scholarly journals Process evaluation of enhancing primary health care for non-communicable disease management in Malaysia: Uncovering the fidelity & feasibility elements

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245125
Author(s):  
Lee Lan Low ◽  
Fathullah Iqbal A. B. Rahim ◽  
Nur Aqlili Riana Hamzah ◽  
Mohd Safiee Ismail
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Delivery ◽  
Human Resource ◽  
Communicable Disease ◽  
Evaluation Research ◽  
Good Clinical Practice ◽  
Evaluation Study ◽  
Physical Structure ◽  
Primary Health

Background In combating the increasing trend of non-communicable diseases (NCDs) over the last two decades in the country, the Ministry of Health Malaysia developed the Enhanced Primary Health Care (EnPHC) initiative to improve care management across different levels of the public service delivery network. An evaluation research component was embedded to explore the implementation issues in terms of fidelity, feasibility, adaptation and benefit of the initiative’s components which were triage, care coordination, screening, risk management and referral system. Methods A mixed methods study was conducted at 20 participating EnPHC clinics in Johor and Selangor, two months after the intervention was initiated. Data collected from self-reported forms and a structured observation checklist were descriptively analysed. In-depth interviews were also conducted with 20 participants across the clinics selected to clarify any information gaps observed in each clinic, and data were thematically analysed. Results Evaluation showed that all components of EnPHC intervention had been successfully implemented except for the primary triage counter and visit checklist. The challenges were mainly discovered in terms of human resource and physical structure. Although human resource was a common implementation challenge across all interventions, clinic-specific issues could still be identified. Among the adaptive measures taken were task sharing among staff and workflow modification to match the clinic’s capacity. Despite the challenges, early benefits of implementation were highlighted especially in terms of service outcomes. Conclusions The evaluation study disclosed issues of human resource and physical infrastructure when a supplementary intervention is implemented. To successfully achieve a scaled-up PHC service delivery model based on comprehensive management of NCDs patient-centred care, the adaptive measures in local clinic context highlight the importance of collaboration between good organisational process and good clinical practice and process.

scholarly journals Experiential Learning Curriculum Delivery Approach for Quality Improvement in Resource Limited Settings: Mobile Learning for Point-of-Care Technologies

2019 ◽  
Vol 11 (13) ◽  
pp. 158
Author(s):  
Nkosinothando Chamane ◽  
Tivani Phosa Mashamba-Thompson
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Experiential Learning ◽  
Service Delivery ◽  
Point Of Care ◽  
Service Improvement ◽  
Quality Service ◽  
Resource Limited Settings ◽  
Primary Health ◽  
Resource Limited

BACKGROUND: Despite impressive progress that has been made in the provision of health care services to all, the issue of quality service delivery still remains a challenge particularly for point-of-care (POC) diagnostics in resource-limited-settings. Poor competency of primary health care workers in these settings has been shown to be amongst the main contributors to poor quality service delivery. FINDINGS: Participatory-based continuous professional development (CPD) strategies to support technology advancements in health care are recommended. Experiential learning approaches have been shown to be efficient in supplementing traditional teaching methods for both health care students and professionals. These approaches have been shown to further contribute towards continuous skills development and lifelong learning. CONCLUSION: This review therefore provided an overview of literature on experiential learning as one of CPD approaches in relation to health care service improvement in resource-limited setting. In addition, this review has recommended a mobile-based experiential learning approach to help deliver a quality POC technology curriculum to Primary health care-based workers in resource-limited settings.

scholarly journals Desempenho e Importância da Atenção Básica na Prevenção e Controle da Tuberculose: Revisão de Literatura

2019 ◽  
Vol 23 (2) ◽  
pp. 80
Author(s):  
Mikaela Lopes de Caldas ◽  
Francisco Das Chagas Cardoso Filho
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mycobacterium Tuberculosis ◽  
Primary Health Care ◽  
Communicable Disease ◽  
Control Measures ◽  
Historical Period ◽  
Tuberculosis Control ◽  
Treatment And Prevention ◽  
Primary Health

