Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh

Background: Drug therapy can improve a patient’s quality of life and health outcomes if only used properly. However, data on prescription quality at primary health care facilities in Tanzania is scanty. The objective of this study was to assess the quality of drug prescriptions in selected health care facilities in two districts of Mwanza, Tanzania.Methods: This descriptive cross-sectional study was carried out in Ilemela and Nyamagana districts in Mwanza, Tanzania. The study included 20 randomly selected public and private health care facilities. A random sample of the patient records in each facility was included. From each patient record, the latest prescription was assessed. Information assessed and recorded included prescribing indicators, frequency of prescription error, various formulations and groups of drugs prescribed. Prescribers were interviewed on factors affecting prescribing practices.Results: A total of 570 prescriptions were studied. The average number of drugs prescribed per encounter was 2.8. The percentage of encounters with an antibacterial agent prescribed was 33.8% and injections constituted 7.9% of cases. Prescriptions by generic name were 85.8% while 90.6% of drugs prescribed were from the national essential drug list. Antibacterial agents, analgesics and antimalarial agents accounted for 75.3% of all drugs prescribed. Of all prescriptions, 485 (85.1%) had at least an error. A total of 1,177 errors were made. Errors of omissions accounted for the majority (99.3%) of all errors. The most commonly observed missing prescription particulars were the drug strength (23.2%) and patient weight (22.2%). The average number of drugs per encounter was higher in private facilities (3.2) than in public facilities (2.4) (P <0.0001). The range of drugs per prescription was also higher in private (1-7) than in public facilities (1-5) (P<0.0001). There were statistically significant differences in the distribution of various drug groups prescribed between public and private facilities and between health centres and dispensaries (P <0.001 and 0.027, respectively).Conclusion: Prescribing of higher number of drugs than the WHO recommendations and overuse of antibiotics is still a problem at health care facilities in Mwanza Tanzania. The frequency of occurrence of prescription errors found during the study was considerably high.

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Inter-rater agreement of scores to assess quality of care in public sector primary health care facilities – a pattern of performance

Evaluation and Program Planning ◽

10.1016/j.evalprogplan.2021.102004 ◽

2021 ◽

pp. 102004

Author(s):

Ronel Steinhöbel ◽

Jacqueline E. Wolvaardt ◽

Elizabeth M. Webb

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Facilities ◽

Rater Agreement ◽

Primary Health ◽

Care Facilities ◽

Assess Quality ◽

Pattern Of Performance ◽

Primary Health Care Facilities

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Health System Adaptability at Primary Level Care in the Time of COIVD-19: Experiences From Ethiopia

10.21203/rs.3.rs-88250/v1 ◽

2020 ◽

Author(s):

Yared Abebe ◽

Ismael Ali Beshir ◽

Zergu Tafese Tsegaye ◽

Binyam Fekadu Desta ◽

Mengistu Asnake Kibret ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health System ◽

Health Systems ◽

Health Care Facilities ◽

Effective Response ◽

Primary Health ◽

Care Facilities ◽

System Resilience ◽

Primary Health Care Facilities

Abstract BackgroundCOVID-19 is a global public health emergency, that has had massive implications on the ability of health systems to avail essential services both during and after the emergency. An effective response thus requires an agile health system that can adjust, reorganize, transform or modify in response to shocks and stress, and to recover quickly in the aftermath. This study aims to identify the major attributes that health systems needed to be adaptable in early stages of the COVID-19 pandemic, as observed in selected primary health care facilities in Ethiopia. MethodsThis study employed a retrospective cross-sectional study design based on the ‘ready, willing and able’ framework for health system resilience. The assessment used two independent, concurrently administrated instruments. A total of 163 health centers were visited from April to June 2020. ResultsThe overall mean score for COVID-19 preparedness was 73.1±16.1 standard deviation (SD) and it ranged from 28.9 to 99.9 out of 100. The mean score for the ‘ready’ dimension of preparedness was 75.1±19.1 SD, for the ‘willing’ dimension it was 61.6±24.6 SD and for the ‘able’ dimension the score was 82.8±21.0 SD. Multivariable linear regression analysis showed that levels of functionality of governing, and management systems, integration of emergency responses into the routine system, and prior experience of implementing quality improvement efforts were positively associated with COVID-19 preparedness. ConclusionHealth system resilience is a result of investments made prior to any incidents to ensure that the system is prepared for unpredicted shocks. Early adaptation required to contain the effects of COVID-19 may be considered as a litmus test to understand the capacity of primary health care facilities in Ethiopia to withstand future health system stressors.

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