scholarly journals A National Survey of Private-Sector Outpatient Care of Sick Infants and Young Children in Nepal

2019 ◽  
Author(s):  
Bharat Ban ◽  
Steve Hodgins ◽  
Pranita Thapa ◽  
Surakschha Thapa ◽  
Deepak Joshi ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Private Sector ◽  
Outpatient Care ◽  
Service Providers ◽  
Infants And Children ◽  
Sub Saharan Africa ◽  
Scope Of Practice ◽  
Urban Centers ◽  
Young Infants

Abstract Background: Previous research has documented that across South Asia, as well as in some countries in Sub-Saharan Africa, the private sector is the primary source of outpatient care for sick infants and children and, in many settings, informal providers play a bigger role than credentialed health professionals (particularly for the poorer segments of the population). This is the case in Nepal. This study sought to characterize medicine shop-based service providers in rural areas and small urban centers in Nepal, their role in the care and treatment of sick infants and children (with a particular focus on infants aged <2 months), and the quality of the care provided. A secondary objective was to characterize availability and quality of such care provided by physicians in these settings. Methods: A nationally representative sample of medicine shops was drawn, in rural settings and small urban centers in Nepal, from 25 of the 75 districts in Nepal, using multi-stage cluster methodology, with a final sample of 501 shops and 82 physician-run clinics. Face-to-face interviews were conducted. Results: Most medicine shops outside urban areas were not registered with the Department of Drug Administration (DDA). Most functioned as de facto clinics, with credentialed paramedical workers (having 2-3 years of training) diagnosing patients and making treatment decisions. Such a role falls outside their formally sanctioned scope of practice. Quality of care problems were identified among medicine shop-based providers and physicians, including over-use of antibiotics for treating diarrhea, inaccurate weighing technique to determine antibiotic dose, and inappropriate use of injectable steroids for treating potentially severe infections in young infants. Conclusions : Medicine shop-based practitioners in Nepal represent a particular type of informal provider; although most have recognized paramedical credentials, they offer services falling outside their formal scope of practice. Nevertheless, given the large proportion of the population served by these practitioners, engagement to strengthen quality of care by these providers and referral to the formal health sector is warranted.

scholarly journals A National Survey of Private-Sector Outpatient Care of Sick Infants and Young Children in Nepal

2020 ◽  
Author(s):  
Bharat Ban ◽  
Steve Hodgins ◽  
Pranita Thapa ◽  
Surakschha Thapa ◽  
Deepak Joshi ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Private Sector ◽  
Outpatient Care ◽  
Service Providers ◽  
Infants And Children ◽  
Sub Saharan Africa ◽  
Scope Of Practice ◽  
Urban Centers ◽  
Young Infants

Abstract Background: Previous research has documented that across South Asia, as well as in some countries in Sub-Saharan Africa, the private sector is the primary source of outpatient care for sick infants and children and, in many settings, informal providers play a bigger role than credentialed health professionals (particularly for the poorer segments of the population). This is the case in Nepal. This study sought to characterize medicine shop-based service providers in rural areas and small urban centers in Nepal, their role in the care and treatment of sick infants and children (with a particular focus on infants aged <2 months), and the quality of the care provided. A secondary objective was to characterize availability and quality of such care provided by physicians in these settings.Methods: A nationally representative sample of medicine shops was drawn, in rural settings and small urban centers in Nepal, from 25 of the 75 districts in Nepal, using multi-stage cluster methodology, with a final sample of 501 shops and 82 physician-run clinics. Face-to-face interviews were conducted.Results: Most medicine shops outside urban areas were not registered with the Department of Drug Administration (DDA). Most functioned as de facto clinics, with credentialed paramedical workers (having 2-3 years of training) diagnosing patients and making treatment decisions. Such a role falls outside their formally sanctioned scope of practice. Quality of care problems were identified among medicine shop-based providers and physicians, including over-use of antibiotics for treating diarrhea, inaccurate weighing technique to determine antibiotic dose, and inappropriate use of injectable steroids for treating potentially severe infections in young infants.Conclusions: Medicine shop-based practitioners in Nepal represent a particular type of informal provider; although most have recognized paramedical credentials, they offer services falling outside their formal scope of practice. Nevertheless, given the large proportion of the population served by these practitioners, engagement to strengthen quality of care by these providers and referral to the formal health sector is warranted.

