scholarly journals KAJIAN KEBERLANGSUNGAN RUMAH TUNGGU KELAHIRAN (RTK) DALAM UPAYA MENURUNKAN ANGKA KEMATIAN MATERNAL DI INDONESIA

2018 ◽  
Vol 21 (2) ◽  
pp. 114-124 ◽  
Author(s):  
Noor Edi Widya Sukoco
Keyword(s):  
Local Government ◽  
Pregnant Women ◽  
Health Workers ◽  
Secondary Data ◽  
Access To Health Services ◽  
Policy Makers ◽  
Care Services ◽  
Access To Health ◽  
Asean Countries ◽  
Emergency Detection

Maternal Mortality Rate in Indonesia is still the highest compared to other ASEAN countries and faces a gap in access to health services. It needs a waiting house that is close to health service facility and can be temporarily occupied by pregnant mother before delivery which is Maternal Waiting Homes (MWH). This analysis to know aspects that can maintain the continuity of RTK services. This study uses secondary data by listing the policy and regulatory documents related to RTK policy and by organizing several workshops to gain a view of policy makers. The results show that the MWH fi nancing system is still local and not well coordinated. The number of health workers who provide services in MWH is still limited. Likewise, MWH facilities and facilities are still inadequate, in particular, water and electricity problems, as well as a place for families accompanying maternity mothers. Most MWH s only provide facilities for living without maternal and neonatal care services. Several efforts have been made by the local government in encouraging the utilization of MWH in pregnant women among others by involving customary institutions and the use of communication technology for early emergency detection of pregnant women. MWH sustainability can be built with the full support of local government, socialization and synergies with related sectors. Abstrak Angka Kematian Ibu di Indonesia tertinggi dibandingkan negara-negara ASEAN lain dan menghadapikesenjangan akses pelayanan kesehatan. Rumah tempat menunggu yang dekat dengan fasilitas pelayanankesehatan dan dapat dihuni sementara oleh ibu hamil sebelum persalinan yaitu Rumah Tunggu Kelahiran(RTK) merupakan salah satu alternatif solusi. Analisis dilakukan untuk mengetahui aspek yang dapat menjagakeberlangsungan layanan RTK. Kajian ini menggunakan data sekunder dengan cara menginventarisir dokumenkebijakan dan peraturan perundangan yang terkait dengan kebijakan RTK serta dengan mengadakan beberapaworkhop untuk memperoleh sudut pandang para penentu kebijakan. Hasil menunjukkan sistem pembiayaanRTK masih bersifat lokal dan belum terkoordinasi dengan baik. Jumlah tenaga kesehatan yang memberikanpelayanan di RTK masih terbatas. Demikian juga fasilitas dan sarana RTK masih belum memadai, terutama,masalah air dan listrik, serta tempat untuk keluarga yang mendampingi ibu bersalin. Sebagian besar RTKhanya menyediakan fasilitas untuk tinggal tanpa pelayanan perawatan kesehatan ibu dan bayi. Beberapaupaya telah dilakukan pemerintah lokal dalam mendorong pemanfaatan RTK pada ibu hamil di antaranyadengan melibatkan lembaga adat dan penggunaan teknologi komunikasi untuk deteksi darurat dini bumil risti.Keberlangsungan RTK dapat dibangun dengan dukungan penuh pemerintah daerah, sosialisasi dan bersinergidengan lintas sektor terkait.

scholarly journals Utilization of Maternity Waiting Home (MWH) to Improve Access to Health Services: Systematic Literature Review

2020 ◽  
Vol 7 (3) ◽  
pp. 368-375
Author(s):  
Nuraina Nuraina
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Health Workers ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Access To Health Services ◽  
Care Services ◽  
Access To Health ◽  
Maternity Waiting Home ◽  
Improve Access

Maternity waiting home (MWH) is a home built in the compound or near to health facilities that provides standard medical and emergency obstetric care services. MWH is considered to be a key strategy to "bridge the geographical gap" in obstetric care between rural areas with poor access to equipped facilities, and urban areas where the services are available. This study aimed to systematically review the utilization of MWH to improve access to health service. The method of finding articles in this study was in the period 2014 to 2018, free full text, human species, and scholarly journals which were then identified using an electronic database from Pubmed, Proquest and Onesearch. Three articles were carried out with thematic analysis to identify the main points. Factors associated with the utilization of MWH included (1) Distance; (2) Complication during pregnancy; and (3) Income. Barrier in the utilization of MWH were (1) Inadequate number of room and postpartum bed; (2) Lack of water and sanitation facilities; and (3) Unavailable electricity. Partnership between health workers in rural facilities, stronger role of stakeholders, and a broader health system, were expected to increase the utilization of MWH.

