The Untold Story: How the Health Care Systems in Developing Countries Contribute to Maternal Mortality

1992 ◽  
Vol 22 (3) ◽  
pp. 513-528 ◽  
Author(s):  
T. K. Sundari
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Health Services ◽  
Maternal Mortality ◽  
Health Care Systems ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Life Saving ◽  
Referral Hospitals ◽  
Care Systems

This article attempts to put together evidence from maternal mortality studies in developing countries of how an inadequate health care system characterized by misplaced priorities contributes to high maternal mortality rates. Inaccessibility of essential health information to the women most affected, and the physical as well as economic and sociocultural distance separating health services from the vast majority of women, are only part of the problem. Even when the woman reaches a health facility, there are a number of obstacles to her receiving adequate and appropriate care. These are a result of failures in the health services delivery system: the lack of minimal life-saving equipment at the first referral level; the lack of equipment, personnel, and know-how even in referral hospitals; and worst of all, faulty patient management. Prevention of maternal deaths requires fundamental changes not only in resource allocation, but in the very structures of health services delivery. These will have to be fought for as part of a wider struggle for equity and social justice.

Emergence of Coproduction and Participatory Care in European Clinical Practice

2016 ◽  
Vol 6 (3) ◽  
pp. 155-161
Author(s):  
Dawid Szescilo
Keyword(s):  
Health Care ◽  
Health Services ◽  
Early Stage ◽  
Health Care Systems ◽  
Stage Of Development ◽  
Services Delivery ◽  
European Experience ◽  
Care Systems ◽  
European Health ◽  
The Uk

Coproduction as a participatory and collaborative innovation in public service delivery might be particularly useful as a tool for improving quality, efficiency and patient satisfaction in the course of health services provision. This article reviews the practices of coproduction identified in European health care systems. This aims at exploring if the coproduction has already gained a status of significant trend in health services provision and what are the outcomes of coproductive arrangements implemented. In the first part, drawing from the literature review, major types of coproduction in health care have been identified, including shared decision making, self management and expert patient initiatives, and peer support networks. In the second part the existing evidence on European experience with coproduction in health care has been analysed in terms of scale and outcomes. This review demonstrates that while coproduction might be promising addition to institutional mix in health services delivery, it is still at early stage of development. The number and scope of coproductive arrangements is rather low and most of them could be identified in the UK health care system. Possible reasons for limited dissemination of coproduction in the European health care systems are discussed in the last part of the article.

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 Operational challenges in conducting a community-based technology-enabled mental health services delivery model for rural India: Experiences from the SMART Mental Health Project

2018 ◽  
Vol 3 ◽  
pp. 43
Author(s):  
Pallab K. Maulik ◽  
Sudha Kallakuri ◽  
Siddhardha Devarapalli
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Care ◽  
Rural India ◽  
Operational Strategies ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Health Project

Background: There are large gaps in the delivery of mental health care in low- and middle-income countries such as India, and the problems are even more acute in rural settings due to lack of resources, remoteness, and lack of infrastructure, amongst other factors. The Systematic Medical Appraisal Referral and Treatment (SMART) Mental Health Project was conceived as a mental health services delivery model using technology-based solutions for rural India. This paper reports on the operational strategies used to facilitate the implementation of the intervention. Method: Key components of the SMART Mental Health Project included delivering an anti-stigma campaign, training of primary health workers in screening, diagnosing and managing stress, depression and increased suicide risk and task sharing of responsibilities in delivering care; and using mobile technology based electronic decision support systems to support delivery of algorithm based care for such disorders. The intervention was conducted in 42 villages across two sites in the state of Andhra Pradesh in south India. A pre-post mixed methods evaluation was done, and in this paper operational challenges are reported. Results: Both quantitative and qualitative results from the evaluation from one site covering about 5000 adults showed that the intervention was feasible and acceptable, and initial results indicated that it was beneficial in increasing access to mental health care and reducing depression and anxiety symptoms. A number of strategies were initiated in response to operational challenges to ensure smoother conduct of the project and facilitated the project to be delivered as envisaged. Conclusions: The operational strategies initiated for this project were successful in ensuring the delivery of the intervention. Those, coupled with other more systematic processes have informed the researchers to understand key processes that need to be in place to develop a more robust study, that could eventually be scaled up.

scholarly journals The importance of intervening in adult mental health services when patients are parents

2014 ◽  
Vol 3 (6) ◽  
pp. 56 ◽  
Author(s):  
Camilla Lauritzen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Health Care Systems ◽  
Theoretical Background ◽  
Parental Mental Illness ◽  
Adult Mental Health ◽  
Care Systems

This article addresses the issue of parental mental illness. The theoretical background and rationale for developing new routines to change clinical practice is described, suggesting a policy change in which a child focus is implemented in adult mental health services. Furthermore, proposed strategies that have the potential of being effective within existing health care systems are discussed.

scholarly journals A Simplified Technique for Drainage of Chronic Calcified Pleural Empyema

2017 ◽  
Vol 65 (07) ◽  
pp. 586-588 ◽  
Author(s):  
Hama Younssa ◽  
James Didier ◽  
Magagi Ibrahim ◽  
Adamou Harissou ◽  
Ousseini Adakal ◽  
...  
Keyword(s):  
Health Care ◽  
Developing Countries ◽  
Early Diagnosis ◽  
Pulmonary Resection ◽  
Health Care Systems ◽  
Pleural Empyema ◽  
Complete Resection ◽  
Organizational System ◽  
Care Systems ◽  
Principles Of Treatment

AbstractChronic pleural pocket has well-known diagnosis and treatment principles since first described by Hippocrates 2,400 years ago. However, its treatment remains constant even though its causes, severity during management, and terrain vary considerably. In well-structured health care systems, posttuberculous empyema has become rare; its well-codified medical treatment relies on early diagnosis and adapted antibiotherapy, punctures/drainage, and appropriate intrapleural antifibrinolytics. In developing countries, a poor health organizational system increases the incidence of pleural pocket, which can progress until surgery is indicated. In such a context, the general principles of treatment include pleural decortication along with pulmonary resection. This technique remains difficult, risky, and, sometimes, impossible due to the chronicity of the lesion. In patients debilitated by several months of septic evolution, a simplified thoracostomy technique permits complete resection of the pocket.

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