scholarly journals Designing an Empowerment Model for Iranian Health Centre Managers: A comprehensive study

2020 ◽  
Vol 15 (4) ◽  
pp. 28-41
Author(s):  
Fatemeh Yousef Yaghoobi ◽  
Leila Riahi ◽  
Seyed Jamaleddin Tabibi ◽  
Mahmood Mahmoodi Majdabadi Farahani

OBJECTIVES: Empowering managers plays a crucial role in developing the capabilities and competencies of individuals to improve the continuous performance of health center organizations. The purpose of this study is to design a model of empowerment of health center managers in Iran during 2018-2019. DESIGN: In this applied, exploratory and cross-sectional study, human resource empowerment components were extracted by reviewing the literature and interviewing subject specialists. Then, the conceptual model of the research was designed and the questionnaire was formulated and validated. Data were collected by filling out a questionnaire from a total of 416 managers of health centers selected by stratified random sampling. The collected data were analyzed using descriptive statistics and confirmatory and exploratory factor analysis. RESULTS: In the final model of empowerment of health center managers, five factors were identified as effective factors. The standardized regression coefficients among the contextual, self-efficacy, managerial, organizational-value, and psychological factors with empowerment were 0.98, 0.95, 0.92, 0.90, and 0.76, respectively. The results of confirmatory factor analysis indicate the suitability of the final model of health center managers’ empowerment. CONCLUSIONS: Due to the influence of contextual, self-efficacy, managerial, organizational-value, and psychological factors in the model approved in this study, the health system senior managers can have a systemic approach to issues. In addition, they can improve managers’ abilities by employing a continuous self-assessment system in health centers, applying the proposed model, improving administrative infrastructure and working environment, paying attention to organizational culture, reward system, participatory management, information sharing, continuous training, and modeling.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ianita Zlateva ◽  
Amanda Schiessl ◽  
Nashwa Khalid ◽  
Kerry Bamrick ◽  
Margaret Flinter

Abstract Background In recent years, health centers in the United States have embraced the opportunity to train the next generation of health professionals. The uniqueness of the health centers as teaching settings emphasizes the need to determine if health professions training programs align with health center priorities and the nature of any adjustments that would be needed to successfully implement a training program. We sought to address this need by developing and validating a new survey that measures organizational readiness constructs important for the implementation of health professions training programs at health centers where the primary role of the organizations and individuals is healthcare delivery. Methods The study incorporated several methodological steps for developing and validating a measure for assessing health center readiness to engage with health professions programs. A conceptual framework was developed based on literature review and later validated by 20 experts in two focus groups. A survey-item pool was generated and mapped to the conceptual framework and further refined and validated by 13 experts in three modified Delphi rounds. The survey items were pilot-tested with 212 health center employees. The final survey structure was derived through exploratory factor analysis. The internal consistency reliability of the scale and subscales was evaluated using Chronbach’s alpha. Results The exploratory factor analysis revealed a 41-item, 7-subscale solution for the survey structure, with 72% of total variance explained. Cronbach’s alphas (.79–.97) indicated high internal consistency reliability. The survey measures: readiness to engage, evidence strength and quality of the health professions training program, relative advantage of the program, financial resources, additional resources, implementation team, and implementation plan. Conclusions The final survey, the Readiness to Train Assessment Tool (RTAT), is theoretically-based, valid and reliable. It provides an opportunity to evaluate health centers’ readiness to implement health professions programs. When followed with appropriate change strategies, the readiness evaluations could make the implementation of health professions training programs, and their spread across the United States, more efficient and cost-effective. While developed specifically for health centers, the survey may be useful to other healthcare organizations willing to assess their readiness to implement education and training programs.


