scholarly journals Being ready, willing and able: understanding the dynamics of family planning decision-making through community-based group discussions in the Northern Region, Ghana

Genus ◽  
2021 ◽  
Vol 77 (1) ◽  
Author(s):  
Adriana A. E. Biney ◽  
Kalifa J. Wright ◽  
Mawuli K. Kushitor ◽  
Elizabeth F. Jackson ◽  
James F. Phillips ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Services ◽  
Contraceptive Use ◽  
Community Health Services ◽  
Community Services ◽  
Northern Region ◽  
Direct Access ◽  
Social Constraints ◽  
Group Discussions ◽  
Community Based

AbstractRegional contraceptive use differentials are pronounced in Ghana, with the lowest levels occurring in the Northern Region. Community-based health services, intended to promote maternal and child health and family planning use, may have failed to address this problem. This paper presents an analysis of qualitative data on community perspectives on family planning “readiness,” “willingness,” and “ability” compiled in the course of 20 focus group discussions with residents (mothers and fathers of children under five, young boys and girls, and community elders) of two communities each in two Northern Region districts that were either equipped with or lacking direct access to community health services. The study districts are localities where contraceptive use is uncommon and fertility is exceptionally high. Results suggest that direct access to community services has had no impact on contraceptive attitudes or practice. Widespread method knowledge is often offset by side-effect misperceptions. Social constraints are prominent owing to opposition from men. Findings attest to the need to improve the provision of contraceptive information and expand method choice options. Because societal acceptance and access in this patriarchal setting is critical to use, frontline worker deployment should prioritize strategies for outreach to men and community groups with prominent attention to social mobilization themes and strategies that support family planning.

scholarly journals Cross-sectoral collaboration in mental health services: Identifying the role of mental health care teams in the community

2021 ◽  
Vol 4 (3) ◽  
pp. 169
Author(s):  
Osi Kusuma Sari ◽  
Subandi Subandi ◽  
Carla Raymondalexas Marchira
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Flow Model ◽  
Direct Access ◽  
Health Care Teams ◽  
Group Discussions ◽  
Community Based ◽  
Inductive Thematic Analysis

Strengthening integrated and community-based mental health services is essentially needed to address the treatment gap and provide effective services that can be accessed by all groups. To realize this goal, the cross-sectoral involvement that is part of the Tim Pembina, Pengarah, dan Pelaksana Kesehatan Jiwa Masyarakat (TPKJM) is at the forefront because it has direct access to mental disorders cases in their region. This article aims to identify the role of each member of TPKJM in pursuing mental health services. Participants involved in each stage of data collection were members of TPKJM at the sub-district and village levels. The data were collected using three methods: surveys, focus group discussions, and interviews. The collected data were analyzed using an inductive thematic analysis approach to obtain a description of the role of each member of TPKJM within the case handling flow model. Five role themes were identified, including: (a) setting regulations and planning; (b) community clinical services; (c) psychoeducation; (d) safeguarding emergency cases; and (e) administrative advocacy. Regulations regarding the clarity of roles and handling flow are recommended.

scholarly journals User involvement in developing community-based public health services: a scoping review of methods

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K S Petersen ◽  
J F Pedersen ◽  
B Egilstroed ◽  
C Overgaard
Keyword(s):  
Public Health ◽  
Health Services ◽  
Scoping Review ◽  
User Involvement ◽  
Community Services ◽  
Cochrane Library ◽  
Public Health Services ◽  
Community Based ◽  
Comprehensive Overview ◽  
The Impact

