Experiences of households using municipal ward-based primary health care outreach teams in Kwa-Zulu Natal, South Africa: a cross-sectional survey

2019 ◽  
Author(s):  
Landiwe Khuzwayo ◽  
Mosa Moshabela
Keyword(s):  
Health Care ◽  
Sub Saharan Africa ◽  
Service Improvement ◽  
Health Care Teams ◽  
Community Based ◽  
Cross Sectional ◽  
Skill Sets ◽  
Team Members ◽  
Outreach Team ◽  
Wide Range

Abstract BACKGROUND: Globally, the success of community-based health care teams varies between programmes, and their designs tend to be unique based on local needs and context. Whilst the body of knowledge on community-based health care teams is growing in sub-Saharan Africa, there is still a lack of evaluation studies designed from the perspective of service users. OBJECTIVE: To assess household experiences of health care services delivered by outreach teams, and identify potential areas for service improvement by further examining sub-optimal household experiences.METHODS: We used a cross-sectional household survey in three municipality wards with functional ward-based outreach teams in the iLembe District, out of 74 wards, carried out from October to December 2016. Systematic random sampling was used, and 383 households were surveyed. The mean point of 70% in the strongly agreed category was used to classify household experiences as either optimal (70% and above) or sub-optimal (below 70%). Further univariate and multivariate analyses were conducted for sub-optimal experiences. RESULTS: Nearly all households (99.2%) reported being visited most frequently by community health workers, relative to other outreach team members. Optimal experiences reported by households included services being free-of-charge (91.3%), convenient operating hours (77.9%), and outreach team members treating people with respect and courtesy (72.4 %). Sub-optimal experiences were identified as; outreach teams bringing with them sufficient equipment and medication (46.5%), associated with perceived skill level of team member (aOR 0.28, p: 0.001); teams perceived as being professional in carrying out their duties (56.3%), associated with age (aOR 3.22, p: 0.022) and marital status (aOR 1.80, p: 0.027); and teams providing a satisfactory service to respondents (61.8%), associated with quality of information provided (aOR 0.10, p: 0.002). CONCLUSION: Household experiences are influenced by team composition, and limited to skill sets of CHWs frequently visiting households. Whilst policy-related aspects of the outreach team programme were considered optimal, there was a gap in the service-related experience, which should not only be improved by upskilling CHWs, but also ensuring the full implementation of the heterogenous outreach team to enable different household members to come into contact with a wide range of skill sets and broader service package.

scholarly journals Minimum acceptable diet among children aged 6–23 months in South Kivu, Democratic Republic of Congo: a community-based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Richard Mbusa Kambale ◽  
Gaylord Amani Ngaboyeka ◽  
Joe Bwija Kasengi ◽  
Sarah Niyitegeka ◽  
Boss Rutakaza Cinkenye ◽  
...  
Keyword(s):  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Feeding Practices ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Republic Of Congo ◽  
Wide Range ◽  
South Kivu

Abstract Background Suboptimal child nutrition remains the main factor underlying child undernutrition in Democratic Republic of Congo (DRC). This study aimed to assess the prevalence of minimum acceptable diet and associated factors among children aged 6–23 months old. Methods Community-based cross-sectional study including 742 mothers with children aged 6–23 months old was conducted in 2 Health Zones of South Kivu, Eastern DRC. WHO indicators of Infant and Young Child Feeding (IYCF) regarding complementary feeding practices were used. Logistic regression analysis was used to quantify the association between sociodemographic indicators and adequate minimum acceptable diet for both univariate and multivariate analysis. Results Overall, 33% of infants had minimum acceptable diet. After controlling for a wide range of covariates, residence urban area (AOR 2.39; 95% CI 1.43, 3.85), attendance postnatal care (AOR 1.68; 95% CI 1.12, 2.97), education status of mother (AOR 1.83; 95% CI 1.20, 2.77) and household socioeconomic status (AOR 1.72; 95% CI 1.14, 2.59) were factors positively associated with minimum acceptable diet. Conclusion Actions targeting these factors are expected to improve infant feeding practices in South Kivu.

