scholarly journals Integration of Systematic Screening for Tuberculosis in Outpatient Departments of Urban Primary Health-Care Facilities in Zambia: A Case Study of Kitwe District

2022 ◽  
Author(s):  
Davy Wadula Zulu ◽  
Adam Silumbwe ◽  
Patricia Maritim ◽  
Joseph Mumba Zulu
Keyword(s):  
Health System ◽  
Performance Management ◽  
Primary Healthcare ◽  
Screening Program ◽  
Health Care Facilities ◽  
World Health ◽  
Systematic Screening ◽  
Healthcare Facilities ◽  
Outpatient Departments

Abstract Background Tuberculosis (TB) is the leading cause of death from a single infectious agent globally, yet 3 million cases are missed every year. The World Health Organization recommends systematic screening of suspected active TB patients among those visiting the healthcare facilities. While many countries have scaled-up systematic screening of TB, there has been limited assessment of the extent of its integration into the health system. This study sought to explore factors that shaped the integration of systematic screening of TB in outpatient departments of primary healthcare facilities in Kitwe district, Zambia. Methods This was a qualitative case study with health providers including district managers, TB focal point persons and laboratory personnel working in six purposively selected primary healthcare facilities. Data was collected through key informant (n=8) and in-depth (n=15) interviews. Data analysis was conducted using QDA Miner software and guided by Atun’s Integration framework. Results Integration was facilitated by perceptions of the magnitude of the TB burden, alignment of the intervention with national TB aspirations, knowledge of stakeholder interests, power and values, regular performance management and intra-facility collaboration. Constraining factors included external partners’ influence in the TB screening program, unbalanced incentivization mechanisms, donor-driven financing and social determinants of health such as gender and stigma including the COVID-19 pandemic. Conclusion Systematic screening of TB is not well integrated into the primary healthcare facilities to capture all those suspected with active TB that make contact with the health system. Finding the missing TB cases will, therefore, require contextual adaptation of the systematic screening for TB and strengthening the health system.

scholarly journals Integration of Systematic Screening For Tuberculosis in Outpatient Departments of Urban Primary Health-Care Facilities in Zambia: A Case Study of Kitwe District

2021 ◽  
Author(s):  
Davy Wadula Zulu ◽  
Adam Silumbwe ◽  
Patricia Maritim ◽  
Joseph Mumba Zulu
Keyword(s):  
Health System ◽  
Performance Management ◽  
Primary Healthcare ◽  
Screening Program ◽  
Health Care Facilities ◽  
World Health ◽  
Systematic Screening ◽  
Healthcare Facilities ◽  
Outpatient Departments

Abstract Background: Tuberculosis (TB) is the leading cause of death from a single infectious agent globally, yet 3 million cases are missed every year. The World Health Organization recommends systematic screening of suspected active TB patients among those visiting the healthcare facilities. While many countries have scaled-up systematic screening of TB, there has been limited assessment of the extent of its integration into the health system. This study sought to explore factors that shaped the integration of systematic screening of TB in outpatient departments of primary healthcare facilities in Kitwe district, Zambia. Methods: This was a qualitative case study with health providers including district managers, TB focal point persons and laboratory personnel working in six purposively selected primary healthcare facilities. Data was collected through key informant (n=8) and in-depth (n=15) interviews. Data analysis was conducted using QDA Miner software and guided by Atun’s Integration framework.Results: Integration was facilitated by perceptions of the magnitude of the TB burden, alignment of the intervention with national TB aspirations, knowledge of stakeholder interests, power and values, regular performance management and intra-facility collaboration. Constraining factors included external partners’ influence in the TB screening program, unbalanced incentivization mechanisms, donor-driven financing and social determinants of health such as gender and stigma including the COVID-19 pandemic.Conclusion: Systematic screening of TB is not well integrated into the primary healthcare facilities to capture all those suspected with active TB that make contact with the health system. Finding the missing TB cases will, therefore, require contextual adaptation of the systematic screening for TB and strengthening the health system.

scholarly journals Analyzing efforts to synergize the global health agenda of universal health coverage, health security and health promotion: a case-study from Ethiopia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam
Keyword(s):  
Health Promotion ◽  
Global Health ◽  
Health System ◽  
Universal Health Coverage ◽  
World Health ◽  
Health Coverage ◽  
Health Security ◽  
Universal Health ◽  
Health Agenda

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.

scholarly journals Prevention of mother-to-child transmission of HIV guidelines: Nurses’ views at four primary healthcare facilities in the Limpopo Province

