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.

Investigating the Impact of Healthcare Environmental Design on Staff Security: A Systematic Review

2020 ◽  
pp. 193758672092140
Author(s):  
Soheyla MohammadiGorji ◽  
Sheila J. Bosch ◽  
Shabboo Valipoor ◽  
Giuliano De Portu
Keyword(s):  
Behavioral Health ◽  
Physical Environment ◽  
Healthcare Professionals ◽  
Environmental Design ◽  
Health Facilities ◽  
Design Strategies ◽  
Ambient Conditions ◽  
Environmental Interventions ◽  
Healthcare Facilities ◽  
The Impact

Objective: To systematically review the literature regarding the role of the physical environment in preventing or mitigating aggressive behavior toward healthcare professionals in acute care, outpatient, and psychiatric/behavioral health facilities. Background: Globally, the incidence of violence against healthcare professionals is alarming. Poor environmental design has been identified as a risk factor of violence toward employees. The design of the physical setting in which healthcare is provided may moderate the incidence and severity of violence against healthcare workers. Methods: We conducted electronic database searches of PubMed and CINAHL through November 2018. Result: Findings were organized according to four categories identified in the literature regarding crime prevention through environmental design (CPTED) including natural surveillance, access control, territoriality, and other CPTED elements. Fifteen studies (published between 1991 and 2017) met the inclusion criteria. Of the 15 studies, 4 incorporated environmental interventions. In the 11 remaining studies, physical environment attributes (i.e., layout, location, ambient conditions, equipment) were among the factors affecting violent incidents and staff security. Most study settings were hospital-based (11, with 10 of those specifically focused on emergency departments), followed by behavioral health facilities (4 studies). Design-focused recommendations, such as providing a second door in a triage room and a sub-waiting area inside the treatment zone, were summarized according to CPTED categories. Conclusion: This review suggests that the physical environment in healthcare facilities may affect the incidence of violence by patients or visitors against staff. Further research is needed to identify environmental design strategies that may protect the safety of healthcare professionals.

scholarly journals Geographical perspective of modeling primary healthcare accessibility

2017 ◽  
Vol 10 (1) ◽  
pp. 56-67 ◽  
Author(s):  
Justice Surage ◽  
Richard Tawiah ◽  
Timothy Twumasi-Mensah
Keyword(s):  
Health Facility ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Healthcare Facility ◽  
Access To Healthcare ◽  
Health Facilities ◽  
Spatial Accessibility ◽  
Content Type ◽  
Central District ◽  
Healthcare Accessibility

Purpose The purpose of this paper is to measure the spatial accessibility of primary healthcare facility in Ghanaian rural areas, by determining the barriers to healthcare accessibilities in the Amansie Central District. Design/methodology/approach Both network and proximity analyses were performed on the digitized data such as road networks, settlements, population, district boundary, natural resources (rivers, streams and forest) and site location (health facilities). To quantify the population who have access to healthcare the authors used the Ghana Health Service access criteria that health facility should be accessible to an estimated population within 8 km radius from the facility. Findings The overall mean distance to the nearest health facility in the district was 8.9 km. Fiankoma sub-district recorded the highest mean distance whereas Tweapease sub-district recorded the least. In general, 31.2 percent of the district population has no access to healthcare facility. Transportation was identified to be one of the major hindrances to healthcare accessibility and this was as a result of poor road network in the district. Research limitations/implications The study was restricted to the Amansie Central District of Ghana. This limits the extent of generalization of results. Originality/value The study proposed additional sites for siting new health facilities base on criteria such as population, distance, centrality and existing infrastructural development. This will consequently improve healthcare accessibility and utilization by increasing total coverage closer to 100 percent.

scholarly journals Implementation of Tuberculosis Infection Control Practices in Tuberculosis Diagnostic and Treatment Health Facilities in Kampala District, Uganda, August 2015

2020 ◽  
Author(s):  
Didas Tugumisirize ◽  
Stavia Turyahabwe ◽  
Lilian Bulage ◽  
Stella Zawedde Muyanja ◽  
Robert Kaos Majwala ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Infection Control ◽  
Health Facility ◽  
Health Workers ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Tuberculosis Infection ◽  
Care Services ◽  
Tuberculosis Infection Control

