scholarly journals Availability And Readiness of Healthcare Facilities And Their Effects On Long-Acting Modern Contraception Use In Bangladesh: Analysis of Linked Data

2021 ◽  
Author(s):  
Md Nuruzzaman Khan ◽  
M Mofizul Islam ◽  
Shahinoor Akter
Keyword(s):  
Health Facility ◽  
Linked Data ◽  
Average Distance ◽  
Health Facilities ◽  
Outcome Variable ◽  
Mixed Effect ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Contraception Use ◽  
Long Acting

Abstract Aim: Evidence on the availability and accessibility of health facilities and their impacts on long-acting modern contraceptives (LAMC) use in low- and middle-Income countries are scarce. This study examined the influence of the availability and readiness of health facilities in determining the use of LAMC in Bangladesh.Methods: We linked data of the Bangladesh Demographic and Health Survey and the Health Facility Survey using the administrative-boundary linkage method. Mixed effect multilevel logistic regression was conducted. The sample comprised 10,938 married women of 15-49 years of age, who were fertile but did not desire a child within two years of the date of survey. The outcome variable was the current use of LAMC (yes, no) and the explanatory variables were health facility-, individual-, household- and community-level factors.Results: Nearly 34% of participants used LAMC with significant variations across areas in Bangladesh. The average distance between the nearest LAMC-providing health facilities and women’s homes was 6.36 km, higher in the Sylhet division (8.34 km) and lower in the Dhaka division (4.34 km). Increased scores for the management (adjusted odds ratio (AOR) 1.59; 95% CI, 1.21-2.42) and infrastructure (AOR, 1.44; 95% CI, 1.01-1.69) of health facilities were positively associated with the overall uptake of LAMC. AORs for women to report using LMAC were 2.16 (95% CI, 1.18-3.21) and 1.74 (95% CI, 1.15-3.20), respectively, for per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities. Nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometer increase in the average regional-level distance between women’s homes and the nearest health facilities.Conclusion: The availability of health facilities close to residence and their improved management, infrastructure, and readiness to provide LAMC play a significant role in increasing LAMC uptake among women. Policies and programs should prioritize increasing the availability and accessibility of health facilities that provide LAMC services.

scholarly journals Availability and readiness of healthcare facilities and their effects on long-acting modern contraception use in Bangladesh: Analysis of linked data

2021 ◽  
Author(s):  
Md Nuruzzaman Khan ◽  
M Mofi Islam ◽  
Shahinoor Akter
Keyword(s):  
Health Facility ◽  
Linked Data ◽  
Average Distance ◽  
Health Facilities ◽  
Outcome Variable ◽  
Mixed Effect ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Contraception Use ◽  
Long Acting

Aim Evidence on the availability and accessibility of health facilities and their impacts on long-acting modern contraceptives (LAMC) use in low- and middle-Income countries are scarce. This study examined the influence of the availability and readiness of health facilities in determining the use of LAMC in Bangladesh. Methods We linked data of the Bangladesh Demographic and Health Survey and the Health Facility Survey using the administrative-boundary linkage method. Mixed effect multilevel logistic regression was conducted. The sample comprised 10,938 married women of 15-49 years of age, who were fertile but did not desire a child within two years of the date of survey. The outcome variable was the current use of LAMC (yes, no) and the explanatory variables were health facility-, individual-, household- and community-level factors. Results Nearly 34% of participants used LAMC with significant variations across areas in Bangladesh. The average distance between the nearest LAMC-providing health facilities and womens homes was 6.36 km, higher in the Sylhet division (8.34 km) and lower in the Dhaka division (4.34 km). Increased scores for the management (adjusted odds ratio (AOR) 1.59; 95% CI, 1.21-2.42) and infrastructure (AOR, 1.44; 95% CI, 1.01-1.69) of health facilities were positively associated with the overall uptake of LAMC. AORs for women to report using LMAC were 2.16 (95% CI, 1.18-3.21) and 1.74 (95% CI, 1.15-3.20), respectively, for per unit increase in the availability and readiness scores to provide LAMC at the nearest health facilities. Nearly 27% decline in the likelihood of LAMC uptake was observed for every kilometer increase in the average regional-level distance between womens homes and the nearest health facilities. Conclusion The availability of health facilities close to residence and their improved management, infrastructure, and readiness to provide LAMC play a significant role in increasing LAMC uptake among women. Policies and programs should prioritize increasing the availability and accessibility of health facilities that provide LAMC services.

