scholarly journals Distance to primary care facilities and healthcare utilization for preschool children in rural northwestern Burkina Faso: results from a surveillance cohort

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Catherine E. Oldenburg ◽  
◽  
Ali Sié ◽  
Mamadou Ouattara ◽  
Mamadou Bountogo ◽  
...  
Keyword(s):  
Burkina Faso ◽  
Healthcare Utilization ◽  
Primary Healthcare ◽  
Healthcare Facility ◽  
Median Number ◽  
Community Level ◽  
Care Seeking ◽  
Healthcare Facilities ◽  
Sick Children ◽  
Children Under 5

Abstract Background Delays in care-seeking for childhood illness may lead to more severe outcomes. We evaluated whether community distance from a primary healthcare facility was associated with decreased healthcare utilization in a rural district of northwestern Burkina Faso. Methods We conducted passive surveillance of all government-run primary healthcare facilities in Nouna District, Burkina Faso from March 1 through May 31, 2020. All healthcare visits for children under 5 years of age were recorded on a standardized form for sick children. We recorded the age, sex, and community of residence of the child as well as any diagnoses and treatments administered. We calculated healthcare utilization per 100 child-months by linking the aggregate number of visits at the community level to the community’s population of children under 5 months per a census that was conducted from August 2019 through February 2020. We calculated the distance between each community and its corresponding healthcare facility and assessed the relationship between distance and the rate of healthcare utilization. Results In 226 study communities, 12,676 primary healthcare visits were recorded over the three-month period. The median distance between the community and primary healthcare facility was 5.0 km (IQR 2.6 to 6.9 km), and median number of healthcare visits per 100 child-months at the community level was 6.7 (IQR 3.7 to 12.3). The rate of primary healthcare visits declined with increasing distance from clinic (Spearman’s rho − 0.42, 95% CI − 0.54 to − 0.31, P < 0.0001). This relationship was similar for cause-specific clinic visits (including pneumonia, malaria, and diarrhea) and for antibiotic prescriptions. Conclusions We documented a distance decay effect between community distance from a primary healthcare facility and the rate of healthcare visits for children under 5. Decreasing distance-related barriers, for example by increasing the number of facilities or targeting outreach to more distant communities, may improve healthcare utilization for young children in similar settings.

User fees removal and community-based management of undernutrition in Burkina Faso: what effects on children’s nutritional status?

2021 ◽  
pp. 1-12
Author(s):  
David Y Zombré ◽  
Manuela De Allegri ◽  
Valéry Ridde ◽  
Kate Zinszer
Keyword(s):  
Burkina Faso ◽  
Household Survey ◽  
Community Level ◽  
User Fees ◽  
Nutrition Status ◽  
Control Group ◽  
Community Based ◽  
Sahel Region ◽  
Intervention District ◽  
Children Under 5

Abstract Objective: To examine the effect of an intervention combining user fees removal with community-based management of undernutrition on the nutrition status in children under 5 years of age in Burkina Faso. Design: The study was a non-equivalent control group post-test-only design based on household survey data collected 4 years after the intervention onset in the intervention and comparison districts. Additionally, we used propensity score weighting to achieve balance on covariates between the two districts, followed by logistic multilevel modelling. Setting: Two health districts in the Sahel region. Participants: Totally, 1116 children under 5 years of age residing in 41 intervention communities and 1305 from 51 control communities. Results: When comparing children living in the intervention district to children living in a non-intervention district, we determined no differences in terms of stunting (OR = 1·13; 95 % CI 0·83, 1·54) and wasting (OR = 1·21; 95 % CI 0·90, 1·64), nor in severely wasted (OR = 1·27; 95 % CI 0·79, 2·04) and severely stunted (OR = 0·99; 95 % CI 0·76, 1·26). However, we determined that 3 % of the variance of wasting (95 % CI 1·25, 10·42) and 9·4 % of the variance of stunting (95 % CI 6·45, 13·38) were due to systematic differences between communities of residence. The presence of the intervention in the communities explained 2 % of the community-level variance of stunting and 3 % of the community-level variance of wasting. Conclusions: With the scaling-up of the national free health policy in Africa, we stress the need for rigorous evaluations and the means to measure expected changes in order to better inform health interventions.

