scholarly journals Determinants of pregnant mothers to bypass primary health facilities and directly seek postnatal care in hospitals in Dar es Salaam region – A Community health needs assessment, Cross Sectional Study

2019 ◽  
Author(s):  
Joseph Christopher Hokororo ◽  
Eliudi S. Eliakimu ◽  
Ruth Ngowi ◽  
Mohammed A. Mohammed ◽  
Hamisi M. Malebo ◽  
...  

Abstract Introduction Dar es Salaam is the region with a large number of Primary healthcare facilities (dispensaries and health centres) outnumber the available hospitals. Although policies on referral system are available, there is a gap in terms of compliance and adherence to the governance system. Hospitals are overwhelmed with patients as compared to primary healthcare facilities, leading to poor quality of the healthcare services. The aim was to assess the needs of community members for primary healthcare services, as well as, to identify the reasons and determinants that influence mothers to bypass primary healthcare facilities.Methodology A cross-sectional study that assessed the determinants associated with pregnant mothers to bypass primary healthcare facilities in their healthcare needs. The study was conducted in Kinondoni, Ilala, Kigamboni, Temeke and Ubungo healthcare facilities in Dar es Salaam region. It targeted all postnatal women. A consecutive sampling procedure was used and a total of 544 of respondents were involved in the study. A structured questionnaire was used to collect information on: social demographic; Clinical factors of the mother; Health services; and provider’s factors that might contribute to the observed bypass. Data were analysed in levels of univariate, bivariate and multivariate using SPSS statistical package number 20.Results A total of 544 respondents were interviewed. Mothers who bypassed the primary healthcare facilities were 94%. After adjustment it was found that, those with income more than 1USD a day were (OR=4.27, CI=1.8- 15.4, P=0.01) more likely to bypass the primary facilities and go straight to the upper levels of healthcare facilities.Conclusions This study has found postnatal women in Dar es Salaam region are at high chance of going straight to the secondary and tertiary Hospitals without passing at primary healthcare facilities. Nine in every ten postnatal women were found to have by passed the primary healthcare facilities. Findings from this study reveals a strong and urgent need to strengthen primary healthcare facilities and as well implement the referral guidelines on all clients who seek health care to reduce the bypass.

Author(s):  
Ju Young Kim ◽  
Dae In Kim ◽  
Hwa Yeon Park ◽  
Yuliya Pak ◽  
Phap Ngoc Hoang Tran ◽  
...  

The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and the associated factors among people living in rural Vietnam. This cross-sectional study was conducted with 233 participants in a rural area. The methods included face-to-face interviews using a structured questionnaire, and anthropometric and blood pressure measurements. We considered participants to have unmet health needs if they had any kind of health problem during the past 12 months for which they were unable to see a healthcare provider. Multivariate logistic regression analysis was performed to determine the factors associated with unmet healthcare needs. Of the participants, 18% (n = 43) had unmet healthcare needs, for reasons like transportation (30%), a lack of available doctors or medicine (47%), and communication issues with healthcare providers (16%). The multivariate logistic regression showed that living in a rural area, having stage 2 hypertension, and having insurance were associated with unmet healthcare needs. To better meet the healthcare needs in rural or suburban areas of Vietnam, allocation of adequate healthcare resources should be distributed in rural areas and insurance coverage for personalized healthcare needs might be required. Efforts should focus on availability of medicine, improvement of transportation systems, and communication skills of healthcare providers to improve access to healthcare services.


2020 ◽  
Author(s):  
Arezoo Yari ◽  
Yadolah Zarezadeh ◽  
Farin Fatemi ◽  
Ali Ardalan ◽  
Siamak Vahedi ◽  
...  

Abstract Primary Healthcare facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of these facilities is essential. In this cross-sectional study, using the safety evaluation checklist of primary healthcare centers provided by the Ministry of Health and Medical Education, 805 health centers in Kurdistan Province were evaluated in terms of functional, structural, and non-structural safety. The levels of total, functional, structural, and non-structural safety were equal to 28.7, 23.8, 20.2, and 42.3 out of 100 respectively. Regarding the functional preparedness, the highest score was related to rapid response team, while the lowest score was belonged to financial affairs. Nevertheless, in structural and non-structural areas, the scores of different items were almost similar to one another. Both Iran and Kurdistan Province are disaster-prone areas. This study concluded that the safety score of primary healthcare facilities in total was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery is essential during disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard


2020 ◽  
Author(s):  
Arezoo Yari ◽  
Yadolah Zarezadeh ◽  
Farin Fatemi ◽  
Ali Ardalan ◽  
Siamak Vahedi ◽  
...  

