Mainstreaming youth-friendly health services into existing primary health care facilities: experiences from South-South Nigeria

Author(s):  
Rosemary Ogu ◽  
Omosivie Maduka ◽  
Folusho Alamina ◽  
Obelebra Adebiyi ◽  
Vetty Agala ◽  
...  

Abstract Background Youth friendly services, an evidence based approach to overcome the barriers experienced by youths in accessing care, is poorly implemented. The Medical Women’s Association of Nigeria (MWAN) Rivers State chapter, was supported by Ford Foundation to mainstream youth-friendly health services (YFHS) into existing primary health care facilities in two hard-to-reach communities. This paper presents the interventions, findings, challenges and recommendations. Methods This study project was implemented in stages: design, baseline survey, interventions and evaluation, between 2014 and 2016. Interventions included facility modifications, health worker capacity building, school and community outreaches, peer group activities, and interpersonal communication. Pre-and-post-intervention surveys were carried out among in- and out-of-school youths to determine the effects of the interventions. Results The most commonly stated barriers to uptake of youth friendly health services included: unavailability of services (154; 33.1%), unavailability of health care workers (167; 38.9%), unaffordability of services (108; 45.8%) and difficulty in communicating with health workers (85; 36.0%). Post-intervention, utilization improved across all services while the perception of barriers to utilization of services reduced (p < 0.05). The interventions implemented increased the odds of youths utilizing YFHS 1.81 times (95% CI = 1.39–2.37). Conclusion Facility modifications, capacity building of health workers, school and community outreaches, peer group activities, and interpersonal communication improved utilization across all services while the perception of barriers to utilization of services reduced. Implementation of YFHS is impacted by external factors often beyond the control of project implementers. Innovative solutions outside of routine health care delivery systems are critical for success. Further evaluation to explore the effect of these interventions is needed. Strengthening of health systems remains a vital strategy for scale-up of YFHS.

PEDIATRICS ◽  
1981 ◽  
Vol 68 (5) ◽  
pp. 677-683
Author(s):  
R. Giel ◽  
M. V. de Arango ◽  
C. E. Climent ◽  
T. W. Harding ◽  
H. H. A. Ibrahim ◽  
...  

To ascertain the frequency of mental disorders in Sudan, Philippines, India, and Colombia, 925 children attending primary health care facilities were studied. Rates of between 12% and 29% were found in the four study areas. The range of mental disorders diagnosed was similar to that encountered in industrialized countries. The research procedure involved a two-stage screening in which a ten-item "reporting questionnaire" constituted the first stage. The study has shown that mental disorders are common among children attending primary health care facilities in four developing countries and that accompanying adults (usually the mothers) readily recognize and report common psychologic and behavioral symptoms when these are solicited by means of a simple set of questions. Despite this, the primary health workers themselves recognized only between 10% and 22% of the cases of mental disorder. The results have been used to design appropriate brief training courses in childhood mental disorders for primary health workers in the countries participating in the study.


2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Kyaw Lin ◽  
Sun Lin ◽  
Than Tun Sein

PurposeMyanmar has an insufficient number of mental health workers with few institutional facilities resulting in a significant treatment gap. Although few mental health services are integrated into primary health care (PHC), the challenges are unknown. This study aimed to assess the challenges perceived by providers in the service delivery of satellite mental health care (SMHC) in two sample townships in Yangon.Design/methodology/approachThe research was based on a case study design by applying a qualitative approach using in-depth interviews (IDIs). In the three types of service providers, a total of six staff participated as interviewees. These consisted of two team leaders, two clinical specialists providing consultations to clients and two mental health nurses.FindingsProviders perceived the following as major challenges in the provision of services: unstable financial resources and management, insufficient human resources and capacity of service providers, restricted outpatient services, the lack of a functional referral system, overcrowding, inadequate individual consultation time, long-waiting hours, finite opening days and hours and poor setting of infrastructure, resulting in lack of privacy.Research limitations/implicationsIn the absence of similar studies in Myanmar, findings could not be placed in the context of the national literature for comparison. Further, the study involved a limited number of respondents, which may have affected the findings.Originality/valueAlthough the challenges revealed were not uncommon in mental health services in developing countries, this study focused on a specific model of mental health care integrated into general healthcare settings in Myanmar. The findings offer a benchmark on efforts to develop decentralized mental health services in Myanmar and provide input for future in-depth studies.


2019 ◽  
Author(s):  
Sabere Anselme Traoré ◽  
Serge M.A. Somda ◽  
Joël Arthur Kiendrébéogo ◽  
Jean-Louis Kouldiati ◽  
Paul Jacob Robyn ◽  
...  