Abstract Background User involvement in developing community-based public health services has been on the agenda for decades. User involvement refers to the variety of ways in which service users or public citizens participate in the development of health services: from proving information on their needs to actively being involved in decisions about future services. Former studies found that user involvement is meaningful to the people involved and could have a favorable impact on the quality of services. Thus, it is timely to systematically identify and provide a comprehensive overview of user involvement methods used in public health studies. The aim of this scoping review is to provide an overview of the current body of empirical research where user involvement methods have been used to develop community public health services and identify its possible impact on the individual as well as services. Methods A systematic scoping review of user involvement methods aiming to develop public health services followed Arksey and O'Malley, 2005 framework. Six databases: CINAHL, Cochrane Library, Embase, PsycINFO. PubMed, Scopus and ProQuest, were searched from October till November, 2019. Search terms were: user involvement, methods and health care with corresponding synonym. All hits were double screened. Results 6.044 studies were identified of which 38 studies lived up to the criteria. Preliminary findings from coding and synthesizing studies have identified a variety of user involvement Methods 19 of the studies used complex, multi-facetted packages of methods aiming to identify needs, prioritize and formulate recommendations for future services. 19 studies used different kinds of group meetings and some used certain techniques to facilitate the process. Many reported the impact, and 13 evaluated the methods. The impact of using the methods varied from impact on individual, group, or service/political level. Final results will be presented at the conference. Key messages Studies on user involvement methods in developing community public health services and its impact are sparse. User involvement is privotal in developing sustainable public health community services.

scholarly journals Perspektif Aset Ekonomi Berbasis Keumatan Pada Amal Usaha Muhammadiyah Klinik Kesehatan

2021 ◽  
Vol 4 (1) ◽  
pp. Editing
Author(s):  
Diyah Probowulan ◽  
Nina Martiana
Keyword(s):  
Public Health ◽  
Health Services ◽  
Human Resource ◽  
Community Health Services ◽  
Public Health Services ◽  
Community Based ◽  
Non Profit ◽  
The People ◽  
Economic Assets ◽  
Research Show

Muhammadiyah's charitable efforts as a community based on economic assets have a significant number of assets that are non-profit oriented. This certainly will be very different in the perspective of economic assets when viewed from the accounting field because Muhammadiyah charity efforts are based on publicity, this is very interesting to study because there are still a lack of public-based research. The purpose of this study is to reveal the perspective of the meaning of charity business as a community based on economic assets in the Muhammadiyah Business Charity sector in health in Jember Regency. This research uses a phenomenology paradigm with qualiative methods to interpret charity business as an asset-based economy of humanity. The perspective of economic assets is similar to the founders statement of Muhammadiyah, KH Ahmad Dahlan, such as ta'awun, tawashi ', and fastabikhul khoirot. When the internalization of economic assets is successful, the performance of charity efforts will continue to increase and not cause fundamental ideological conflicts. The results of the research show that Amal is a community-based economic asset and human resource as an economic driver of the people, of course as a means of propaganda, a means of improving public health services, and as an organizational asset. In essence, the charitable endeavors of Ranap Ambulu clinic, Asyifa Wuluhan Clinic, Ar Rahman Bangsalsari Clinic and dr. Suherman Sumbersari in Jember Regency is a means to improve the community health services community and also the assets of Muhammadiyah organizations in Jember Regency.Keywords Business Charity, Perspective, Economic Assets, PhenomenologyAbstrak: Upaya amal usaha Muhammadiyah sebagai komunitas yang didasarkan pada aset ekonomi memiliki sejumlah besar aset yang berorientasi nirlaba. Ini tentu akan sangat berbeda dalam perspektif aset ekonomi jika dilihat dari bidang akuntansi karena upaya amal usaha Muhammadiyah didasarkan pada publisitas, ini sangat menarik untuk dikaji karena masih kurangnya penelitian berbasis publik. Penelitian ini bertujuan untuk mengungkap perspektif makna aset ekonomi amal usaha Muhammadiyah di bidang kesehatan di Kabupaten Jember. Penelitian ini menggunakan paradigma kualitatif dengan metode fenomenologis interpretif untuk menginterpretasikan aset ekonomi amal usaha berbasis keumatan. Perspektif aset ekonomi dikonfirmasi oleh nilai permaknaan yang dipromosikan oleh pendiri Muhammadiyah yaitu Kyai Haji Ahmad Dahlan, antara lain ta'awun, tawashi ', dan fastabikhul khoirot. Kemudian makna aset ekonomi diinternalisasi dalam semua upaya amal melalui beberapa tahap secara bersamaan. Ketika internalisasi aset ekonomi berhasil, kinerja upaya amal akan terus meningkat dan tidak menyebabkan konflik ideologis mendasar. Hasil penelitian menunjukkan bahwa Amal adalah aset ekonomi berbasis masyarakat dan sumber daya manusia sebagai pendorong ekonomi rakyat, tentu saja sebagai sarana propaganda, sarana meningkatkan pelayanan kesehatan masyarakat, dan sebagai aset organisasi. Intinya, upaya amal klinik Ranap Ambulu, Klinik Asyifa Wuluhan, Klinik Ar Rahman Bangsalsari dan dr. Suherman Sumbersari di Kabupaten Jember adalah sarana untuk meningkatkan pelayanan kesehatan masyarakat dan juga aset organisasi Muhammadiyah di Kabupaten Jember.Kata Kunci:  Amal Usaha, Aset Ekonomi, Berbasis Keumatan 