Developing a Consistent Approach to Determining Priority for HACC Services

2003 ◽  
Vol 9 (1) ◽  
pp. 78 ◽  
Author(s):  
Kirsten J. Black ◽  
Patricia L. Buckley
Keyword(s):  
Local Government ◽  
Local Governments ◽  
Community Services ◽  
Metropolitan Region ◽  
Access To Health Services ◽  
Service Allocation ◽  
Care Services ◽  
Home And Community Care ◽  
Access To Health ◽  
Allocation Decisions

This paper reports on the development of a Priority of Access tool for Home and Community Care services provided by local governments in the Western Metropolitan Region of Victoria. Managing the demand for these services requires an equitable approach to service allocation decisions. The Priority of Access tool was developed with input from Western Metropolitan Region local government HACC representatives and the Department of Human Services. A literature review identified indicators of need that predicted use of community services; however, no substantial contributions were identified relating to prioritising access to health services in the home. The tool developed relies on cross-referencing responses from the Service Coordination tools developed through the Victorian Primary Care Partnership initiative. A pilot was conducted with assessment staff and their feedback led to modification of the tool. Staff found the tool a useful method of increasing objectivity in assessments and providing a framework to consistently determine priority. The importance of training in the use of the tool was reinforced during piloting of the tool. The Priority of Access tool provides a simple and consistent, yet comprehensive, approach for Western Metropolitan Region local government HACC services to equitably determine priority of access for clients.

scholarly journals Equitable access to health services for children aged 5 to 9 in a medium city of northeasth of Brazil: a result of Family Health Strategy

2014 ◽  
Vol 17 (suppl 2) ◽  
pp. 39-52 ◽  
Author(s):  
Adriana Xavier de Santiago ◽  
Ivana Cristina de Holanda Cunha Barreto ◽  
Ana Cecília Silveira Lins Sucupira ◽  
José Wellington de Oliveira Lima ◽  
Luiz Odorico Monteiro de Andrade
Keyword(s):  
Health Services ◽  
Health System ◽  
Family Health ◽  
Northeastern Brazil ◽  
Local Health ◽  
Access To Health Services ◽  
Care Services ◽  
Health Strategy ◽  
Access To Health ◽  
Family Health Strategy

INTRODUCTION: The Brazilian National Health System may reduce inequalities in access to health services through strategies that can reach those most in need with no access to care services. OBJECTIVE: To identify factors associated with the use of health service by children aged 5 to 9 years in the city of Sobral, Ceará, northeastern Brazil. RESULTS: Only 558 (17.0%) children used health care services in the 30 days preceding this survey. Children with any health condition (OR = 3.90) who were frequent attenders of primary care strategy of organization (the Family Health Strategy, FHS) (OR = 1.81) and living in the city's urban area (OR = 1.51) were more likely to use health services. Almost 80% of children used FHS as their referral care service. Children from poorer families and with easier access to services were more likely to be FHS users. CONCLUSION: The study showed that access to health services has been relatively equitable through the FHS, a point of entry to the local health system.

scholarly journals Integrated home-based screening for people living with disabilities: A case study from rural Malawi

2019 ◽  
Vol 8 ◽  
Author(s):  
Elizabeth M. Petersen ◽  
Emily B. Wroe ◽  
Kondwani Nyangulu ◽  
Chisomo Kanyenda ◽  
Sam Njolomole ◽  
...  
Keyword(s):  
Hiv Testing ◽  
Screening Programme ◽  
Health Workers ◽  
Hiv Care ◽  
Access To Health Services ◽  
Home Based ◽  
Poor Access ◽  
Access To Health ◽  
Integrated Screening