Author(s):  
Astuti Lamid ◽  
Nova Sri Hartati ◽  
Fitriana Fitriana ◽  
Srilaning Driyah

Abstrak Masalah balita gizi buruk cenderung menurun pada tahun 2018, namun di beberapa daerah kasus gizi buruk meningkat menjadi KLB. Salah satu penanganannya melalui pemulihan di puskesmas. Tujuan penelitian ini untuk mengetahui sejauh mana penanganan gizi buruk dilakukan oleh tenaga kesehatan puskesmas dan kader posyandu. Desain penelitian menggunakan pendekatan mix methods, berlokasi di Kalimantan Barat, Banten, Jawa Barat dan Nusa Tenggara Timur. Dua kabupaten dipilih dari masing-masing provinsi, selanjutnya dari tiap kabupaten diambil satu puskesmas yang banyak kasus gizi buruk. Informan penelitian adalah Tenaga Pelaksana Gizi (TPG) puskesmas dan kader posyandu. Data yang dikumpulkan meliputi pelayanan gizi dan kesehatan, makanan terapi, dan penyuluhan serta peranan kader. Cara pengumpulan data dengan wawancara, in-depth interview dan diskusi kelompok terarah. Analisis data kuantitatif disajikan secara deskriptif dan kualitatif dengan content analysis. Hasil penelitian menunjukkan sebagian besar puskesmas di daerah penelitian menangani gizi buruk dengan cara rawat jalan. Belum semua TPG puskesmas mendapat pelatihan gizi buruk, hanya sebagian puskesmas menggunakan makanan terapi sedangkan lainnya menggunakan makanan tambahan yang tidak sesuai dengan pedoman. Dukungan sebagian kader dalam penanganan gizi buruk di puskesmas berupa penemuan kasus gizi buruk dan merujuknya, membagikan PMT ke rumah balita. Penanganan balita gizi buruk di puskesmas belum optimal karena tidak didukung dengan ketersediaan input berupa makanan terapi dan belum semua TPG mendapat pelatihan gizi buruk. Pelatihan gizi buruk untuk tenaga puskesmas perlu ditingkatkan dan sistem pengadaan makanan terapi di daerah perlu diperbaiki, agar kualitas pelayanan gizi buruk menjadi lebih baik. Kata kunci: gizi buruk, TPG, PMT, sistem pengadaan, pelayanan kesehatan Abstract The problem of severe malnutrition children under five years old tends to decline in 2018. One of the treatment measures was through recovery at the health center. The purpose of this study was to evaluate the extent to which severe malnutrition children was handled by health center nutrition officer and posyandu cadre. Mix methods approach was used as research design and the study was located in West Kalimantan, Banten, West Java and East Nusa Tenggara Provinces. Two districts were chosen, then one health center from each district was selected based on the highest severe malnutrition cases. The informants were nutrition officer of health center and posyandu cadres. The data collected were nutrition and health services, therapeutic food, counseling, and the role of cadres. Data was collected through interview, in-depth interview, and focus group discussion. Quantitative data analysis was presented descriptively and qualitative data was presented with content analysis.The majority of health centers handled severe malnutrition children in outpatient treatment setting. Not all nutrition officer of health centre have received training in handling severe malnutrition. Only some health centers used therapeutic food while others used supplementary foods that was not recommended. The support of cadre was seen in the form of finding cases of malnutrition and distributing supplementary food to the malnourished children’s homes. The handling of malnourished children in health centers was not optimal, because it was not supported by the availability of therapeutic food and not all nutrition officer have been trained. For recommendations, nutrition training for health center staff needs to be increased and the system for provision therapeutic food in the regions needs to be improved in order to improve the quality of nutrition services. Keywords: severe malnutrition, health center nutrition officer, mix methods, indepth interview, content analysis


10.28945/4414 ◽  
2019 ◽  
Vol 14 ◽  
pp. 637-649
Author(s):  
Anique A Falconer ◽  
Borivoje-Boris Djokic

Aim/Purpose: The purpose of this study was to determine to which degree age, race, and Socioeconomic Status (SES) influence academic self-efficacy and academic self-handicapping behaviors in doctoral. Background: Across all disciplines, more than 50% of students who begin a doctoral program do not persist to graduation. Although the issue of student retention and psychological factors have been proffered, much attention has not been placed on this relationship. Past researchers have focused primarily on academic-related, student-related, institutional, and financial factors. Methodology: A quantitative study was conducted, using the exploratory factor analysis. One-hundred and sixty-five participants, of legal age, who had completed at least one semester of a doctoral program, were involved in this current study. Contribution: The findings from this study increase the empirical evidence reported on the scarce literature on student retention and psychological factors in doctoral students. Findings: The factor analysis test did not show a statistically significance between the dependent variables -academic self-efficacy and academic self-handicapping- and any of the independent variables – gender, race, age, and socioeconomic status. Recommendations for Practitioners: Higher education leaders should make a proactive effort to understand the issue of student retention from a psychological perspective and make implementations to reduce these problems for doctoral students. Recommendation for Researchers: Future researchers should explore in-depth psychological variables that contribute to the high attrition rates in doctoral students. Impact on Society: A better understanding of the factors affecting the cognitive strategies and self-constructs of doctoral students could provide those working in academia with a better understanding of the problem and increase awareness at a societal level. Future Research: It is recommended that future research be carried using a mixed methods approach to offset the limitations found in the quantitative strand and gain thick, rich data from the qualitative strand.