AbstractObjectiveTo assess the adherence to Integrated Management of Childhood Illness (IMCI) guidelines in primary health care facilities in Burkina Faso and to determine the factors associated.Materials and MethodsWe used data from a large survey on health facilities, held from October 2013 to April 2014. Primary health facilities were evaluated, health workers interviewed and consultations observed. The standard guideline for an under five year’s old child consultation was the Integrated Management of Childhood Illness (IMCI).Results1,571 consultations were observed, carried out by 522 different practitioners. The danger signs were usually not checked (13.9% only checking for at least three general danger signs). The adherence for cough (74.8%), diarrhoea (64.9%), fever (83.8%) and anaemia (70.3%) was higher. The principal factors found to be associated with poorer adherence to guidelines of consultation were female sex (Rate Ratio (RR) = 0.91; 95% CI 0.86 – 0.95), non-nurse practitioner (RR=0.93; 95% CI 0.88 – 0.97), IMCI training (RR=1.06; 95% CI 1.01 – 1.11), non-satisfaction of the salary (RR=0.95 95% CI 0.91 – 0.99).ConclusionThis study highlights a poor adherence to the IMCI guidelines and by then, revealing a poor quality of under-five care. Indeed, many characteristics of health workers including gender, type of profession, training satisfaction with salary were found to be associated with this adherence. Therefore, more initiatives aiming at improving the quality of care should be developed and implemented for improving the child health care.


2021 ◽  
Vol 15 (8) ◽  
pp. 2301-2306
Author(s):  
Mario J. Valladares-garrido ◽  
Laura M. Ccosco-blas ◽  
Paula Gutiérrez ◽  
Paola J. Ramos-rupay ◽  
Alix X. Rivera-pinto ◽  
...  

Introduction: There is limited evidence on factors associated with access to health primary health care services in users of marginal urban areas of Lima, Peru. Objective: To determine factors associated with access to primary health care services in Lima, Peru. Material and Methods: Cross-sectional study in users treated at seven primary health care facilities in a marginal urban area of Lima, Peru in 2019. A questionnaire was used to measure accessibility to health services; demographic and socioeconomic factors and characteristics of health services were investigated as well. Simple and multiple regression analyses were performed, estimating prevalence ratios. Results: Out of a total of 150 participants, 85.2% had access to health services. Female gender was positively associated with access to health services (aPR:1.17, 95% CI:1.11-1.23). Secondary education (aPR:0.65, 95% CI:0.44-0.98) and higher technical education or armed forces (aPR:0.64, 95%CI:0.46-0.89) were negatively associated with access to health services. On the other hand, we found that waiting time for care reduces the possibility of accessing health care; in case wait time is more than 30 minutes (aPR:0.83, 95% CI: 0.77-0.95), more than one hour (RPa:0.85, CI95%:0.75-0.95) and more than two hours (RPa:0.84, CI95%:0.75-0.93). Conclusions: The majority of users treated at the Primary Health Care facilities had access to health services. Having a higher educational level and reporting a longer waiting time for care were associated with a lower frequency of accessibility, while being a woman was associated with a higher frequency of accessibility. Key words: Health services, primary health care, health services accessibility, delivery of health care, public health.


Author(s):  
Nurhayati Nurhayati ◽  
Hadi Siswoyo ◽  
Lucie Widowati ◽  
Ondri Dwi Sampurno ◽  
Delima Delima ◽  
...  

