scholarly journals Quality of care in public sector family planning services in KwaZulu-Natal, South Africa: a qualitative evaluation from community and health care provider perspectives

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yolandie Kriel ◽  
Cecilia Milford ◽  
Joanna Paula Cordero ◽  
Fatima Suleman ◽  
Petrus S. Steyn ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Quality Of Care ◽  
Family Planning ◽  
Health Care Providers ◽  
Contraceptive Use ◽  
Care Providers ◽  
Contraceptive Methods ◽  
Integration Of Services

Abstract Background Quality of care is a multidimensional concept that forms an integral part of the uptake and use of modern contraceptive methods. Satisfaction with services is a significant factor in the continued use of services. While much is known about quality of care in the general public health care service, little is known about family planning specific quality of care in South Africa. This paper aims to fill the gap in the research by using the Bruce-Jain family planning quality of care framework. Methods This formative qualitative study was conducted in South Africa, Zambia, and Kenya to explore the uptake of family planning and contraception. The results presented in this paper are from the South African data. Fourteen focus group discussions, twelve with community members and two with health care providers, were conducted along with eight in-depth interviews with key informants. Thematic content analysis using the Bruce-Jain Quality of Care framework was conducted to analyse this data using NVIVO 10. Results Family planning quality of care was defined by participants as the quality of contraceptive methods, attitudes of health care providers, and outcomes of contraceptive use. The data showed that women have limited autonomy in their choice to either use contraception or the method that they might prefer. Important elements that relate to quality of care were identified and described by participants and grouped according to the structural or process components of the framework. Structure-related sub-themes identified included the lack of technically trained providers; integration of services that contributed to long waiting times and mixing of a variety of clients; and poor infrastructure. Sub-themes raised under the process category included poor interpersonal relations; lack of counselling/information exchange, fear; and time constraints. Neither providers nor users discussed follow up mechanisms which is a key aspect to ensure continuity of contraceptive use. Conclusion Using a qualitative methodology and applying the Bruce-Jain Quality of Care framework provided key insights into perceptions and challenges about family planning quality of care. Identifying which components are specific to family planning is important for improving contraceptive outcomes. In particular, autonomy in user choice of contraceptive method, integration of services, and the acceptability of overall family planning care was raised as areas of concern.

scholarly journals Barriers to Contraceptive Use Among Urban Adolescents and Youth in Conakry, in 2019, Guinea

2021 ◽  
Vol 2 ◽  
Author(s):  
Nafissatou Dioubaté ◽  
Hawa Manet ◽  
Charlotte Bangoura ◽  
Sidikiba Sidibé ◽  
Mariama Kouyaté ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Health Care Providers ◽  
Urban Adolescents ◽  
Contraceptive Use ◽  
Modern Contraceptive ◽  
Care Providers ◽  
Contraceptive Methods ◽  
Care System

Background: Despite efforts to improve access to family planning, contraceptive prevalence remains relatively low among adolescents and youth in Guinea. The objective of this study was to understand the barriers to the use of modern contraceptive methods among urban adolescents and youth (15–24 years) in Conakry, Guinea.Methods: This was a qualitative study using an exploratory design. It was conducted in the capital city of Guinea, Conakry in 2019. Respondents included adolescents and youth aged 15–24 years, health care providers, and parents of adolescents and youth. In-depth individual interviews (IDIs) and focus group discussions (FGDs) were used to collect the data. Sixty IDIs and ten FGDs were planned in Conakry. These data were recorded and transcribed, when applicable, from the local languages into French in an anonymous manner. The data were analyzed using a mixed (inductive and deductive) thematic approach following the elements of the socio-ecological model.Results: Overall, 56 IDIs and 10 FGDs were conducted with 136 participants and included in this analysis. Respondents were adolescents (16%), youth (30%), and key informants (54%) who were health care providers (public and private), decision-makers, parents of adolescents and youth, and neighbors. Among adolescent respondents, 75% were female, and of the youth, 61% were female. Our analysis indicates various and interrelated barriers that limit the access and use of contraceptives by adolescents and youth. These included the individual (fear of side effects, cost, and rumor-related misinformation), interpersonal or family (spouse perception and sexuality taboo and perception of sexual activity before marriage), sociocultural (religious prohibitions and ethnicity), and health care system (breakdown of contraceptive methods in public health facilities, perception of service delivery, provider attitudes, visiting hours, geographic proximity of services, and quality of training received by health care providers) barriers.Conclusion: In our context, the use of modern contraceptive methods by adolescents and youth is influenced by an interaction of various barriers, including individual, interpersonal, sociocultural, and health care system factors. Strengthening contraceptive uptake interventions by involving different stakeholders, including adolescents, parents, religious, and community leaders, and improving the quality of sexual and reproductive health services would help in reducing barriers to contraceptive use among adolescents and youth.