Abstract Background: Primary healthcare facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of these facilities is essential. Methods: In this cross-sectional study, using the safety evaluation checklist of primary healthcare centers provided by the Ministry of Health and Medical Education, 805 health centers in Kurdistan Province were evaluated in terms of functional, structural, and non-structural safety. Results: The levels of total, functional, structural, and non-structural safety were equal to 28.7, 23.8, 20.2, and 42.3 out of 100 respectively. Regarding the functional preparedness, the highest score was related to rapid response team, while the lowest score was belonged to financial affairs. Nevertheless, in structural and non-structural areas, the scores of different items were almost similar to one another. Both Iran and Kurdistan Province are disaster-prone areas. Conclusions: This study concluded that the safety score of primary healthcare facilities in total was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery is essential during disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard


BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020611
Author(s):  
Frank-Leonel Tianyi ◽  
Joel Noutakdie Tochie ◽  
Valirie Ndip Agbor ◽  
Benjamin Momo Kadia

IntroductionHIV testing is an invaluable entry point to prevention, care and treatment services for people living with HIV and AIDS. Poor adherence to recommended protocols and guidelines reduces the performance of rapid diagnostic tests, leading to misdiagnosis and poor estimation of HIV seroprevalence. This study seeks to evaluate the adherence of primary healthcare facilities in Cameroon to recommended HIV counselling and testing (HCT) procedures and the impact this may have on the reliability of HIV test results.Methods and analysisThis will be an analytical cross-sectional study involving primary healthcare facilities from all the 10 regions of Cameroon, selected by a multistaged random sampling of primary care facilities in each region. The study will last for 9 months. A structured questionnaire will be used to collect general information concerning the health facility, laboratory and other departments involved in the HCT process. The investigators will directly observe at least 10 HIV testing processes in each facility and fill out the checklist accordingly.Ethics and disseminationClearance has been obtained from the National Ethical Committee to carry out the study. Informed consent will be sought from the patients to observe the HIV testing process. The final study will be published in a peer-reviewed journal and the findings presented to health policy-makers and the general public.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arezoo Yari ◽  
Yadolah Zarezadeh ◽  
Farin Fatemi ◽  
Ali Ardalan ◽  
Siamak Vahedi ◽  
...  

Abstract Background Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential. Methods In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01–66.0) and high (> 66.0). Results The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar. Conclusions The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.


2020 ◽  
Author(s):  
Ju Young Kim ◽  
Ju Young Kim ◽  
Dae In Kim ◽  
Hwa Yeon Park ◽  
Yuliya Pak ◽  
...  

Abstract Background: Although health status in Vietnam has been much improved, people living in rural areas have faced several challenges, including a rapid increase of the aging population, inadequate capacity of health system, and problems of inequities in access to the healthcare system. The purpose of this study was to examine the current utilization of healthcare services, exploring unmet healthcare needs and their associated factors among adults living in rural Vietnam.Methods: This cross sectional study was conducted with 233 participants in a rural area of Binh Phuoc province and a suburban area of Da Lat city in Vietnam from October–December 2017. The methods included face-to-face interviews using a structured questionnaire as well as anthropometric and blood pressure measurements. We considered participants to have unmet health needs if they had any kind of health problem during the past 12 months for which they were unable to see a healthcare provider in the same period. Multivariate logistic regression analysis was performed to determine the factors associated with unmet healthcare needs.Results: Of the participants, 18% (n=43) had unmet healthcare needs. The common causes of unmet healthcare were transportation (30%), a lack of available doctors or medicines (47%), and communication issues with healthcare providers (16%). The multivariate logistic regression showed that having stage 2 high blood pressure and reporting no place to go for medical problems were associated with unmet healthcare needs.Conclusions: Healthcare services are still needed in disadvantaged group living in rural or suburban area of Vietnam. Efforts should focus on availability of medicines, improvement of transportation system as well as communication skills of healthcare providers to improve access to healthcare services.


2021 ◽  
Vol 10 (10) ◽  
pp. 3688
Author(s):  
PrashantKumar Bajpai ◽  
Divyata Sachan ◽  
Deepak Kumar ◽  
Abhinav Gangwar ◽  
PankajKumar Jain ◽  
...  

2021 ◽  
Author(s):  
Arezoo Yari ◽  
Yadolah Zarezadeh ◽  
Farin Fatemi ◽  
Ali Ardalan ◽  
Siamak Vahedi ◽  
...  

Abstract Background: Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential.Methods: In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01-66.0) and high (>66.0). Results: The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar. Conclusions: The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.


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