People living with disabilities (PLWDs) have poor access to health services compared to people without disabilities. As a result, PLWDs do not benefit from some of the services provided at health facilities; therefore, new methods need to be developed to deliver these services where PLWDs reside. This case study reports a household-based screening programme targeting PLWDs in a rural district in Malawi. Between March and November 2016, a household-based and integrated screening programme was conducted by community health workers, HIV testing counsellors and a clinic clerk. The programme provided integrated home-based screening for HIV, tuberculosis, hypertension and malnutrition for PLWDs. The programme was designed and implemented for a population of 37 000 people. A total of 449 PLWDs, with a median age of 26 years and about half of them women, were screened. Among the 404 PLWDs eligible for HIV testing, 399 (99%) agreed for HIV testing. Sixty-nine per cent of PLWDs tested for HIV had never previously been tested for HIV. Additionally, 14 patients self-reported to be HIV-positive and all but one were verified to be active in HIV care. A total of 192 of all eligible PLWDs above 18 years old were screened for hypertension, with 9% (n = 17) referred for further follow-up at the nearest facility. In addition, 274 and 371 PLWDs were screened for malnutrition and tuberculosis, respectively, with 6% (n = 18) of PLWDs referred for malnutrition, and 2% (n = 10) of PLWDs referred for tuberculosis testing. We successfully implemented an integrated home-based screening programme in rural Malawi.

scholarly journals Community Health Workers: Challenges and Vulnerabilities of Accredited Social Health Activists Working in Conflict-affected Settings in the State of Assam, India

2020 ◽  
Author(s):  
Preety R Rajbangshi ◽  
Devaki Nambiar ◽  
Aradhana Srivast
Keyword(s):  
Community Health ◽  
Community Health Workers ◽  
Social Relations ◽  
Health Workers ◽  
Social Health ◽  
Access To Health Services ◽  
North East ◽  
The North ◽  
East Region ◽  
Access To Health

Abstract Introduction:. It is well acknowledged that India’s Community Health workers known as Accredited Social Health Activists (ASHA) are the bedrock of its health system. Many ASHAs are currently working in fragile and conflict-affected settings. No efforts have yet been made to understand the challenges and vulnerabilities of these female workers. This paper seeks to address this gap by bringing attention to the situation of ASHAs working in the fragile and conflict settings and how conflict impacts them and their work. Methods: Qualitative fieldwork was undertaken in four conflict-affected villages in two conflict-affected districts -Kokrajhar and Karbi Anglong of Assam state situated in the North-East region of India. Detailed account of four ASHAs from the majority (Bodo or Karbi) and minority (Adivasi or Koch) communities serving roughly 4000 people is presented. Data transliterated into English were analysed by authors by developing a codebook using grounded theory and thematic organisation of codes. Results: ASHAs reported facing challenges in ensuring access to health services during and immediately after outbreaks of conflict. They experienced difficulty in arranging transport and breakdown of services at remote health facilities. Their physical safety and security were at risk during episodes of conflict. ASHAs reported hostile attitudes of the communities they served due to the breakdown of social relations, trauma due to displacement, and loss of family members, particularly their husbands. Conclusion: Conflict must be recognised as an important context within which community health workers operate, with greater policy focus and research devoted to understanding and addressing the barriers they face as workers and as persons affected by conflict.

scholarly journals Socioeconomic inequalities in the access to and quality of health care services

2014 ◽  
Vol 48 (6) ◽  
pp. 968-976 ◽  
Author(s):  
Bruno Pereira Nunes ◽  
Elaine Thumé ◽  
Elaine Tomasi ◽  
Suele Manjourany Silva Duro ◽  
Luiz Augusto Facchini
Keyword(s):  
Health Care ◽  
Socioeconomic Status ◽  
Health Care Services ◽  
Access To Health Services ◽  
Socioeconomic Groups ◽  
Care Services ◽  
Access To Health ◽  
To Receive ◽  
Use Of Health Care