scholarly journals Travel time to health facilities as a marker of geographical accessibility across heterogeneous land coverage in Peru

2019 ◽  
Author(s):  
Gabriel Carrasco-Escobar ◽  
Edgar Manrique ◽  
Kelly Tello-Lizarraga ◽  
J. Jaime Miranda
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Urban Areas ◽  
Health Facilities ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Rural And Urban Areas ◽  
Rural And Urban ◽  
Tertiary Healthcare ◽  
Geographical Accessibility

ABSTRACTThe geographical accessibility to health facilities is conditioned by the topography and environmental conditions overlapped with different transport facilities between rural and urban areas. To better estimate the travel time to the most proximate health facility infrastructure and determine the differences across heterogeneous land coverage types, this study explored the use of a novel cloud-based geospatial modeling approach and use as a case study the unique geographical and ecological diversity in the Peruvian territory. Geospatial data of 145,134 cities and villages and 8,067 health facilities in Peru were gathered with land coverage types, roads infrastructure, navigable river networks, and digital elevation data to produce high-resolution (30 m) estimates of travel time to the most proximate health facility across the country. This study estimated important variations in travel time between urban and rural settings across the 16 major land coverage types in Peru, that in turn, overlaps with socio-economic profiles of the villages. The median travel time to primary, secondary, and tertiary healthcare facilities was 1.9, 2.3, and 2.2 folds higher in rural than urban settings, respectively. Also, higher travel time values were observed in areas with a high proportion of the population with unsatisfied basic needs. In so doing, this study provides a new methodology to estimate travel time to health facilities as a tool to enhance the understanding and characterization of the profiles of accessibility to health facilities in low- and middle-income countries (LMIC), calling for a service delivery redesign to maximize high quality of care.

scholarly journals Determinants of Immunization Completeness among Children Aged 12-23 Months in South-West Nigeria

2021 ◽  
pp. 82-92
Author(s):  
Abayomi Olarinmoye ◽  
Olanrewaju Davies Eniade ◽  
Blessing O Enyinnaya ◽  
Yusuff Akinkunmi Olasunkanmi ◽  
Blessing Chizorom Nwaneri ◽  
...  
Keyword(s):  
Health Facility ◽  
Immunization Coverage ◽  
Outcome Variable ◽  
Residential Areas ◽  
Strict Adherence ◽  
Healthcare Facilities ◽  
Health Card ◽  
Explanatory Variables ◽  
Factors Influencing ◽  
South West

Introduction: Vaccine preventable disease remained issue of major concern to the global health system. Low coverage of immunization necessitated the need to explore the determinants of immunization uptake. Factors influencing immunization coverage in South-West Nigeria were investigated in this study. Methods: Data from the Nigeria demographic and health survey (NDHS) was used for this study. Our focus was on children between 12 to 23 months whose parents were residents of South-West Nigeria. A total of 655 records were used for the analysis of this study. The outcome variable (child’s immunization status) was categorized as “non-or- under immunized and fully immunized”. Considered explanatory variables were children and parents’ characteristics. Data were analyzed using Statistical package for social sciences (SPSS) version 25. Descriptive statistics were presented and generalized linear model was used to explore the determinants of immunization completeness. Results: Of the 665 children whose mean age was 16.7 ± 3.4 SD months, 62.3% were non-or-under immunized, while only 79.8% were birthed in the health facility. Majority of them (65.1%) were not presented for postnatal check within two months of birth while 51% do not have health card. About 79% of the mothers said distance to the health facility was not a problem. In this study, postnatal check within 2 months of birth, type of residence and ownership of health card were identified factors influencing the uptake of immunization. For instance, Those who said distance is a problem were 3 times less likely to fully immunize their children (AOR=0.28, p=0.000, 95% CI: 0.16-0.47). Obviously, ownership of health card (AOR=15.34, p=0.000, 95% CI: 9.86-23.88) and postnatal check within 2 months of birth (AOR=1.78, 95% CI: 0.37-0.86) were associated with the likelihood of complete immunization. Conclusion: Immunization uptake was very low in South-West Nigeria. Factors that were positively associated with completeness of immunization include observance of postnatal check and ownership of healthcare card while problem of distance to health facility was negatively associated. Increasing vaccination coverage/ completeness would ameliorate, if policy geared towards the improvement of postnatal check-ups, distribution of healthcare facilities within residential areas and strict adherence to the use of health care are considered in the South-West Nigeria.

