scholarly journals Citizen engagement in social health insurance purchasing, in selected counties in Kenya

2019 ◽  
Vol 6 (10) ◽  
pp. 4145
Author(s):  
Eunice M. Mwangi ◽  
Wanja M. Tenambergen ◽  
Job O. Mapesa ◽  
Isaac K. Mutai
Keyword(s):  
Social Health Insurance ◽  
Insurance Fund ◽  
Citizen Engagement ◽  
Benefit Package ◽  
Cross Sectional ◽  
Primary Care Health ◽  
Care Health ◽  
Engagement Factors ◽  
Purchasing Model

Background: National hospital insurance fund (NHIF) uses capitation as a strategic purchasing model to provide primary care health services (PCHS). This study sought information on citizen knowledge of PCHS benefit package, NHIF communication to citizens, determination of citizen views and values, NHIF accountability to citizens, citizen choice of PCHS provider and how these factors influence citizen access to NHIF, PCHS.Methods: This was a cross sectional research conducted between March 2017 to March 2018. 426 patients were sampled from Nyandarua and Nakuru Counties.Results: 366 (93%) patients knew the PCHS benefit package, 226 (57%) said NHIF communication to them was adequate, 280 (71%) said NHIF does not take into account their view and values, 272 (69%) said NHIF is not accountable to them, 269 (68%) knew how to select an outpatient facility, 111 (28%) said they did not receive NHIF, PCHS. Multivariate logistics regression analysis of citizen engagement factors and access to PCHS, indicate that NHIF communication to citizens (p<0.05, OR=2.358, 95% CI [1.399-3.975]), purchaser accountability (p<0.05, OR=2.073, 95% CI [1.017-4.226]) and provider choice (p<0.05, OR=2.990, 95% CI [1.817-4.920]) added significantly to the regression model.Conclusions: There is inadequate engagement of citizens in NHIF decision making which may hinder access to NHIF PCHS, therefore NHIF should establish citizens’ needs and preference through public forums, elicit citizens’ feedback, act on complains when raised, inform citizens on how the capitation system works and NHIF should visit health facilities regularly to establish if patients are accessing PCHS.

scholarly journals Cognitive Impairment in Rural Elderly Population in Ecuador

2017 ◽  
Vol 08 (S 01) ◽  
pp. S020-S022 ◽  
Author(s):  
Xavier Wong-Achi ◽  
Gabriela Egas ◽  
Dayana Cabrera
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Rural Communities ◽  
Female Gender ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Physiological Factors ◽  
Primary Care Health ◽  
Care Health ◽  
And Control

ABSTRACT Introduction: The Mini-Cog is a simple and short test that identifies cognitive impairment. Its detection helps provide an early dementia diagnosis, rapid access to treatments, and even delay or reversion. Materials and Methods: This multicenter, observational, descriptive, and cross-sectional study included 214 patients. Patients enrolled in this study were community dwellers aged ≥55-year-old, without prior diagnosis of cognitive impairment or dementia, with adequate hearing and vision functions. It was conducted in primary care health centers localized in rural communities of Ecuador. Results: Ages ranged from 50 to 98 years and there was predominance of female gender: 66% versus 33%. The percentage of illiteracy was 26.4% (CI: 25.32–27.48), and 63% (CI: 62.1–63.94) of patients had complete primary educational level. The overall prevalence of cognitive impairment was 50.9% (95% CI: 48.5–53.3) and 47.2% (95% CI: 45.2–49.2) in patients with risk factors. We found several established risk factors associated with cognitive impairment onset, including social factors, physiological factors, and comorbidities. Conclusion: This is the first epidemiological research of CI in rural populations in this country using the Mini-Cog as a screening tool. Adopting public health measures for the prevention and control of those modifiable risk factors could reduce the prevalence of cognitive impairment and even its progression to dementia.

scholarly journals Rastreamento de doença renal em pacientes com Diabetes Mellitus na atenção primaria de saúde [Kidney disease screening in patients with Diabetes Mellitus in primary health care] [Seguimiento de enfermedad renal en pacientes con Diabetes Mellitus en la atención primaria de salud]