scholarly journals Community Based Study of Rural, Tribal Women Seeking Induced Abortions in a Extremely Low Resource Region

2020 ◽  
Vol 2 (2) ◽  
pp. 22-29
Author(s):  
S. CHHABRA ◽  
Jain S ◽  
Thool K
Keyword(s):  
Contraceptive Use ◽  
Group Discussions ◽  
Community Based ◽  
Private Hospitals ◽  
Economic Class ◽  
Medical College ◽  
Tribal Women ◽  
Primary Health Centres ◽  
Induced Abortions ◽  
Unskilled Workers

Background Induced abortions are globally sought, whether permitted, or not permitted. Community based information about abortion seeking by rural tribal women is scarce. Objectives Community based study was carried out to know the magnitude, profile, reasons, places, persons performing IA for rural tribal women. Material Methods Study was conducted in 118 villages to get the study subjects . Women from every fourth house were interviewed for desired information. Results and Conclusion Of all abortions, 2.17% in Melghat and 24.38 %in Sewagram were IA. Most women who had IA were young and 19% in Melghat region, 2.6% in Sewagram region were illiterate. Majority of Sewagram region, were housewives of low middle class, in Melghat unskilled workers of low economic class. In Melghat region all women reported seeking IA at health facilities,63% Private hospitals (PH), 18.5% Sub centres (SC), 7.4% Medical College (MC), 7.4% District hospital(DH), 3.7% Primary Health Centres (PHCs) and In Sewagram region 58% PH, 23% MC, 6.7% PHCs, 3.9% DH, 3.9% SCs and 3.9% at home. Most women said they had IA for spacing with no contraceptive use or contraceptive failure, poor health, poverty, IA were done medically in 76.2%, surgically 23%. No sex–selective IA were reported and there was no evidence Many women lacked awareness and had misconceptions, more so in Melghat region. In focus group discussions, common reasons for disfavoring IA were personal beliefs (34%), practice restrictions (19%). There was extreme poverty, still PH were used. Lot of awareness is required.

DESIRE FOR MORE CHILDREN, CONTRACEPTIVE USE AND UNMET NEED FOR FAMILY PLANNING IN A REMOTE AREA OF BALI, INDONESIA

2010 ◽  
Vol 42 (4) ◽  
pp. 549-562 ◽  
Author(s):  
MELLISSA WITHERS ◽  
MEGUMI KANO ◽  
GDE NGURAH INDRAGUNA PINATIH
Keyword(s):  
Family Planning ◽  
Health Services ◽  
Contraceptive Use ◽  
Unmet Need ◽  
Multivariate Logistic Regression Analysis ◽  
Reproductive Age ◽  
Access To Health Services ◽  
The Past ◽  
Access To Health ◽  
Living Children