OBJECTIVE To assess the inequalities in access, utilization, and quality of health care services according to the socioeconomic status. METHODS This population-based cross-sectional study evaluated 2,927 individuals aged ≥ 20 years living in Pelotas, RS, Southern Brazil, in 2012. The associations between socioeconomic indicators and the following outcomes were evaluated: lack of access to health services, utilization of services, waiting period (in days) for assistance, and waiting time (in hours) in lines. We used Poisson regression for the crude and adjusted analyses. RESULTS The lack of access to health services was reported by 6.5% of the individuals who sought health care. The prevalence of use of health care services in the 30 days prior to the interview was 29.3%. Of these, 26.4% waited five days or more to receive care and 32.1% waited at least an hour in lines. Approximately 50.0% of the health care services were funded through the Unified Health System. The use of health care services was similar across socioeconomic groups. The lack of access to health care services and waiting time in lines were higher among individuals of lower economic status, even after adjusting for health care needs. The waiting period to receive care was higher among those with higher socioeconomic status. CONCLUSIONS Although no differences were observed in the use of health care services across socioeconomic groups, inequalities were evident in the access to and quality of these services.

Effectiveness of website application (Sumiferos) for preventing anemia with pregnant women compliance in consuming Fe tablets

2020 ◽  
Vol 11 (3) ◽  
pp. 197-200
Author(s):  
Rosmaria . ◽  
Sri Yun Utama ◽  
Titik Hindriati ◽  
Diniyati .
Keyword(s):  
Pregnant Women ◽  
Health Workers ◽  
Intervention Group ◽  
Control Group ◽  
Test Design ◽  
Communication Tool ◽  
Care Services ◽  
Post Test ◽  
Quasi Experimental ◽  
Group Post

Background: The consumption of Fe tablets needs to be the attention of midwives as one of the spearheads in providing antenatal care services. Due to the low level of compliance of pregnant women to consume Fe tablets, it is necessary to provide appropriate counseling as an effort to increase compliance with Fe tablets. Objective: This study aimed to determine the effectiveness of the application model (Sumiferos) for preventing anemia with pregnant women compliance in consuming Fe tablets at Putri Ayu Health Center in Jambi city. Materials and methods: This study used a quasi-experimental research design with a post-test design by involving an intervention group and a control group (post-test), two group designs. With the total of 70 subjects;the intervention group, 35 respondents were given a website application (sumiferos), and a control group 35 respondents were given a leflet. After a month, the number of Fe tablets that have been consumed was monitored. Compliance of pregnant women in consuming Fe tablets required a monitoring or supervisioncarried out by health workers. Therefore, an intervention was given by using a website-based application (sumiferos) for pregnant women as a communication tool that has been created and designed previously by researchers. Results: Posttest statistical analysis showed that pregnant women who were given a website application (sumiferos) in the intervention group showed better compliance than pregnant women in the control group given lefket. Conclusion: Based on the results,a website application (sumiferos) is more effective than leaflets in improving maternal compliance to consume Fe tablets given by health workers.

scholarly journals Barriers to accessing health care services: A qualitative study of migrant construction workers in a Southwestern Indian city

2020 ◽  
Author(s):  
Maija Santalahti ◽  
Kumar Sumit ◽  
Mikko Perkiö
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Care Access ◽  
Access To Health Care ◽  
Health Care Services ◽  
Construction Workers ◽  
Access To Health Services ◽  
Care Access ◽  
Care Services ◽  
Access To Health

Abstract Background: This study examined access to health care in an occupational context in an urban city of India. Many people migrate from rural areas to cities, often across Indian states, for employment prospects. The purpose of the study is to explore the barriers to accessing health care among a vulnerable group – internal migrants working in the construction sector in Manipal, Karnataka. Understanding the lay workers’ accounts of access to health services can help to comprehend the diversity of factors that hinder access to health care. Methods: Individual semi-structured interviews involving 15 migrant construction workers were conducted. The study applied theory-guided content analysis to investigate access to health services among the construction workers. The adductive analysis combined deductive and inductive approaches with the aim of verifying the existing barrier theory in a vulnerable context and further developing the health care access barrier theory. Results: This study’s result is a revised version of the health care access barriers model, including the dimension of trust. Three known health care access barriers – financial, cognitive and structural, as well as the new barrier (distrust in public health care services), were identified among migrant construction workers in a city context in Karnataka, India. Conclusions: Further qualitative research on vulnerable groups would produce a more comprehensive account of access to health care. The socioeconomic status behind access to health care, as well as distrust in public health services, forms focal challenges for any policymaker hoping to improve health services to match people’s needs.