AbstractBackgroundEffective implementation of Tuberculosis infection control (TB IC) measures in health facilities delivering TB care services is very critical in controlling nosocomial transmission of TB infections among health workers, patients and their attendants. The aim of the study was to assess and document the implementation of TB IC practices in TB diagnostic and treatment health facilities in Kampala District, which accounts for 15-20% of the total TB burden in Uganda.MethodsIn August 2015, we conducted a cross-sectional study in 25 health facilities including 07 Public and 18 Private healthcare facilities in Kampala. We used a modified checklist adopted from the national manual for implementing TB control measures in health care facilities. We reviewed health facility records and where necessary observed TB IC practices to triangulate our findings. We conducted univariate analysis and generated proportions in order to describe the extent of implementation of TB IC measures.ResultsOn average, 73% of both administrative and managerial, 65% environmental, and 56% personal protective TB IC measures were complied with at the health facilities visited. Private health facilities implemented 71% of both administrative and managerial TBIC measures compared to public health facilities (31%). Thirty Six percent of health facilities reported that they were regularly screening health care workers for TB. By Observation, 28% had TB IC guideline, 36% had TB IC plan, 12% had a designated area for sputum collection, 56% were regularly opening windows, 40% had fans installed in the waiting areas and/or consultation rooms and 24% had bio-safety cabinets fitted with UV light. In addition, 60% had N95 respirators but only 32% of the facilities reported that their health workers routinely wore them.ConclusionImplementation of WHO recommended TB IC measures in health facilities delivering TB care services in Kampala was sub optimal. Routine involvement of health facility management as well as increasing human resources for health is critical in implementing easy to do TBIC measures like triaging, patients’ educating on coughing etiquette and respiratory hygiene and daily window opening particularly in public health care settings where implementation of administrative TB IC measures is wanting

scholarly journals PENGEMBANGAN MEDIA INFORMASI UNTUK PELAYANAN PENDAFTARAN PASIEN DI BPM RIKA HARDI, S.ST

2020 ◽  
Vol 4 (1) ◽  
pp. 123
Author(s):  
Rahmi Septia Sari
Keyword(s):  
Health Facility ◽  
Information Needs ◽  
Health Workers ◽  
Health Management ◽  
Community Health Services ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Media Planning ◽  
Information Media ◽  
The Government

Fasilitas kesehatan merupakan pelayanan yang sangat penting bagi masyarakat. Pelayanan kesehatan adalah tulang punggung fasilitas kesehatan di Indonesia. Fasilitas kesehatan bisa dimiliki oleh Pemerintah, Pemerintah Daerah atau swasta. Tenaga kesehatan terdiri dari beragam profesi seperti tenaga dokter, bidan, perawat, apoteker, ahli gizi, tenaga perekam medis, tenaga manajemen kesehatan maupun tenaga non kesehatan. Pasien yang datang ke fasilitas kesehatan pun memiliki beragam jenis penyakit mulai dari penyakit menular sampai penyakit degeneratif. Oleh karena itu, dalam hal ini dilakukan penyusun alur dan prosedur pendaftaran pasien sehingga pelayanan berlangsung baik. Salah satu kriteria penilaian akreditasi pada suatu fasilitas kesehatan adalah tersedianya informasi tentang alur prosedur pendaftaran pelayanan saat pasien mendaftar di loket pendaftaran. Kejelasan informasi yang diterima pasien akan memberikan rasa puas terhadap pasien. Kesan pertama di loket pendaftaran akan membentuk persepsi pasien terhadap keseluruhan pelayanan di fasilitas kesehatan. Tujuan kegiatan ini menyediakan media informasi untuk edukasi pasien saat mendaftar tentang alur dan prosedur pelayanan di loket pendaftaran. Metode yang lakukan adalah observasi ke fasilitas pelayanan kesehatan, identifikasi dan analisis kebutuhan media informasi, perencangan media informasi, ujicoba media, sosialisasi, dan evaluasi. Hasil yang diperoleh tersedianya media informasi dalam bentuk banner tentang alur prosedur pelayanan di fasilitas kesehatan. Kata Kunci: Media, Alur prosedur pendaftaran, Bidan praktek mandiri ABTRACT Health facilities are very important services for the community. Health services are the backbone of health facilities in Indonesia. Health facilities can be owned by the Government, Local Government or private. Health workers consist of various professions such as doctors, midwives, nurses, pharmacists, nutritionists, medical record workers, health management personnel and non-health workers. Patients who come to health facilities also have a variety of diseases ranging from infectious diseases to degenerative diseases. Therefore, here I am trying to develop a flow and procedure for patient registration. One of the criteria for evaluating accreditation at a health facility is the availability of information about the flow of the procedure for registering services when patients register at the registration counter. Clarity of information received by the patient will give satisfaction to the patient. First impressions at the registration window will shape the patient's perception of the overall service in the health facility. The purpose of this activity is to provide information media for patient education when registering the flow and procedure of service at the registration counter. The method used is observation to health care facilities, identification and analysis of media information needs, information media planning, media testing, outreach, and evaluation. The results obtained are the availability of information media in the form of banners about the flow of service procedures in health facilities. Keywords: Media, Registration procedure flow, Midwife independent practice

