scholarly journals Impact of COVID-19 on Health Services Utilization in Province-2 of Nepal: A Qualitative Study Among Community Members and Stakeholders

2020 ◽  
Author(s):  
Devendra Raj Singh ◽  
Dev Ram Sunuwar ◽  
Sunil Kumar Shah ◽  
Kshitij Karki ◽  
Lalita Kumari Sah ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Services Utilization ◽  
Health Workers ◽  
Care Delivery ◽  
Essential Medicine ◽  
Local Health ◽  
Community Perceptions ◽  
Services Utilization ◽  
Services Delivery

Abstract Background The COVID-19 pandemic is posing unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aims to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. MethodsThe semi-structured qualitative interviews were conducted among purposively selected participants (n=41) from a mix of rural and urban settings in all districts (n =8) in Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. ResultsThe findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and, iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and fearful about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions of health services were mostly due to the closure of health services at local health facilities, limited involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from governments at all levels towards health services management during the COVID-19 pandemic. ConclusionsThis study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is essential to expand the service coverage and its quality in addition to increasing public-private sector engagement to ensure the essential health services are utilized by the population.

scholarly journals Impact of COVID-19 on health services utilization in Province-2 of Nepal: a qualitative study among community members and stakeholders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Devendra Raj Singh ◽  
Dev Ram Sunuwar ◽  
Sunil Kumar Shah ◽  
Kshitij Karki ◽  
Lalita Kumari Sah ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Services Utilization ◽  
Care Delivery ◽  
Essential Medicine ◽  
Health Care Facilities ◽  
Local Health ◽  
Community Perceptions ◽  
Services Utilization ◽  
Services Delivery

Abstract Background The COVID-19 pandemic has posed unprecedented challenges and threats to the health care system, particularly affecting the effective delivery of essential health services in resource-poor countries such as Nepal. This study aimed to explore community perceptions of COVID-19 and their experiences towards health services utilization during the pandemic in Province-2 of Nepal. Methods The semi-structured qualitative interviews were conducted among purposively selected participants (n = 41) from a mix of rural and urban settings in all districts (n = 8) of the Province 2 of Nepal. Virtual interviews were conducted between July and August 2020 in local languages. The data were analyzed using thematic network analysis in NVivo 12 Pro. Results The findings of this research are categorized into four global themes: i) Community and stakeholders’ perceptions towards COVID-19; ii) Impact of COVID-19 and lockdown on health services delivery; iii) Community perceptions and experiences of health services during COVID-19; and iv) COVID-19: testing, isolation, and quarantine services. Most participants shared their experience of being worried and anxious about COVID-19 and reported a lack of awareness, misinformation, and stigma as major factors contributing to the spread of COVID-19. Maternity services, immunization, and supply of essential medicine were found to be the most affected areas of health care delivery during the lockdown. Participants reported that the interruptions in health services were mostly due to the closure of health services at local health care facilities, limited affordability, and involvement of private health sectors during the pandemic, fears of COVID-19 transmission among health care workers and within health centers, and disruption of transportation services. In addition, the participants expressed frustrations on poor testing, isolation, and quarantine services related to COVID-19, and poor accountability from the government at all levels towards health services continuation/management during the COVID-19 pandemic. Conclusions This study found that essential health services were severely affected during the COVID-19 pandemic in all districts of Province-2. It is critical to expand and continue the service coverage, and its quality (even more during pandemics), as well as increase public-private sector engagement to ensure the essential health services are available for the population.

scholarly journals Cost-Related Non-Utilization of Health Services and Self-Perceived Reactions to Race

2020 ◽  
Vol 30 (3) ◽  
pp. 399-410
Author(s):  
Eberechukwu Onukwugha ◽  
Jacquelyn McRae ◽  
Wendy Camelo Castillo
Keyword(s):  
Health Care ◽  
Health Services ◽  
Physician Visit ◽  
Health Services Utilization ◽  
Physical Symptoms ◽  
Limited Information ◽  
Cross Sectional ◽  
Physician Visits ◽  
Care Experience ◽  
Services Utilization

