
K. Bruce Newbold
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Service Providers ◽  
Health Services Accessibility ◽  
Refugee Health ◽  
Cultural Barriers ◽  
Structured Interviews ◽  
Care Services ◽  
Specialist Health Care

Refugees face considerable challenges upon seeking asylum in Canada, and accessing health care services remains a prominent issue. Recurrent themes in the literature outlining barriers to health-services accessibility include geographic, economic, and cultural barriers. Drawing on the experiences of service providers in Hamilton, Ontario, we explored the efficacy of telemedicine services in bridging the gap between refugee health and health services accessibility. Research methodology included structured interviews with clinicians who provide health-care services to refugees, complemented by a scoping literature review. The results of this exploratory study demonstrate the efficacy of telemedicine in encouraging dialogue and policy change in the greater health-care setting, and its potential to increase access to specialist health-care services.

scholarly journals Avaliação dos serviços de atenção primária à saúde na tuberculose

2019 ◽  
Vol 13 ◽  
Author(s):  
Tatiana Castro da Costa ◽  
Felipe Lima dos Santos ◽  
Alexandre Tadashi Inomata Bruce ◽  
Jaqueline Garcia de Almeida Ballestero ◽  
Mônica Cristina Ribeiro Alexandre d’Auria de Lima ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Web Of Science ◽  
Care Services ◽  
Primary Health ◽  
Concept Of Health ◽  
Primary Health Care Services ◽  
The Family

RESUMOObjetivo: analisar produções científicas sobre a avaliação dos serviços da Atenção Primária à Saúde no controle da tuberculose. Método: trata-se de estudo bibliográfico, tipo revisão integrativa, que incluiu artigos completos disponibilizados nas Bases de Dados LILACS, CINAHL, SCOPUS, Web of Science e MEDLINE,  publicados no Brasil entre janeiro de 2013 a setembro de 2017. Apresentaram-se os resultados em forma de figuras. Resultados: selecionaram-se e classificaram-se 12 artigos em duas categorias temáticas: “Avaliação dos serviços na perspectiva dos profissionais de saúde” e “Avaliação dos serviços na perspectiva dos usuários”. Conclusão: ratificam-se, pela síntese dos estudos, as fragilidades, sugerindo a formação complementar aos profissionais, além do resgate do conceito expandido de saúde, principalmente, com relação à família e à comunidade, contribuindo para o embasamento de condutas de gestão para a melhoria das intervenções em saúde. Descritores: Atenção Primária à Saúde; Tuberculose; Pesquisa sobre Serviços de Saúde; Enfermagem; Brasil; Serviços Básicos de Saúde. ABSTRACT Objective: to analyze scientific production on the evaluation of Primary Health Care services in the control of tuberculosis. Method: this is a bibliographical study, including an integrative review, which included complete articles available in the LILACS, CINAHL, SCOPUS, Web of Science and MEDLINE databases, "published in Brazil between January 2013 and September 2017. The results were presented in the form of figures. Results: 12 articles were selected and classified in two thematic categories: "Evaluation of services from the perspective of health professionals" and "Evaluation of services from the perspective of users". Conclusion: the synthesis of the studies confirms the weaknesses, suggesting the complementary training to the professionals, besides the rescue of the expanded concept of health, mainly, in relation to the family and the community, contributing to the base of management conduits for the improvement of health interventions. Descriptors: Primary health care; Tuberculosis; Research on Health Services; Nursing; Brazil; Basic Health Services. RESUMEN Objetivo: analizar producciones científicas sobre la evaluación de los servicios de la   Atención Primaria a la Salud en el control de la tuberculosis. Método: se trata de un estudio bibliográfico, tipo revisión integrativa, que incluyó artículos completos disponibles en las Bases de Datos LILACS, CINAHL, SCOPUS, Web of Science y MEDLINE, publicados en Brasil entre enero de 2013 a septiembre de 2017. Se presentaron los resultados en forma de figuras. Resultados: se seleccionaron y se clasificaron 12 artículos en dos categorías temáticas: "Evaluación de los servicios en la perspectiva de los profesionales de salud" y "Evaluación de los servicios en la perspectiva de los usuarios". Conclusión: se ratifican, por la síntesis de los estudios, las fragilidades, sugiriendo la formación complementaria a los profesionales, además del rescate del concepto ampliado de salud, principalmente, con relación a la familia y a la comunidad, contribuyendo para el basamento de conductas de gestión para la mejora de las intervenciones en salud. Descritores: Atención Primaria a la Salud; Tuberculosis; Investigación sobre Servicios de Salud; Enfermeira; Brasil; Servicios Básicos de Salud.