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 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 Fraud in healthcare facilities: A Narrative Review

2021 ◽  
Vol 7 (4) ◽  
pp. 166-171
Author(s):  
Sarah Mauren Michaela ◽  
Mieke Nurmalasari ◽  
Hosizah Hosizah
Keyword(s):  
Public Health ◽  
Health Care ◽  
Universal Health Coverage ◽  
Review Article ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Coverage ◽  
Healthcare Facilities ◽  
Care Facilities ◽  
Universal Health

Every country needs to develop Universal Health Coverage (UHC) to promote optimal levels of public health. But in realizing UHC, there must be some problems, one of which is fraud. Based on the Corruption Eradication Commission (KPK) data, potential fraud is detected from 175,774 claims of Advanced Referral Health Facilities (FKRTL) or worth Rp. 440 billion until June 2015. This review article describes the incidence of fraud in health care facilities. Out of a total of 12,736 cases of fraud, readmission occupies the most cases of fraud, which is 4,827 cases or 37.9%.

scholarly journals Distribution of primary health care facilities in Mtwara District, Tanzania: availability and accessibility of services

1970 ◽  
Vol 20 (4) ◽  
Author(s):  
Irene R. Mremi ◽  
Mercy Mbise ◽  
Job A. Chaula
Keyword(s):  
Health Care ◽  
Health Facility ◽  
Low Income ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Child Health Services ◽  
Healthy Population ◽  
Care Services ◽  
Care Facilities

Background: Access to health care services is a significant factor to health seeking practices that contributes to a healthy population. Improving health care accessibility is an important health priority in low-income countries. The objective of this study was to determine distribution of health care facilities and identify the high priority areas, which require more services in Mtwara, southern Tanzania.Methods: This study was carried in Mtwara Rural district of southern Tanzania and involved health care facilities. A hand held global positioning system was used to geo-reference the coordinates of all facilities. A questionnaire with both closed and open-ended questions was used to gather information from patients who attended the respective facilities. Interviews with district health officials and facility in-charges were conducted.Results:  There were 38 health in the district. Most of them were located within southern part of the district. The majority of facilities (97%) were government owned. On average each facility was serving 2,400 population. Malaria management, reproductive and child health services, family planning and integrated management of childhood illnesses were offered by all health facilities in the district. Prevention of mother to child transmission of HIV was offered by 34 (89.5%) facilities. Tuberculosis services were offered by only 3 facilities while voluntary counselling and testing of HIV and anti-retroviral treatment services were available in 15 and 10 health facilities, respectively. Only 4 facilities had laboratory and inpatients services. The majority of the staff included Medical Attendants (39%), Nurse Midwives (34%), and Clinical Officers (20%). Assistant Medical Officers and Nursing Officers each accounted for 2% of the total staff. There were no Medical Officers, laboratory technicians or pharmaceutical technicians in the district.  A total of 408 health facility clients (≥18yrs) were interviewed. Factors influencing the choice of a health facility were the availability of special services, medicine and qualified human resources.Conclusion: The majority of facilities in Mtwara are government and there is disparity in the distribution of the facilities. Availability of medicines and qualified human resources were the major factors on the preference for accessing health care services.