scholarly journals Impact of Traffic Congestion on Spatial Access to Healthcare Services in Nairobi: an ecological study

2021 ◽  
Author(s):  
Mutono Nyamai ◽  
Jim A. Wright ◽  
Mumbua Mutunga ◽  
Henry Mutembei ◽  
SM Thumbi
Keyword(s):  
Health Facility ◽  
Traffic Congestion ◽  
One Health ◽  
Healthcare Professionals ◽  
Access To Healthcare ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Healthcare Facilities ◽  
African Cities ◽  
Geographical Access

Abstract Background Geographic accessibility is an important determinant of healthcare utilisation and is critical for achievement of universal health coverage. Despite the high disease burden and severe traffic congestion in many African cities, few studies have assessed how traffic congestion impacts geographical access to healthcare facilities and to health professionals in these settings. Methods Using data on health facilities obtained from the Ministry of Health in Kenya, we mapped 944 primary, 94 secondary and four tertiary healthcare facilities in Nairobi County. We then used traffic probe data to identify areas within a 15-, 30- and 45-minute drive from each health facility during peak and off-peak hours and calculated the proportion of the population with access to healthcare in the County. We employed a 2-step floating catchment area model to calculate the ratio of healthcare and healthcare professionals to population during these times. Results During peak hours, <70% of Nairobi’s 4.1 million population was within a 30-minute drive from a health facility. This increased to >75% during off-peak hours. In 45 minutes, the majority of the population had an accessibility index of one health facility accessible to more than 100 people (<0.01) for primary health care facilities while secondary and tertiary health facilities had a ratio of one health facility for more than 10,000 people (<0.0001) and at least two health facilities per 100,000 people (>0.00002) respectively. Of people with access to health facilities, a sub-optimal ratio of <2.3 healthcare professionals per 1000 people was observed in facilities offering primary and secondary healthcare during peak and off-peak hours. Conclusion These findings can guide urban planners and policymakers in improving access to healthcare facilities to optimise coverage during peak and off-peak traffic times. Similarly, growing availability of traffic probe data in African cities should enable similar analysis in other countries.

scholarly journals Satisfaction with Delivery Services Offered under the Free Maternal Healthcare Policy in Kenyan Public Health Facilities

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
C. M. Gitobu ◽  
P. B. Gichangi ◽  
W. O. Mwanda
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Healthcare Services ◽  
Healthcare Policy ◽  
Health Facilities ◽  
Maternal Healthcare ◽  
Healthcare Facilities ◽  
Public Health Facilities ◽  
Delivery Services ◽  
Consultation Time

