Towards Universal Healthcare Coverage: Experience form the Implementation of the National Basic Public Health Service Program in China (Preprint)

2021 ◽  
Author(s):  
Guixia Fang ◽  
Li Wang ◽  
Yuanyuan Liang ◽  
Zhihao Wang ◽  
Jinxia Yang
Keyword(s):  
Public Health ◽  
Health Service ◽  
System Integration ◽  
Public Health Service ◽  
Health Sector ◽  
Health Service Delivery ◽  
Health Coverage ◽  
Service Program ◽  
Financing System

UNSTRUCTURED Public health service is an important component and pathway to achieve universal health coverage (UHC), a major direction where many countries are striving for. China's National Basic Public Health Service Program are highly consistent with the direction. It provides life cycle services to the whole population with an equitable and affordable financing system. Its implementation builds up capacity and quality of health workforce and contributes to the integration of public health service delivery system. All of these is useful experience for China on its journey to UHC. Meanwhile, there are also some challenges, including lack of selection and exit mechanism of service items, inadequate system integration, shortage of qualified professionals, limited role of actors outside of health sector, and subsidy standard lower than the cost. In the future, China needs to address those challenges, especially to optimize service items, enhance quality of the services, and evaluate the health outcomes.

Rebuilding India’s Public Health

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Imrana Qadeer
Keyword(s):  
Public Health ◽  
Health Service ◽  
Structural Adjustment ◽  
Public Health Service ◽  
Developmental Process ◽  
Health Sector ◽  
Public Hospitals ◽  
International Standards ◽  
Local Context ◽  
Inequality In Health

Assuming impervious boundaries of public health service systems when searching for answers to its problems can be misleading as historically, economic and welfare planning to improve the quality of life of all was considered critical. Despite years of planning, the health sector in India has acquired a tumultuous trajectory with chaos prevailing at different levels – conceptualization, policy, financing, organization and community participation. Using the concept of order in Chaos, this paper attempts to trace four basic underlying elementary patterns in the developmental process rooted in the larger socio-political structures that led to this chaos. Its second section explores the roots from where these patterns explaining the links between health, poverty and inequality in health emanate - the zone of conflict of interests among those who hold power and those whom they represent. It explores how they altered the public health service system and settled in favour of a small but powerful elite (the corporates, the upper-middle class and the professionals) seeking international standards irrespective of the local context. Structural Adjustment and the Health Sector Reforms benefited them by shifting subsidies to the private/corporate sector, transforming services into a costly commodity, fragmented and marginalized primary health care and public hospitals while ushering in hi-tech medicine.

scholarly journals The role of boards in clinical governance: activities and attitudes among members of public health service boards in Victoria

2013 ◽  
Vol 37 (5) ◽  
pp. 682 ◽  
Author(s):  
Marie M. Bismark ◽  
Simon J. Walter ◽  
David M. Studdert
Keyword(s):  
Public Health ◽  
Quality Of Care ◽  
Health Service ◽  
Health Services ◽  
Public Health Service ◽  
Clinical Governance ◽  
Board Members ◽  
Quality And Safety ◽  
Quality Performance