scholarly journals An Analysis of the Usage Patterns of Health Services Funded through Capitation and Non-Capitation in Government Owned Primary Healthcare Facilities in The District of Pandeglang

2017 ◽  
Vol 1 (2) ◽  
Author(s):  
Arovian Yuliardi ◽  
Amal Sjaaf
Keyword(s):  
Quality Control ◽  
Health Insurance ◽  
Health Status ◽  
Primary Healthcare ◽  
Analytical Study ◽  
Healthcare Facility ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Usage Patterns ◽  
Cross Sectional Design

Abstract. The National Health Insurance (JKN) is basically a form of managed care, a technique that integrates health costing and service quality through cost control and quality control. In that concept, the Puskesmas acts as the government’s primary healthcare facility, its vanguard. The aim of this research is to discover and analyze the healthcare usage patterns funded by capitation and non-capitation in government primary healthcare facilities (FKTP). This was an analytical study utilizing a cross-sectional design. 615 patients visiting the government’s FKTP were involved in this research. The results indicated that 47.3% of patients utilizing the government’s FKTP at Pandeglang district were JKN funded, while 52.7% were not funded by the JKN. 66.7% were funded by capitation methods and 33.3% used non-capitation funding. More JKN recipients access non-capitation healthcare than non-recipients. The factors that are related with the type of healthcare accessed are the patient’s health status, JKN status, and ability to pay. Keywords: JKN, utilization, Pandeglang, capitation

scholarly journals The experience, results, and possible perspectives of organizing the optimally accessible primary medical care for the rural population of Zaporizhzhia region

2021 ◽  
Vol 14 (3) ◽  
pp. 369-373
Author(s):  
O. H. Aleksieiev ◽  
V. V. Taranov ◽  
V. P. Petrykhin
Keyword(s):  
Primary Care ◽  
Medical Care ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Rural Population ◽  
Healthcare Facility ◽  
Service Area ◽  
Healthcare Facilities ◽  
Care Facilities

Nowadays, the assessment of the activity of the domestic healthcare system is an important and actual issue, especially against the background the active reformation of this industry. One of the important elements of the assessment is studying the availability of primary healthcare to the rural population. The aim of this work is to study the territorial accessibility of primary healthcare, the adequacy and effectiveness of the principles of forming a network of primary care facilities in the rural areas of Zaporizhzhia region that enables to address issues and optimize the location of primary care facilities in the rural areas. Materials and methods. The materials of the research were the data of the official statistical reports for the past 20 years, which characterize the state of health and the degree of medical care accessibility to the rural population. During the research, the technique of complex social and hygienic research was applied, with the use of historical, sociological, sanitary and statistical methods, organizational experiment and others. Results. The article presents the main results of studying the current state of primary healthcare organization for the rural population of Zaporіzhzhia region against the background of active reforming processes. According to the research results, the main elements forming the system of accessibility are territorial, medical, social and economic. The main factors of impact on territorial accessibility are identified. These are: the nature of the settlement of rural residents (density, compactness, service-area radius, the proportion of the rural population, the distance between villages, the distance from a household to a healthcare facility); quality of roads; transport connections between settlements and healthcare facilities; availability of communication means. Conclusions. As a result of the research, the following conclusions were drawn. Such factors as population density, compactness of its location, service-area radius, distance between villages, distance from a household to a healthcare facility, condition and quality of roads, transport connections between settlements and healthcare facilities are important during forming or improving the network of healthcare facilities in rural areas. These factors must be considered for the rational placement of primary care facilities in rural areas.  

scholarly journals Profile of Maternal Referral Cases

2016 ◽  
pp. 64
Author(s):  
Junita Indarti ◽  
Dwiyana Ocviyanti ◽  
Reyhan Aditya
Keyword(s):  
Primary Healthcare ◽  
Monitoring And Evaluation ◽  
Healthcare Facility ◽  
Health Department ◽  
Referral System ◽  
Local Health ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Tertiary Healthcare ◽  
Cross Sectional Design