SummaryExploring fertility preferences in relation to contraceptive use can increase the understanding of future reproductive behaviour and unmet family planning needs. This knowledge can help assist women in meeting their reproductive goals. The influences on the desire for more children and current contraceptive use were examined among 1528 married women of reproductive age in an isolated community in Bali, Indonesia, using multivariate logistic regression analysis. Women who were younger, had fewer living children, had given birth in the past year and had regular access to health services were more likely to desire children. Being older, having fewer living children, not having regular access to health services, having given birth in the past year and having the desire for more children were associated with a lower likelihood of using contraception. Women with regular access to health care are more likely to desire more children, probably because they are confident in their ability to have successful birth outcomes. However, specialized clinics or family planning outreach workers may be required to reduce barriers to service utilization among some groups. The findings of this study identify key target populations for family planning, including older women and postpartum women – groups that may not perceive themselves to be at risk for unintended pregnancy. Meeting unmet need for family planning among these groups could help women meet their fertility goals, as well as reduce maternal morbidity and mortality.

How Should We Organise Community Health Services?

1997 ◽  
Vol 3 (1) ◽  
pp. 6 ◽  
Author(s):  
Hal Swerissen
Keyword(s):  
Public Health ◽  
Health Services ◽  
Community Health ◽  
Community Health Services ◽  
Community Services ◽  
Health Networks ◽  
General Direction ◽  
Functional Relations ◽  
Community Health Networks ◽  
The Creation

This paper reviews the organisation of Victorian community health services in the context of the general direction of reform for the Australian and Victorian health systems. It notes that the emphasis has shifted to a greater focus on improving the efficiency of the relationship between needs, resources, services and outcomes. Within this context, in addition to public health measures, national reforms have advocated the creation of funding and organisational arrangements around three service functions: general care, acute care and co-ordinated care. It is argued that the organisation of community services should be driven by these functional relations, not vice versa. The efficiency of vertical and horizontal integration and the creation of community health networks is considered in relation to transaction costs, organisational scale, transition costs and distributional equity. It is concluded that community health networks offer the most efficient model for the delivery of community based public health and general, acute and co-ordinated care services.

scholarly journals Access to Home and Community Health Services for Older Adults With Serious, Life-Limiting Illness: A Study Protocol

2020 ◽  
Vol 38 (1) ◽  
pp. 12-18
Author(s):  
Jacob D. Hill ◽  
Allison M. Cuthel ◽  
Corita R. Grudzen
Keyword(s):  
Health Care ◽  
Emergency Medicine ◽  
Health Services ◽  
Health Care Utilization ◽  
Qualitative Interviews ◽  
Community Health Services ◽  
Community Services ◽  
Care Utilization ◽  
Service Availability ◽  
Access To Services

Objectives: The objective of this study is to identify contextual access factors to home and community health services for end-of-life support for older adults with serious life-limiting illness, as well as determine if access to home and community services is associated with health-care utilization. Design: This study includes an environmental scan, grey literature review, qualitative interviews, and health-care utilization analysis. This study is a subproject of the Grudzen et al. Primary Palliative Care for Emergency Medicine (PRIM-ER) study. Settings/Location: Analysis will include data collection from 17 health systems implementing the PRIM-ER intervention. Participants: For the qualitative interviews, one emergency medicine (EM) physician and one EM nurse will be interviewed from each of the 17 participating health systems. For the health-care utilization analysis, we will use the Senior Care Services Scale (SCSS), American Hospital Association Annual Survey of Hospitals (AHA-ASH), and Medicare claims for all emergency department (ED) visits for serious illness who present at each participating health system. Outcome Measures: The contextual analysis will obtain data on home and community services, such as hospice, home health services, assisted living, integrative medicine services, etc., available around each health system’s highest volume ED, federal and state regulations influencing access to services, as well as EM provider perspectives on access to services. The health-care utilization analysis will determine if SCSS scores, which measure service availability, are associated with health-care usage. High or low SCSS scores are determined by comparing health system service availability on the AHA-ASH to the national median SCSS value.