Objectives To determine the nature and extent of governance activities by health service boards in relation to quality and safety of care and to gauge the expertise and perspectives of board members in this area. Methods This study used an online and postal survey of the Board Chair, Quality Committee Chair and two randomly selected members from the boards of all 85 health services in Victoria. Seventy percent (233/332) of members surveyed responded and 96% (82/85) of boards had at least one member respond. Results Most boards had quality performance as a standing item on meeting agendas (79%) and reviewed data on medication errors and hospital-acquired infections at least quarterly (77%). Fewer boards benchmarked their service’s quality performance against external comparators (50%) or offered board members formal training on quality (53%). Eighty-two percent of board members identified quality as a top priority for board oversight, yet members generally considered their boards to be a relatively minor force in shaping the quality of care. There was a positive correlation between the size of health services (total budget, inpatient separations) and their board’s level of engagement in quality-related activities. Ninety percent of board members indicated that additional training in quality and safety would be ‘moderately useful’ or ‘very useful’. Almost every respondent believed the overall quality of care their service delivered was as good as, or better than, the typical Victorian health service. Conclusions Collectively, health service boards are engaged in an impressive range of clinical governance activities. However, the extent of engagement is uneven across boards, certain knowledge deficits are evident and there was wide agreement among board members that further training in quality-related issues would be useful. What is known about the topic? There is an emerging international consensus that effective board leadership is a vital element of high-quality healthcare. In Australia, new National Health Standards require all public health service boards to have a ‘system of governance that actively manages patient safety and quality risks’. What does this paper add? Our survey of all public health service Boards in Victoria found that, overall, boards are engaged in an impressive range of clinical governance activities. However, tensions are evident. First, whereas some boards are strongly engaged in clinical governance, others report relatively little activity. Second, despite 8 in 10 members rating quality as a top board priority, few members regarded boards as influential players in determining it. Third, although members regarded their boards as having strong expertise in quality, there were signs of knowledge limitations, including: near consensus that (additional) training would be useful; unfamiliarity with key national quality documents; and overly optimistic beliefs about quality performance. What are the implications for practitioners? There is scope to improve board expertise in clinical governance through tailored training programs. Better board reporting would help to address the concern of some board members that they are drowning in data yet thirsty for meaningful information. Finally, standardised frameworks for benchmarking internal quality data against external measures would help boards to assess the performance of their own health service and identify opportunities for improvement.

scholarly journals KUALITAS PENCATATAN ASUHAN KEPERAWATAN KOMUNITAS

2020 ◽  
Vol 9 (1) ◽  
pp. 1048-1059
Author(s):  
Diding Sarifudin
Keyword(s):  
Public Health ◽  
Health Service ◽  
Path Analysis ◽  
Public Health Service ◽  
Community Nursing ◽  
Cross Sectional ◽  
Record Keeping ◽  
Nursing Activity ◽  
Nursing Record