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Barbara A. Hanrahan ◽  
Adri Williams
Keyword(s):  
Patient Education ◽  
Registered Nurses ◽  
Primary Healthcare ◽  
Limpopo Province ◽  
World Health ◽  
Mother To Child Transmission ◽  
Child Transmission ◽  
Pmtct Programme ◽  
Healthcare Facilities ◽  
Mother To Child

Background: When new guidelines for existing programmes are introduced, it is often the clinicians tasked with the execution of the guidelines who bear the brunt of the changes. Frequently their opinions are not sought. In this study, the researcher interviewed registered nurses working in the field of the prevention of mother-to-child transmission (PMTCT) of human immunodeficiency virus (HIV) to gain an understanding of their perspectives on the changes introduced to the guidelines. The guideline changes in 2014 were to move from the World Health Organization (WHO) Option B to Option B + which prescribes lifelong antiretroviral therapy (ART) for all HIV-positive pregnant women regardless of CD4 cell count.Objective: To determine what the registered nurses’ perspectives are on the PMTCT programme as implemented at four PHC facilities in the Limpopo Province.Method: For this qualitative investigation, a descriptive research design was implemented. The data were collected during semi-structured interviews with nurses from four primary healthcare facilities in the Limpopo Province of South Africa. Data were analysed using thematic analysis.Results: Challenges preventing effective implementation (e.g. increased workloads, viz. staff shortages; poor planning of training; equipment and medication shortages and long lead times; poor patient education) were identified.Conclusion: In spite of the successes of the PMTCT programme, considerable challenges still prevail; lack of patient education, poor facilities management and staff shortages could potentially influence the implementation of the PMTCT guidelines negatively.

scholarly journals Drones Optimized Therapy System (DrOTS): Use of Drones for Tuberculosis Diagnosis in Nepal

2019 ◽  
pp. 14
Author(s):  
Uttam Pudasaini
Keyword(s):  
Public Health ◽  
Primary Healthcare ◽  
Urban Areas ◽  
Access To Health Care ◽  
Health Workers ◽  
Healthcare Access ◽  
Health Care Facilities ◽  
Health Centers ◽  
Diagnostic Tools ◽  
Healthcare Facilities

Over 50% of the total Nepalese population lives in hilly and mountainous areas with extremely poor transportation and access to health care facilities. With advanced health centers concentrated only in urban areas, and diagnostic laboratories not being present in most primary healthcare facilities, majority of people are forced to have to walk by foot, in an average 6-8 hours, to access proper healthcare facilities. Drone Optimized Therapy System, (DrOTS) aims to improve access to healthcare access in rural villages of Nepal. The pilot phase currently involved improving the accessibility of Tuberculosis diagnostic tests by linking communit y health workers (CHWs) with state-of-the-art diagnostic tools (GeneXpert) via drones in two municipalities of Pyuthan district, Nepal. The drones fly from central Hospitals to remote healthcare centers and bring back sputum samples for diagnosis. The purpose of this project is to assist the Ministry of Health and Population (MoHP) and National Tuberculosis Center (NTC) by generating the data necessary to assess the suitability of the drones-based services for nationwide expansion. The aerial distance between any two points being lesser than the actual road distance, drone technology has come out as a very popular tool in transporting medical samples/medicines between health centers. Drones can be used as crucial tools to connect primary healthcare facilities to hospitals by delivering patient information such as blood, urine, sputum, stool etc. samples required for diagnosis from primary facilities to hospitals, and medicines from hospitals to patients in nearby rural locations for treatment. The project team consists of multisector experts; Public Health- Birat Nepal Medical Trust (BNMT), Drones & Tech - WeRobotics, Nepal Flying Labs & DroNepal, Research: The Liverpool School of Tropical Medicine, Govt. stakeholders: MoHP Nepal, the National TB Center and the District Public Health Office (DPHO Pyuthan) is supported by Stony Brook University and the Simons Foundation.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 14

scholarly journals Strategizing Public Sector Hospitals In Megacity Karachi: A Case Study On Gender Based Healthcare Facility Selection Criteria And Concerns (From Demand And Supply Perspective)

2019 ◽  
Vol 19 (1) ◽  
pp. 179-196
Author(s):  
Shamaila Burney ◽  
Khalid Mahmood Iraqi
Keyword(s):  
Public Sector ◽  
Selection Criteria ◽  
Healthcare Facility ◽  
Health Care Facilities ◽  
Public Hospitals ◽  
Public Healthcare ◽  
Demand And Supply ◽  
Healthcare Facilities ◽  
The Public