2018 ◽  
Vol 26 ◽  
pp. e21495
Author(s):  
Edli Araújo Pinheiro Carvalho ◽  
Clarissa Cordeiro Alves Arrelias ◽  
Maria Lucia Zanetti ◽  
Carla Regina De Sousa Teixeira ◽  
Francineide Pereira da Silva Pena ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Kidney Disease ◽  
Cross Sectional Study ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Albumin Creatinine Ratio ◽  
Primary Care Health ◽  
Patients With Diabetes ◽  
Care Health

Objetivo: determinar a ocorrência de albuminúria aumentada em pacientes com Diabetes Mellitus tipo 2. Método: estudo quantitativo e transversal. A amostra de conveniência foi constituída por 46 pacientes, atendidos em um serviço de atenção primaria de saúde, no município de Macapá, Amapá, em 2012. A coleta de dados ocorreu no período de março a julho de 2012, utilizou-se formulário para registro das variáveis demográficas (sexo e idade) e clínicas (tratamento para o Diabetes Mellitus, hemoglobina glicada A1c, albuminúria de 24 horas e índice albumina-creatinina). Os dados foram analisados por meio de estatística descritiva. O projeto foi aprovado por Comitê de Ética em Pesquisa. Resultados: dos 46 participantes, 4,3% apresentaram albuminas aumentada no exame de urina de 24 horas e 19,6%, no índice albumina-creatinina. Conclusão:os resultados ratificam a importância do rastreamento anual de doença renal com vistas ao diagnóstico e tratamento precoce, no intuito de retardar a progressão da doença.ABSTRACTObjective: to determine the occurrence of elevated albumin in patients with type 2 Diabetes Mellitus. Method: this quantitative, cross-sectional study considered a convenience sample of 46 patients treated at a primary care health service in Macapá, Amapá, in 2012. Data were collected from March to July 2012, using a form to record demographic (sex and age) and clinical variables (treatment for DM, HbA1c, 24-hour albuminuria and albumin-creatinine ratio). Data were analyzed using descriptive statistics. The project was approved by the research ethics committee. Results: of the 46 patients with diabetes investigated, 4.3% had elevated albumin in 24-hour urinalysis and a 19,6% albumin-creatinine ratio. Conclusion: these results confirm the importance of annual screening for kidney disease with a view to early diagnosis and treatment in order to slow the progression of the disease.RESUMENObjetivo: determinar la presencia de albuminuria elevada en pacientes con Diabetes Mellitus tipo 2. Método: estudio cuantitativo y transversal. La muestra de conveniencia fue constituida por 46 pacientes, atendidos en un servicio de salud de atención primaria en la ciudad de Macapá, Amapá, en 2012. La recolección de datos tuvo lugar en el período de marzo a julio de 2012, se utilizó el formulario para el registro de las variables demográficas (sexo y edad) y clínicas (tratamiento para la Diabetes Mellitus, la Hemoglobina glicosilada A1c, la albuminuria de 24 horas y la relación albúmina-creatinina). Los datos se analizaron por medio de estadística descriptiva. El proyecto fue aprobado por Comité de Ética en Investigación. Resultados: de los 46 pacientes investigados, el 4,3% presentó aumento de albuminas en el análisis de orina de 24 horas y el 19,6% en la tasa albúmina-creatinina. Conclusión: los resultados confirman la importancia del seguimiento anual de la enfermedad renal con vistas al diagnóstico y el tratamiento precoz, con el fin de retardar la progresión de la enfermedad.

Occurrence and Impact of IPV in Men Attending Primary Care Health Clinics: A Cross Sectional Survey

2014 ◽  
Author(s):  
Marianne Hester ◽  
Emma Williamson ◽  
Sue K. Jones ◽  
Giulia Ferrari ◽  
Tim Peters ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Clinics ◽  
Primary Care Health ◽  
Care Health

scholarly journals Job strain and supervisor support in primary care health centres and glycaemic control among patients with type 2 diabetes: a cross-sectional study

BMJ Open ◽  
2013 ◽  
Vol 3 (5) ◽  
pp. e002297 ◽  
Author(s):  
Anne Koponen ◽  
Jussi Vahtera ◽  
Janne Pitkäniemi ◽  
Marianna Virtanen ◽  
Jaana Pentti ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Job Strain ◽  
Supervisor Support ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Care Health ◽  
Health Centres ◽  
Care Health

scholarly journals 2019 cardio-vascular risk and socioeconomic classification in central Portugal