scholarly journals A Pregnant Women’s Group: Its Effects on Maternal and Neonatal Health Care Services among Disadvantaged Community in Makawanpur, Nepal

2017 ◽  
Vol 3 (1) ◽  
pp. 22-36
Author(s):  
Bhagawan Das Shrestha
Keyword(s):  
Pregnant Women ◽  
Health Care Services ◽  
Teaching And Learning ◽  
Educational Status ◽  
Health Staff ◽  
Local Health ◽  
Access To Health Services ◽  
Disadvantaged Community ◽  
Care Services ◽  
Postnatal Mothers

In Nepal, the utilization of maternal, newborn and child health (MNCH) care services exhibit big gaps between rich and poor, for instance poorest quintile is at 10.7% skill births attendant services but richest at 81.5%, despite the services being free of cost. Pregnant women group (PWG) approach was initiated to address MNCH inequities prevailing in the disadvantaged community. The PWG is a socially cohesive peer support group of 8-15 pregnant women and postnatal mothers who meet monthly for participatory teaching and learning sessions on MNCH cares and semi-annual publicly group commitment meetings. At the meetings, husbands and mothers-in-law verbally commit to support their pregnant wives and daughters-in-law in present of pregnant women. Local health staff also commits to provide those services. Retrospective cohort study was undertaken in which 449 randomly selected recently delivered women who were members of PWG in last pregnancy and next 449 non-members to PWG from same villages of Makwanpur were introduced the structured questionnaires between March and April 2015. The results indicated that the increase in the utilization of MNCH care services was statistically significant (P<0.0001 for all indicators) among women who were PWG members than those who were not. Despite the fact that the average age, educational status, parity, ethnicity, location and access to health services were constant. Pregnant women’s group approach increases the utilization of MNCH care services for disadvantaged community in Makwanpur, Nepal. Thus, the PWG approach can be a strategy to reduce the inequity MNCH care services coverage in developing countries.

scholarly journals Piloting a trachomatous trichiasis patient case-searching approach in two localities of Sudan

2020 ◽  
Vol 114 (8) ◽  
pp. 561-565
Author(s):  
Angelia M Sanders ◽  
Maha Adam ◽  
Nabil Aziz ◽  
E Kelly Callahan ◽  
Belgesa E Elshafie
Keyword(s):  
Control Program ◽  
Case Finding ◽  
Access To Health Services ◽  
Patient Case ◽  
Medical Assistants ◽  
Remote Areas ◽  
Care Services ◽  
Access To Health ◽  
Advanced Stages ◽  
Trachomatous Trichiasis

Abstract Background Approximately 1.9 million people have become blind or visually impaired from trachoma, the leading cause of infectious blindness. Trachoma prevalence surveys conducted in Sudan have shown that thousands of Sudanese suffer from the advanced stages of the disease, trachomatous trichiasis (TT), and warrant sight-saving surgery. Sudan’s National Trachoma Control Program (NTCP) provides free TT surgery; however, given that many TT patients live in remote areas with limited access to health services, identifying patients and providing eye care services has proved challenging. For this reason, the Sudan NTCP piloted a systematic TT case-finding approach to identify patients. Methods In Gedarif state, 11 villages in Baladyat el Gedarif locality and 21 villages in West Galabat locality were included in a TT case-searching activity from September to November 2018. TT case finders were selected from the villages where the activity took place and were trained by ophthalmic medical assistants to identify possible patients. Results Of 66 626 villagers examined, 491 were identified as having TT by TT case finders. Of those, 369 were confirmed as true cases by the TT surgeons, a 75.2% (369/491) success rate. Conclusions The TT case-finding approach provides an example of an effective method for identifying TT patients and should be expanded to other parts of the country known to be endemic for trachoma.

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