Objective: To explore the demography of maternal referral cases in Dr. Cipto Mangunkusumo Hospital (RSCM) along with the accuracy of referral. We also aim to evaluate the types of referral, origin of referral, referring healthcare facility and quality of referring healthcare facility. Method: The design of this study was a cross sectional design which described the accuracy of obstetrics referred cases in Emergency Unit Dr. Cipto Mangunkusumo Hospital from 2013 to 2014. Result: The total referred obstetric cases in 2013 was 1,645 patients. It was consisted of 1,307 appropriate (79.5%) and 338 inappropriate (20.5%) referred cases. Primary healthcare and general hospital were the most often referring cases to RSCM during two consecutive years. The top three cases referred to RSCM in both 2013 and 2014 were preterm premature rupture of membrane (PPROM), continued by severe preeclampsia and preterm labor. Conclusion: The number of referral cases in Indonesia is considered high, particularly in RSCM as the tertiary healthcare facility. There are still a high number of inappropriate referrals originating from primary healthcare facilities, pointing to the fact that the referral system is not running according to design or plan. To improve the quality of referral system, proper monitoring and evaluation of referral should be performed by local health department. [Indones J Obstet Gynecol 2016; 4-2: 64-66] Keywords: maternal case, referral system

scholarly journals Profil Rujukan Kasus Nonspesifik pada Fasilitas Kesehatan Tingkat Primer

2015 ◽  
Vol 9 (4) ◽  
pp. 327
Author(s):  
Elda Nazriati ◽  
Nuzelly Husnedi
Keyword(s):  
Health Care ◽  
Focus Group ◽  
Focus Group Discussion ◽  
Primary Healthcare ◽  
Service Management ◽  
Group Discussion ◽  
Healthcare Facility ◽  
Health Care Facilities ◽  
Healthcare Facilities ◽  
Resource Service

AbstrakSalah satu indikator kualitas fasilitas kesehatan tingkat primer (FKTP)adalah rendahnya rujukan nonspesialistik. Rujukan nonspesialistik adalahrujukan dari 144 penyakit yang seharusnya dapat diatur di FKTP.Kenyataannya, masih banyak kasus nonspesialistik yang dirujuk ke fasilitas kesehatan sekunder. Penelitian deskriptif dengan metode campuran kuantitatif dan kualitatif ini bertujuan untuk mengetahui pola dan penyebab kasus penyakit nonspesialistik yang dirujuk ke fasilitas kesehatan tingkat sekunder di Kota Pekanbaru. Gambaran kasus penyakit nonspesialistik dikumpulkan dari data Badan Penyelenggara Jaminan Sosial Kesehatan Kota Pekanbaru periode Desember 2014 - April 2015, sedangkan faktor penyebab rujukan diperoleh dari focus group discussion yang diikuti oleh 40 dokter berdasarkan jenis FKTP. Penelitian ini menampilkan 20 kasus nonspesialistik yang paling sering dirujuk, di antaranya hipertensi esensial, miopia ringan, dan diabetes melitus. Penyebab rujukan kasus penyakit nonspesialistik antara lain kesalahan kode serta terbatasnya fasilitas, sumber daya manusia, manajemen pelayanan, dan kompetensi dokter. Semua faktor keterbatasan tersebut perlu diantisipasi agar upaya rujukan dapat diminimalisir.AbstractOne of primary healthcare facility quality indicators is the low non-specialistreferral. Non-specialist referral is referral of 144 diseases that should bearranged in primary healthcare facilities. In fact, there are many non-specialist cases referred to secondary health care facilities. This descriptive study using quantitative and qualitative method aimed to determine patterns and causes of non-specialist diseases referred to secondary primary health care in Pekanbaru City. Depiction of non-specialist disease cases was collected from data of the state health insurance scheme in Pekanbaru City on December 2014 - April 2015 period, meanwhile causes of referral were obtained from focus group discussion participated by 40 doctors based on types of primary healthcare facilities. This study showed 20 non-specialist cases oftenly referred including essential hypertension, mild myopia and diabetes mellitus. Causes of non-specialist disease referrals were code error as well as limited facilities, human resource, service management and competence of doctors. Such limitations need to be anticipated in order to minimalize act of referrals.

