scholarly journals The impact of the nurses’, doctors’ and clinical officer strikes on mortality in four health facilities in Kenya

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Grace Kiringa Kaguthi ◽  
Videlis Nduba ◽  
Mary Beth Adam
Keyword(s):  
Health Facilities ◽  
Clinical Officer ◽  
The Impact

scholarly journals Does Social Franchising Private Health Facilities Shift Consumers Budget Line? An Econometric Analysis of the Average Treatment Effect within Private Health Facilities in Embu County, Kenya

2020 ◽  
Vol 6 ◽  
pp. 1
Author(s):  
Stephen Nyag ◽  
Susan Okeri ◽  
◽  
Keyword(s):  
Average Treatment Effect ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Social Franchising ◽  
Cost Variance ◽  
Matching Criteria ◽  
The Cost ◽  
The Impact ◽  
Radius Matching

The Kenyan private health sector is one of the most developed in Sub-Saharan Africa and is highly critical in healthcare delivery. It is estimated 47 percent of the first quintile of income earners utilize the private facility for healthcare needs and 33 percent of women seek family planning (FP) services in this sector. However, the cost of healthcare services has been a great impediment to service utilization. To improve service quality and increase access, social franchising, interventions on the demand side such as the use of insurance and vouchers, and supply of subsidized medical products on the supply side are intended to reduce the cost of services. This study sought to investigate the impact of interventions of social franchisors on the cost of healthcare in private facilities in Kenya. The study used primary data collected from 215 individuals living within catchment areas with private health facilities using researcher-administered questionnaire. The main franchisors included in this study were Sustainable Health Foundation (CFW) and Population Services Kenya (Tunza). Results revealed that women whose primary motivation to visit private facilities included FP services, need of a lower cost of treatments, and quality services had higher odds of choosing franchised health facilities. Propensity score matching (PSM) using three matching criteria—nearest neighbor, kernel matching, and radius matching of 0.01—indicated that individuals seeking children’s health services and 3-month FP methods paid similar amounts in either franchised or nonfranchised health facilities. However, there was a huge cost variance for long-term FP methods where women paid significantly less, implying that social franchisors’ main impact is on long-term FP methods. The cost variance was due to vouchers utilized by some respondents hence, incurring zero cost in franchised facilities. Therefore, the study recommends the expansion of social franchising membership and the use of the voucher system for financially incapable consumers.

Enhanced surveillance for covid-19 response in Lagos State, Nigeria: lessons learnt, 2020 (Preprint)

2021 ◽  
Author(s):  
Gregory Chukwuemeka Umeh ◽  
Khalid Abubakar ◽  
Peter Akinmusire ◽  
Adamu M. Isa ◽  
Aminu Zauro ◽  
...  
Keyword(s):  
Service Industry ◽  
Respiratory Infections ◽  
Health Facilities ◽  
Acute Respiratory Infections ◽  
Surveillance Strategy ◽  
Active Case ◽  
Governmental Organizations ◽  
Significant Difference ◽  
Lagos State ◽  
The Impact