Assessing the Preparedness of Healthcare Facilities for Disasters and Emergencies in Damghan, Iran

2021 ◽  
pp. 1-7
Author(s):  
Behrad Pourmohammadi ◽  
Ahad Heydari ◽  
Farin Fatemi ◽  
Ali Modarresi
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Mitigation Measures ◽  
Health Staff ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Wide Range ◽  
Care Facilities ◽  
The Impact

Abstract Objectives: Iran is exposed to a wide range of natural and man-made hazards. Health-care facilities can play a significant role in providing life-saving measures in the minutes and hours immediately following the impact or exposure. The aim of this study was to determine the preparedness of health-care facilities in disasters and emergencies. Methods: This cross-sectional study was conducted in Damghan, Semnan Province, in 2019. The samples consisted of all the 11 health-care facilities located in Damghan County. A developed checklist was used to collect the data, including 272 questions in 4 sections: understanding threatening hazards, functional, structural, and nonstructural vulnerability of health-care facilities. The data were analyzed using SPSS 21. Results: The results revealed that the health-care facilities were exposed to 22 different natural and man-made hazards throughout the county. The total level of preparedness of the health-care centers under assessment was 45.8%. The average functional, structural, and nonstructural vulnerability was assessed at 49.3%, 31.6%, and 56.4%, respectively. Conclusions: Conducting mitigation measures is necessary for promoting the functional and structural preparedness. Disaster educational programs and exercises are recommended among the health staff in health-care facilities.

Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014–2016

2021 ◽  
pp. 1-10
Author(s):  
Shijun Xia ◽  
Chi Wang ◽  
Xin Du ◽  
Lizhu Guo ◽  
Jing Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Lipid Lowering ◽  
Community Based ◽  
Cross Sectional ◽  
History Of ◽  
Cvd Prevention

<b><i>Background:</i></b> Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. <b><i>Methods:</i></b> In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. <b><i>Results:</i></b> There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44–0.66) or all 3 medications (aOR 0.27, 95% CI 0.20–0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66–0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27–0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. <b><i>Conclusion:</i></b> Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.

scholarly journals Scaling-up health insurance through community- based health insurance schemes in rural sub- Saharan African communities

2013 ◽  
Vol 3 (1) ◽  
pp. 14 ◽  
Author(s):  
Ufuoma John Ejughemre
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Rural Communities ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Seek Health Care ◽  
Community Based Health Insurance ◽  
The Poor ◽  
Sub Saharan

Context: The knotty and monumental problem of health inequality and the high burden of diseases in sub-Saharan Africa bothers on the poor state of health of many of its citizens particularly in rural communities. These issues are further exacerbated by the harrowing conditions of health care delivery and the poor financing of health services in many of these communities. Against these backdrops, health policy makers in the region are not just concerned with improving peoples’ health but with protecting them against the financial costs of illness. What is important is the need to support more robust strategies for healthcare financing in these communities in sub-Saharan Africa. Objective: This review assesses the evidence of the extent to which community-based health insurance (CBHI) is a more viable option for health care financing amongst other health insurance schemes in rural communities in sub-Saharan Africa. Patterns of health insurance in sub-Saharan Africa: Theoretically, the basis for health insurance is that it allows for risk pooling and therefore ensures that resources follow sick individuals to seek health care when needed. As it were, there are different models such as social, private and CBHI schemes which could come to bear in different settings in the region. However, not all insurance schemes will come to bear in rural settings in the region. Community based health insurance: CBHI is now recognized as a community-initiative that is community friendly and has a wide reach in the informal sector especially if well designed. Experience from Rwanda, parts of Nigeria and other settings in the region indicate high acceptability but the challenge is that these schemes are still very new in the region. Recommendations and conclusion: Governments and international development partners in the region should collect- ively develop CBHI as it will help in strengthening health systems and efforts geared towards achieving the millennium development goals. This is because it is inextricably linked to the health care needs of the poor. 

scholarly journals Noncommunicable Lung Disease in Sub-Saharan Africa. A Community-based Cross-Sectional Study of Adults in Urban Malawi

2016 ◽  
Vol 194 (1) ◽  
pp. 67-76 ◽  
Author(s):  
Jamilah Meghji ◽  
Gilbert Nadeau ◽  
Kourtney J. Davis ◽  
Duolao Wang ◽  
Moffat J. Nyirenda ◽  
...  
Keyword(s):  
Lung Disease ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Sub Saharan

Primary health care teams: team members' perceptions of the collaborative process

