scholarly journals Assessment of infrastructure of first referral unit facilities in Surguja division: a responsibility of providing emergency obstetric care

2019 ◽  
Vol 6 (12) ◽  
pp. 5168
Author(s):  
Abha Ekka ◽  
Shubra A. Gupta ◽  
Divya Sahu ◽  
Anmol Madhur Minj ◽  
G. P. Soni
Keyword(s):  
Healthcare Delivery ◽  
Essential Medicine ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Civil Infrastructure ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Physical Infrastructure ◽  
Maternal And Newborn

Background: Availability of emergency obstetric care (EmOC) is one of interventions to reduce maternal and newborn deaths. The health system fails when effective and affordable health interventions do not reach the population, when Poor infrastructure, drugs and equipment are lacking, and qualified human resources are scarce. The objective of the present study was to assess the availability of EmOC infrastructure in first referral units (FRUs) of Surguja division, Chhattisgarh.Methods: A cross sectional study was designated with 13 FRUs of Surguja division. A semi structured, closed-ended questionnaires was observed on the basis of check list, reviewing record, and interview by available staff.Results: FRUs of Surguja division for physical infrastructure scored 68.5%, for essential medicine 69.2%, for equipments 50.7%, for instruments 45.3% and for availability of blood 34.6%, for health man power category of specialist score was 25.7% but for supportive staff 65.4%.Conclusions: Our study revealed three existing bottlenecks in the healthcare delivery system as inadequate civil infrastructure, short fall of specialists as well as inadequate supplies of drugs and equipment, hampering the function of facility.

scholarly journals Evaluation of Drug Use Patterns of Out Patient Attendees in a Tertiary Care Teaching Hospital in Dermatology and Venereology Department as a Tool to Promote Rational Prescribing

2014 ◽  
Vol 4 (1) ◽  
pp. 4-9
Author(s):  
Nushrat Noor ◽  
Md Jamal Uddin ◽  
Mohammad Afsan ◽  
Hafiza Akhter ◽  
Farhana Kabir
Keyword(s):  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
Healthcare Delivery ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Carbon Paper ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Prescribing Indicators

Background: Drug utilization studies are pre requisite for the formulation of drug policies. They offer useful methods for teaching and training in drug therapy and also identify the problems that arise from drug usage in healthcare delivery system and highlight the current approaches to the rational use of medicines. Objectives: The main objective of the prescription audit or evaluation was to measures for improving the prescription practices and to generate information on the core prescribing indicators proposed by the World Health Organization (WHO). Methods: This was a descriptive type of cross sectional study. The study was conducted in the Out Patient Department (OPD) of Dermatology & Venereology in a tertiary care private hospital, Dhaka, Bangladesh in between January and March’2012. A total of 300 prescriptions were obtained with the help of a pre-inserted carbon paper in a special format using WHO core prescribing indicators. Results: The average number of drugs per encounter was 3.8 and no single drug was prescribed by generic name. Use of antibiotic (56% of encounters) was frequent, but injection use (2.67% of encounters) was within the recommendation of WHO. The use of fixed drug combinations (FDCs) was 15.28% of prescribed drugs. Only 22.08% drugs were prescribed from national essential medicine list. Conclusion: The findings from the current study showed a trend towards inappropriate prescribing. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21158 Update Dent. Coll. j: 2014; 4 (1): 04-09

scholarly journals Morbidity profile and prescription audits using WHO core prescribing indicator in government hospitals of Province 1, Nepal

2021 ◽  
Vol 3 (2) ◽  
pp. 15-22
Author(s):  
Shambhu Shah ◽  
Prasanna Dahal ◽  
Anil Kumar Sah ◽  
Surya B. Parajuli ◽  
Naveen Shrestha
Keyword(s):  
Metabolic Diseases ◽  
Healthcare Delivery ◽  
Circulatory System ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Essential Medicine List ◽  
Tertiary Hospitals