BACKGROUND The SARS-CoV-2, the novel virus which causes the coronavirus disease (COVID-19), has changed the world. No aspect of humanity is untouched from health, aviation, service industry, politics, economy, education, and entertainment to social and personal lives, since the outbreak of influenza-like illness in Wuhan, China, in December 2019. The Lagos State COVID-19 response team deployed enhanced surveillance through Active Case Search (ACS) for Acute Respiratory Infections (ARI) at health facilities and communities in the 20 Local Government Areas (LGAs) of Lagos State. Lagos State was the first state in Nigeria to deploy this specific surveillance strategy for Nigeria’s COVID-19 response. OBJECTIVE We documented the methods, findings, and review of the active case search for acute respiratory infections, part of COVID-19 response in 20 LGAs of Lagos State, between 1st April and 15th May 2020. METHODS We utilized descriptive and quantitative approaches to describe and assess the impact of the Active Case Search (ACS) for Acute Respiratory Infections (ARI) in health facilities and communities in 20 LGAs of Lagos State between 1st April and 15th May 2020. RESULTS We found a significant difference in mean scores of suspected COVID-19 cases (M=60, SD=109, before ACS for ARI compared to M=568, SD=732, after ACS for ARI, P=0.0039), confirmed cases (M=10, SD=19, before ACS for ARI compared to M=144, SD=187, after ACS for ARI, P=0.0028) and contacts (M=56, SD=116, before ACS for ARI compared to M=152, SD=177, after ACS for ARI, P=0.044) before and after ACS for ARI in 20 LGAs of Lagos State, between 1st April and 15th May 2020. CONCLUSIONS The deployment of the Lagos State government’s polio-eradication structure for the COVID-19 response is both innovative and effective. The response to COVID-19 requires robust surveillance, credible and timely communication, collaboration, coordination among government, inter-governmental organizations (e.g., WHO), non-governmental organizations, and citizens to succeed and limit the medical, economic, social, and personal losses to the COVID-19 pandemic.

scholarly journals Mobile Money Use and Healthcare Utilization: Evidence from Rural Uganda

2020 ◽  
Vol 12 (9) ◽  
pp. 3741
Author(s):  
Hiroyuki Egami ◽  
Tomoya Matsumoto
Keyword(s):  
Antenatal Care ◽  
Fixed Effects ◽  
Developed Countries ◽  
Health Facilities ◽  
Care Utilization ◽  
Skilled Birth Attendants ◽  
Mobile Money ◽  
Birth Attendants ◽  
Heterogeneity Analysis ◽  
The Impact

Lack of cash on hand is a significant obstacle in accessing healthcare services in developing countries. Many expectant mothers in the least developed countries do not receive sufficient care during pregnancy due to financial constraints. If such hurdles in accessing healthcare can be overcome, it will contribute to reduction in maternal and newborn mortality, which is a key target of Sustainable Development Goal 3. This study reports the first assessment of the impact of mobile money services on maternal care utilization. We hypothesize that mobile money adoption would motivate rural Ugandan women to receive antenatal care and to deliver their children at health facilities or with skilled birth attendants. By receiving remittances utilizing mobile money, poor rural households may obtain more cash in hand, which might change women’s health-seeking behavior. We apply community- and mother-fixed effects models with heterogeneity analysis to longitudinal panel data (the RePEAT [Research on Poverty, Environment, and Agricultural Technology] survey) of three waves (2009, 2012, and 2015). The analysis uses pregnancy reports of 2007–2015 from 586 rural Ugandan households. We find suggestive evidence that mobile money adoption positively affects the take-up of antenatal care. Heterogeneity analysis indicates that mobile money brings a larger benefit to geographically challenged households by easing their liquidity constraint as they face higher cost of traveling to distant health facilities. The models failed to reject the null hypothesis of no mobile money effect on the delivery-related outcome variables. This study suggests that promoting financial inclusion by means of mobile money motivates women in rural and remote areas to make antenatal care visits while the evidence of such effect is not found for take-up of facility delivery or delivery with skilled birth attendants.

Looking at the bigger picture: effect of performance-based contracting of district health services on equity of access to maternal health services in Zambia

2019 ◽  
Author(s):  
Collins Chansa ◽  
Mulenga Mary Mukanu ◽  
Chitalu Miriam Chama-Chiliba ◽  
Mpuma Kamanga ◽  
Nicholas Chikwenya ◽  
...  
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Health System ◽  
Health Expenditure ◽  
Maternal Health Services ◽  
Health Facilities ◽  
District Level ◽  
Health Service Provision ◽  
Equity Of Access ◽  
The Impact

