scholarly journals Comprehensive primary health facilities are more efficient in delivering primary care: Efficiency analysis of primary healthcare facilities in Afghanistan

2019 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Relative Efficiency ◽  
Healthcare Services ◽  
Efficiency Score ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Average Efficiency ◽  
Primary Health

Abstract Background The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan.Method Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level.Results The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement.Conclusions Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.

scholarly journals Comprehensive primary health facilities are more efficient in delivering primary care: Efficiency analysis of primary healthcare facilities in Afghanistan

2020 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Relative Efficiency ◽  
Healthcare Services ◽  
Efficiency Score ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Average Efficiency ◽  
Primary Health

Abstract Background: The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan. Method: Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level. Results: The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement. Conclusions: Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.

scholarly journals Accessibility Analysis of Primary Healthcare Services in Mysore District Using Geospatial Techniques

2021 ◽  
pp. 62-69
Author(s):  
Dr. Minutha. V
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Health Centre ◽  
Healthcare Services ◽  
Service Area ◽  
Health Centers ◽  
Primary Health ◽  
Thiessen Polygon ◽  
The Impact

The accessibility of healthcare centers is one of the most important indicators for measuring the efficiency of a healthcare system. Accessibility is a complex indicator that reflects the number of health care institutions, their geographical distribution and the impact of different types of barriers social, Economic and culture (1). Primary health centre which acts as the first level of contact between the population and health centers. It acts has a cornerstone of rural health services. Primary healthcare is affordable, accessible and appropriate care for the particular needs of a given population especially in rural areas. The main objectives of the study are to study the spatial distribution pattern and delineation of service area of primary health centers; to identify the gap between the availability and accessibility of health services. The base map of study area has been geo-referenced and digitized using ARC GIS software. The Global positioning system (GPS) was adopted to take the coordinate of all the existing primary health centers in the study area. Simple Euclidean buffers are mapped and analyzed to define the service area, Thiessen polygon and Nearest Neighbour Technique was used here to identify the availability of health services in Mysore district. The results reveal that, the spatial variation in the distribution of PHC’s, which were not evenly distributed across the study area and there is scarcity in the availability of workforce among the study area.

scholarly journals Reduced health services at under-electrified primary healthcare facilities: Evidence from India

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252705
Author(s):  
Vivek Shastry ◽  
Varun Rai
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Fixed Effects ◽  
Negative Binomial ◽  
State Level ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Health Centers ◽  
Primary Health ◽  
Electricity Access

Primary healthcare systems worldwide suffer from major gaps in infrastructure and human resources. One key infrastructure gap is access to reliable electricity, absence of which can significantly affect the quantity and quality of healthcare services being delivered at rural primary health facilities. However, absence of granular empirical evidence is a barrier for quantitatively understanding the significance of electricity access as one of the determinants of access to reliable primary healthcare. Using data from India’s District Level Household and Facility Survey, we develop zero-inflated negative binomial models with co-variates and state-level fixed effects to estimate the relationship between levels of electricity access and the quantity of basic health services delivered at Primary Health Centers (PHCs). We find that lack of electricity access is associated with a significant and large decrease in the number of deliveries (64 percent), number of in-patients (39 percent), and number of out-patients (38 percent). We further find that lower level of electricity access at primary health centers is disproportionately associated with adverse effects on women’s access to safe and quality healthcare.

scholarly journals Integrative literature review: access to primary healthcare services

2018 ◽  
Vol 71 (3) ◽  
pp. 1178-1188 ◽  
Author(s):  
Maura Cristiane e Silva Figueira ◽  
Wellington Pereira da Silva ◽  
Eliete Maria Silva
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Health Plans ◽  
Access To Health Services ◽  
Primary Health ◽  
Study Selection ◽  
Access To Health ◽  
Access To Primary Care

ABSTRACT Objective: Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services. Method: An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles. Results: The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care. Conclusion: The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.

scholarly journals Decentralisation and urban primary health services: a case study of Delhi’s Mohalla Clinics

2020 ◽  
Author(s):  
Sejal Patel ◽  
Priyankita Pant
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Urban Poor ◽  
Current Form ◽  
Healthcare Facilities ◽  
Primary Health ◽  
National Capital ◽  
Primary Health Services ◽  
The Government ◽  
City State

