scholarly journals 40 years after Alma Ata: How people trust in primary health care?

2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Public Trust ◽  
Short Version ◽  
Lead System ◽  
Services Delivery ◽  
Trust Level ◽  
Primary Health ◽  
Individual Variables

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. It needs to be more trustful to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression. Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.

scholarly journals 40 Years after Alma Ata: How People Trust in Primary Health Care?

2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Health Services ◽  
Public Trust ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Trust Level ◽  
Primary Health ◽  
Individual Variables

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. PHC as a first level of health services delivery needs to be more trustfulness to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in 2016 in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression.Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.

scholarly journals Forty Years after Alma-Ata: How People Trust Primary Health Care?

2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Economic Status ◽  
Public Trust ◽  
Short Version ◽  
Socio Economic Status ◽  
Services Delivery ◽  
Trust Level ◽  
Primary Health

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma-Ata declaration. However, after forty years, it needs to be more trustful to achieve its predefined objectives. Public trust in PHC is one of the neglected issues in the context. The aim of this study is to evaluate public trust in PHC in Iran.Methods: The present investigation is a household survey conducted in East Azerbaijan Province, Iran. Two-stage cluster sampling method with Probability Proportional to Size (PPS) approach was used. Totally, 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of Socio-Economic Status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA software (version 15) through descriptive statistics and linear regression. Results: The mean± SD age of the participants was 41.2±15.1 and most (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between residents of Tabriz (the capital of province) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married, and households higher socio-economic status had a significant positive effect on PHC trust level with R2 = 0.14383.Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but key role in trust level. PHC trust cannot be only affected by individual's variables and experiences but also by health system and health providers' characteristics and public context in which PHC system exists. PHC trust level could be used as a public indicator in health systems especially in Low and Middle Income Countries (LMIC) to contribute in system strengthening policies at the national and international levels.

scholarly journals Service providing scenario of urban primary health care services delivery project working in selected municipality

2019 ◽  
Vol 6 (7) ◽  
pp. 2764
Author(s):  
Hasan M. Reza ◽  
M. Abdul M. Sarkar
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Child Health ◽  
Health Care Services ◽  
Rapid Expansion ◽  
Care Services ◽  
Services Delivery ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Study Results

Background: The urbanization and urban growth is going through very rapid in Bangladesh. This growth is being fuelled by rising incomes due to rapid expansion of commerce and industry. The rapid and incessant growth of urbanization on Kushtia district is creating continuous pressure on urban health care services. Urban poor people are also a vital factor for promoting urban primary health care services delivery project (UPHCSDP) to provide health care facilities.Methods: A cross sectional survey was carried out among 576 patients in 3 selected urban primary health care centres in Kushtia Municipality with a major concentration of people residing in urban areas. Data were collected using questionnaires regarding type of care or treatment patients demanded and type of care they received from the clinic.Results: Study results showed that total of 46.5% of the subjects demanded maternal and obstetric health services and 8.6% demanded child health diagnosis and care. It was found that a total of 22.0% of the subjects received physical diagnosis from the centres. About 7.1% clients received advice or suggestions and 8.0% received normal delivery service from the centres.Conclusions: The result shows that these clinics provide a lot of health care services to the clients especially on maternal and child health care delivery system. These services are provided to the patient with less or free of cost. Study exhibited that the overall health care services of health care centres are good. The clients come to these centres for the good quality of treatment.

Integrating Reproductive Health into Emergency Response Assessments and Primary Health Care

2001 ◽  
Vol 16 (4) ◽  
pp. 223-230 ◽  
Author(s):  
Lorelei Goodyear ◽  
Michelle Hynes
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Reproductive Health ◽  
Health Care Services ◽  
Assessment Tool ◽  
Health Indicators ◽  
Psychosocial Health ◽  
Health Needs ◽  
Services Delivery ◽  
Primary Health

AbstractWar-affected populations often are displaced for years. When primary health care is focused on the acute conditions that often present in the emergency phase of a complex emergency, insufficient attention often is directed towards other evolving needs of the population. Their reproductive health, psychosocial health, and problems with chronic diseases may be overlooked even after the situation stabilizes.This article examines currently available resources for conducting rapid assessments of health needs and services during complex emergencies. Their respective strengths and weaknesses are discussed, particularly for assessing a population's reproductive health needs, and for fostering the integration of reproductive health and primary health-care services, and for designing health services delivery.When more specific indicators are included in a needs assessment tool, the likelihood that the assessment results will influence the design and scope of the health program is increased. Needs assessments for primary health care that incorporate reproductive health indicators will assist health officials to integrate these services, and thus, use staff and facilities more efficiently, and will highlight areas of opportunity for providing services.