Cakupan kegiatan keperawatan komunitas di Kabupaten Cirebon masih rendah, sedangkan perawat sebagai pelaksananya merupakan tenaga kesehatan terbanyak dibandingkan dengan tenaga kesehatan lainnya. Perawat melakukan asuhan keperawatan komunitas seharusnya dengan pendokummentasian atau pencatatan yang merupakan panduan sehingga kegiatannya terarah dan terpadu sesuai dengan masalah yang ditemukan. Tujuan penelitian ini adalah ingin mengetahui kualitas pencatatan asuhan keperawatan komunitas di Kabupaten Cirebon tahun 2006 dan faktor-faktor yang mempengaruhinya. Penelitian ini adalah penelitian kuantitatif dengan menggunakan rancangan cross-sectional. Data dikumpulkan dari 71 perawat puskesmas dengan menggunakan perhitungan besar sampel Lot quality assurance sampling (LQAS-Lot) secara sistematic random sampling, selain dilakukan wawancara juga dilakukan pemeriksaan catatan asuhan keperawatan masing-masing responden 5 dokumen. Penelitian dilakukan pada bulan September 2006 dengan menggunakan analisis univariat dan analisis jalur (path analysis). Dari data yang dikumpulkan diperoleh kualitas pencatatan dengan baik sebesar 59,2%. Hasil pemodelan dengan analisis jalur ternyata kepemimpinan merupakan variabel utama yang mempunyai pengaruh sebesar 46,8% terhadap kualitas pencatatan asuhan keperawatan, variabel lain yang mempunyai pengaruh terhadap kualitas pencatatan asuhan keperawatan adalah pengetahuan sebesar 31%, sikap sebesar 17,6 %, imbalan sebesar 11,6%, dan variabel masa kerja melalui sikap sebesar 4%. Kepemimpinan kepala puskesmas mampu meningkatkan kualitas pencatatan asuhan keperawatan yang dilakukan karyawannya, selain itu kepemimpinan dapat meningkatkan pengetahuan, mengatur imbalan yang diberikan, dan dapat merubah sikap karyawannya. Bagi Dinas Kesehatan yang mempunyai kewajiban membina kepala puskesmas maka harus selalu membina dan mengevaluasi kinerja kepala puskesmas.Kata Kunci : Kualitas pencataan Asuhan Keperawatan ABSTRACTScope of community nursing activity in district of Cirebon has undervalued. In fact, number of nurse resources there larger than another medical profession. They to be organized in community nursing activity and nursing activity record-keeping as principal guide, they will working in sistematic way and well integrated according to the problem raised from public health service. This research aim to determine the quality of community nursing activity record-keeping in district of Cirebon for year of 2006 and the influencing factors within. Research belong to quantitative research with cross-sectional design. Data collecting using Lot quality assurance sampling (LQAS-Lot) with sistematic random sampling method by surveying and interviewing 71 nurse from local public health services, including checking of  5 document from each respondent’s nursing record. Research taken during september 2006 and using univariat analysis and path analysis. The result shows the quality of record-keeping which noticed as good are 52,2 % in value. Modelling result from path analysis put leadership as main variable which influence the quality of nursing record-keeping at 46,8%. Another variable which having influence on quality of nursing record-keeping are nurse’s knowledge at 31%, nurse’s attitude at 17,6%, rewards at 11,6% and working period at 4%. Leadership skills of local public service’s head can improve the quality of record-keeping of community nursing activity by its employees (nurses). Besides, leaderships skills direct to improvement of knowledge, remuneration management, and change in attitude. District public health service which has responsibility in training and developing officer to become head of local public health service should  control and monitor their working performance continuously.Key word : quality of community nursing

scholarly journals Socioeconomic and parasitological aspects in Quilombola communities in two of the oldest municipalities in Brazil

2019 ◽  
Vol 21 (6) ◽  
pp. 1-7
Author(s):  
Alline Mikaele Nunes Wildemberg Brauer ◽  
Débora Barreto Teresa Gradella ◽  
Anelise Andrade de Souza ◽  
Marco Antônio Andrade de Souza
Keyword(s):  
Public Health ◽  
Health Service ◽  
Public Health Service ◽  
Septic Tank ◽  
The Public ◽  
Piped Water ◽  
Basic Sanitation ◽  
Study Population ◽  
Made In

Objective To carry out a socioeconomic, demographic and parasitological evaluation of quilombola communities in two of the oldest municipalities in Brazil.Material and Methods Between December 2015 and June 2016, of the total of 231 residents of the communities, socioeconomic questionnaires were applied and fecal samples collected from 150 individuals were analyzed by spontaneous sedimentation method and the Kato-Katz method.Results It was observed that 95.3% (n=143) of the interviewees had piped water at their residence, and 76% (n=114) came from wells or springs; 85.3% (n=128) reported that the toilet drain was made in a rudimentary septic tank and 59.3% (n=89) reported having litter buried or burned, showing precarious conditions in basic sanitation. Still on socioeconomic aspects, 80.7% (n=121) of the individuals reported having access to the public health service. Parasitological tests were positive for 48% (n=72) of the analyzed samples, and 25% (n=18) had two or more parasites. The most frequent organism in the study population was the commensal Entamoeba coli (55.6%, n=40), followed by Ascaris lumbricoides (19.4%, n=14) and the commensal Endolimax nana (16.7%, n=12). The Poisson regression showed an increase of 1.59 in the prevalence of parasites for individuals who do not have access to the public health service, when compared to those who have access to these services.Conclusions The results indicate the need to implement public health measures in order to reduce, prevent and treat the parasitological condition of the population to obtain better conditions and quality of life.

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