scholarly journals “The Financial Is the Main Issue, It’s Not Even the Child”: Exploring the Role of Finances in Men’s Concepts of Fatherhood and Fertility Intention

2018 ◽  
Vol 12 (4) ◽  
pp. 1074-1083 ◽  
Author(s):  
Megan Hamm ◽  
Elizabeth Miller ◽  
Lovie Jackson Foster ◽  
Mario Browne ◽  
Sonya Borrero
Keyword(s):  
Family Planning ◽  
Reproductive Health ◽  
Health Services ◽  
Low Income ◽  
Financial Stability ◽  
Sexual And Reproductive Health ◽  
Contraceptive Use ◽  
Fertility Intention ◽  
Reproductive Health Services ◽  
Family Planning Services

Despite demonstrable need, men’s utilization of sexual and reproductive health services remains low. This low utilization may particularly affect low-income men, given the disproportionate prevalence of unintended pregnancy in low-income populations. Bolstering men’s utilization of sexual and reproductive health services requires understanding the services that are most relevant to them. Semistructured interviews about fatherhood, fertility intention, and contraceptive use were conducted with 58 low-income Black and White men in Pittsburgh, Pennsylvania. The interviews were analyzed using content analysis to determine common themes that were most relevant to the men interviewed. The primacy of financial stability emerged as a dominant theme in men’s perceptions of fatherhood readiness, successful fathering, and fertility intentions. However, men had children despite feeling financially unprepared, and their contraceptive use was not always congruent with their stated fertility intentions. Some men described financial services as a feature of family planning services that they would find useful. Because of the salience of financial stability in preparation for fatherhood, integrating financial counseling and job skills training into the context of sexual and reproductive health services could be a useful structural intervention to increase men’s use of family planning services and to provide them with the support they say they need as fathers.

scholarly journals Predictors of Time-to-Contraceptive Use from Resumption of Sexual Intercourse after Birth among Women in Uganda

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Robert Wamala ◽  
Allen Kabagenyi ◽  
Simon Kasasa
Keyword(s):  
Family Planning ◽  
Sexual Intercourse ◽  
Formal Education ◽  
Contraceptive Use ◽  
Traditional Birth Attendant ◽  
Wealth Quintile ◽  
Northern Region ◽  
Modern Contraceptive ◽  
Sampling Weights ◽  
Modern Contraceptive Use

Globally, there is extant literature on patterns and dynamics of postpartum contraceptive use with hardly any evidence examining time-to-contraceptive use from resumption of sexual intercourse after birth among women in Uganda. Methods. The analysis was based on data from 2011 Uganda Demographic and Health Survey on a sample of 2983 married women with a birth in the past three years preceding the survey and had resumed sexual intercourse. A time-to-contraceptive use was adopted in the analysis using life tables based on the Kaplan-Meier estimates, while the Log-Rank Chi-square tests assessed the variables to be included in regression analysis. Cox-Proportional Hazard regression was run to identify the predictors of time-to-contraceptive use among postpartum women in Uganda. Sampling weights were applied in the analysis to ensure representativeness. Results. The median time-to-contraceptive use was 19 months (range 0–24). Time to adoption of modern contraceptive use was significantly longer among women with no formal education, residing in northern region, who (HR=0.56, CI: 0.40–0.78) had delivered at home/traditional birth attendant (HR=0.75, CI: 0.60–0.93), had 1–3 antenatal care visits (HR=0.83, CI: 0.70–0.98), and were in poorest wealth quintile. Conclusions. Measures for enhancing modern contraceptive use during and after the postpartum period should focus on (i) addressing hindrances in accessing family planning, particularly among poor and noneducated women; (ii) integration of family planning service delivery into routine ANC through counseling; and (iii) promoting deliveries in health facilities.

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