A tuberculose (TB) é uma doença infecciosa e transmissível, causada pelo Mycobacterium tuberculosis. A detecção de casos figura entre as principais medidas de controle da tuberculose, embora grandes avanços tenham ocorrido no que se relaciona ao diagnóstico, tratamento e prevenção da doença, a mesma ainda requer atenção especial, por parte dos profissionais da saúde (equipe multiprofissional) e da sociedade como um todo. A Atenção Básica se caracteriza como ferramenta primordial na suspeição e na detecção dos casos de tuberculose na comunidade. O objetivo geral do presente trabalho é identificar produções científicas que avaliem o desempenho da Atenção Básica no controle da tuberculose. Os objetivos específicos foram: ressaltar a importância da Atenção Básica na detecção dos casos suspeitos; expor a relevância da Atenção Básica como fator indispensável no controle da tuberculose. Caracteriza-se como uma pesquisa bibliográfica explicativa e explorativa, realizada no recorte histórico de 1998 a 2011, período esse definidor para a implementação de medidas de controle da tuberculose. Encontraram-se 29 referências, das quais 19 obedeciam aos critérios de inclusão. Portanto, a Atenção Básica caracterizada como principal porta de entrada ao acesso à saúde, proporciona a aproximação do cidadão às medidas de controle da tuberculose, assim como promove a educação em saúde, que visa a prevenção dos agravos e proporcionam autonomia e autoconhecimento que são indispensáveis para a manutenção da saúde frente às doenças preveníveis como a tuberculose, porém que se configuram como problemas de saúde pública. Palavras-chave: Tuberculose. Atenção Básica. Controle. AbstractTuberculosis (TB) is an infectious and communicable disease caused by mycobacterium tuberculosis. The case detection is one of the main control  measures of tuberculosis, although major advances have occurred regarding the diagnosis, treatment and prevention of the disease, the same still requires special attention on the part of health professionals (multidisciplinary team) and society as a whole. The primary care is characterized as a primary tool in suspicion and detection of tuberculosis cases in the community. The overall objective of this study is to identify scientific production to assess the performance of primary health care in tuberculosis control. The specific objectives were to highlight the importance of primary care in the detection of suspected cases; expose the relevance of primary health care as an essential factor in tuberculosis control. It is characterized as an explanatory and exploratory literature survey, conducted in historical period from 1998 to 2011, a period defined for the implementation of tb control measures. It was found 29 references, 19 of which obeyed the inclusion criteria. Therefore, the primary care characterized as the main gateway to access to health, provides the citizen’s approach to tuberculosis control measures and promotes health education aimed at prevention of injuries and provides autonomy and self-knowledge that are essential for maintenance health against preventable diseases such as tuberculosis, but which are seen as  the main  public health problems. Keywords: Tuberculosis. Primary Care. Control. 

Seeking Solutions to the Challenges in Health Services in Developing Nations

2015 ◽  
pp. 1-51
Author(s):  
Jessica McCormack ◽  
Patrick Rawstorne ◽  
Mohamud Sheikh
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Diseases ◽  
Burden Of Disease ◽  
Communicable Disease ◽  
Developing Nations ◽  
Global Burden ◽  
Primary Health ◽  
Non Communicable Disease

The Global Burden of Disease (GBD) study, 2010, confirmed that the world's population is living longer and we are now less likely than a decade earlier to die from an infectious disease but also more likely to live our twilight years with morbidity (Murray et al., 2012). We will also most likely die from a chronic non-communicable disease (NCD) such as cardiovascular diseases, cancers, respiratory diseases, and diabetes (Beaglehole, et al., 2008). However this brief glimpse at the trends in the health of the world's population obscures massive inequalities in the burden of disease as well as variations across the globe. In this piece, we will revisit primary health care, both at its dawn, its contribution to developing nations, and the ills it struggled through over the years. Cuba and Thailand are the key examples of developing nations that have experienced the contribution of primary health care more than most other countries.

Towards Integrated Service Delivery for Primary Health Care: Can Programs Meet People's Lives?

2000 ◽  
Vol 6 (4) ◽  
pp. 43
Author(s):  
Vivian Lin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Delivery ◽  
Health Care Policy ◽  
Unit Cost ◽  
Policy Research ◽  
Evidence Base ◽  
Integrated Service Delivery ◽  
Primary Health ◽  
Integrated Service

The primary health care sector faces a number of challenges. Some of these are in the form of persistent problems which include, inter alia, health disparities in resources and outcomes, a fragmented health system, issues of power with respect to priority setting and resource allocation, and a poor information and evidence base with which to allocate resources and evaluate outcomes. These problems are perennially accompanied by a gap between the rhetoric of policy and the reality of implementation. Neo-liberal reforms present a series of challenges to primary health, with the introduction of unit-cost funding, competitive tendering and increased user pays. Changing epidemiological patterns, the rise of evidence-based medicine, and new information and communication technology all question accepted methods of practice. Eroding community confidence in government and professionals, and the growing polarisation of society are also cause for concern. Three areas for development in primary health care policy and practice may provide the keys for dealing with these challenges. These are, first, the development of integrated service delivery models, which move away from narrowly defined single purpose programs delivered by one provider. Second, the development of innovative policy and managerial tools that support the objectives of primary health care while addressing the concerns of policy makers. Finally, the development of a strategic research and development agenda that effectively links policy, research and practice.