scholarly journals Quality of care in the free maternal healthcare era in sub-Saharan Africa: a scoping review of providers’ and managers’ perceptions

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Monica Ansu-Mensah ◽  
Frederick Inkum Danquah ◽  
Vitalis Bawontuo ◽  
Peter Ansu-Mensah ◽  
Tahiru Mohammed ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Research Question ◽  
Healthcare Providers ◽  
Poor Quality ◽  
Sub Saharan Africa ◽  
Healthcare Financing ◽  
Maternal Healthcare ◽  
Sub Saharan ◽  
The Impact

Abstract Background Free maternal healthcare financing schemes play an essential role in the quality of services rendered to clients during antenatal care in sub-Saharan Africa (SSA). However, healthcare managers’ and providers’ perceptions of the healthcare financing scheme may influence the quality of care. This scoping review mapped evidence on managers’ and providers’ perspectives of free maternal healthcare and the quality of care in SSA. Methods We used Askey and O’Malley’s framework as a guide to conduct this review. To address the research question, we searched PubMed, CINAHL through EBSCOhost, ScienceDirect, Web of Science, and Google Scholar with no date limitation to May 2019 using keywords, Boolean terms, and Medical Subject Heading terms to retrieve relevant articles. Both abstract and full articles screening were conducted independently by two reviewers using the inclusion and exclusion criteria as a guide. All significant data were extracted, organized into themes, and a summary of the findings reported narratively. Results In all, 15 out of 390 articles met the inclusion criteria. These 15 studies were conducted in nine countries. That is, Ghana (4), Kenya (3), and Nigeria (2), Burkina Faso (1), Burundi (1), Niger (1), Sierra Leone (1), Tanzania (1), and Uganda (1). Of the 15 included studies, 14 reported poor quality of maternal healthcare from managers’ and providers’ perspectives. Factors contributing to the perception of poor maternal healthcare included: late reimbursement of funds, heavy workload of providers, lack of essential drugs and stock-out of medical supplies, lack of policy definition, out-of-pocket payment, and inequitable distribution of staff. Conclusion This study established evidence of existing literature on the quality of care based on healthcare providers’ and managers’ perspectives though very limited. This study indicates healthcare providers and managers perceive the quality of maternal healthcare under the free financing policy as poor. Nonetheless, the free maternal care policy is very much needed towards achieving universal health, and all efforts to sustain and improve the quality of care under it must be encouraged. Therefore, more research is needed to better understand the impact of their perceived poor quality of care on maternal health outcomes.

scholarly journals Tuberculosis practices among private medical practitioners in Kaski district, Nepal

2013 ◽  
Vol 1 (2) ◽  
pp. 68-75
Author(s):  
AK Nepal ◽  
A Shrestha ◽  
SC Baral ◽  
R Bhattarai ◽  
Y Aryal
Keyword(s):  
Quality Of Care ◽  
Private Sector ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public And Private ◽  
Medical Practitioners ◽  
Sputum Microscopy ◽  
Public And Private Sector