2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Linda Herigstad ◽  
Kari Glavin

Parents' experiences of completing the ASQ tool at the two-year consultation at the Child Health Center – a qualitative studyThis study has investigated the user perspective of parent-based screening tools at Child Health Centers. Age & Stage Questionnaires (ASQ) are used at the two years consultation at Child Health Centers. The aim was to explore parents experience of completing the ASQ tool at two years consultation at the Child Health Center. We used qualitative research methodology with in-depth interviews with parents. The findings show that parents felt positive to fill in the ASQ form. The study also shows a large variation in how parents experienced how the tool was used at the Child Health Centre. The parents' experiences are discussed against theory and other research in the field. The findings are also discussed in light of the purpose of implementing screening tools and results of previous studies in the field. The study concludes that there are many challenges related to the implementation of the tool in the service, and more research is needed in this area.


Author(s):  
Agiesta Sephya Shobarina ◽  
Aat Sriati ◽  
Iwan Shalahuddin

ABSTRACT Background: Elderly Health problems can lead to decline in elderly body functions and become a factor that improves health problems. As a result, many elderly people come to public health services every day with the same complaints and different complaints.Purpose: to recognize the description of health problems among the elderly at Majalaya  public health centers (Puskesmas) West Java-IndonesiaMethods: A descriptive research with documentation study. The object of research is medical records of elderly who went to public health center during the last 1 year from April 2017 until March 2018. The number of samples is 3899 elderly based on elderly visit number gained by total sampling technique. The technique of data collection is through elderly medical records at Majalaya Public Health Centre during  the last 1 year. This research uses frequency distribution and proportion analysis.Results: Showed that almost all elderly came independently without being escorted by their families and hypertension was the highest-ranking health problems experienced by elderly (40,9%) others were rheumatoid atritis (14,9%), cough  and flu (8.2%) , gastritis (7,9%) and chepalgia (7.6%) , they were the 5th highest health problems experienced by the elderly at Majalaya Public Health center during the last 1 year.Conclusion: Among 22 health problems that are experienced by elderly, hypertension is the most common problem complained by elderly. It is recommended that health care workers optimize services regarding the handling and treatment of chronic health problems among elderly.


2016 ◽  
Vol 13 (1) ◽  
pp. 22
Author(s):  
Wan Asrida ◽  
Rafni Puspita Pohan

Public Services of Public Health Centers at the Sub District MarpoyanDamai in the City of Pekanbaru year 2013-2014. Purpose of this study was todetermine the Public Services in Public Health Centers at the District MarpoyanDamai in City of Pekanbaru and what are the factors that obstruct the services. Thisresearch used qualitative methods, research that provides an explanation of data isdone through the process of preparation, presentation of data, observation, interviewtechniques, and Documentation. The result of this research. concluded that the PublicService is still not optimal given employee health centers. Can be seen from thestandard indicators of public services according to kepmenpan No. 63 of 2003,service procedures are difficult, long turnaround time of service, limited serviceproducts, facilities and infrastructure is not yet complete, and then the employeecompetence of Health Centre, who do not show a friendly attitude to patients.Keywords : Public Services, Obstruction Factors, Public Health Center (PHC)


2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Iin Nurlinawati ◽  
Rosita Rosita ◽  
Sefrina Werni

