scholarly journals The Trend of Health Service Utilization and Challenges Faced During the COVID-19 Pandemic at Primary Units in Addis Ababa: A Mixed-Methods Study

2021 ◽  
Vol 8 ◽  
pp. 233339282110311
Author(s):  
Tariku Shimels
Keyword(s):  
Time Series ◽  
Health Service ◽  
Service Delivery ◽  
Quantitative Data ◽  
Health Service Utilization ◽  
Qualitative Data ◽  
Addis Ababa ◽  
Health Centers ◽  
Key Informant ◽  
Key Informant Interview

Introduction: The COVID-19 pandemic has imposed an extraordinary challenge to the health and socio-economic facet of nations globally. Health facilities have encountered tremendous challenges to contain service delivery at all levels. This study aims to assess the trend of health service utilization and challenges faced during the COVID-19 pandemic at primary units in Addis Ababa, Ethiopia. Method: A multi-facility-based cross-sectional study was conducted in Addis Ababa between 1 and 30 of August 2020. A mixed-methods design was employed, and both quantitative and qualitative data were collected at 5 health centers. Facilities were selected randomly from 5 sub-cities while interviewees were recruited purposively. A structured questionnaire was used to collect quantitative data from the HMIS units of each facility. Qualitative data was collected using a semi-structured key-informant interview guide. Quantitative data were analyzed using Microsoft Excel, and a 10-month time-series trend was generated. For the qualitative data, qualitative data analysis (QDA-minor) software was used. Results: Time-series comparison of the pre-COVID-19 era loads with the COVID-19 period showed that there was an extensive disparity in the service delivery capacity of the health facilities. A huge drop in inpatient flow of some units such as PICT, VCT, FP services, and most sub-units of the OPDs has been recorded following the COVID-19 outbreak. The key-informant interview also revealed that such challenges, as fear of infection and stigma, poor infrastructure, challenges related to human resources, and challenges related to the supply of prevention and treatment inputs were prominently encountered at the health centers. Conclusion: The COVID-19 wave has negatively impacted many service delivery points in the study settings. The presence of weak infrastructure, lack of PPEs, fear of the infection and stigma, and staff workload have been mentioned as the predominant challenges faced during the outbreak. Health authorities should arrange multifaceted supports to ensure uninterrupted service delivery at primary healthcare units.

scholarly journals Contraceptive use among Young Adults in Zimbabwe, Questionnaire Study

2021 ◽  
pp. 37-47
Author(s):  
Lianora Manyange ◽  
Tolbert Mucheri ◽  
Thabani Nyoni ◽  
Norman Makunika ◽  
Naftaly Mose
Keyword(s):  
Hiv Prevention ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Contraceptive Use ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Prevention Services ◽  
Sexual Activities ◽  
Key Informant ◽  
Prevention Methods

Adolescents face several challenges where ASRH issues are concerned. One of these issues is the low uptake of HIV prevention services especially those in high-density urban townships who are prone to several factors that hinder their access to HIV prevention services. This study sought to highlight the prevalence of HIV prevention methods use among adolescents and factors that determine their accessibility in Dzivarasekwa and Tynwald Districts. A total of 500 questionnaires were administered to adolescents aged 15-19 years to collect quantitative data. The study also conducted 10 Focus group discussions and 20 Key informant interviews to solicit qualitative data. The findings showed that, though a level of prevention was observed, a significant number of adolescents were engaging in sexual activities. Adolescents were aware of most HIV prevention methods: however, their knowledge was not being translated into the utilization of these methods. Recommendations were also offered to serve on how HIV prevention services uptake can be improved amongst adolescents.

scholarly journals PERSEPSI REMAJA TERHADAP FAKTOR PENGHAMBAT PEMANFAATAN PELAYANAN KESEHATAN REPRODUKSI DI PUSKESMAS GAMBOK KABUPATEN SIJUNJUNG

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Vella Dwi Yani ◽  
Ova Emilia ◽  
Hari Kusnanto
Keyword(s):  
Reproductive Health ◽  
Health Service ◽  
Physical Process ◽  
Qualitative Data ◽  
Psychosocial Factor ◽  
Reproductive Health Service ◽  
Health Centers ◽  
District Health ◽  
Cross Sectional ◽  
Cross Sectional Design