Background. Patients’ satisfaction is an individual's positive assessment regarding a distinct dimension of healthcare and the perception about the quality of services offered in that health facility. Patients who are not satisfied with healthcare services in a certain health facility will bypass the facility and are unlikely to seek treatment in that facility. Objective. To determine satisfaction level of mothers with the free maternal services in selected Kenyan public health facilities after the implementation of the free maternal healthcare policy. Methods. Data was collected through a quantitative exit survey questionnaire. The respondents were mothers who had delivered in the health facilities and were waiting to leave the health facilities after discharge. The sample included 2,216 mothers in 77 public health facilities across 14 counties in Kenya under tier 3 and tier 4 categories. The number of respondents to be interviewed was proportionately arrived at based on each health facility’s bed capacity. Results. The study established a satisfaction rate of 54.5% among the beneficiaries of the free maternal healthcare services in the country. Mothers benefiting from the free delivery services were satisfied with communication by the healthcare workers, staff availability in the delivery rooms, availability of staff in the wards, and drug and supplies availability (>56%) but unsatisfied with consultation time, cleanliness, and privacy in the wards (<56%). High education levels and lengthy stay in healthcare facilities were negatively associated with the satisfaction with the free delivery services (P<0.05). Conclusion. There is a high satisfaction with the free maternal healthcare services in Kenya. However, the implementation of the free maternal healthcare policy was associated with low privacy, poor hygiene, and low consultation time in the health facilities. Therefore there is need to address these service gaps so as to attract more mothers to deliver in public health facilities.

scholarly journals The Governance of Pandemics in Primary Health Care: The Governance Strategies Adopted by Health Facility Governing Committees in Times of COVID Pandemic in Tanzania

2022 ◽  
Author(s):  
Anosisye Mwandulusya Kesale ◽  
Christopher Mahonge ◽  
Mikidadi Muhanga
Keyword(s):  
Health Facility ◽  
Sampling Technique ◽  
Health Facilities ◽  
Middle Income ◽  
Middle Income Countries ◽  
Primary Health ◽  
Governance Strategies ◽  
Governance Institutions ◽  
The Times ◽  
Financial Allocation

The governance of COVID 19 in Lower and Middle-Income Countries (LMICs) is very critical for curbing its effects. However, it is unknown what governance strategies are adopted by Health Facility Governing Committees (HFGCs) s as a response to the pandemic. We employed an exploratory qualitative design to study the governance strategies adopted by HFGCs during the COVID19. Since COVID 19 is new, an inductive approach was used as it involves analyzing collected data with little or no predetermined theory for the study. A purposive sampling technique was employed in which multistage clustered sampling was used to select regions, councils, health facilities and respondents. In-depth interviews with HFGCs chairpersons and Focus Group Discussions with members of HFGCs were used to collect data. The data were analyzed based on the themes which emerged during data collection. We found five governance strategies that were found to be commonly adopted by many HFGCs which are financial allocation, re-planing, mobilization of resources, community sensitization and mobilization of stakeholders. however, these governance structures were not all adopted by all HFGCs. The HFGCs slowly adopted governance strategies in the times of COVID 19 pandemics because were unprepared. Despite being empowered by the Direct Health Facility Financing, still, the newest of the COVID 19 has been a challenge to many HFGCs. This calls for urgent capacity building for governance institutions on how to deal will pandemics in primary health facilities.

scholarly journals Access to public transportation and health facilities offering long-acting reversible contraceptives among residents of formal and informal settlements in two cities in Kenya

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Veronica Escamilla ◽  
Lisa Calhoun ◽  
Norbert Odero ◽  
Ilene S. Speizer
Keyword(s):  
Health Facility ◽  
Informal Settlement ◽  
Household Wealth ◽  
Google Earth ◽  
Exit Interview ◽  
Health Facilities ◽  
Interview Data ◽  
Walking Distance ◽  
Straight Line ◽  
Long Acting

