Enhanced Primary Health Care: An Approach to More Effective Health Services

1988 ◽  
Author(s):  
Demitri Β. Shimkin ◽  
Gary S. Sorock
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Primary Health

scholarly journals Quality of Primary Health Care in Brazil: patients'view

2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Clinical History ◽  
Coordination Of Care ◽  
Primary Health ◽  
Comprehensive Health ◽  
Access And Quality ◽  
Transversal Study

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.

scholarly journals The role of health care workers in collaborating with traditional healers in primary health care. Part 1

1997 ◽  
Vol 2 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Rosemare Troskie
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Plan ◽  
Health Care Workers ◽  
Full Text ◽  
Traditional Healers ◽  
Primary Health ◽  
Care Workers

The Reconstruction and Development Plan as well as the National Health Plan of the ANC supports the reorganisation of health services. OpsommingDie Heropbou en Ontwikkelingsprogram sowel as die Nasionale Gesondheidsplan van die ANC staan die herorganisasie van gesondheidsdienste voor. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Integrating Mental Health Services into the Primary Health Care System: The Need for Reform in Iran

2021 ◽  
Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Financial Resources ◽  
Primary Health Care System ◽  
Primary Health ◽  
Integrated Mental Health

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.

scholarly journals 40 Years after Alma Ata: How People Trust in Primary Health Care?

2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Health Services ◽  
Public Trust ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Trust Level ◽  
Primary Health ◽  
Individual Variables

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. PHC as a first level of health services delivery needs to be more trustfulness to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in 2016 in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression.Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.

scholarly journals The health response to the Rohingya refugee crisis post August 2017: Reflections from two years of health sector coordination in Cox’s Bazar, Bangladesh

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253013
Author(s):  
Rosanna Jeffries ◽  
Hassan Abdi ◽  
Mohammad Ali ◽  
Abu Toha Md Rezuanul Haque Bhuiyan ◽  
Mohamed El Shazly ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Health Sector ◽  
Advisory Group ◽  
Primary Health ◽  
Working Groups

On August 25 2017, an unprecedented influx of Rohingya refugees began from Rakhine State in Myanmar into Bangladesh’s district of Cox’s Bazar. The scale and acuteness of this humanitarian crisis was unprecedented and unique globally, requiring strong coordination of a multitude of actors. This paper reflects on the health sector coordination from August 2017 to October 2019, focusing on selected achievements and persisting challenges of the health sector strategic advisory group (HSSAG), and the health sector working groups including epidemiology and case management, sexual and reproductive health, community health, mental health and psychosocial support, and emergency preparedness. In the early days of the response, minimum service standards for primary health care were established, a fundamental initial step which enabled the standardization of services based on critical needs. Similarly, establishing standards for community health outreach was the backbone for capitalizing on this important health workforce. Novel approaches were adopted for infectious disease responses for acute watery diarrhoea and varicella, drawing on inter-sectoral collaborations. Sexual and reproductive health services were prioritized from the initial onset of the crisis and improvements in skilled delivery attendance, gender-based violence services, abortion care and family planning were recorded. Mental health service provision was strengthened through community-based approaches although integration of mental health programmes into primary health care has been limited by availability of specialist psychiatrists. Strong, collaborative and legitimate leadership by the health sector strategic advisory group, drawing on inter-sectoral collaborations and the technical expertise of the different technical working groups, were critical in the response and proved effective, despite the remaining challenges to be addressed. Anticipated reductions in funding as the crisis moves into protracted status threatens the achievements of the health sector in provision of health services to the Rohingya refugees.

scholarly journals Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

2012 ◽  
Vol 68 (2) ◽  
Author(s):  
N. Mlenzana ◽  
R. Mwansa
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Care Services ◽  
Waiting Times ◽  
Care Providers ◽  
Persons With Disabilities ◽  
Care Services ◽  
Primary Health

To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54%) were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction. Other clients were satisfied with thoroughness ofhealth care providers regarding symptoms, feelings, reception and treatment received at the primary health care centre.Understanding the views of the clients is essential in improving health delivery services and could impact on thecompliance of people attending primary health care services.

scholarly journals Mental health in primary health care: professionals’ perceptions and patients’ levels of depression, anxiety and stress

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Tatiana Varela Madureira ◽  
Maria Cristina Quintas Antunes
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Mental Health Care ◽  
Health Professionals ◽  
Mental Health Problems ◽  
Anxiety And Depression ◽  
Self Administration ◽  
Primary Health

Background: The integration of mental health in primary health care, throughout its various functional units and with effective articulation between primary health care and mental health services, has been considered an essential objective of the legislative documents produced in the last three decades in Portugal, among them the National Health Plan 2011-2016.Goals: This study aimed to inquire health professionals’ perceptions about mental health care provided by public primary health care units, namely their perceptions about the mental health of their patients. It also intended to explore the difficulties perceived by the health professionals in their daily activity about the mental health problems of their patients and about the need of clinical psychologists’ activity in the public primary health care.Methods: This is an observational cross-sectional study with two non-probabilistic samples: health professionals (doctors, nurses and psychologists) and patients from two public health care units. Health professionals were interviewed (individual structured face-to-face interviews) about their perceptions of needs for improving their capacity to provide mental healthcare and about patients’ mental health conditions. Patients responded (by self-administration) to the Depression, Anxiety and Stress Scale (DASS-21), providing a characterization of patients’ stress, anxiety and symptoms of depression.Results: Health professionals in their daily practice often identify in their patients symptoms of stress, anxiety and depression (most particularly in adults),. Several issues were identified as problematic, such as: poor access of the referral system for psychiatric and clinical psychological specialized care, insufficient number of health professionals, particularly of psychologists, and lack of appropriate mental health care specialization. The results also revealed relevant levels of stress, anxiety and depression in primary health care patients (both genders), which seem to increase with age. Discussion: Difficulties identified by health professionals may relate to the centralisation of resources, resistance to change from human resources management, lack of consensus among the various decision groups linked to mental health and, at institutional level, insufficient and inadequate funding. These factors may contribute to a failure in early diagnosis of symptoms of depression, anxiety and stress. It is expected that articulation between primary health services and differentiated health services will improve, with improvement in teamwork among professionals and increase of the quality of life of users, satisfaction with work, from health professionals,  and reduction of health costs.

Factors Influencing Access to Primary Health Care via School Health Services

PEDIATRICS ◽  
1980 ◽  
Vol 65 (3) ◽  
pp. 585-591
Author(s):  
Philip R. Nader ◽  
Susan Gilman ◽  
David E. Bee
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
School Health ◽  
Preventive Health Care ◽  
School Health Services ◽  
Family Status ◽  
Primary Health ◽  
Poor Access

The school health and community primary health care contacts were studied for a group of elementary school children who have sociodemographic characteristics often associated with poor access to primary health services. The school system is engaged in a demonstration project that attempts to link the home with community and school services. Visits to the school health room accounted for 85% of all contacts. A visit rate of 1.13 visits/child/year occurred at primary care sites. Ethnicity is the single most important predictor of use of school health services, followed by family status and number of visits for primary health care in the community. In contrast, use of community primary care facilities is best predicted by socioeconomic status (SES), family status, and sex. The patterns of care received by the population were characterized. Children whose care was initiated, referred, or facilitated by the school were designated as receiving "interactive" care, which occurred mostly among minority and lower SES children. The data suggest that the school provides access to preventive health care for all children and facilitates care for segments of the population that usually have difficulty achieving access to the health care system.

Sign in / Sign up

Export Citation Format

Share Document