PERSEPSI REMAJA TERHADAP FAKTOR PENGHAMBATPEMANFAATAN PELAYANAN KESEHATAN REPRODUKSIDI PUSKESMAS GAMBOK KABUPATEN SIJUNJUNGVella Dwi Yani, Ova Emilia, Hari KusnantoABSTRACTBackground: Reproductive health service is an important component that has to be improved globally becauseteenagers often lack basic information about reproductive health. Despite the need for reproductive health serviceonly a few teenagers utilize the service due to several constraints in having reproductive and sexual health serviceas a result of limited access to the service and negative perception about center of reproductive health service.Data of Sijunjung District Health Office Sumatera Barat show that only 20% of teenagers utilize reproductivehealth service available. Whereas cases in teenagers indicate that 9.2% of teenagers have had premarital sexualintercourse and 40% are married at teenage period (<20 years) and 10% is caused by unwanted pregnancy.Objective: To study the perception of teenagers about physical, process, economic and psychosocial factors asobstacles in the utilization of reproductive health service.Method: The study was observational with cross sectional design and descriptive quantitative approach thatused qualitative data obtained from indepth interview. Subject of the study were students of SMU 1 and 2 of 14-16 years old around the working area of Health Centers that have health service for teenagers with as many as131 respondents.Result and Discussion: Perception of teenagers about physical, process and economic factors showed that themajority had good perception so these factors were not obstacles for teenagers in utilizing reproductive healthservice. The majority of teenagers (68%) had bad perception about psychosocial factor so this was an obstacle inthe utilization of reproductive health service.Conclusion: Obstacles in the utilization of reproductive health service at the health center were caused bypsychosocial factor because of shame and unwillingness to tell the problem to staff that was considered asstrangers. Teenagers also doubted the confidentiality of the problem they told to the staff.Keywords: perception, teenagers, reproductive health, utilizationABSTRAKLatar belakang: Pelayanan kesehatan reproduksi merupakan komponen penting yang harus diperbaiki secaraglobal. Remaja sering kali kekurangan informasi dasar tentang kesehatan reproduksi. Meskipun kebutuhanpelayanan kesehatan reproduksi tinggi namun pemanfaatannya masih rendah karena berbagai hambatanmemperoleh pelayanan dan juga adanya persepsi negatif terhadap pusat pelayanan kesehatan reproduksi. Datadari dinas Kesehatan kabupaten Sijunjung Sumatera Barat menunjukkan hanya 20% remaja yang memanfaatkanpelayanan kesehatan reproduksi. Sedangkan kasus dan masalah kesehatan reproduksi menunjukkan 9,2% sudahberhubungan seks sebelum menikah, dan 40% menikah pada usia remaja (<20 tahun) serta 10% mengakibatkankehamilan tak dikehendaki.Tujuan: Untuk mempelajari persepsi remaja terhadap faktor fisik, proses, ekonomi dan psikososial untukmemanfaatkan pelayanan kesehatan reproduksi remaja.melalui wawancara mendalam.Subyek penelitian adalah siswa SMA kelas 1 dan 2 usia 14-16 tahun di wilayahkerja puskesmas sebanyak 131 responden.Hasil dan Pembahasan: Mayoritas remaja memiliki persepsi baik terhadap faktor fisik, proses, dan ekonomi. Tigafaktor bukanmerupakan penghambatmemperoleh layanan kesehatan reproduksi. Sementara itu faktor psikososialdianggap sebagai penghambat (68%) untuk memanfaatkan pelayanan kesehatan reproduksi.Kesimpulan: Hambatan pemanfaatan layanan kesehatan reproduksi adalah faktor psikososial karena malu dantidak percaya untuk menceritakan masalah pada petugas kesehatan yang tidak dikenal. Remaja juga meragukankerahasiaan masalah yang diungkapkan.Kata kunci: persepsi, remaja, kesehatan reproduksi, pemanfaatan

scholarly journals Influence of community scorecards on maternal and newborn health service delivery and utilization