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 ◽  
Author(s):  
Manasi Kumar ◽  
Vincent Nyongesa ◽  
Martha Kagoya ◽  
Byamah Brian Mutamba ◽  
Beatrice Amugune ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Services ◽  
Health Coverage ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Facilities

Abstract Introduction: We describe a facility mapping exercise conducted in two low-income/primary health facilities in Kenya to identify available service resources, cadres, and developmental partners as well as existing barriers and facilitators in the delivery of mental health services in general and specifically for peripartum adolescents in primary health care. We have tried to embrace the principles of integrating mental health services in primary care and keeping WHO mhGAP in mind. Additionally, primary care facilities’ capacity is a major limiting factor for expanding universal health coverage in low- and middle-income countries. Method and Measures: This study utilized a qualitative evidence synthesis through semi-structured facility services mapping and stakeholder interviews. Services-related data was collected from two facility in-charges using the Nairobi City County Human Resource Health Strategy record forms. Additionally, we conducted 12 key informant interviews (KIIs) with and 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 offered weekly through specialist services by the Ministry of Health directly or non-governmental partner. Despite Health care workers being aware of the urgent need to integrate mental health services into routine care, they expressed limited knowledge about mental health disorders, lack of trained mental health personnel, the need for more significant funding and resources to provide mental health services, and promotion of CMHS to treat mental health conditions in the primary care setting. 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 Analysis of the Effect of Health Insurance on Health Care Utilization in Rwanda

2021 ◽  
Author(s):  
Roger Muremyi ◽  
Dominique Haughton ◽  
François Niragire ◽  
Ignace Kabano
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Services ◽  
Health Care Utilization ◽  
Health Care Services ◽  
Insurance Coverage ◽  
Secondary Data ◽  
Living Condition ◽  
Care Utilization ◽  
Health Coverage

In Rwanda, more than 90% of the population is insured for health care. Despite the comprehensiveness of health insurance coverage in Rwanda, some health services at partner institutions are not available, causing insured patients to pay unintended cost. We aimed to analyze the effect of health insurance on health care utilization and factors associated with the use of health care services in Rwanda. This is an analysis of secondary data from the Rwanda integrated living condition survey 2016-2017. The survey gathered data from 14580 households, and decision tree and multilevel logistic regression models were applied. Among 14580 households only (20%) used health services. Heads of households aged between [56-65] years (AOR=1.28, 95% CI:1.02-1.61), aged between [66-75] years (AOR=1.52, 95% CI: 1.193-1.947), aged over 76 years (AOR=1.48, 95% CI:1.137-1.947), households with health insurance (AOR=4.57, 95% CI: 3.97-5.27) displayed a significant increase in the use of health services. This study shows evidence of the effect of health insurance on health care utilization in Rwanda: a significant increase of 4.57 times greater adjusted odds of using health services compared to those not insured. The findings from our research will guide policymakers and provide useful insights within the Rwanda context as well as for other countries that are considering moving towards universal health coverage through similar models.

scholarly journals Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
N. Mlenzana ◽  
R. Mwansa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Waiting Times ◽  
Care Providers ◽  
Persons With Disabilities ◽  
Care Services ◽  
Primary Health

To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54%) were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction. Other clients were satisfied with thoroughness ofhealth care providers regarding symptoms, feelings, reception and treatment received at the primary health care centre.Understanding the views of the clients is essential in improving health delivery services and could impact on thecompliance of people attending primary health care services.