Abstract Zambia has been using output-based approaches for over two decades to finance whole or part of the public health system. Between 1996 and 2006, performance-based contracting (PBC) was implemented countrywide with the Central Board of Health (CBoH) as the provider of health services. This study reviews the association between PBC and equity of access to maternal health services in Zambia between 1996 and 2006. A comprehensive document review was undertaken to evaluate the implementation process, followed by a trend analysis of health expenditure at district level, and a segmented regression analysis of data on antenatal care (ANC) and deliveries at health facilities that was obtained from five demographic and health survey datasets (1992, 1996, 2002, 2007 and 2014). The results show that PBC was anchored by high-level political support, an overarching policy and legal framework, and collective planning and implementation with all key stakeholders. Decentralization of health service provision was also an enabling factor. ANC coverage increased in both the lower and upper wealth quintiles during the PBC era, followed by a declining trend after the PBC era in both quintiles. Further, the percentage of women delivering at health facilities increased during the PBC era, particularly in rural areas and among the poor. The positive trend continued after the PBC era with similar patterns in both lower and upper wealth quintiles. Despite these gains, per capita health expenditure at district level declined during the PBC era, with the situation worsening after the PBC era. The study concludes that a nationwide PBC approach can contribute to improved equity of access to maternal health services and that PBC is a cost-efficient and sustainable policy reform. The study calls for policymakers to comprehensively evaluate the impact of health system reforms before terminating them.

Investigating the Impact of Healthcare Environmental Design on Staff Security: A Systematic Review

2020 ◽  
pp. 193758672092140
Author(s):  
Soheyla MohammadiGorji ◽  
Sheila J. Bosch ◽  
Shabboo Valipoor ◽  
Giuliano De Portu
Keyword(s):  
Behavioral Health ◽  
Physical Environment ◽  
Healthcare Professionals ◽  
Environmental Design ◽  
Health Facilities ◽  
Design Strategies ◽  
Ambient Conditions ◽  
Environmental Interventions ◽  
Healthcare Facilities ◽  
The Impact

Objective: To systematically review the literature regarding the role of the physical environment in preventing or mitigating aggressive behavior toward healthcare professionals in acute care, outpatient, and psychiatric/behavioral health facilities. Background: Globally, the incidence of violence against healthcare professionals is alarming. Poor environmental design has been identified as a risk factor of violence toward employees. The design of the physical setting in which healthcare is provided may moderate the incidence and severity of violence against healthcare workers. Methods: We conducted electronic database searches of PubMed and CINAHL through November 2018. Result: Findings were organized according to four categories identified in the literature regarding crime prevention through environmental design (CPTED) including natural surveillance, access control, territoriality, and other CPTED elements. Fifteen studies (published between 1991 and 2017) met the inclusion criteria. Of the 15 studies, 4 incorporated environmental interventions. In the 11 remaining studies, physical environment attributes (i.e., layout, location, ambient conditions, equipment) were among the factors affecting violent incidents and staff security. Most study settings were hospital-based (11, with 10 of those specifically focused on emergency departments), followed by behavioral health facilities (4 studies). Design-focused recommendations, such as providing a second door in a triage room and a sub-waiting area inside the treatment zone, were summarized according to CPTED categories. Conclusion: This review suggests that the physical environment in healthcare facilities may affect the incidence of violence by patients or visitors against staff. Further research is needed to identify environmental design strategies that may protect the safety of healthcare professionals.

The impact of supportive supervision of infection prevention and control practices on Ebola outbreak in Liberia

2018 ◽  
Vol 19 (6) ◽  
pp. 287-293
Author(s):  
Ogbaini-Emovon Ephraim ◽  
Sneh Cyrus ◽  
Pajibo Myer ◽  
Abah Steve
Keyword(s):  
Prevention And Control ◽  
Infection Prevention ◽  
Virus Disease ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Small Scale ◽  
Supportive Supervision ◽  
And Control ◽  
Isolation Facilities ◽  
The Impact