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth Ekirapa Kiracho ◽  
Noel Namuhani ◽  
Rebecca Racheal Apolot ◽  
Christine Aanyu ◽  
Aloysuis Mutebi ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Repeated Measures ◽  
Qualitative Data ◽  
Health Workers ◽  
Statistical Significance ◽  
Health Service Delivery ◽  
Collaborative Problem Solving ◽  
Maternal And Newborn Health ◽  
Maternal And Newborn

Abstract Introduction The community score card (CSC) is a participatory monitoring and evaluation tool that has been employed to strengthen the mutual accountability of health system and community actors. In this paper we describe the influence of the CSC on selected maternal and newborn service delivery and utilization indicators. Methods This was a mixed methods study that used both quantitative and qualitative data collection methods. It was implemented in five sub-counties and one town council in Kibuku district in Uganda. Data was collected through 17 key informant interviews and 10 focus group discussions as well as CSC scoring and stakeholder meeting reports. The repeated measures ANOVA test was used to test for statistical significance. Qualitative data was analyzed manually using content analysis. The analysis about the change pathways was guided by the Wild and Harris dimensions of change framework. Results There was an overall improvement in the common indicators across sub-counties in the project area between the 1st and 5th round scores. Almost all the red scores had changed to green or yellow by round five except for availability of drugs and mothers attending Antenatal care (ANC) in the first trimester. There were statistically significant differences in mean scores for men escorting their wives for ante natal care (ANC) (F(4,20) = 5.45, P = 0.01), availability of midwives (F(4,16) =5.77, P < 0.01), availability of delivery beds (F(4,12) =9.00, P < 0.01) and mothers delivering from traditional birth attendants (TBAs), F(4,16) = 3.86, p = 0.02). The qualitative findings suggest that strengthening of citizens’ demand, availability of resources through collaborative problem solving, increased awareness about targeted maternal health services and increased top down performance pressure contributed to positive changes as perceived by community members and their leaders. Conclusions and recommendations The community score cards created opportunities for community leaders and communities to work together to identify innovative ways of dealing with the health service delivery and utilization challenges that they face. Local leaders should encourage the availability of safe spaces for dialogue between communities, health workers and leaders where performance and utilization challenges can be identified and solutions proposed and implemented jointly.

scholarly journals THE EFFECT OF ENVIRONTMENT CHARACTERISTICS ON DIARRHEA OCCURRENCE AMONG CHILDREN UNDER FIVE IN PALEMBANG

2019 ◽  
Vol 10 (2) ◽  
pp. 126-131
Author(s):  
Amrina Rosyada ◽  
Dini Arista Putri ◽  
Nur Alam Fajar
Keyword(s):  
Data Collection ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Public Health Problem ◽  
Secondary Data ◽  
Health Centers ◽  
Department Of Health ◽  
Quantitative Data Analysis ◽  
Depth Interviews ◽  
Water Waste

Diarrhea is still a public health problem in developing countries such as Indonesia because morbidity and mortality rates are still high in these areas. A morbidity survey conducted by the Diarrhea Department of the Ministry of Health in Indonesia between 2000 and 2010 shows rising incidences of diarrhea in children. In 2000, Incidence Rate (IR) diarrhea incidents occurred in 301/1000 members of the population, and this increased to 411/1000 in 2010. Cases of diarrhea have become dangerous when suffered by infants because the mortality rate will increase because weaker immunity than olders. Environmental factors such as water, waste, and toilet contribute greatly to cases of diarrhea; therefore, in this research, we analyze environmental characteristics’ effects on the incidence of diarrhea in infants in Palembang. This study uses a mixed-method design combining quantitative data collection using secondary data from the Department of Health with qualitative data collection using in-depth interviews of Palembang’s local government and health center personnel in the districts with the highest and lowest cases of diarrhea. Quantitative data analysis are visualized in the form of a map, while qualitative data are analyzed using content analysis. The results show that Ilir Timur I has the highest incidences of diarrhea while the Sako district has the lowest. Based on the results of the analysis, Ilir Timur I has more cases of diarrhea largely because of its non-working area health centers. Sako has the fewest cases of diarrhea because the clinics, doctors, and midwives in private practice in the region of Sako do not report the cases, as well as because of factors related to access remote health centers. Therefore, interventions based on health data for diarrhea need to be restyled for a drastic reduction of diarrhea cases. Keywords: Area, diarrhea, children, characteristic, environment, data

scholarly journals Improving quality of 'health service management' clerkship course using action research