Abstrak Saat ini pelayanan kesehatan tradisional semakin berkembang maju. Griya sehat merupakan fasilitas pelayanan kesehatan tradisional (fasyankestrad) komplementer. Di Indonesia, saat ini banyak terdapat fasilitas pelayanan kesehatan tradisional griya sehat, namun tidak semua griya sehat yang ada di masyarakat sesuai dengan persyaratan yang ditetapkan oleh Kementerian Kesehatan Republik Indonesia. Tujuan penelitian ini adalah untuk memperoleh gambaran penyelenggaraan fasilitas pelayanan kesehatan tradisional griya sehat yang ada di Indonesia. Disain penelitian ini adalah potong lintang. Sampel penelitian ini adalah fasilitas pelayanan kesehatan tradisional griya sehat yang memenuhi kriteria inklusi dan eksklusi penelitian. Data penelitian diperoleh melalui wawancara dan observasi terhadap 21 griya sehat yang dikunjungi. Hasil penelitian menunjukkan bahwa menurut kepemilikan griya sehat terdapat 7 milik pemerintah dan 14 milik swasta. Menurut perizinan, terdiri dari 3 UPT pusat, 4 UPT daerah, 10 rekomendasi dinas kesehatan, dan 4 griya sehat belum memiliki perizinan. Ada beberapa jenis pelayanan kesehatan tradisional yang diberikan di setiap griya sehat, terdiri dari 16 herbal, 15 akupunktur, 15 akupresur/pijat, 16 lainnya seperti spa, bekam, totok, fisioterapi. Tenaga yang melakukan pelayanan terdiri dari 16 tenaga kesehatan, 11 tenaga kesehatan tradisional. Pengelola dan penanggung jawab pelayanan fasyankestrad terdiri dari 4 tenaga kesehatan tradisional dan 17 tenaga kesehatan dan lainnya. Pendekatan pelayanan terdiri dari 14 promotif, 18 preventif, 21 kuratif, 16 rehabilitatif, dan 2 paliatif. Penyelenggaraan fasyankestrad komplementer griya sehat masih harus dilengkapi, khususnya terkait perizinan, standar sarana prasarana, standar operasional pelayanan, sistem pelaporan dan pengawasan oleh dinas kesehatan kabupaten/kota. Perlu dilakukan sosialisasi ketentuan standar fasilitas griya sehat kepada penyelenggara sesuai pedoman kementrian kesehatan, termasuk tentang kebutuhan pendidikan dan pelatihan bagi tenaga kesehatan tradisional. Kata kunci: pelayanan kesehatan, tradisional, griya sehat Abstract In recent years, traditional health services are growing forward. Griya Sehat is a complementary traditional health service facility. In Indonesia, there are many traditional health care facilities as griya sehat, but not all are in accordance with the requirements set by the Ministry of Health of the Republic of Indonesia. The purpose of this study was to describe the implementation of traditional health care facilities as griya sehat in Indonesia. The design of this study is cross-sectional. The sample of this study is a traditional health care facility that meets inclusion and exclusion criteria. The quantitative data was collected through interviews and observation of the infrastructure in 21 visited griya sehat. The results showed that according to ownership there were 7 government-owned and 14 private (individual)-owned. The license was 3 from the central government, 4 from the district government, 10 from the health office, and 4 did not have a license. There are several types of traditional health services provided in griya sehat, consisting of 16 herbs, 15 acupuncture, 15 acupressure/massage, 16 others such as spa, cupping, full-blooded, physiotherapy. The managers and the people in charge were 4 traditional health workers, and 17 were other health workers. The service approach consists of 14 promotive, 18 preventive, 21 curative, 16 rehabilitative, and 2 palliatives. The implementation of a complementary traditional health service facility must still be completed, particularly in relation to the license, infrastructure facilities, standard operating procedures, reporting systems, and supervision by district/city health office. It is necessary to socialize the provisions on the standard for griya sehat facilities to the providers in accordance with the ministry of health guidelines, including the need for education and training for traditional health workers. Keywords: health service, traditional, griya sehat


Author(s):  
Irwansyah Reza Mohamad

As a result of the violation of Human Rights ( HAM ) in the health care field can cause harm to people who are in desperate need of adequate provision of health services, so that the necessary law enforcement efforts against violators in health services for the community. It is intended to assure the protection of the public with regard to the violation of the right to obtain health care. In the health sector the perpetration of these violations of human rights can involve leaders of health care facilities or health workers who practice or work in health care facilities as opposed to health care legislation. This research aims to determine the result of the violation of human right in health care, so that the right to health is not achieved and law enforcement against infringement in terms of aspects of health care human rights. The specific objective is to determine the laws governing the right to obtain medical care and enforcement of violations in health care.Akibat terjadinya pelanggaran Hak Asasi Manusia (HAM) di bidang pelayanan kesehatan dapat menimbulkan kerugian bagi masyarakat yang sangat membutuhkan pemenuhan pelayanan kesehatan yang memadai, sehingga diperlukan upaya penegakan hukum terhadap pelaku pelanggaran dalam pelayanan kesehatan bagi masyarakat. Hal ini dimaksudkan untuk memberikan jaminan perlindungan bagi masyarakat berkaitan dengan pelanggaran atas hak untuk memperoleh kesehatan. Di bidang kesehatan terjadinya perbuatan pelanggaran hak-hak asasi manusia dapat melibatkan pimpinan fasilitas pelayanan kesehatan atau tenaga kesehatan yang melakukan praktik atau pekerjaan pada fasilitas pelayanan kesehatan yang bertentangan dengan undang-undang kesehatan. Penelitian bertujuan untuk menentukan akibat terjadinya pelanggaran hak asasi manusia dalam pelayanan kesehatan, sehingga pemenuhan hak atas kesehatan tidak tercapai dan penegakan hukum terhadap pelanggaran dalam pelayanan kesehatan ditinjau dari aspek hak asasi manusia dan tujuan khususnya yaitu untuk mengetahui peraturan perundang-undangan mengatur mengenai hak dalam memperoleh pelayanan kesehatan dan penegakan terhadap pelanggaran dalam pelayanan kesehatan.


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