The Indian political party Aam Aadmi, which assumed power in the city-state of Delhi in 2015, introduced Mohalla Clinics (i.e. neighbourhood clinics) to provide free primary health services for all, as a response to the rising inaccessibility of primary healthcare facilities for the urban poor. These clinics were to be governed through Mohalla Sabhas (i.e. neighbourhood committees), which are instruments of participatory governance within the neighbourhood. The research compares promises and practice for Mohalla Clinics, especially focusing on governance and the politics surrounding it. The authors find that in their current form Mohalla Clinics are limited to providing primary curative healthcare and have shown limited success, although Mohalla Clinic users do save time and expenditure on primary healthcare, and the clinics have led to a more comprehensive form of primary healthcare than in the past. However, Mohalla Clinics are governed in a top-down fashion by the Government of the National Capital Territory-Delhi, and not by urban local bodies or the envisaged neighbourhood committees. As a result, they face problems that may inhibit their functioning in the long term.

Model Spasial Regionisasi dan Rujukan Fasilitas Kesehatan

2018 ◽  
Vol 1 (1) ◽  
pp. 78-86
Author(s):  
Agel Vidian Krama ◽  
Nurul Qamilah
Keyword(s):  
Health Services ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Centers ◽  
Coverage Area ◽  
Spatial Studies ◽  
Descriptive Research ◽  
Care Facilities ◽  
Health Field ◽  
Research Type

Location Hospital and Health Center in Bandar Lampung and the District Pesawaran not currently mapped by conventional or digital. And there is no data base that provides information about the location and distribution of hospitals and health centers in Bandar Lampung City, and the uneven number of health facilities to ensure the availability of health services for all citizens, by optimizing existing health care facilities. Contributions utilization of spatial studies in the health field is used for mapping and modeling of health in order to facilitate access, provision of efficiency and planning of health services in order to take policy related to determining the location of health facilities. The research method uses spatial model approach with descriptive research type and analysis through the use of Huff Model. The results of the regionization shows the coverage area of hospital services serving 33 points in the District Pesawaran and 24 point Population in Bandar Lampung with the spread of regionization is divided into 3 regions. Keywords: Health Service, Regionalization

scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

scholarly journals An assessment of mental health programs at community health centers in north Minahasa, Indonesia

2021 ◽  
Vol 8 (12) ◽  
pp. 5707
Author(s):  
Jessica Gloria Mogi ◽  
Gustaaf A. E. Ratag
Keyword(s):  
Mental Health ◽  
Community Health ◽  
Community Health Centers ◽  
Supported Employment ◽  
Health Workers ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Family Approach ◽  
Mental Health Programs

Background: The Indonesian government recognizes the importance of mental health issues as indicated by the inclusion of such issues as indicators in the national program, the Healthy Indonesian Program with Family Approach (PIS-PK). This program is enforced in community health centers (puskesmas) in every regency in the country. However, the continually increasing number of mental disorder cases and the intense stigmatization of people with these disorders indicate the need to re-evaluate the capacity and delivery of designated centers’ mental health programs.Methods: This community survey involved interviewing the program directors of four community health centers in north Minahasa using the WHO-AIMS 2.2 questionnaire.Results: Very little effort has been made to improve mental health facilities and programs. Examples of aspects of health facilities that are lacking include training for health workers, the provision of psychotropic drugs, and supported employment or occupational rehabilitation.Conclusions: Community health centers are primary healthcare facilities for society. Therefore, mental health services should be implemented as one of their main programs.

scholarly journals A comparison of the levels of satisfaction with the medical services provided by primary healthcare centers in selected communes in Lubelskie Voivodeship

2016 ◽  
Vol 126 (1) ◽  
pp. 8-12
Author(s):  
Daria Przybylska ◽  
Piotr Przybylski ◽  
Bartłomiej Drop ◽  
Krzysztof Czarnocki ◽  
Wojciech Przybylski ◽  
...  
Keyword(s):  
Family Medicine ◽  
Primary Healthcare ◽  
The Elderly ◽  
Healthcare Services ◽  
Medical Services ◽  
Public Healthcare ◽  
Healthcare Facilities ◽  
Primary Type ◽  
Primary Healthcare Centers