2019 ◽  
Author(s):  
S Azami Aghdash ◽  
Z Ostad Ahmadi ◽  
N Shahedifar ◽  
Z Abhari ◽  
J Sajjadi Khasraghi ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Action Research ◽  
Health Service ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Service Management ◽  
Control Group ◽  
Health Service Management ◽  
Management Students

Introduction: Action research is one of the important methods in medical education quality improvement. This study aims to improve quality of 'health service management' student’s clerkship course using action research. Methods: This action research study used mix method approach and was conducted in Tabriz University of Medical Science in 2018 year using Simon’s six stage model. Qualitative data was collected through in deapth interviews and focus group discussions (FGDs). Quantitative data was collected through a reliable and validated questionnaire. The participants were 17 health service management students (enrolled in 2015-2016) and the control group were 28 health service management students enrolled in 2014-2015). Qualitative data were analysed using content-analysis and quantitative data were analysed using T-test by SPSS-16 software. Result: Overall, 14 problems were identified and for 11 problems interventions were designed. The most important strengths of clerkship were;a)regular planning, b) appropriate assessment, c)scoring, high level of tutor attendance and d)more attention to management issues. Coordination problems and inappropriate headline of portfolio in some cases were weakness of this action research. The results of quantitative evaluation show that all items of questionnaire were improved. After reseach, %20.6 increase was observed in students' satisfactions level in the intervention groupcompared with the control group (80.7 vs. 60.1) (p>0.05). Conclusion: This action research significantly improved quality of clerkship course, it’s recommended that in future years same studies with aim to more quality improvement implemented.

scholarly journals Effect of Quality Improvement Approaches on Prevention of Mother to Child Transmission Services Coverage in Nairobi County

2021 ◽  
Vol 6 (05) ◽  
pp. 316-328
Author(s):  
Duece N. Malava ◽  
Peterson Muriithi ◽  
Chrisostim Barasa
Keyword(s):  
Quality Improvement ◽  
Service Delivery ◽  
Health Outcomes ◽  
Quantitative Data ◽  
Qualitative Data ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Purposive Sampling ◽  
Mother To Child ◽  
Over Time

Background: Improving the quality of healthcare is a growing international concern as it ensures that the healthcare system functions efficiently. Quality improvement in the HIV field focuses on achieving essential health outcomes, including patient retention, increasing viral load suppression, and improving overall health outcomes of people living with HIV. Quality Improvement (QI) approaches form part of the global strategies recommended by WHO to improve prevention of mother to child transmission (PMTCT) coverage and to achieve virtual elimination of mother to child transmission (MTCT). Nairobi County is implementing QI approaches using the Kenya Quality Model for Health (KQMH) framework. The implementation of QI began in January 2016, and since then, the facilities have formed work improvement teams (WITs) that work to improve the quality in the facilities. Study objective: This study sought to evaluate the effect of quality improvement approaches on PMTCT coverage in Nairobi County. Methodology: This quasi-experimental study applied a mixed-method research methodology. Purposive sampling determined the four study facilities. The participants were women attending the PMTCT clinic at the selected facilities, identified through a purposive sampling process. DHIS reports and facility registers provided the necessary quantitative data, while Focus Group Discussions (FGDs) and Key informant interviews (KIIs) provided qualitative data. Quantitative data showing service delivery uptake over time provided a trend on the performance of the key indicators under study. This data analysed using an interrupted time series approach as well as by using descriptive statistics showed trends over time. Qualitative data assessed clients’ experiences while accessing PMTCT services, providing key insights from the clients’ perspective. The researcher used content analysis to analyse this data. Results: The study found out that quality improvement is an integral part of PMTCT service delivery. Through the FGDs, the PMTCT services provided generally satisfy the clients’ needs, and that the clients have a significant role in quality improvement. The HCWs can implement QI approaches as long as they have the facility management's support and leadership. Conclusion: The study found out that quality improvement in PMTCT relies heavily on the systems being in place and on teamwork between the HCWs and clients as they access treatment services at the health facilities.

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