scholarly journals Schistosomiasis reinfection and community compliance in a primary health care participatory research project in Menoufia, Egypt

2021 ◽  
Vol 1 (2) ◽  
pp. 215-222
Author(s):  
Amal A. M. Khairy ◽  
Hassan Farag

Thistudy aimed to train local primary health care teams on sound scientific techniques for schistosomiasis case-finding, recording, treatment and follow-up in the context of primary health care; involve local community members in designing and conducting epidemiological research on schistosomiasis and follow-up of positive cases in collaboration with primary health care teams; and assess the impact of this methodology on community compliance to laboratory testing and treatment, besides the impact on rates of prevalence, intensity, incidence and reinfection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.


2015 ◽  
Vol 21 (3) ◽  
pp. 262 ◽  
Author(s):  
I-Hao Cheng ◽  
Sayed Wahidi ◽  
Shiva Vasi ◽  
Sophia Samuel

Refugees can experience problems accessing and utilising Australian primary health care services, resulting in suboptimal health outcomes. Little is known about the impact of their pre-migration health care experiences. This paper demonstrates how the Afghan pre-migration experiences of primary health care can affect engagement with Australian primary care services. It considers the implications for Australian primary health care policy, planning and delivery. This paper is based on the international experiences, insights and expert opinions of the authors, and is underpinned by literature on Afghan health-seeking behaviour. Importantly, Afghanistan and Australia have different primary health care strategies. In Afghanistan, health care is predominantly provided through a community-based outreach approach, namely through community health workers residing in the local community. In contrast, the Australian health care system requires client attendance at formal health service facilities. This difference contributes to service access and utilisation problems. Community engagement is essential to bridge the gap between the Afghan community and Australian primary health care services. This can be achieved through the health sector working to strengthen partnerships between Afghan individuals, communities and health services. Enhanced community engagement has the potential to improve the delivery of primary health care to the Afghan community in Australia.


Author(s):  
S. Josefsson ◽  
M. Kjellmark ◽  
P. Adenmark ◽  
E. Karlsson ◽  
R. Åstrand ◽  
...  

BACKGROUND: In an urban/rural primary health care (PHC) district a five-year integrated project of early detection and management of cognitive disorders was made in collaboration between home care (HC) and family practice services using a single-item case-finding and intervention approach. OBJECTIVES: To assess feasibility, outcome and morbidity over a 5-year period. DESIGN, SETTING AND PARTICIPANT: In autumn 2008, the question “Have you experienced memory difficulties or been told of them by family members?” was mailed to all eligible persons > 75 years of age (n=367) in the urban/rural Vålberg HC and PHC district (population = 5073). 320 (= 87%; 184 no and 136 yes) responded and 117 yes-responders came for further examination. In the follow-up, all diagnoses up till November 2013 were collected and compared anonymously in both yes and no answerers. RESULTS: 114 completed examination. 29 showed low risk of cognitive impairment, 39 moderate and 46 high. Definitive diagnosis was obtained in 34 of the latter: 10 cognitive impairment, 16 Alzheimer’s disease, 5 non-specific, 2 vascular and 1 alcoholic dementia. During follow-up no further dementia diagnoses occurred in the low, two in the moderate, and none in the high-risk group, versus 12 in the no responders. Age and mortality were significantly higher in the high-risk group. Co-morbidity was very frequent but did not differ between the groups. CONCLUSIONS: Population response and compliance were excellent; the single-item direct question approach gave workable results with in particular high negative predictive power persisting over the five-year follow-up period, and can be applied in early case-finding, prevention and intervention of cognitive impairment in an integrated local HC, PHC and Hospital setting.


2021 ◽  
Author(s):  
Marcos Pereira ◽  
Vannessa Sá ◽  
Paulo Henrique Rocha ◽  
João Pedro Oliveira ◽  
Rafael Amorim ◽  
...  

Background: Evidence from longitudinal studies points to the syndromic continuum of dementia. Individuals with mild cognitive impairment (MCI) are at increased risk of progressing to dementia over time, as well as older adults with subjective cognitive decline (SCD). Objective: To assess the impact of treating reversible causes of dementia on the outcome of patients with cognitive decline. Methods: Data were collected between 2017 and 2020 (mean follow-up = 44.52 ±6.85 months) in primary health care in Patos de Minas, MG. Subjects were screened using the MMSE, Figure Memory Test, Verbal Fluency, Clock Drawing Test, Geriatric Depression Scale, Geriatric Anxiety Inventory, and the Functional Activities Questionnaire. Results: Of 15 patients with SCD, 26.7% progressed to MCI. Of 45 patients with MCI, 13.4% progressed to dementia, 4.4% died and 26.7% regressed to SCD. Of 31 individuals with dementia, 6.5% regressed to SCD, 22.6% regressed to MCI and 19.4% died. Clinical improvement can be explained by the treatment of reversible causes, such as hypothyroidism, hypovitaminosis B12, and mood and anxiety disorders. Conclusion: Two-thirds of people who meet the criteria for MCI do not convert to dementia during the follow-up. These results reinforce the need of adequate screening and treatment of reversible causes of dementia in the primary care.