The Finnish healthcare services lean management

2018 ◽  
Vol 31 (1) ◽  
pp. 17-32 ◽  
Author(s):  
Susanna Hihnala ◽  
Lilja Kettunen ◽  
Marjo Suhonen ◽  
Hanna Tiirinki
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Services ◽  
Point Of View ◽  
Lean Management ◽  
Management Skills ◽  
Content Type ◽  
Care Services ◽  
Development Processes ◽  
Specialized Health Care

Purpose The purpose of this paper is to discuss health services managers’ experiences of management in a special health-care unit and development efforts from the point of view of the Lean method. Additionally, the aim is to deepen the knowledge of the managers’ work and nature of the Lean method development processes in the workplace. The research focuses on those aspects and results of Lean method that are currently being used in health-care environments. Design/methodology/approach These data were collected through a number of thematic interviews. The participants were nurse managers (n = 7) and medical managers (n = 7) who applied Lean management in their work at the University Hospital in the Northern Ostrobothnia Health Care District. The data were analysed with a qualitative content analysis. Findings A common set of values in specialized health-care services, development of activities and challenges for management in the use of the Lean manager development model to improve personal management skills. Practical implications Managers in specialized health-care services can develop and systematically manage with the help of the Lean method. This emphasizes assumptions, from the point of view of management, about systems development when the organization uses the Lean method. The research outcomes originate from specialized health-care settings in Finland in which the Lean method and its associated management principles have been implemented and applied to the delivery of health care. Originality/value The study shows that the research results and in-depth knowledge on Lean method principles can be applied to health-care management and development processes. The research also describes health services managers’ experiences of using the Lean method. In the future, these results can be used to improve Lean management skills, identify personal professional competencies and develop skills required in development processes. Also, the research findings can be used in the training of health services managers in the health-care industry worldwide and to help them survive the pressure to change repeatedly.

Case Study E-Tailing Health Services in India

2016 ◽  
pp. 292-308
Author(s):  
Bobby Kurian
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Information Dissemination ◽  
Health Providers ◽  
The Public ◽  
Care Services ◽  
The World

This case study has been developed to promote understanding the e-tailing of health services. E-health web portal provides a new medium for information dissemination, interaction and collaboration among institutions, health professionals, health providers and the public. This case study provides a founders perspective in setting up and running a medical website that offers online health care services to customers across the world. The case study discusses the challenges and issues faced by the founders and also the promoter's perspective on the lucrativeness of offering e-tailing services. Using this case study an attempt is made to stress the importance of a flexible e-tailing business model specific to the services offered and need of periodic assessments to ensure that the business runs profitable.

scholarly journals Perceived risks and barriers to care for international migrants in transit through Mexico

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
S Larrea ◽  
R Leyva-Flores ◽  
N Guarneros-Soto ◽  
C Infante-Xibille
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Personnel ◽  
Health Care Services ◽  
Barriers To Care ◽  
Human Security ◽  
Public Health Services ◽  
Care Services ◽  
In Transit

Abstract Background Mexico has implemented policies seeking to reduce barriers to care for migrants in transit; however, it is estimated that only 3% of migrants use public health services when needed. The main purpose of this study was to identify the barriers to access public health services faced by migrants in transit through Mexico. Methods Under the human security perspective, in 2018, a qualitative study was carried out in Mexican communities with high migrant mobility. 34 semi-structured interviews were conducted with migrants in transit, and personnel from public health services and migrant shelters (NGOs). Values and meanings related to risks, health problems, barriers to care, experiences of health services utilization, and opinions on facilitating elements to diminish these barriers were identified. Results Migrants in transit through Mexico face risks that affect all dimensions of human security. Perceived anti-migratory and discriminative attitudes during the journey were constantly mentioned in the interviews. Barriers to care were found in the four stages of health care access, classified according to the Tanahashi framework, with the majority related to accessibility and acceptability. The following facilitating elements were also identified: political willingness of local government, knowledge and talent management of health personnel, and strategies implemented for adapting local health care services to migrants. Conclusions Social and political conditions in Mexico disrupt any effort to reduce social risks and barriers to care for migrants in transit. Non-governmental actors are key players for facilitating interactions between migrants and local governmental health care institutions. However, the general anti-migratory context negatively affects access to health care and influence the perspectives of migrants, NGOs, and health personnel. Key messages The predominant perceived barriers to care are in counterpoint to local governmental pro-migrant rights perspectives. NGOs are key actors to promote access to public health care services.

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