scholarly journals Determinants of Pregnant Mothers to Bypass Primary Health Facilities and Directly Seek Health Care in Hospitals in Dar es Salaam Region-A Cross Sectional Study

Author(s):  
Hokororo JC ◽  
Eliakimu ES ◽  
Ngowi R ◽  
Mohammed MA ◽  
Malebo HM ◽  
...  
2021 ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  

Abstract BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.


2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Edosa Tesfaye Geta ◽  
Yibeltal Siraneh Belete ◽  
Elias Ali Yesuf

Patient self-referral is a condition when patients refer themselves to higher level health facilities without having to see anyone else first. Despite the expansion in the number of health facilities, it has been seen when patients routinely accessed referral hospitals without a formal referral. The study aims to evaluate cost of treatment among self-referred outpatients at referral hospitals compared to primary health care facilities. Comparative cross-sectional study design was used and the required sample size for the study was determined by using formula of double populations mean comparison cost of treatment for diseases leading to outpatient visits. A total of 794 participants (397 from referral hospital and 397 from primary health facilities) were included in the study. Data was collected using face-to-face interview from December 1 to 30, 2017. Data entry and analysis were made using SPSS version 20. Descriptive statistics and independent samples t-test were performed. A total of 783 outpatients responded to the interview of the study and 391 of them were from referral hospital and 392 from primary health facilities. The mean of outpatient visit cost per visit for the treatment of diseases leading to outpatient visits was significantly higher at referral hospitals compared to primary health facilities [95% CI=6.13 (5.07-7.18)] USD. The mean cost of outpatient visits for the treatment of all type of diseases leading to outpatient visits was significantly higher at referral hospitals and at least two times of primary level health facilities. Health care providers should create awareness in the community about referral linkages to inform patients and their families the additional costs they incur when they bypass the proximal primary health facilities.


2020 ◽  
Author(s):  
Pratik Khanal ◽  
Bishnu P Choulagai ◽  
Pawan Acharya ◽  
Sharad Onta

Abstract BackgroundWork motivation and job satisfaction are linked with the performance and retention of health workforce. Primary health facilities, mostly comprising mid-level health workers, serve the majority of the population in Nepal. The aim of the study was to assess the determinants of job satisfaction in relation to socio-demographics, job characteristics and work motivation status among health workers working in primary health facilities. MethodsA cross-sectional study was conducted in Jhapa district in Eastern Nepal covering 40 primary health facilities. The data collection involved 151 self-administered questionnaire interviews and 16 in-depth interviews with health workers. Mean differences in work motivation among those satisfied and unsatisfied with their job was examined using t tests. Logistic regression with 95% confidence interval at p<0.05 was used for identifying associated factors with job satisfaction. Thematic analysis was done to analyze qualitative data. ResultsAmong the study participants, 78.2% were either auxiliary health workers or auxiliary nurse midwives. The median employment period of health workers was 174 months. On the 5-point Likert scale, the mean score of work motivation was highest for team work (3.99) and lowest for financial motivation (2.21). Higher age of health workers and satisfaction with career development, and financial motivation were significantly associated with job satisfaction. The qualitative findings also revealed that the majority of the health workers were not satisfied with the existing career development opportunities, availability of resources in health facility, or financial motivation. ConclusionSatisfaction with career development and financial motivation significantly increased job satisfaction among health workers. Resource availability in health facility, recognition of work and management support affected work motivation and job satisfaction of health workers. A focus on improving work environment through increased financial motivation and career development opportunities as well as investing in primary health facilities with increased resource support is recommended to improve job satisfaction.


2015 ◽  
Vol 38 (5) ◽  
pp. 343-356
Author(s):  
Ana Maseda ◽  
José Carlos Millán-Calenti ◽  
Julia Carpente ◽  
José Luis Rodríguez-Villamil ◽  
Carmen de Labra

2021 ◽  
Author(s):  
Tesfaye Solomon ◽  
Dejene Lemessa

Abstract Background: Health care workers are susceptible to acquiring blood and body fluids borne infections due to their occupations involving contact with patients and their body fluids, although studies conducted in Ethiopia are scarce. Therefore, the aim of this study was to investigate the magnitude of exposure to blood and body fluids among health care workers in governmental health facilities in West Shewa Zone, Ethiopia.Materials and methods: A facility-based cross-sectional study was conducted from May 19 to June 25, 2018. A total of 381 health care workers were selected by simple random sampling from 31 sampled governmental health facilities using proportional to size allocation. Data were collected through self-administered questionnaires, entered into Epi-info version 7, and analyzed by SPSS version 21. Adjusted odds ratio (AOR) with 95% confidence intervals (CI) calculated for variables retained in the multivariable logistic regression and significance declared at p<0.05.Results: Of 377 health care workers who participated, the study found that 233 (61.2%) were exposed to blood and body fluids in their lifetime. Previous needle stick injury (AOR=0.30; 95%CI: 0.12-0.75), type of health facility (AOR=0.42; 95%CI: 0.26-0.68), handwashing practice (AOR=0.15; 95%CI: 0.07, 0.31), and perceiving at risk (AOR=0.16; 95%CI: 0.03, 0.98) were protective factors whereas long work experience (AOR=1.47; 95%CI: 1.13-1.93) was a risk factor for the exposure.Conclusions: Exposures to blood and body fluids during patient care were common among health care workers in the study area. Therefore, health care workers especially those newly hired and working in hospitals should pay due attention to their occupation's safety and regularly practice hand washing during critical times.


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