Health care seeking behaviors for sick children: time span for seeking health care

2015 ◽  
Vol 19 (2) ◽  
pp. 67-74
Author(s):  
Fulya Akpak ◽  
Nuri Seha Yüksel ◽  
Ayşegül Kabanlı ◽  
Tolga Günvar
Keyword(s):  
Health Care ◽  
Time Span ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Sick Children ◽  
Health Care Seeking Behaviors

scholarly journals DEEP SCOPE: A Framework for Safe Healthcare Design

2021 ◽  
Vol 18 (15) ◽  
pp. 7780
Author(s):  
Ellen Taylor ◽  
Sue Hignett
Keyword(s):  
Human Factor ◽  
Healthcare Facility ◽  
Built Environments ◽  
Facility Design ◽  
Healthcare Facilities ◽  
Healthcare Design ◽  
Accident Causation ◽  
Healthcare Facility Design

Thinking in patient safety has evolved over time from more simplistic accident causation models to more robust frameworks of work system design. Throughout this evolution, less consideration has been given to the role of the built environment in supporting safety. The aim of this paper is to theoretically explore how we think about harm as a systems problem by mitigating the risk of adverse events through proactive healthcare facility design. We review the evolution of thinking in safety as a safety science. Using falls as a case study topic, we use a previously published model (SCOPE: Safety as Complexity of the Organization, People, and Environment) to develop an expanded framework. The resulting theoretical model and matrix, DEEP SCOPE (DEsigning with Ergonomic Principles), provide a way to synthesize design interventions into a systems-based model for healthcare facility design using human factors/ergonomics (HF/E) design principles. The DEEP SCOPE matrix is proposed to highlight the design of safe healthcare facilities as an ergonomic problem of design that fits the environment to the user by understanding built environments that support the “human” factor.

scholarly journals Carbapenemase-Producing, Carbapenem-Resistant Acinetobacter baumannii: Summary of CDC Consultations, 2017–2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s151-s152
Author(s):  
Lauren Epstein ◽  
Alicia Shugart ◽  
David Ham ◽  
Snigdha Vallabhaneni ◽  
Richard Brooks ◽  
...  
Keyword(s):  
Public Health ◽  
Acinetobacter Baumannii ◽  
Median Number ◽  
Skilled Nursing Facilities ◽  
Nursing Facilities ◽  
Skilled Nursing ◽  
Healthcare Facilities ◽  
Carbapenem Resistant ◽  
Number Of Patients ◽  
Single Facility

Background: Carbapenemase-producing carbapenem-resistant Acinetobacter baumannii (CP-CRAB) are a public health threat due to potential for widespread dissemination and limited treatment options. We describe CDC consultations for CP-CRAB to better understand transmission and identify prevention opportunities. Methods: We defined CP-CRAB as CRAB isolates with a molecular test detecting KPC, NDM, VIM, or IMP carbapenemases or a plasmid-mediated oxacillinase (OXA-23, OXA-24/40, OXA-48, OXA-58, OXA-235/237). We reviewed the CDC database of CP-CRAB consultations with health departments from January 1, 2017, through June 1, 2019. Consultations were grouped into 3 categories: multifacility clusters, single-facility clusters, and single cases. We reviewed the size, setting, environmental culturing results, and identified infection control gaps for each consultation. Results: We identified 29 consultations involving 294 patients across 19 states. Among 9 multifacility clusters, the median number of patients was 12 (range, 2–87) and the median number of facilities was 2 (range, 2–6). Among 9 single-facility clusters, the median number of patients was 5 (range, 2–50). The most common carbapenemase was OXA-23 (Table 1). Moreover, 16 consultations involved short-stay acute-care hospitals, and 6 clusters involved ICUs and/or burn units. Also, 8 consultations involved skilled nursing facilities. Environmental sampling was performed in 3 consultations; CP-CRAB was recovered from surfaces of portable, shared equipment (3 consultations), inside patient rooms (3 consultations) and nursing stations (2 consultations). Lapses in environmental cleaning and interfacility communication were common across consultations. Among 11 consultations for single CP-CRAB cases, contact screening was performed in 7 consultations and no additional CP-CRAB was identified. All 4 patients with NDM-producing CRAB reported recent international travel. Conclusions: Consultations for clusters of oxacillinase-producing CP-CRAB were most often requested in hospitals and skilled nursing facilities. Healthcare facilities and public health authorities should be vigilant for possible spread of CP-CRAB via shared equipment and the potential for CP-CRAB spread to connected healthcare facilities.Funding: NoneDisclosures: None

scholarly journals ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger
Keyword(s):  
Health Systems ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Quality Care ◽  
Public Healthcare ◽  
Health Coverage ◽  
Access To Health Services ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

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