2004 ◽  
Vol 18 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Sherry L Dieleman ◽  
Karen B Farris ◽  
David Feeny ◽  
Jeffrey A Johnson ◽  
Ross T Tsuyuki ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Teams ◽  
Collaborative Process ◽  
Team Members ◽  
Primary Health

scholarly journals Epidemiology, ecology and human perceptions of snakebites in a savanna community of northern Ghana

2019 ◽  
Author(s):  
Yahaya Musah ◽  
Evans P. K. Ameade ◽  
Daniel Korley Attuquayefio ◽  
Lars Haubye Holbech
Keyword(s):  
Public Health ◽  
West Africa ◽  
Activity Patterns ◽  
Sub Saharan Africa ◽  
World Health ◽  
Northern Ghana ◽  
General Situation ◽  
Community Based ◽  
Cross Sectional ◽  
Health Crisis

Background Worldwide, snakebite envenomations total ~2.7 million reported cases annually with ~100,000 fatalities. Since 2009, snakebite envenomation has been classified as a very important ‘neglected tropical disease’ by the World Health Organisation. Despite this emerging awareness, limited efforts have been geared towards addressing the serious public health implications of snakebites, particularly in sub-Saharan Africa, where baseline epidemiological data remain incomplete. Due to poverty as well as limited infrastructure and public health facilities, people in rural Africa, including Ghana, often have no other choice than to seek treatment from traditional medical practitioners (TMP). The African ‘snakebite crisis’ is highlighted here using extensive complementary data from a community-based epidemiological study conducted by snake ecologists in the savanna zone of northern Ghana. Methodology and findings Our cross-sectional study included 1,000 residents and 24 TMPs in the Savelugu-Nanton District in northern Ghana between December 2008 and May 2009, and a 10-year (1999-2008) retrospective snakebite data from the district hospital. Variables tested included demography, human activity patterns, seasonality, snake ecology and clinical reports. Complementary data showed higher snakebite prevalence during the rainy season, and a hump-shaped correlation between rainfall intensity and snakebite incidences. Almost 6% of respondents had experienced a personal snakebite, whereas ~60% of respondents had witnessed a total of 799 snakebite cases. Out of a total of 857 reported snakebite cases, 24 (~2.8%) died. Highest snakebite prevalence was recorded for males in the age group 15-44 years during farming activities, with most bites occurring in the leg/foot region. Highest snakebite rate was within farmlands, most frequently caused by the Carpet viper (Echis ocellatus). Conclusion The relatively high community-based prevalence rate of ~6%, and fatality rate of ~3%, indicate that snakebites represent an important public health risk in northern Ghana. Based on the high number of respondents and long recording period, we believe these data truly reflect the general situation in rural Ghana and West Africa at large. We recommend increased efforts from both local and international health authorities to address the current snakebite health crisis generally compromising livelihoods and productivity of rural farming communities in West Africa.

scholarly journals A community based cross sectional study on morbidities and social problems among geriatric population

2019 ◽  
Vol 6 (8) ◽  
pp. 3554
Author(s):  
Sangeetha Jairaj ◽  
Ramesh Palabindela ◽  
Sridhar D.
Keyword(s):  
Health Care ◽  
Elder Abuse ◽  
Urban Slum ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Sectional Study ◽  
Community Based ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Psychological Assistance

Background: In India, in the last one and half decades longevity of the people has increased due to decline in mortality rate, better medical and health care facilities and improvements in overall quality of life of people. Presently India has the second largest geriatric population in the globe. In 2001, geriatric population was 77 million in India and it is estimated that in India total number of elderly will rise to 150 million by 2025 and by the year 2050 the number would rise to about 324 million.4  Methods: A community based cross sectional study was conducted in an urban slum located in Secunderabad. Almost 225 subjects more than 60 years were included in study after giving oral consent. People with severe morbidity and unable to give consent were excluded from study.Results: Majority (70%) of the resident experienced verbal abuse followed by physical abuse (13%) at least one time. About 11% felt they were being neglected by their family members. Daughter-in-law was the major person involved in the elder abuse accounting for 45.9%, followed by son 24.3%. Abuse from relatives accounted for 21.6%. Spouse and daughter were involved in elder abuse in about 5.4% and 2.7% cases respectively.Conclusions: As recently said by Financial Minister in Parliament of India, old age population growing drastically in India, especially in south India. Increasing geriatric population leading to increase in need of health care and psychological assistance.

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