scholarly journals Delirium and Antipsychotic Medications at Hospital Intake: Screening to Decrease Likelihood of Aggression in Inpatient Settings Among Unknown Patients With Dementia

2018 ◽  
Vol 34 (2) ◽  
pp. 118-123 ◽  
Author(s):  
Tracy Wharton ◽  
Daniel Paulson ◽  
Kimberly Burcher ◽  
Heather Lesch
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Antipsychotic Medication ◽  
Care Providers ◽  
Antipsychotic Medications ◽  
Inpatient Settings ◽  
Logistic Regressions

For individuals with dementia, disorientation and both external and internal stimuli may trigger behaviors that are difficult to manage or dangerous to health-care providers. Identification of correlational risk factors to aggressive behavior in patients who are unknown to the hospital can allow providers to adapt patient care quickly. Records for patients aged 60+ who spent at least 24 hours at the hospital other than in the psychiatric unit were used (N = 14 080). The first 4000 records and every 10th person who met criteria (N = 5008) were searched for documentation of dementia (n = 505). Logistic regressions and χ2 tests were used to examine relationships between variables. Recognition of delirium ( P = .014, Exp(B) = 2.53), coupled with an existing prescription for antipsychotic medication at intake ( P < .001, Exp(B) < 4.37), may be a reliable means of screening for risk and intervening at the earliest possible contact, improving quality of care and safety in acute care for individuals with dementia.

scholarly journals Birth Companions, Health workers perspective: Mixed Method Study in St. Paul’s Hospital and Millennium Medical College and its Catchment Centers in Addis Ababa, Ethiopia

2021 ◽  
Author(s):  
Kidist Gizachew ◽  
Tewodros Getinet ◽  
Delayehu Bekele
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Addis Ababa ◽  
Post Partum ◽  
Care Providers ◽  
Child Birth ◽  
Medical College

Abstract Background: Birth companions have been shown to improve quality of care provided to laboring women. Various studies have shown the benefits of companion during child birth. The objective of this study was to assess the knowledge, attitude and practice of health care providers towards the involvement of birth companions during child birth in St Paul’s Hospital Millennium Medical College (SPHMMC) and its selected catchment health centers. Methods: The study used a cross-sectional study which was supplemented by qualitative study design which employed phenomenological design was conducted using in depth interview of health care providers who were on practice during the study period in SPHMMC. Result: The study included a total 58 health care providers. The finding from the study showed that great proportion of health care providers involved in the study (90 %) have positive attitude towards involvement of birth companions but majority 82.4 % didn’t allow birth companions. The commonest reasons mentioned for not involving companions include fear of breach of privacy, interference with routine medical care and risk of litigation/complaints.Conclusion and Recommendation: The findings from this study showed that majority of the health care providers are against the practice of involving birth companions. Since involvement of birth companions is one way to ensure the quality of care provided there should be an effort to increase the knowledge of health professionals on benefits of birth companions. There is also a need for improvement of the work setup. Simple measures like providing screens, providing separate rooms for laboring and post-partum women will have a significant impact on the quality of care provided.

scholarly journals Online public reactions to frequency of diagnostic errors in US outpatient care