Referral System for Individual Health Services states that health services are conducted in stages according to medical needs, starting from basic, second, and then third level health . The BPJS standard on the referral ratio limitation from health center to hospital is 15%. A total of 22 out of 32 health centers (69%) in Depok have referral ratios above 15%. This study was to identify factors infl uencing high referral ratios at health centers in Depok..This study was implemented from March to October 2017 by cross sectional design. The population was 32 health centers in Depok. Samples were health centers in Depok registered by BPJS as FKTP. There were 12 health centers, each 6 with high and low referrals. The sample of health workers were providers such as: doctors and dentist, heads of health centers and health offi ces. The results showed that the most referenced disease was a refraction disorder, unspecifi ed. Most primary health care with a high referral ratio (> 15%) did not have the required compulsory services at the primary health care, especially emergency and laboratory services (66.7%). The type of health personnel was less than that at Permenkes 75 of 2014 (83.3%). Facilities and infrastructure in health center were out of standards. Less drugs supplies also affected to referral. Suggestion: The government needs to provide more types of services, numbers of health workers and infrastructure in order to support the capacity of the health centre as well as better services . Abstrak Sistem Rujukan Pelayanan Kesehatan Perorangan menyebutkan bahwa pelayanan kesehatan dilaksanakan secara berjenjang sesuai kebutuhan medis, dimulai dari pelayanan dasar ke pelayanan kesehatan tingkat kedua berlanjut ke tingkat ketiga. Standar BPJS mengenai batasan rasio rujukan puskesmas ke pelayanan kesehatan tingkat lanjut maksimal 15%. Sebanyak 22 puskesmas (69%) dari 32 puskesmas di Kota Depok yang memiliki rasio rujukan diatas 15%. Penelitian ini bertujuan untuk memberikan gambaran faktor yang mempengaruhi rasio rujukan tinggi di puskesmas Kota Depok. Penelitian dilaksanakan pada bulan Maret sampai Oktober 2017. Metode yang digunakan adalah cross sectional (potong lintang). Populasi penelitian sebanyak 32 puskesmas di Kota Depok. Sampel yang diambil adalah puskesmas Kota Depok yang telah terdaftar pada BPJS sebagai FKTP sebanyak 12 puskesmas, 6 puskesmas dengan rujukan tinggi dan 6 puskesmas dengan rujukan rendah. Sampel tenaga kesehatan yang diwawancara meliputi pemberi pelayanan (dokter dan dokter gigi), kepala puskesmas dan Kepala Bidang Yankes Dinas Kesehatan. Hasil penelitian menunjukkan bahwa penyakit yang paling banyak dirujuk adalah disorder of refraction, unspecifi ed (kelainan refraksi mata). Sebagian besar puskesmas dengan rasio rujukannya tinggi (>15%) tidak memiliki kelengkapan pelayanan yang wajib ada di puskesmas terutama pelayanan gawat darurat dan laboratorium (66,7%). Jenis tenaga kesehatan kurang dari jumlah yang ada berdasarkan Permenkes 75 tahun 2014 (83,3%). Sarana dan prasarana belum sesuai dengan standar yang harus ada di puskesmas. Obat-obatan yang tidak tersedia di puskesmas menjadi salah satu alasan melakukan rujukan. Saran: Pemerintah harus selalu berupaya melengkapi jenis pelayanan, tenaga kesehatan dan sarana prasarana di puskesmas, agar kemampuan puskesmas dalam memberikan pelayanan menjadi lebih baik lagi.  


2017 ◽  
Vol 2 (3) ◽  
Author(s):  
Febriyeni Febriyeni

<pre>Chronic Energy Deficiency is a situation where the nutritional status someone is on the Less Good Condition. Among the 22 health centers in the district of Lima Puluh Kota, CED highest coverage at the health center are Banja Laweh Namely Case 17 (16.50%) of 103 pregnant mothers. Preliminary Survey of 10 pregnant women at health centers Banja Laweh, note 4 people (40%) of them suffered CED. Based on the findings of interviews stating Not pregnant women know the importance of the size upper arm circumference on Against her pregnancy, in addition to pregnant women consume no food Diversified, because lust Eating Less and Economics not sufficient. Objectives for review determine factors related to the occurrence of Chronic energy deficiency on pregnant women. Methods descriptive analytic with cross sectional approach. Data collection is done on Date in January-February 2017. CASE is a whole population of pregnant women in the region are working Health Center Banja Laweh Year 2017, amounted to 55 people, with sampling total sampling. Operating data analysis using univariate and bivariate statistical test Chi Square. Results of univariate analysis 87,3% of respondents experienced Genesis not CED, (60,0%) High Knowledge, (56,4%) Economy High, and 61,8% of Eating Well. Bivariate analysis known Relationship of Knowledge (p = 0.013 and OR = 12,000, Economics (p = 0.035 and OR = 10,000), and Diet (p = 0.019 and OR = 13,200) with the Genesis CED pregnant women. Can be concluded that the factors related to the occurrence of CED pregnant women is Science, Economics and the Diet. Expected to conduct monitoring of the health center and Supervision of pregnant women at risk Against The Genesis CED, so the negative impact of the CED can be addressed early on.</pre>