scholarly journals The Relative Influence of Generic Essential Drugs and Nursing Staff Supplies on Access to Primary Healthcare Services in Burkina Faso: A Trivariate Probit Modeling Approach

2018 ◽  
Author(s):  
Ibrahim Niankara
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Burkina Faso ◽  
Nursing Staff ◽  
Healthcare Services ◽  
Care Needs ◽  
Essential Drugs ◽  
Services Delivery ◽  
Primary Health ◽  
Community Monitoring

This study uses data from the pilot project "Community Monitoring for Better Health and Education Services Delivery Project'' in Burkina Faso, to model the joint impact of generic essential drugs and nursing staff supplies constraints on access to primary health care in the country. The results show that statistical endogeneity of supply side constraints are present in the standard univariate probit specification of access to care. However, when accounted for, the resulting Trivariate Probit model shows that although shortages of generic essential drugs supply do not seem to constitute a significant barrier to access in Burkina Faso, shortages in nursing staff supply do. In fact, the likelihood of primary care access is reduced by 85.5% among those that reported having experienced a shortage in nursing staff, while paradoxically increasing by 60.3% among those that reported having experienced a shortage in generic essential drugs. A potential explanation for these findings is that overall the health care needs in the three surveyed regions in the country were more linked to primary health care services consumption from nurses, although further research would be important to clearly elucidate the position of health goods such as generic essential drugs.

scholarly journals Quality of life of elders in the primary health care in Uberaba, MG

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Giovanna Gaudenci Nardelli ◽  
Eliana Maria Gaudenci ◽  
Rodrigo Eurípedes Da Silveira ◽  
Álvaro da Silva Santos ◽  
Camila Cristina Neves Romanato Ribeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Social Impact ◽  
Linear Regression Analysis ◽  
Sexual Life ◽  
Human Beings ◽  
Primary Health

This study aimed to evaluate social and economic predictors, as well social behavior and its influence on the quality of life of elders who use the primary health care network of Uberaba, Minas Gerais. Methods: Descriptive, exploratory, cross-sectional and quantitative study, conducted with 248 60 year old or older subjects, from November 2016 to May 2017. A structured questionnaire was applied to evaluate sociodemographic data, health conditions and life habits as well the WHOQOL-Bref and the WHOQOL-Old. The analysis were conducted through relative frequencies and t-test as well multiple linear regression were used to associate variables. The study was approved by the Committee of Ethics in Researches with Human Beings of the Federal University of the Triângulo Mineiro (CEP/UFTM). Results: Most elders were women, catholic, with 4 years or more of formal education, had partners, a sexually inactive life, and were retired. The linear regression analysis, found a positive and light or moderate association between sexual life and the physical, social, and environmental domains, and the past, present and future activities facet. The educational level variable had a positive and light association with the psychological domain, whereas the variable occupation had a negative and light association with the death and dying facet. Conclusions: The results found show an important social impact regarding the studied population, making it clear that public policies should be created and executed as to offer subsidies for actions which are specifically targeted at the QoL of elders.

scholarly journals Prevalence of osteoporosis and its associated factors in older adult’s users of the Primary Health Care

2019 ◽  
Vol 23 ◽  
pp. 1-6
Author(s):  
Daniel Vicentini de Oliveira ◽  
Gustavo Vinicius do Nascimento de Oliveira ◽  
Diogo Alves da Silva ◽  
Naelly Renata Saraiva Pivetta ◽  
Mateus Dias Antunes ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Primary Health Care ◽  
Binary Logistic Regression ◽  
Cross Sectional Study ◽  
Short Version ◽  
Cross Sectional ◽  
Primary Health ◽  
History Of ◽  
Prevalence Of Osteoporosis

This study examine the prevalence and factors associated to osteoporosis among older adults users of the primary health care. This cross-sectional study was carried out with 654 older adults (56% women) from primary health care in Maringá, Paraná, Brazil. The instruments used were the sociodemographic questionnaire and the International Physical Activity Questionnaire (IPAQ), short version. Data analysis was conducted through Chi-square test and Binary Logistic Regression (p < 0.05). The results showed a prevalence of 15.6% of older adults who reported the presence of osteoporosis. There was a higher prevalence of women with osteoporosis (p = 0.001), and on the other hand, there was a greater proportion of married elderly individuals (p = 0.003), and elderly with income above three minimum wages (p = 0.020) with absence of osteoporosis. The results showed that women (OR = 4.45; 95%CI: 2.47-8.01) and the older adults who take more than two medications (OR = 1.67; 95%CI: 1.15-2.42) were more likely to present osteoporosis. Older adults who presented a history of falls are 47.0% more likely to present osteoporosis. It was concluded that sex, the amount of medications and the history of falls are associated with the prevalence of osteoporosis in the older adults.