Karachi is the most populous city in Pakistan and it plays an important role in urban demography of Pakistan. It is growing rapidly, as every fifth urban citizen lives here. This urbanization creates serious challenges for all sectors of Karachi. Especially the health sector, from demand and supply view point is facing serious challenges in terms of non-availability of qualified doctors, specifically female doctors, medicines, latest equipment, poor infrastructure, and patient’s queues belonging to other rural areas because of the lack of quality healthcare facilities, makes the public hospitals crowded and overburdened. Like all over Pakistan, public sector hospitals are very much neglected in Karachi also and needs special consideration. The focus should be on developing patient oriented supply chains for efficient patient’s care and healthcare facilities. Moreover, the case study of Qatar hospital a part of our basic research study also highlighted the depriving condition for women patients’ in Emergency Department, because only male doctors are there but female doctors are not available. Although we observed that the gender wise daily patient flow was consist of 65% females, whereas only 35% male patients. The study suggests that there is an urgent need of women doctors and paramedics staff in the public sector hospitals of suburbs of Karachi. This paper presents a synoptic view of concerns of the residents of Karachi, and identification of their selection criteria of health care facilities. The study also aimed to provide solutions and recommendations for the improvement of these facilities. Cross sectional questionnaire and random sampling with two stage clusters sampling was used to record the responses of 1991 households, 46% respondents were female and 54% were male. Among the total of 11127 respondents, only 580, (5.2 %) sought treatment in public health hospitals and, 2440 (21.9 %) visited private hospitals. Research results shows that Cost is the only significant factor because of which people opt for treatment at public healthcare facility.

Case study: Reducing preventable maternal mortality in Rwandan healthcare facilities through improvements in WASH protocols

2018 ◽  
Vol 23 (3) ◽  
pp. 129-134 ◽  
Author(s):  
Andrea Guzman
Keyword(s):  
Low Income ◽  
Low Cost ◽  
Disease Outbreaks ◽  
Health Care Facilities ◽  
Low Income Countries ◽  
Water Access ◽  
Healthcare Facilities ◽  
Record Keeping ◽  
Hygiene Practices

Problem A lack of proper water, sanitation, and hygiene (WASH) infrastructure and poor hygiene practices reduce the preparedness and response of health care facilities (HCFs) in low-income countries to infection and disease outbreaks. According to a World Bank Service Provision Assessment conducted in 2007, only 28% of HCFs in Rwanda had water access throughout the year supplied by tap and 58% of HCFs provided functioning latrines. 1 This evaluation of services and infrastructure in HCFs in Rwanda indicates that targets for WASH in-country need to be enhanced. Objectives To present a case study of the causes and management of sepsis during delivery that led to the death of a 27-year-old woman, and propose a WASH protocol to be implemented in HCFs in Rwanda. Methods The state of WASH services used by staff, caregivers, and patients in HCFs was assessed in 2009 in national evaluations conducted by the Ministry of Infrastructure of Rwanda. Site selection was purposive, based on the presence of both water and power supply. Direct observation was used to assess water treatment, presence and condition of sanitation facilities and sterile equipment in the delivery room, provision of soap and water, gloves, alcohol-based hand rub, and WASH-related record keeping. Results All healthcare facilities met Ministry policies for water access, but WHO guidelines for environmental standards, including for water quality, were not fully satisfied. Conclusions The promotion and provision of low-cost technologies that enable improved WASH practices could help to reduce high rates of morbidity and mortality due to infection in low-income countries.

scholarly journals Disaster safety assessment of primary healthcare facilities: a cross-sectional study in Kurdistan province of Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Arezoo Yari ◽  
Yadolah Zarezadeh ◽  
Farin Fatemi ◽  
Ali Ardalan ◽  
Siamak Vahedi ◽  
...  
Keyword(s):  
Primary Healthcare ◽  
Safety Evaluation ◽  
Rapid Response Team ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Response Team ◽  
Primary Health Care Facilities