scholarly journals Modelling geographical accessibility to support disaster response and rehabilitation of a healthcare system: an impact analysis of Cyclones Idai and Kenneth in Mozambique

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039138
Author(s):  
Fleur Hierink ◽  
Nelson Rodrigues ◽  
Maria Muñiz ◽  
Rocco Panciera ◽  
Nicolas Ray
Keyword(s):  
Travel Time ◽  
Health Facility ◽  
Healthcare System ◽  
Disaster Response ◽  
Health Facilities ◽  
Functional Health ◽  
Geographical Access ◽  
Spatial Differences ◽  
Geographical Accessibility ◽  
Children Under 5

ObjectivesModelling and assessing the loss of geographical accessibility is key to support disaster response and rehabilitation of the healthcare system. The aim of this study was therefore to estimate postdisaster travel times to functional health facilities and analyse losses in accessibility coverage after Cyclones Idai and Kenneth in Mozambique in 2019.SettingWe modelled travel time of vulnerable population to the nearest functional health facility in two cyclone-affected regions in Mozambique. Modelling was done using AccessMod V.5.6.30, where roads, rivers, lakes, flood extent, topography and land cover datasets were overlaid with health facility coordinates and high-resolution population data to obtain accessibility coverage estimates under different travel scenarios.Outcome measuresTravel time to functional health facilities and accessibility coverage estimates were used to identify spatial differences between predisaster and postdisaster geographical accessibility.ResultsWe found that accessibility coverage decreased in the cyclone-affected districts, as a result of reduced travel speeds, barriers to movement, road constraints and non-functional health facilities. In Idai-affected districts, accessibility coverage decreased from 78.8% to 52.5%, implying that 136 941 children under 5 years of age were no longer able to reach the nearest facility within 2 hours travel time. In Kenneth-affected districts, accessibility coverage decreased from 82.2% to 71.5%, corresponding to 14 330 children under 5 years of age having to travel >2 hours to reach the nearest facility. Damage to transport networks and reduced travel speeds resulted in the most substantial accessibility coverage losses in both Idai-affected and Kenneth-affected districts.ConclusionsPostdisaster accessibility modelling can increase our understanding of spatial differences in geographical access to care in the direct aftermath of a disaster and can inform targeting and prioritisation of limited resources. Our results reflect opportunities for integrating accessibility modelling in early disaster response, and to inform discussions on health system recovery, mitigation and preparedness.

Availability and satisfactoriness of latrines and hand washing stations in health facilities, and role in health seeking behavior of women: evidence from rural Pune district, India

2015 ◽  
Vol 5 (3) ◽  
pp. 474-482 ◽  
Author(s):  
Peter Steinmann ◽  
Martin W. Bratschi ◽  
Pallavi Lele ◽  
Uddhavi Chavan ◽  
Neisha Sundaram ◽  
...  
Keyword(s):  
Health Facility ◽  
Household Survey ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Hand Washing ◽  
Local Health ◽  
Health Seeking ◽  
Public Facilities ◽  
Local Health Facility ◽  
Seeking Behavior

Water, sanitation and hygiene (WASH) installations are indispensable in health care facilities. Their quality might also influence the decision whether to visit a health facility. We investigated the WASH infrastructure in small health facilities in rural Pune, India, and surveyed expectations and satisfactoriness among women. The availability and quality of WASH installations was assessed in 12 facilities using a checklist. Dedicated questions in a household survey provided the community perspective, complemented by qualitative methods. A few public facilities had no latrine or hand washing station. On the contrary, all private facilities offered such installations. The bed/outpatient-to-installation ratio was also lower in private compared to public facilities. While most latrines were functional and well maintained, they often lacked garbage bins. Soap was often missing from hand washing stations. Dedicated latrines for women were rare. Women were generally satisfied with the WASH installations in the local health facility, but considered private facilities as better. WASH installations in health facilities are generally acceptable in private facilities while improvements are needed in some government facilities. Women expect WASH installations in health facilities, and view their quality in a broader framework of ‘cleanliness,’ which they consider when choosing facilities.

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