Diagnosis ◽  
2016 ◽  
Vol 3 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Traber Davis Giardina ◽  
Urmimala Sarkar ◽  
Gato Gourley ◽  
Varsha Modi ◽  
Ashley N.D. Meyer ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Diagnostic Errors ◽  
News Article ◽  
Care Providers ◽  
Qualitative Researcher ◽  
Related Quality ◽  
The Impact

AbstractDiagnostic errors pose a significant threat to patient safety but little is known about public perceptions of diagnostic errors. A study published inWe searched the World Wide Web for any news article reporting findings from the study. We then gathered all the online comments made in response to the news articles to evaluate public reaction to the newly reported diagnostic error frequency (n=241). Two coders conducted content analyses of the comments and an experienced qualitative researcher resolved differences.Overall, there were few comments made regarding the frequency of diagnostic errors. However, in response to the media coverage, 44 commenters shared personal experiences of diagnostic errors. Additionally, commentary centered on diagnosis-related quality of care as affected by two emergent categories: (1) US health care providers (n=79; 63 commenters) and (2) US health care reform-related policies, most commonly the Affordable Care Act (ACA) and insurance/reimbursement issues (n=62; 47 commenters).The public appears to have substantial concerns about the impact of the ACA and other reform initiatives on the diagnosis-related quality of care. However, policy discussions on diagnostic errors are largely absent from the current national conversation on improving quality and safety. Because outpatient diagnostic errors have emerged as a major safety concern, researchers and policymakers should consider evaluating the effects of policy and practice changes on diagnostic accuracy.

scholarly journals Standards and outcome measures in Cardiovascular Rehabilitation. Position Paper GICR/IACPR

2015 ◽  
Vol 78 (4) ◽  
Author(s):  
Raffaele Griffo ◽  
Marco Ambrosetti ◽  
Giuseppe Furgi ◽  
Roberto Carlon ◽  
Carmine Chieffo ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Cardiovascular Diseases ◽  
Health Care Providers ◽  
Professional Competence ◽  
Care Delivery ◽  
Position Paper ◽  
Care Providers ◽  
Cardiac Events

Despite major improvements in diagnostics and interventional therapies, cardiovascular diseases remain a major health care and socio-economic problem in Italy. Costs and resources required are increasing in close correlation to both the improved quality of care and to the population ageing. There is an overwhelming evidence of the efficacy of cardiac rehabilitation (CR) in terms of reduction in morbidity and mortality after acute cardiac events. CR services are by definition multi-factorial and comprehensive. Furthermore, systematic analysis and monitoring of the process of delivery and outcomes is of paramount importance. The aim of this position paper promoted by the Italian Association for Cardiovascular Prevention and Rehabilitation (GICR-IACPR) is to provide specific recommendations to assist CR staff in the design, evaluation and development of their care delivery organization. The position paper should also assist health care providers, insurers, policy makers and consumers in the recognition of the quality of care requirements, standards and outcome measure, quality and performance indicators, and professional competence involved in such organization and programs. The position paper i) include comprehensive CR definition and indications, ii) describes priority criteria based on the clinical risk for admission to both inpatient or outpatient CR, and iii) defines components and technological, structural and organizing requirements for inpatient or outpatient CR services, with specific indicators and standards, performance measures and required professional skills. A specific chapter is dedicated to the requirements for highly specialized CR services for patients with more advanced cardiovascular diseases.

scholarly journals Quality of Care of Patients with Diabetes in Primary Health Services in Southeast Brazil

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Christiane Chaves Augusto Leite Simão ◽  
Mônica Barros Costa ◽  
Fernando Antônio Basile Colugnati ◽  
Elaine Amaral de Paula ◽  
Chislene Pereira Vanelli ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Diabetes Management ◽  
Diabetic Patients ◽  
Care Providers ◽  
Southeast Brazil ◽  
Primary Health ◽  
Health Care Structure