Background: Periodic assessment of morbidity and drug use at various levels of healthcare delivery system is important to recognize common prevalent morbidities and rationalize the use of medicines. The study was conducted to determine the common morbidities and audit prescription using WHO prescribing indicator in government operated tertiary hospitals of eastern Nepal. Methods: A cross-sectional study was carried out in government tertiary hospitals of Province 1, Nepal, from March 2019 to August 2019. For analysis, descriptive statistics were used.  Prescribing characteristics were evaluated using recommended guidelines of the World Health Organization (WHO) prescribing indicators. Results: Six hundred prescriptions were analyzed. The most prevalent morbidity was endocrine, nutrition & metabolic diseases (21.5%) followed by diseases of the respiratory system (19.8%), circulatory system (17.6%), and digestive system (12.8%). The most frequently encountered individual disease entity were hypertension (18.7%), diabetes (15.5%), acid peptic disorders (14%). A total of 2072 drugs were prescribed with an average of 3.45 (± 1.39) drugs per consultation. About 30.2% of prescriptions encountered contain at least one antibiotics, whereas injectable were prescribed in 1.8%. Only 3.9% of total medicines were prescribed in generic name and 31.7% of drug prescribed were from essential medicine list. Conclusion: Among the prescriptions evaluated, diseases of the endocrine, respiratory, cardiovascular, and gastrointestinal systems were the most common morbidities. Polypharmacy was prevalent to some extent whereas prescribing in generic and essential medicine list was poor relative to standard WHO recommendations. However, the overall prescribing of antibiotics and injection were found to be satisfactory.

scholarly journals Estimating the met need for emergency obstetric care (EmOC) services in three payams of Torit County, South Sudan: a facility-based, retrospective cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018739 ◽  
Author(s):  
Pontius Bayo ◽  
Imose Itua ◽  
Suzie Paul Francis ◽  
Kofi Boateng ◽  
Elijo Omoro Tahir ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Postpartum Haemorrhage ◽  
South Sudan ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Obstetric Complications ◽  
Secondary Outcome ◽  
Sectional Study ◽  
Cross Sectional

ObjectiveTo determine the met need for emergency obstetric care (EmOC) services in three Payams of Torit County, South Sudan in 2015 and to determine the frequency of each major obstetric complication.DesignThis was a retrospective cross-sectional study.SettingFour primary healthcare centres (PHCCs) and one state hospital in three payams (administrative areas that form a county) in Torit County, South Sudan.ParticipantsAll admissions in the obstetrics and gynaecology wards (a total of 2466 patient admission files) in 2015 in all the facilities designated to conduct deliveries in the study area were reviewed to identify obstetric complications.Primary and secondary outcome measuresThe primary outcome was met need for EmOC, which was defined as the proportion of all women with direct major obstetric complications in 2015 treated in health facilities providing EmOC services. The frequency of each complication and the interventions for treatment were the secondary outcomes.ResultsTwo hundred and fifty four major obstetric complications were admitted in 2015 out of 390 expected from 2602 pregnancies, representing 65.13% met need. The met need was highest (88%) for Nyong Payam, an urban area, compared with the other two rural payams, and 98.8% of the complications were treated from the hospital, while no complications were treated from three PHCCs. The most common obstetric complications were abortions (45.7%), prolonged obstructed labour (23.2%) and haemorrhage (16.5%). Evacuation of the uterus for retained products (42.5%), caesarean sections (32.7%) and administration of oxytocin for treatment of postpartum haemorrhage (13.3%) were the most common interventions.ConclusionThe met need for EmOC in Torit County is low, with 35% of women with major obstetric complications not accessing care, and there is disparity with Nyong Payam having a higher met need. We suggest more support supervision to the PHCCs to increase access for the rural population.

scholarly journals Measuring equity in utilization of emergency obstetric care at Wolisso Hospital in Oromiya, Ethiopia: a cross sectional study

2013 ◽  
Vol 12 (1) ◽  
pp. 27 ◽  
Author(s):  
Calistus Wilunda ◽  
Giovanni Putoto ◽  
Fabio Manenti ◽  
Maria Castiglioni ◽  
Gaetano Azzimonti ◽  
...  
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