scholarly journals Creating performance intelligence for primary health care strengthening in Europe

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Erica Barbazza ◽  
Dionne Kringos ◽  
Ioana Kruse ◽  
Niek S. Klazinga ◽  
Juan E. Tello
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Information Systems ◽  
Health Priorities ◽  
Weak Links ◽  
Health Coverage ◽  
Middle Income ◽  
Services Delivery ◽  
Primary Health

Abstract Background Primary health care and its strengthening through performance measurement is essential for sustainably working towards universal health coverage. Existing performance frameworks and indicators to measure primary health care capture system functions like governance, financing and resourcing but to a lesser extent the function of services delivery and its heterogeneous nature. Moreover, most frameworks have weak links with routine information systems and national health priorities, especially in the context of high- and middle-income countries. This paper presents the development of a tool that responds to this context with the aim to create primary health care performance intelligence for the 53 countries of the WHO European Region. Methods The work builds-off of an existing systematic review on primary care and draws on priorities of current European health policies and available (inter)national information systems. Its development included: (i) reviewing and classifying features of primary care; (ii) constructing a set of tracer conditions; and (iii) mapping existing indicators in the framework resulting from (i). The analysis was validated through a series of reviews: in-person meetings with country-nominated focal points and primary care experts; at-distance expert reviews; and, preliminary testing with country informants. Results The resulting framework applies a performance continuum in the classical approach of structures-processes-outcomes spanning 6 domains – primary care structures, model of primary care, care contact, primary care outputs, health system outcomes, and health outcomes – that are further classified by 26 subdomains and 63 features of primary care. A care continuum was developed using a set of 12 tracer conditions. A total of 139 indicators were mapped to the classification, each with an identified data source to safeguard measurability. Individual indicator passports and a glossary of terms were developed to support the standardization of the findings. Conclusion The resulting framework and suite of indicators, coined the Primary Health Care Impact, Performance and Capacity Tool (PHC-IMPACT), has the potential to be applied in Europe, closing the gap on existing data collection, analysis and use of performance intelligence for decision-making towards primary health care strengthening.

scholarly journals Strengthening the primary health care response to COVID-19: an operational tool for policymakers

2021 ◽  
Vol 22 ◽  
Author(s):  
Anne S. Johansen ◽  
Amanda Shriwise ◽  
Daniel Lopez-Acuna ◽  
Pia Vracko
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
System Level ◽  
Guidance Document ◽  
Services Delivery ◽  
Primary Health ◽  
Modifiable Factors ◽  
Facility Level

Abstract Aims: The aim of this paper is to introduce an operational checklist to serve as a tool for policymakers in the WHO European Region to strengthen primary health care (PHC) services and address the COVID-19 pandemic more effectively and to present the results from piloting the tool in Armenia. Backgrounds: PHC has the potential to play a fundamental role in countries’ responses to COVID-19. However, this potential remains unrealized in many countries. To assist countries, the WHO Regional Office for Europe developed a guidance document – Strengthening the Health Systems Response to COVID-19: Adapting Primary Health Care Services to more Effectively Address COVID-19 – that identifies strategic actions countries can take to strengthen their PHC response to the pandemic. Based on this guidance document, an operational checklist was developed to serve as a tool for policymakers to operationalize the recommended actions. Methods: The operational checklist was developed by transforming key points in the guidance document into questions in order to identify potentially modifiable factors to strengthen PHC in response to COVID-19. The operational checklist was then piloted in Armenia in June 2020 as part of a WHO mission to provide technical advice on strengthening Armenia’s PHC response to COVID-19. Two WHO experts performed semi-structured, face-to-face interviews with nine key informants (both facility managers and clinical staff) in three PHC facilities (two in a rural and one in an urban area). The data collected were analyzed to identify underlying challenges limiting PHC providers’ ability to effectively and efficiently respond to COVID-19 and maintain essential health services. Findings: The paper finds that making adjustments only to health services delivery will be insufficient to address most of the challenges identified by PHC providers in the context of COVID-19 in Armenia. In particular, strategic responses to the pandemic were missed, due, in part, to the absence of COVID-19 management teams at the facility level. Furthermore, the absence of PHC experts in Armenia’s national pandemic response team meant that health system issues identified at the facility level could not easily be communicated to or addressed by policymakers. The checklist therefore helps policymakers identify critical challenges – at both the facility and health system level – that need to be addressed to strengthen the PHC response to the COVID-19 pandemic.

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