scholarly journals Nutritional well-being of young children in Duncan Village, East London, South Africa: accessibility of primary health care clinics

2005 ◽  
Vol 8 (5) ◽  
pp. 520-532 ◽  
Author(s):  
Anniza de Villiers ◽  
Kholeka Koko-Mhlahlo ◽  
Marjanne Senekal
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Focus Group ◽  
Young Children ◽  
Service Delivery ◽  
Data Retrieval ◽  
Well Being ◽  
Primary Health ◽  
Heavy Workload

AbstractObjectiveThe aim was to contribute to the nutritional well-being of young children living in Duncan Village by investigating factors that influence clinic attendance of mothers and to formulate recommendations for optimisation of accessibility of primary health care (PHC) clinics in the area.DesignPHC clinic accessibility was evaluated by assessing the experiences of mothers who attended clinics in the area as well as the experiences of health care workers (HCWs) in these clinics of service delivery and its recipients (mothers/children), using the focus group technique. The ATLAS/ti program was used to analyse the data in the following steps: preparation and importing of the data, getting to know and coding the data, retrieval and examination of codes and quotations, creation of families and creation of networks.SettingDuncan Village, a low socio-economic urban settlement in East London, South Africa.SubjectsFocus group discussions (four to seven participants per group) were conducted with four groups of mothers who do not attend PHC clinics, six with mothers who do attend the clinics (including pregnant women) and four groups of HCWs.ResultsFour networks that provide a summary of all the major trends in the data were created. The results clearly indicate that mothers in Duncan Village perceive and/or experience serious problems that make it difficult for them to attend clinic and even prevent them from doing so. These problems include both the way they are treated at the clinics (especially the problem of verbal abuse) as well as the actual services delivered (no medicines, no help, disorganised, long waiting periods, being turned away). The main problem experienced by the HCWs with service delivery seems to be a heavy workload, as well as the fact that many mothers do not come for follow-up visits.ConclusionEfforts to increase the accessibility of PHC clinics in Duncan Village should focus on improving the relationship between mothers and HCWs and the heavy workload experienced by these workers.

scholarly journals How well are non-communicable disease services being integrated into primary health care in Africa: A review of progress against World Health Organization’s African regional targets

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0240984
Author(s):  
Azeb Gebresilassie Tesema ◽  
Whenayon Simeon Ajisegiri ◽  
Seye Abimbola ◽  
Christine Balane ◽  
Andre Pascal Kengne ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Communicable Disease ◽  
World Health ◽  
Primary Health ◽  
Non Communicable Disease

scholarly journals Relevance of Improving Human Resource Management in the Organization of Primary Healthcare

2020 ◽  
Vol 4 (39) ◽  
pp. 31-39
Author(s):  
Gulzhan Mukhanova ◽  
◽  
Sultanbek Tultabaev ◽  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Resource Management ◽  
Human Resource Management ◽  
Human Resource ◽  
Health Care Organizations ◽  
Systems Approach ◽  
Primary Health ◽  
The Republic ◽  
Effective Use

The aim of this study: To determine the trajectory of improving human resource management as an element of operational management in the organization of primary health care. Methods. Within the framework of the study, a comparative analysis of statistical data on the provision of PHC doctors by regions for 2017-2019 was carried out according to the information system of the Ministry of Health of the Republic of Kazakhstan «Additional component of the per capita standard». Results. When analyzing the provision of health care organizations with general practitioners, district pediatricians, district therapists at the level of primary health care (PHC) in the republic, a dynamic decrease in the quantitative indicator of doctors providing PHC was revealed. And also noted a stable tension in the workload of a doctor in terms of the number of served (attached) population. Conclusions. Staff-oriented approaches, such as calculating the required number of staff or creating formulas and algorithms, provide only partial solutions. More comprehensive solutions are needed that will focus on effective multifactor human resource management. For the most effective use of human resources, health care organizations must expand a systems approach that takes into account organizational and institutional conditions

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