Background. Diabetes management involves multiple aspects that go beyond drug therapy as a way of providing high quality care. The objective of this study was to describe quality of care indicators for individuals with diabetes in southeast Brazil and to explore associations among these indicators. Methods. In this cross-sectional, observational study, health care providers filled out a questionnaire addressing health care structure and processes at 14 primary health care units (PHCUs). Clinical and laboratory data of diabetic patients attending the PHCUs and from patients referred to a secondary health care (SHC) center were collected. Results. There was a shortage of professionals in 53.8% of the PHCUs besides a high proportion of problems regarding referrals to SHC. At the PHCU, glycated hemoglobin results were available only in half of the medical records. A low rate of adequate glycemic control was also observed. An association between structure and process indicators and the outcomes analyzed was not found. Conclusion. Major deficiencies were found in the structure and processes of the PHCUs, in addition to unsatisfactory diabetes care outcomes. However, no association between structure, process, and outcomes was found.

Physicians’ career satisfaction, quality of care and patients’ trust: the role of community uninsurance

2007 ◽  
Vol 2 (4) ◽  
pp. 347-362 ◽  
Author(s):  
JOSÉ A. PAGÁN ◽  
LAKSHMI BALASUBRAMANIAN ◽  
MARK V. PAULY
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Career Satisfaction ◽  
Relative Size ◽  
Insurance Companies ◽  
Care Providers ◽  
Patient Trust ◽  
Financial Difficulties

Abstract:There is evidence that health care providers located in communities with relatively large uninsured populations face financial difficulties because of low service demand and high levels of uncompensated care. Data on 4,920 physicians from the 2000–2001 Community Tracking Study Physician Survey and from 25,637 adults from the 2003 Community Tracking Study Household Survey were used to analyze whether the relative size of the local uninsured population is associated with the level of career satisfaction and the quality of care provided by physicians and to assess whether patient trust is associated with the level of community uninsurance. The results indicate that the proportion of uninsured adults in a given community is negatively related to physicians’ career satisfaction and the perceived quality of health care provided. Community uninsurance is also negatively related to patient trust in their doctor and positively related to whether insured patients believed that their doctor was influenced by rules from health insurance companies. Physicians in communities with relatively large uninsured populations may have lower career satisfaction and lower perceptions of the quality of care provided due to financial difficulties. Patients in these communities are also less likely to trust their physician.

scholarly journals Health Disparities: Challenges, Opportunities, and What You Can Do About It

2018 ◽  
Vol 28 (3) ◽  
pp. 223-231 ◽  
Author(s):  
Hani K. Atrash
Keyword(s):  
Health Care ◽  
Health Disparities ◽  
Quality Of Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
The United States ◽  
Care Providers ◽  
Access To Health ◽  
Race Ethnicity

Racial disparities in health outcomes, access to health care, insurance coverage, and quality of care in the United States have existed for many years. The Development and implementation of effective strategies to reduce or eliminate health disparities are hindered by our inability to accurately assess the extent and types of health disparities due to the limited availability of race/ethnicity-specific information, the limited reliability of existing data and information, and the increasing diversity of the American population. Variations in racial and ethnic classification used to collect data hinders the ability to obtain reliable and accurate health-indicator rates and in some instances cause bias in estimating the race/ethnicity-specific health measures. In 1978, The Office of Management and Budget (OMB) issued "Directive 15" titled "Race and Ethnic Standards for Federal Statistics and Administrative Reporting" and provided a set of clear guidelines for classifying people by race and ethnicity. Access to health care, behavioral and psychosocial factors as well as cultural differences contribute to the racial and ethnic variations that exist in a person’s health. To help eliminate health disparities, we must ensure equal access to health care services as well as quality of care. Health care providers must become culturally competent and understand the differences that exist among the people they serve in order to eliminate disparities. Enhancement of data collection systems is essential for developing and implementing interventions targeted to deal with population-specific problems. Developing comprehensive and multi-level programs to eliminate healthcare disparities requires coordination and collaboration between the public (Local, state and federal health departments), private (Health Insurance companies, private health care providers), and professional (Physicians, nurses, pharmacists, laboratories, etc) sectors.  

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