Background: Supportive supervision of infection prevention and control (IPC) practices was one of a range of interventions employed at the county level in the control of the world’s most deadly Ebola virus disease outbreak that affected Liberia during 2013–2016. Methods: Datasets generated from four consecutive assessment visits to 25 health facilities in Maryland County, in Liberia, were analysed. Information on IPC practices was obtained by interview, direct observation and completion of a standardised assessment tool. For each of the IPC fields assessed, a score < 50% was graded poor, 50–75% as fair, while > 75% was rated as good. Results: Before the intervention, the first assessment (baseline) indicated that the majority of the health facilities scored low in terms of isolation facilities, IPC administration, supply and equipment, personnel and staffing, triage and waste management. Following the application of supportive supervision and monitoring, all the facilities recorded moderate to good performance in all the fields during the fourth round of assessment, except for isolation facilities, which scored low. Conclusion: Supportive supervision and monitoring of healthcare facilities appeared to have contributed to the improvement in IPC standards and compliance during the Ebola outbreak as demonstrated in this small-scale study and should be sustained as a core component of IPC programs, particularly in prolonged outbreak situations.

Intervention to promote physical health in staff within mental health facilities and the impact on patients’ physical health

2015 ◽  
Vol 70 (1) ◽  
pp. 62-71 ◽  
Author(s):  
Peter Hjorth ◽  
Annette S. Davidsen ◽  
Reinhold Kilian ◽  
Signe O.W. Jensen ◽  
Povl Munk-Jørgensen
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Health Facilities ◽  
Mental Health Facilities ◽  
The Impact

scholarly journals Examining person-centered maternity care in a peri-urban setting in Embakasi, Nairobi, Kenya

PLoS ONE ◽  
2021 ◽  
Vol 16 (10) ◽  
pp. e0257542
Author(s):  
Jackline Oluoch-Aridi ◽  
Patience Afulani ◽  
Cindy Makanga ◽  
Danice Guzman ◽  
Laura Miller-Graff
Keyword(s):  
Maternity Care ◽  
Multilevel Models ◽  
First Trimester ◽  
Health Facilities ◽  
Urban Setting ◽  
Clinical Officer ◽  
Cross Sectional ◽  
Urban Settings ◽  
Factors Associated ◽  
Nurse Midwife

Introduction Peri-urban settings have high maternal mortality and the quality of care received in different types of health facilities is varied. Yet few studies have explored the construct of person-centered maternity care (PCMC) within peri-urban settings. Understanding women’s experience of maternity care in peri-urban settings will allow health facility managers and policy makers to improve services in these settings. This study examines factors associated with PCMC in a peri-urban setting in Kenya. Methods and materials We analyzed data from a cross-sectional study with 307 women aged 18–49 years who had delivered a baby within the preceding six weeks. Women were recruited from public (n = 118), private (n = 76), and faith based (n = 113) health facilities. We measured PCMC using the 30-item validated PCMC scale which evaluates women’s experiences of dignified and respectful care, supportive care, and communication and autonomy. Factors associated with PCMC were evaluated using multilevel models, with women nested within facilities. Results The average PCMC score was 58.2 (SD = 13.66) out of 90. Controlling for other factors, literate women had, on average, about 6-point higher PCMC scores than women who were not literate (β = 5.758, p = 0.006). Women whose first antenatal care (ANC) visit was in the second (β = -5.030, p = 0.006) and third trimester (β = -7.288, p = 0.003) had lower PCMC scores than those whose first ANC were in the first trimester. Women who were assisted by an unskilled attendant or an auxiliary nurse/midwife at birth had lower PCMC than those assisted by a nurse, midwife or clinical officer (β = -8.962, p = 0.016). Women who were interviewed by phone (β = -7.535, p = 0.006) had lower PCMC scores than those interviewed in person. Conclusions Factors associated with PCMC include literacy, ANC timing and duration, and delivery provider. There is a need to improve PCMC in these settings as part of broader quality improvement activities to improve maternal and neonatal health.

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