INTRODUCTION: Although the evidences suggest that more than one third tuberculosis (TB) cases are being managed in private sector, the quality of care in private sector is major concern. However, the information regarding the private practices were lacking. Therefore the study was conducted to gain insights on current practices of TB management at private sectors. MATERIALS AND METHODS: A descriptive cross sectional study, applying quantitative method, was conducted at two cities of Kaski among all private practitioners, private pharmacies and private laboratories through self administered questionnaire and structured interview schedule. RESULTS: Nearly one fourth of the TB suspects in the district were found to have consulted private providers with about 20.0% of the total smear positive cases diagnosed in private laboratories. Beside sputum microscopy, Private Medical Practitioners (PMPs) were also found to prefer other tests like X-ray, culture for TB diagnosis. Similarly, PMPs’ varying prescription of anti TB drugs beyond National TB Programme (NTP) recommendation along with their weak recording and case holding were noteworthy, and the cost of TB treatment seemed higher in private sector. Only one third of private institution had their staff trained in TB. Except some informal linkage, no collaboration between public and private sector was noted. CONCLUSIONS: Private sector was managing many TB cases in the district. However, their practice of TB management was not much satisfactory. Therefore NTP should take effective measures for Public Private Mix and to make them aware of the standards through training and orientation in order to improve the quality of care. DOI: http://dx.doi.org/10.3126/ijim.v1i2.7085 Int J Infect Microbiol 2012;1(1):68-75

scholarly journals Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

BMJ Open ◽  
2016 ◽  
Vol 6 (3) ◽  
pp. e010632 ◽  
Author(s):  
Anthony K Mbonye ◽  
Esther Buregyeya ◽  
Elizeus Rutebemberwa ◽  
Siân E Clarke ◽  
Sham Lal ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Of Care ◽  
Private Sector ◽  
Improve Quality ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Drug Shops

scholarly journals Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian’s model

2019 ◽  
Author(s):  
Charles Ssemugabo ◽  
Sarah Nalinya MPH ◽  
Abdullah Ali Halage ◽  
Ruth Mubeezi Neebye ◽  
David Musoke ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Sub Saharan Africa ◽  
Major Public Health Problem ◽  
Pesticide Poisoning ◽  
Process And Outcome ◽  
Sub Saharan

Abstract Background Pesticide poisoning is a major public health problem in many Low-and-Middle Income Countries (LMICs). Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Majority of the pesticide related deaths can be averted if poisoning patients are managed well. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. Therefore, this study was aimed at exploring doctors’ experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda. Methods Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent ensuring quality care. Results Presence of hospital units such as medical wards including Intensive Care Unit (ICU), pediatrics and internal medicine; availability of equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors’ knowledge and experiences improved the quality of care given to pesticide poisoning patients. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients. Conclusion Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance to improving management of pesticide poisoning cases in hospitals in Kampala, Uganda.

scholarly journals Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian’s model

2020 ◽  
Author(s):  
Charles Ssemugabo ◽  
Sarah Nalinya MPH ◽  
Abdullah Ali Halage ◽  
Ruth Mubeezi Neebye ◽  
David Musoke ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Of Care ◽  
Outcome Measures ◽  
Health Workers ◽  
Sub Saharan Africa ◽  
Pesticide Poisoning ◽  
Process And Outcome ◽  
Sub Saharan

Abstract Background Pesticides are responsible for a significant percentage of deaths globally with majority occurring in sub-Saharan Africa. Deaths due to pesticide poisoning can be reduced if poisoning cases are managed optimally. However, the quality of care given to pesticide poisoning patients is still insufficient especially in sub-Saharan Africa. This study was aimed at exploring doctors’ experiences on quality of care for pesticide poisoning cases in hospitals in Kampala, Uganda.Methods Fifteen (15) in-depth interviews were conducted with doctors who were directly involved in management of pesticide poisoning patients in the accident and emergency, Medicine, Pediatrics and Intensive Care Unit wards in 5 hospitals in Kampala, Uganda. All interviews were transcribed and subjected to directed content analysis with the guidance of the Donabedian model of quality of care which emphasizes structure, process and outcome measures as pertinent ensuring quality care.Results Doctors reported structural, process and outcome facets that support diagnosis and treatment of pesticide poisoning cases improved the quality of care provided by doctors. Among the structures includes hospital units such as Intensive Care Unit (ICU), pediatrics and internal medicine; equipment and clinical guidelines such as airway, breathing and consciousness (ABC) protocol; and doctors’ knowledge and experiences. Doctors relied on history, and signs and symptoms to establish the cause and severity of pesticide poisoning. However, some patients and caretakers provided inaccurate pesticide poisoning history. Due to its availability in hospitals, doctors largely relied on atropine to manage pesticide poisoning cases whether or not relevant to treat the actual pesticide poisoning. Although majority of the cases treated recovered, those due to suicide were further referred to the hospital psychiatrist. Sharing experiences of managing pesticide poisoning patients among health workers and engaging in sensitization outreaches against pesticide poisoning were reported as potential activities to improve quality of care for pesticide poisoning patients.Conclusion Doctors reflected on the structure, process and outcome measures of quality of care given to pesticide poisoning patients. The implications of hospital structures and clinical process to the quality of the outcomes of care demonstrates their importance to improve management of pesticide poisoning cases in hospitals in Kampala, Uganda.