Abstract Introduction. Family medicine remains the primary type of medical services in Poland and it is supposed to treat both individual patients and the society as a whole. Due to the growing commercialization of the health service, most primary healthcare centers have transformed into non-public healthcare facilities. The public ones (called SPZOZ in Polish) account only for a small fraction of the whole number of primary healthcare facilities. The quality of medical services provided by such facilities, as patients see it, remains one of the key elements determining the development of family medicine centers. Aim. The aim of this paper was to assess patient satisfaction levels regarding the healthcare services they received in two primary healthcare institutions, both of the NZOZ and SPZOZ type, in a small town located close to Lublin. Material and methods. An anonymous survey was filled out by 30 patients of both a public and non-public healthcare center located in Niemce (Niemce Commune, Lublin District). The quality of services was assessed using an original questionnaire in the form of a poll. Results. The results obtained indicate a clear relationship between one’s trust to the physician, diagnosis accuracy and visiting the particular center again, in order to continue the treatment. For older subjects, it was nurses’ kindness and politeness that was the most important. The elderly appreciated the kindness and politeness of the nurses in particular. No significant differences were found between the institutions in respect of the overall perception of satisfaction with services. In terms of infrastructure assessment, the majority of positive feedback was provided for NZOZ. Conclusions. The findings above suggest that it is essential to conduct surveys on a regular basis, in order to check patients’ assessment of the service quality in various institutons.

scholarly journals Nurses’ attitudes towards the implementation of the Mother-Baby Friendly Initiative in selected primary healthcare facilities at Makhuduthamaga Municipality, Limpopo province

Curationis ◽  
2019 ◽  
Vol 42 (1) ◽  
Author(s):  
Siyabulela E. Mgolozeli ◽  
Hilda N. Shilubane ◽  
Lunic B. Khoza
Keyword(s):  
Primary Healthcare ◽  
Positive Attitude ◽  
Negative Attitude ◽  
Healthcare Services ◽  
Primary Objective ◽  
Strategy Implementation ◽  
Limpopo Province ◽  
Healthcare Facilities ◽  
Positive Attitudes ◽  
The Ideal

Background: The implementation of the Mother-Baby Friendly Initiative (MBFI) strategy demonstrated its capabilities to improve global children’s health and maternal survival. However, its implementation in primary healthcare (PHC) facilities remains a challenge as many nurses are reluctant to adopt it for the improvement of child and maternal healthcare services in their respective clinics.Objectives: The primary objective of this study was to determine the attitudes of nurses towards the implementation of the MBFI in selected PHC facilities in the Makhuduthamaga Municipality, Limpopo province.Method: This study used a quantitative, descriptive design, and all respondents were conveniently sampled. A self-administered questionnaire was used to collect data. One-hundred and seventy-seven questionnaires were distributed, and 153 nurses responded and completed the questionnaire. The Statistical Package for Social Sciences version 23 was used to analyse data.Results: Results show that the majority of nurses (professional nurses [PNs] = 65, 78%; enrolled nurses [ENs] = 18, 72%; enrolled nursing auxiliaries [ENAs] = 23, 51%) had a positive attitude towards the MBFI strategy implementation as they agreed that it increased breastfeeding rates. Most PNs (n = 58, 70%) and ENs (n = 15, 60%) showed positive attitudes towards exclusive breastfeeding (EBF) as they agreed that it was the ideal feeding option for any child, and most ENAs (n = 38, 84%) showed a negative attitude as they disagreed that EBF was the ideal feeding option for any child.Conclusion: In this study, most PNs and ENs had a positive attitude in all the aspects that determined their attitudes towards MBFI strategy implementation. A concern is the fact that most ENAs showed negative attitudes in almost all the statements that were in line with the principles of MBFI, as they disagreed in most aspects. Therefore, this study recommends that on-going orientation and trainings should be offered to all nurses including ENAs to equip them with information that can assist in changing their attitudes towards MBFI implementation in PHC facilities.

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