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Luiz Miguel Santiago ◽  
Maria Castro
Keyword(s):  
Primary Care ◽  
Cardiovascular Risk ◽  
Cross Sectional ◽  
Primary Care Population ◽  
Primary Care Health ◽  
Central Portugal ◽  
Care Health ◽  
Cardio Vascular ◽  
The Relationship ◽  
Very High

Abstract Background The relationship between Cardiovascular Risk (CVR) and the socio-economic family classification (SEC) by the Graffar Index in the Portuguese General and Family Medicine setting is still unknown being an impoirtant Health determinant. SEC interferes with disease perception altering possible health out-comes. Use of specific tools can improve patient’s guidance. So the knowledge of the frequency of estimation of CVR and SEC to understand how they were distributed and related in the Primary Care population of Central Portugal, according to sex, age and place of residence was made using Primary Care generated data. Methods Cross-sectional observational study based on informatics data in anonymity of the population attending all the National Health Service Primary Care Health Units in Central Portugal in December 31, 2019, aged [40–65] years with descriptive and non-parametric analysis at P &lt; 0.05. Results In a Universe of 707 806 CVR was calculated for 27.9%, SEC for 2.5% and both simultaneously for 1.2%. CVR distribution was different by gender (P &lt; 0.001), High/very high risk more prevalent in males. By age group, High/Very high CVR was more prevalent in those over 60 years of age (P &lt; 0.001) and if residing in the southern and more in-land locations presenting a higher risk (P &lt; 0.001). High/very high CVR was more frequent in SEC lower classes (P = 0.047). Conclusions Cardiovascular risk and socioeconomic status were simultaneously registered in 1.2% of the population. Highest Cardiovascular Risk is more frequent in lower SEC classes, males, older and residing in the southern region. Docotr's awareness on these themes mst be increased.

scholarly journals Training needs for Ugandan primary care health workers in management of respiratory diseases: a cross sectional survey

2020 ◽  
Author(s):  
Rebecca Nantanda ◽  
Gerald Kayingo ◽  
Rupert Jones ◽  
Frederik van Gemert ◽  
Bruce Kirenga
Keyword(s):  
Primary Care ◽  
Respiratory Diseases ◽  
Health Workers ◽  
Cross Sectional ◽  
Respiratory Illnesses ◽  
Knowledge And Skills ◽  
Chronic Respiratory Diseases ◽  
Primary Care Health ◽  
Service Training ◽  
Care Health

Abstract Background Respiratory diseases are among the leading causes of morbidity and mortality in Uganda, but there is little attention and capacity for management of chronic respiratory diseases in the health programmes. This survey assessed gaps in knowledge and skills among healthcare workers in managing respiratory illnesses. Methods A cross sectional study was conducted among primary care health workers, specialist physicians and healthcare planners to assess gaps in knowledge and skills and, training needs in managing respiratory illnesses. The perspectives of patients with respiratory diseases were also sought. Data were collected using questionnaires, patient panel discussions and review of pre-service training curricula for clinicians and nurses. Survey Monkey was used to collect data and descriptive statistical analysis was undertaken for quantitative data, while thematic content analysis techniques were utilized to analyze qualitative data. Results A total of 104 respondents participated in the survey and of these, 76.9% (80/104) were primary care health workers, 16.3% (17/104) specialist clinicians and 6.7% (7/104) healthcare planners. Over 90% of the respondents indicated that more than half of the patients in their clinics presented with respiratory symptoms. More than half (52%) of the primary care health workers were not comfortable in managing chronic respiratory diseases like asthma and COPD. Only 4% of them were comfortable performing procedures like pulse oximetry, nebulization, and interpreting x-rays. Majority (75%) of the primary care health workers had received in-service training but only 4% of the sessions focused on respiratory diseases. The pre-service training curricula included a wide scope of respiratory diseases, but the actual training had not sufficiently prepared health workers to manage respiratory diseases. The patients were unsatisfied with the care in primary care and reported that they were often treated for the wrong illnesses. Conclusions Respiratory illnesses contribute significantly to the burden of diseases in primary care facilities in Uganda. Management of patients with respiratory diseases remains a challenge partially because of inadequate knowledge and skills of the primary care health workers. A training programme to improve the competences of health workers in respiratory medicine is highly recommended. Key words: respiratory diseases, primary care, health workers, knowledge, skills

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