Abstract Background Despite improved health facility access relative to rural areas, distance and transportation remain barriers in some urban areas. Using household and facility data linked to residential and transportation geographic information we describe availability of health facilities offering long-acting reversible contraceptive (LARC) methods and measure access via matatus (privately owned mid-size vehicles providing public transport) in urban Kenya. Methods Study data were collected by the Measurement, Learning and Evaluation (MLE) Project. Location information for clusters (2010) representative of city-level population were used to identify formal and informal settlement residents. We measured straight-line distances between clusters and facilities that participated in facility audits (2014) and offered LARCs. In Kisumu, we created a geographic database of matatu routes using Google Earth. In Nairobi, matatu route data were publicly available via the Digital Matatus Project. We measured straight-line distance between clusters and matatu stops on ‘direct’ routes (matatu routes with stop(s) ≤1 km from health facility offering LARCs). Facility and matatu access were compared by settlement status using descriptive statistics. We then used client exit interview data from a subset of facilities in Nairobi (N = 56) and Kisumu (N = 37) Kenya (2014) to examine the frequency of matatu use for facility visits. Results There were 141 (Informal = 71; Formal = 70) study clusters in Nairoibi and 73 (Informal = 37; Formal = 36) in Kisumu. On average, residential clusters in both cities were located ≤1 km from a facility offering LARCs and ≤ 1 km from approximately three or more matatu stops on direct routes regardless of settlement status. Client exit interview data in Nairobi (N = 1602) and Kisumu (N = 1158) suggest that about 25% of women use matatus to visit health facilities. On average, women who utilized matatus travelled 30 min to the facility, with 5% travelling more than 1 hour. Matatu use increased with greater household wealth. Conclusions Overall, formal and informal settlement clusters were within walking distance of a facility offering LARCs, and multiple matatu stops were accessible to get to further away facilities. This level of access will be beneficial as efforts to increase LARC use expand, but the role of wealth and transportation costs on access should be considered, especially among urban poor.

scholarly journals A syndromic approach to assess diagnosis and management of patients presenting with respiratory symptoms to health facilities in Vietnam

2020 ◽  
pp. 00572-2020
Author(s):  
Wan-Chun Huang ◽  
Gregory J Fox ◽  
Ngoc Yen Pham ◽  
Thu Anh Nguyen ◽  
Van Giap Vu ◽  
...  
Keyword(s):  
Respiratory Symptoms ◽  
Inhaled Corticosteroids ◽  
Improve Patient Care ◽  
Health Facilities ◽  
Airflow Limitation ◽  
Upper Respiratory Tract ◽  
Healthcare Facilities ◽  
Clinical Diagnoses ◽  
Using Data ◽  
Long Acting

BackgroundThe aim of the study was to establish syndromic diagnoses in patients presenting with respiratory symptoms to healthcare facilities in Vietnam and to compare the diagnoses with the facility-level clinical diagnoses and treatment decisions.MethodsA representative sample of patients, aged≥5 years, presenting with dyspnoea, cough, wheezing, and/or chest tightness to health facilities in four provinces of Vietnam were systematically evaluated. Eight common syndromes were defined using data obtained.ResultsWe enrolled 977 subjects at 39 facilities. We identified fixed airflow limitation (FAL) in 198 (20.3%) patients and reversible airflow limitation (RAL) in 26 (2.7%) patients. Patients meeting the criteria for upper respiratory tract infection (URTI) alone constituted 160 (16.4%) patients and 470 (48.1%) did not meet the criteria for any of the syndromes. Less than half of patients with FAL were given long-acting bronchodilators. A minority of patients with either RAL or FAL with eosinophilia were prescribed inhaled corticosteroids. Antibiotics were given to more than half of all patients, even among those with URTI alone.ConclusionThis study identified a substantial discordance between prescribed treatment, clinician diagnosis and a standardised syndromic diagnosis among patients presenting with respiratory symptoms. Increased access to spirometry and implementation of locally-relevant syndromic approaches to management may help to improve patient care in resource-limited settings.

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

scholarly journals Improving Tanzanian childbirth service quality

2018 ◽  
Vol 31 (3) ◽  
pp. 190-202 ◽  
Author(s):  
Jennie Jaribu ◽  
Suzanne Penfold ◽  
Cathy Green ◽  
Fatuma Manzi ◽  
Joanna Schellenberg
Keyword(s):  
Health Facility ◽  
Low Income ◽  
Healthcare Providers ◽  
Health Facilities ◽  
Rural District ◽  
Local Data ◽  
Content Type ◽  
Primary Health ◽  
Primary Health Facilities ◽  
Childbirth Care

Purpose The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania. Design/methodology/approach A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs. Findings Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months. Research limitations/implications The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures. Originality/value Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.

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