Difficulties leaving home: A cross-sectional study of delays in seeking emergency obstetric care in Herat, Afghanistan

2011 ◽  
Vol 73 (7) ◽  
pp. 1003-1013 ◽  
Author(s):  
Atsumi Hirose ◽  
Matthias Borchert ◽  
Homa Niksear ◽  
Ahmad Shah Alkozai ◽  
Jonathan Cox ◽  
...  
Keyword(s):  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Leaving Home

scholarly journals What the percentage of births in facilities does not measure: readiness for emergency obstetric care and referral in Senegal

2020 ◽  
Vol 5 (3) ◽  
pp. e001915
Author(s):  
Francesca L Cavallaro ◽  
Lenka Benova ◽  
El Hadji Dioukhane ◽  
Kerry Wong ◽  
Paula Sheppard ◽  
...  
Keyword(s):  
Rural Areas ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Cross Sectional ◽  
Public Facilities ◽  
Facility Births

IntroductionIncreases in facility deliveries in sub-Saharan Africa have not yielded expected declines in maternal mortality, raising concerns about the quality of care provided in facilities. The readiness of facilities at different health system levels to provide both emergency obstetric and newborn care (EmONC) as well as referral is unknown. We describe this combined readiness by facility level and region in Senegal.MethodsFor this cross-sectional study, we used data from nine Demographic and Health Surveys between 1992 and 2017 in Senegal to describe trends in location of births over time. We used data from the 2017 Service Provision Assessment to describe EmONC and emergency referral readiness across facility levels in the public system, where 94% of facility births occur. A national global positioning system facility census was used to map access from lower-level facilities to the nearest facility performing caesareans.ResultsBirths in facilities increased from 47% in 1992 to 80% in 2016, driven by births in lower-level health posts, where half of facility births now occur. Caesarean rates in rural areas more than doubled but only to 3.7%, indicating minor improvements in EmONC access. Only 9% of health posts had full readiness for basic EmONC, and 62% had adequate referral readiness (vehicle on-site or telephone and vehicle access elsewhere). Although public facilities accounted for three-quarters of all births in 2016, only 16% of such births occurred in facilities able to provide adequate combined readiness for EmONC and referral.ConclusionsOur findings imply that many lower-level public facilities—the most common place of birth in Senegal—are unable to treat or refer women with obstetric complications, especially in rural areas. In light of rising lower-level facility births in Senegal and elsewhere, improvements in EmONC and referral readiness are urgently needed to accelerate reductions in maternal and perinatal mortality.

scholarly journals Patient Choice and Willingness Toward Gatekeepers as First-Contact Medical Institutions in Chinese Tiered Healthcare Delivery System: A Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Xia Li ◽  
Liang Zhang ◽  
Zhong Li ◽  
Wenxi Tang
Keyword(s):  
Delivery System ◽  
Family Income ◽  
Healthcare Delivery ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Patient Choice ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Primary Care Institutions ◽  
First Contact

Introduction: Gatekeeping mechanism of primary care institutions (PCIs) is essential in promoting tiered healthcare delivery system in China. However, patients seeking for higher-level institutions instead of gatekeepers as their first contact has persisted in the past decade. This study aims to explain patients' choice and willingness and to provide potential solutions.Methods: A survey was conducted among residents who had received medical care within the previous 14 days. Patients' choice and willingness of PCIs for first contact together with influencing factors were analyzed using binary logistic regression.Results: Of 728 sampled patients in Hubei, 55.22% chose PCIs for first contact. Patients who are older, less educated, with lower family income, not living near non-PCIs, with better self-perceived health status, only buying medicines, and living in rural instead of urban area had significantly higher probability of choosing PCIs. As of willingness, over 90% of the patients inclined to have the same choice for their first contact under similar health conditions. Service capability was the primary reason limiting patients' choice of PCIs.Conclusions: The gatekeeper system did not achieve its goal which was 70% of PCIs among all kinds of institutions for first contact. Future measures should aim to improve gate-keepers' capability.

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