Purpose: There is limited information regarding the prevalence and predictors of cost-related non-utilization (CRNU), while there is increasing attention to the rising out-of-pocket cost of health services includ­ing prescription medications. Prior studies have not quantified the role of perceived racism despite its documented relationship with health services utilization. We examine perceptions of reactions to race and quan­tify their relationship with CRNU.Methods: This retrospective cross-sectional study utilized data from the 2014 Behav­ioral Risk Factor Surveillance System (BRFSS) public use file, an annual, state-based telephone survey of US adults aged 18 and older. We utilized data for four states that provided responses to five Reactions to Race items, including information about the self-perceived quality of the respon­dent’s health care experience compared with people of other races (worse vs same or better) and whether the respondent experienced physical symptoms because of treatment due to their race. The three binary outcomes were: 1) did not visit a physician; 2) did not visit a physician due to cost; 3) did not fill a prescription due to cost. We estimated covariate-adjusted odds ratios associated with each outcome using logistic regression models.Results: The BRFSS sample consisted of 20,366 respondents of whom 8% were African American non-Hispanic, 12% were Hispanic and 73% were White. Three percent of respondents considered their experience to be worse than people of other races. Three percent of individuals reported physical symptoms because of treatment due to their race while 5% of respondents reported becoming emotion­ally upset because of treatment due to their race. The proportions for the three study outcomes were 11%, 13% and 7%, respectively. In covariate-adjusted models, a worse experience with the health care system was statistically significantly associ­ated with CRNU (physician visit: 2.6 [95% CI: 1.6 – 4.3]). The experience of physical symptoms because of treatment due to race was statistically significantly associated with CRNU (physician visit: 2.6 [95% CI: 1.7 – 4]; prescription fills: 2.1 [1.2 – 3.6]). No Reactions to Race items were associated with general non-utilization.Conclusions: Negative perceptions of reactions to race during the time of health services utilization is positively associated with CRNU, ie, foregoing physician visits and prescription fills due to cost.Ethn Dis. 2020;30(3):399-410; doi:10.18865/ed.30.3.399

scholarly journals Pemanfaatan Pelayanan Kesehatan Sasaran Program Jaminan Tabalong Sehat di Kabupaten Tabalong Kalimantan Selatan

2018 ◽  
pp. 102-112
Author(s):  
Amir Su'udi ◽  
Harimat Hendarwan
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Services ◽  
Health Services Utilization ◽  
Health Centre ◽  
Cross Sectional ◽  
Public Health Centre ◽  
Health Security ◽  
Services Utilization ◽  
Free Health Care

Abstrak Pemerintah Kabupaten Tabalong Kalimantan Selatan menerapkan pelayanan kesehatan gratis di Puskesmas melalui program Jaminan Tabalong Sehat (JTS) sejak tahun 2008. Peserta JTS adalah seluruh penduduk Tabalong yang tidak memiliki asuransi atau jaminan kesehatan. Penelitian ini bertujuan mengetahui faktor-faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan di puskesmas. Penelitian ini menggunakan desain cross sectional dan wawancara mendalam. Sampel uji sebanyak 253 rumah tangga sasaran program JTS, diambil dari 405 sampel rumah tangga yang dipilih secara sistematik, dari klaster 15 desa/kelurahan di tiga wilayah puskesmas terpilih. Hasil penelitian menunjukkan bahwa pemanfaatan pelayanan kesehatan gratis di puskesmas belum optimal. Sebanyak 52% rumah tangga pernah memanfaatkan pelayanan kesehatan puskesmas dalam setahun terakhir. Faktor yang berhubungan dengan pemanfaatan pelayanan kesehatan di puskesmas adalah pengetahuan, kemauan untuk membayar/WTP, adanya penyakit tertentu, waktu tempuh, kemudahan dan biaya transportasi. Rendahnya pemanfaatan pelayanan kesehatan di puskemas yang sudah digratiskan disebabkan karena kurang optimalnya kegiatan puskesmas, kurangnya sosialisasi ke masyarakat dan sasaran masyarakat yang disubsidi kurang tepat. Kata kunci: Pemanfaatan pelayanan kesehatan, Puskesmas, Subsidi, Tabalong Abstract Government of Tabalong District have been giving free health care subsidies at public health centre (PHC) through Tabalong Health Security (Jaminan Tabalong Sehat /JTS) program since 2008. Targetting of JTS program are all of Tabalong citizens that have not covered by health insurance or other health security programs. The objective of this research was to know the factors that related with utilization of health services at PHC in Tabalong District. Approach of this research were cross sectional design and deep interview. Sampels were 253 targetting household taken form 405 household that selected by systematic random from 15 villages cluster at three selected PHC areas. The result showed that utilization of free health services subsidies were not optimize yet. Just 52% of household utilized health services at PHC in the last year. The factors that related with health services utilization at PHC are knowledge, willingness to pay (WTP), diseases avalaibility, travelling time, easiness and cost of transportation. The low rates utilization of free health care were also caused by un-optimize of PHC’s activities, lack of promotion the JTS programs, not matching of subsidies targetting. Keywords: Health services utilization, public health centre, subsidy, Tabalong

Multidimensional Social Support and Health Services Utilization Among Noninstitutionalized Older Persons in Ghana

2018 ◽  
Vol 32 (3-4) ◽  
pp. 227-239 ◽  
Author(s):  
Razak M. Gyasi ◽  
David R. Phillips ◽  
Padmore Adusei Amoah
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Health Care ◽  
Health Services ◽  
Health Services Utilization ◽  
Community Dwelling ◽  
Health Care Use ◽  
Care Utilization ◽  
Health Seeking ◽  
Services Utilization