scholarly journals Then Effects of rural-urban migration on economic status of rural residents

2020 ◽  
Vol 9 (6) ◽  
pp. 154-160
Author(s):  
Thiengtham Keopasith ◽  
Shen Neng
Keyword(s):  
Quality Of Life ◽  
Private Sector ◽  
Rural Areas ◽  
Economic Status ◽  
Urban Migration ◽  
Urban Centers ◽  
Rural Residents ◽  
Rural Farmers ◽  
Rural Urban Migration

The study examined the effects of rural-urban migration on the economic status of rural residents. The study utilized a mixed-methods research approach to collect and analyze data, first, data were collected through a questionnaire from households whose family members migrated to urban centers, and interviews were held with various heads of villages in the study area. The study reveals that the majority of the migrants were able-bodied youth who migrated to urban centers to seek employment and education. Migrants’ families at places of origin benefited from migration of their own relations to urban centers mainly through remittances which enabled them to improve their livelihood as the remittances were spent on daily consumption and investment into business activities. The study recommends that government should formulate policies that would create employment for citizens in rural areas, and encourage the private sector to build industries in rural areas to prevent rural-urban migration. Government and the private sector should also empower rural farmers through the promotion of markets for farm produce in order to improve the income of rural farmers, reduce poverty, improve the quality of life and well-being, increase their happiness, satisfaction, and minimize rural-urban migration. The study findings are limited to developing countries where rural-urban migration is a challenge due to the generally low quality of life in rural areas. Further research on the effects of rural-urban migration on the economic status of rural residents should involve a quantitative analysis of the impact of remittances by migrants on poverty reduction in rural areas.

scholarly journals UPAYA RESTORAN DALAM MENCIPTAKAN KEPUASAN PELANGGAN: Studi Pengendalian Mutu Restoran Dave Kitchen di Yogyakarta

2018 ◽  
Author(s):  
Daisy Christiana Santoso
Keyword(s):  
Quality Of Care ◽  
Service Provider ◽  
Service Providers ◽  
Tourism Industry ◽  
Quality Of Services ◽  
The World ◽  
Food And Beverage ◽  
Independent States ◽  
Unit Analysis

ABSTRACRestaurant or caffee is part of tourism industry that played a role as service providers food and beverage for people who were far from home. The customer’s need of value service pushing the service provider of food and beverage to get involved in the competition and won them all. Any activities of the restaurant must be focused on management efforts to provide the performances of service that exceed expectations of customers. These efforts can be done through the development of the quality of care with consists of reability, responsibility, assurance, empathy, and tangibles. Based on the above description, then done reseacrh on the strategy the development of the quality of services to the satisfaction of customers. Unit analysis of this research are the guests who has ever been and making purchases at Dave Kichen. Methods used in this study is the method of observation, interview and documentation. The analysis of data used is the analysis of qualitative to see the influence of a variable is independent of variable dependent. The analysis is shown by those independent states (in the world service) to variable dependent (reward customers). These other factors that arent pursuing.

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