Author(s):  
Wulan Citra Sari, Ana Safitri Wulan Citra Sari, Ana Safitri

ABSTRAK   Pneumonia masih merupakan masalah kesehatan yang penting karena menyebabkan kematian bayi dan balita yang cukup tinggi yaitu kira-kira satu dari empat kematian yang terjadi. Tujuan penelitian ini adalah diketahuinya hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Cross Sectional. Populasi pada penelitian ini adalah semua ibu yang membawa atau memeriksakan balitanya yang umur < 5 tahun di Puskesmas Cambai tahun 2016, pada saat penelitian. Pengambilan sampel tersebut secara Non Random dengan teknik Accidental Sampling. Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan ada hubungan antara umur balita dan pengetahuan ibu dengan kejadian pneumonia pada balita di Puskesmas Cambai tahun 2016. Dari hasil penelitian ini, peneliti berharap petugas pelayanan kesehatan dapat meningkatkan pelayanan kesehatan bayi dan balita di Puskesmas Cambai , serta lebih sering melaksanakan penyuluhan tentang pneumonia dan penyuluhan mengenai makanan 4 sehat 5 sempurna, agar terciptanya balita sehat.     ABSTRACT Pneumonia is an important health problem because it causes the death of infants and toddlers are quite high, roughly one in four deaths. The purpose of this study is known huubungan between toddler age and maternal knowledge with pneumonia incidence in infants in health centers Cambai 2016. This study used a survey method with the Analytical cross-sectional approach. The population in this study were all mothers who carry their babies or check the age < 5 years at Health Center Cambai in 2016, at the time of the study. The sampling is non- random with accidental sampling technique. Data analysis was done using univariate and bivariate statistical test Chi - Square with significance level α = 0.05. The results of this study showed association between maternal age and knowledge toddlers with pneumonia incidence in infants in Health Center Cambai in 2016. From these results, researchers expect health care workers to improve health services in health centers babies and toddlers Cambai, and more frequently to conduct information about pneumonia and counseling about 4 healthy 5 perfect food , in order to create a healthy toddler.


1970 ◽  
pp. 132-141
Author(s):  
Lilik Koernia Wahidah

In developing countries, many antibiotics are used without a doctor's prescription, causing someone to use antibiotics incorrectly. Lack of knowledge about antibiotics is a major factor that triggers an increase in the rate of bacterial resistance to antibiotics. Knowledge and attitude become one of the social cognitive factors that influence antibiotic use behavior.This study aims to determine the relationship of knowladge and attitudes toward of antibiotic usage behavior in community of Talang jawa public health centre. The research is an observasional analytic research using cross sectional study design. sampling using non-probability sampling methode with type purposive sampling and instruments in the form of questionnaires. The data analysis was based univariate and bivariate analysis eqipped with chi square. The study was conducted on 100 community respondents in the Talang Jawa Health Center. The results showed respondents with good knowledge (25%), enough (27%) and less (48%). Respondents with positive attitudes (64%) and negative attitudes (35%). Respondents with positive behavior (43%) and negative behavior (57%). Chi square test result showed that there was a significant relationship between knowladge and antibiotic use behavior (p= 0,000) and there was a significant relationship between attitude and antibiotic use behavior (p= 0,000). This study has a meaningful relationship between and attitudes with antibiotic use behavior in Talang Jawa Health Center. Keywords: Antibiotics,Knowledge, Attitudes, Behavior


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