Objectives: This study examines multidimensional social supports as predictors of health services utilization among community-dwelling older Ghanaians. Method: Using data from a 2016/2017 Aging, Health, Psychological Wellbeing and Health-Seeking Behavior Study ( N = 1,200), Poisson regression models estimated the associations of aspects of informal social support and health facility utilization among older people. Results: Findings suggest that regular contacts with family/close friends (odds ratio [OR] = 1.299; 95% confidence interval [CI] = [1.111, 1.519]), social participation (OR = 1.021; 95% CI = [1.140, 1.910]), and remittances from adult children (OR = 1.091; 95%CI = [1.086, 1.207]) were associated with increased health services utilization with some gender variations. Having caregivers increased health care use generally (OR = 1.108; 95% CI = [1.016, 1.209]) and among men (OR = 1.181; 95% CI = [1.015, 1.373]). However, we found decrease in health care use among those who received pecuniary assistance (OR = 0.893; 95% CI = [0.805, 0.990]). Discussion: Perceived structural and functional social support domains appear influential in health care utilization among older adults in Ghana. The findings underscore the need for intervention programs and social policies targeted at both micro-factors and wider social factors, including the novel area of remittances to older adults.

Yugoslavia's Autonomous Health Institutions

1973 ◽  
Vol 3 (2) ◽  
pp. 213-221 ◽  
Author(s):  
B. Popović ◽  
M. Škribić ◽  
R. Kohn
Keyword(s):  
Health Care ◽  
Health Services ◽  
Care Delivery ◽  
General Pattern ◽  
Development Planning ◽  
Self Management ◽  
Local Health ◽  
Health Institution ◽  
Individual Health ◽  
Health Institutions

Health care in Yugoslavia is provided through a partnership of federal, republic, and local health authorities in collaboration with health insurance funds, sociopolitical and work associations, as well as other associations which represent either the providers or users of health services, or those who shape the development of health policy. The concept of cooperation culminates in a high degree of autonomy for individual health institutions, with self-management characterizing the general pattern of Yugoslav health care delivery. Self-management entails legal, administrative, and fiscal autonomy of the institution, both in its relations with other agencies and within the institution itself, with high levels of self-management within individual departments and sections. Given this diminished role of classical hierarchical organization, the health institution operates with a minimum of legal restraints in responding to the special social interests concerned with health matters. To deal with the institution's external role on the one hand, and its internal cohesion on the other, two organs have been created to serve these respective functions: the council and the management board. Self-management requires planning for several distinct levels: the individual health institution, the local community, and the entire republic. Health services development planning requires cooperation of all pertinent organizations in achieving a “social agreement” on the objectives and priorities of the health services, the resources required, and the specific plans for construction and renovation of health facilities. The principles of the “social agreement” encourage the interest as well as the broad support of citizens and their representatives in the development, implementation, and financing of health protection plans.

Continuous Improvement Learning for Residents

PEDIATRICS ◽  
1998 ◽  
Vol 101 (Supplement_3) ◽  
pp. 768-774
Author(s):  
Linda A. Headrick ◽  
Amy Richardson ◽  
Gregory P. Priebe
Keyword(s):  
Health Care ◽  
Health Services ◽  
Continuous Improvement ◽  
Care Delivery ◽  
Active Role ◽  
Process Of Care ◽  
Children's Hospital ◽  
Services Delivery ◽  
Children’S Hospital ◽  
The Impact

Physicians must be ready to assume an active role in the design, implementation, and improvement of emerging models of health care delivery. Knowledge and skill in continuous improvement prepare them to engage seriously in the processes of change, on the basis of the same scientific principles they always have relied on in the use of evidence to improve outcomes. This includes include the ability to 1) identify the health needs of the individuals and communities for which they provide health services; 2) assess the impact of current practice with appropriate outcome measures; 3) discover what in the process of health care may be contributing to less than desired outcomes; 4) design and test interventions to change the process of care to improve outcomes; 5) act as an effective member of the interdisciplinary team required to complete these tasks; and 6) consider ethical principles and professional values when making decisions about change in health services delivery. Graduate medical education presents special opportunities and challenges for learning about continuous improvement. Early experiences at Rainbow Babies and Children's Hospital in Cleveland and Children's Hospital in Boston suggest how we might prepare pediatricians and other physicians to create positive change and continually improve health care.

scholarly journals Direct Health Care Costs, Health Services Utilization, and Outcomes of Biliary Atresia

2020 ◽  
Vol 70 (4) ◽  
pp. 436-443
Author(s):  
Shabnaz Siddiq ◽  
Carolina Jimenez-Rivera ◽  
M. Ellen Kuenzig ◽  
Isac Lima ◽  
Michael T. Geraghty ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Biliary Atresia ◽  
Health Care Costs ◽  
Health Services Utilization ◽  
Services Utilization ◽  
Care Costs
Sign in / Sign up

Export Citation Format

Share Document