Author(s):  
Joia S. Mukherjee

This chapter outlines the historical roots of health inequities. It focuses on the African continent, where life expectancy is the shortest and health systems are weakest. The chapter describes the impoverishment of countries by colonial powers, the development of the global human rights framework in the post-World War II era, the impact of the Cold War on African liberation struggles, and the challenges faced by newly liberated African governments to deliver health care through the public sector. The influence of the World Bank and the International Monetary Fund’s neoliberal economic policies is also discussed. The chapter highlights the shift from the aspiration of “health for all” voiced at the Alma Ata Conference on Primary Health Care in 1978, to the more narrowly defined “selective primary health care.” Finally, the chapter explains the challenges inherent in financing health in impoverished countries and how user fees became standard practice.


2015 ◽  
Vol 21 (1) ◽  
pp. 2 ◽  
Author(s):  
Jessamy Bath ◽  
John Wakerman

Community participation is a foundational principle of primary health care, with widely reputed benefits including improved health outcomes, equity, service access, relevance, acceptability, quality and responsiveness. Despite considerable rhetoric surrounding community participation, evidence of the tangible impact of community participation is unclear. A comprehensive literature review was conducted to locate and evaluate evidence of the impact of community participation in primary health care on health outcomes. The findings reveal a small but substantial body of evidence that community participation is associated with improved health outcomes. There is a limited body of evidence that community participation is associated with intermediate outcomes such as service access, utilisation, quality and responsiveness that ultimately contribute to health outcomes. Policy makers should strengthen policy and funding support for participatory mechanisms in primary health care, an important component of which is ongoing support for Aboriginal Community Controlled Health Services as exemplars of community participation in Australia. Primary health-care organisations and service providers are encouraged to consider participatory mechanisms where participation is an engaged and developmental process and people are actively involved in determining priorities and implementing solutions.


2007 ◽  
Vol 13 (3) ◽  
pp. 29 ◽  
Author(s):  
Emily Mauldon

This paper reports on the attitudes of a sample of health care providers towards the use of telehealth to support rural patients and integrate rural primary health and urban hospital care. Telehealth and other information technologies hold the promise of improving the quality of care for people in rural and remote areas and for supporting rural primary health care providers. While seemingly beneficial for rural patients, study participants believed that telehealth remains underused and poorly integrated into their practice. In general, participants thought that telehealth is potentially beneficial but places constraints on their activities, and few actually used it. Published literature usually reports either on the success of telehealth pilot projects or initiatives that are well resourced and do not reflect the constraints of routine practice, or has an international focus limiting its relevance to the Australian context. Because of the paucity of systematic and generalisable research into the effects of the routine use of telehealth to support rural patients, it is unclear why health care professionals choose to provide such services or the costs and benefits they incur in doing so. Research and policy initiatives continue to be needed to identify the impact of telehealth within the context of Australian primary health care and to develop strategies to support its use.


2017 ◽  
Vol 70 (5) ◽  
pp. 949-957 ◽  
Author(s):  
Claudia Nery Teixeira Palombo ◽  
Elizabeth Fujimori ◽  
Áurea Tamami Minagawa Toriyama ◽  
Luciane Simões Duarte ◽  
Ana Luiza Vilela Borges

ABSTRACT Introduction: Nutritional counseling and growth follow-up are priorities when providing care to children; however, these have not been completely incorporated into primary health care. Objective: To know the difficulties for providing nutritional counseling and child growth follow-up, from a professional healthcare perspective. Method: Qualitative study, using Donabedian as theoretical framework, developed by 53 professionals in the field of primary health care. Data was obtained from focal groups and submitted to content analysis. Results: The main difficulties for nutritional counseling were clustered in the category of ‘perceptions and beliefs related to child feeding’. The ‘problems of infrastructure and healthcare’ and ‘maintenance of the hegemonic medical model’ are the main difficulties for following-up growth. Final considerations: Besides investments in infrastructure, healthcare training is indispensable considering beliefs and professional experiences, so in fact, nutritional counseling and child growth follow-up are incorporated in primary health care.


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