Abstract Background Kurdistan province of Iran is among disaster prone areas of the country. The Primary Health Care facilities in Iran deliver health services at all levels nationwide. Resiliency and flexibility of such facilities is important when a disaster occurs. Thus, evaluating functional, structural, and non-structural aspects of safety of such facilities is essential. Methods In this cross-sectional study, the instrument used to evaluate four sections of functional, structural, non-structural, and total safety of 805 healthcare facilities in Kurdistan Province was the safety evaluation checklist of primary healthcare centers, provided by the Iranian Ministry of Health and Medical Education. Each section scored from 0 to 100 points, and each section of the safety was classified to three safety classes according to their total score: low (≤34.0), average (34.01–66.0) and high (> 66.0). Results The levels of functional, structural, non-structural and total safety were equal to 23.8, 20.2, 42.3 and 28.7, out of 100, respectively. Regarding the functional safety, rapid response team scored the highest, while financial affairs scored the lowest. Nevertheless, in structural and non-structural sections, the scores of different items were almost similar. Conclusions The results of the study revealed that safety score of primary healthcare facilities in general was unsatisfactory. Thus, promoting preparedness, resilience and continuity of service delivery of these facilities are essential to response to disasters and emergencies. The finding of this study could be beneficial for national and provincial decision-makers and policymakers in this regard.

scholarly journals Assessment of healthcare worker’s implementation of childhood routine immunization in primary healthcare centers in Edo State, Nigeria: A mixed method survey

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Noel Ebehiremen Uwaibi ◽  
Francis Osezua Erah
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Primary Healthcare ◽  
Mixed Method ◽  
Health Care Facilities ◽  
World Health ◽  
Care Providers ◽  
Immunization Service ◽  
Immunization Services ◽  
Edo State

The role of the health care personnel in the delivery of immunization services is very important in achieving the target of immunization coverage of 90% given by the world Health Organisation (WHO). The objective of the study was to determine the challenges affecting healthcare worker’s implementation of immunization services in Primary Healthcare Care (PHC) centres in Edo State, Nigeria. A descriptive cross-sectional study design, with a mixed method of data collection approach (incorporating quantitative and qualitative methods) using an interviewer administered questionnaire among 295 respondents (comprised of 270 health care providers, 7 key informants and 18 supervisors) of immunization activities in the various health care facilities for the Focus Group Discussion (FGD) guide. Ethical clearance for the study was obtained from the Ethics Committee of the University of Benin Teaching Hospital. Quantitative data collected was analyzed using the International Business Machine statistical package for Social Science (IBM) version 21.0 while themes occurring in the qualitative data were analyzed using ATLAS.ti software. Logistic regression was calculated to determine odds ratio and level of significance was set at <0.05. This study showed that good knowledge of immunization. age, training on the implementation of immunization, and designation affected their knowledge of immunization, and some of the challenges encountered were insufficient workers and transport for outreach activities, funding and impress, lack of motivation. Health worker’s knowledge of immunization was good, majority were trained on implementation on immunization services but there were still numerous challenges such as insufficient workers and transportation which must be addressed to strengthen and improve immunization service delivery.

scholarly journals Evaluation of prescribing pattern at basic health care facilities of Islamabad Pakistan

2020 ◽  
Vol 11 (3) ◽  
pp. 3119-3126
Author(s):  
Nabeel Siddique ◽  
Azhar Hussain ◽  
Madeeha Malik
Keyword(s):  
Significant Risk ◽  
Health Care Facilities ◽  
Prescribing Patterns ◽  
World Health ◽  
Prescribing Pattern ◽  
Prescribing Indicators ◽  
Healthcare Facilities ◽  
Basic Health ◽  
Essential Drug List ◽  
Health Organization

Failure to adopt the rational pattern of prescribing and dispensing by health professionals represents a significant risk to the safety of patient and lead to pharmaceuticals wastage. This study was designed to evaluate the prescribing and dispensing pattern at the selected basic healthcare facilities of Islamabad Pakistan. World Health Organization with collaboration to International Network for the Rational Use of Drugs has provided the core indicators to configure and examine the prescribing patterns. The study was conducted in 2018, using these indicators following the study sites, fourteen Basic Health Units, three Rural Health Centres and three local dispensaries located in Islamabad (Pakistan) were randomly visited and that accounts overall 600 prescribing episodes collected retrospectively. The results of this study highlighted that the average number of drugs prescribed was 2.751. Percentage of drugs prescribed by generic was 41.15%. Percentage of steroids, injections and antibiotics were 7.68%, 16.05% and 48.6%. The drugs prescribed from Essential Drug List were 75.08%. Average consultation time was 2.699 minutes. The average dispensing time was 1.479 minutes. We concluded that high number of average drugs per prescription, over prescription of antibiotics, low generic prescribing, less average consultation and dispensing time found in healthcare facilities. Keywords: Prescribing pattern, Basic health facilities, INRUD prescribing indicators, WHO prescribing indicators

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