scholarly journals Achieving Universal Access to Health Care in Africa: The Role of Primary Health Care

2016 ◽  
Vol 20 (3) ◽  
pp. 29-31 ◽  
Author(s):  
Andrew Onokerhoraye
Author(s):  
Joseph Asumah Braimah ◽  
Yujiro Sano ◽  
Kilian Nasung Atuoye ◽  
Isaac Luginaah

AbstractBackground:Ghana in 1999 adopted the Community-based Health Planning and Service (CHPS) policy to enhance access to primary health care (PHC) service. After two decades of implementation, there remains a considerable proportion of the country’s population, especially women who lack access to basic health care services.Aim:The aim of this paper is to understand the contribution of Ghana’s CHPS policy to women’s access to PHC services in the Upper West Region (UWR) of Ghana.Methods:A logistic regression technique was employed to analyse cross-sectional data collected among women (805) from the UWR.Findings:We found that women who resided in CHPS zones (OR = 1.612;P ≤0.01) were more likely to have access to health care compared with their counterparts who resided in non-CHPS zones. Also, rural-urban residence, distance to health facility, household wealth status and marital status predicted access to health care among women in the region. Our findings underscore the need to expand the CHPS policy to cover many areas in the country, especially rural communities and other deprived localities in urban settings.


2013 ◽  
Vol 119 (6) ◽  
pp. 1432-1436 ◽  
Author(s):  
Arman Jahangiri ◽  
Aaron J. Clark ◽  
Seunggu J. Han ◽  
Sandeep Kunwar ◽  
Lewis S. Blevins ◽  
...  

Object Pituitary apoplexy is associated with worse outcomes than are pituitary adenomas detected without acute clinical deterioration. The association between pituitary apoplexy and socioeconomic factors that may limit access to health care has not been examined in prior studies. Methods This study involved retrospectively evaluating data obtained in all patients who underwent surgery for nonfunctioning pituitary adenoma causing visual symptoms between January 2003 and July 2012 at the University of California, San Francisco. Patients were grouped into those who presented with apoplexy and those who did not (“no apoplexy”). The 2 groups were compared with respect to annual household income, employment status, health insurance status, and whether or not the patient had a primary health care provider. Associations between categorical variables were analyzed by chi-square test and continuous variables by Student t-test. Multivariate logistic regression was also performed. Results One hundred thirty-five patients were identified, 18 of whom presented with apoplexy. There were significantly more unmarried patients and emergency room presentations in the apoplexy group than in the “no apoplexy” group. There was a nonsignificant trend toward lower mean household income in the apoplexy group. Lack of health insurance and lack of a primary health care provider were both highly significantly associated with apoplexy. In a multivariate analysis including marital status, emergency room presentation, income, insurance status, and primary health care provider status as variables, lack of insurance remained associated with apoplexy (OR 11.6; 95% CI 1.9–70.3; p = 0.008). Conclusions The data suggest that patients with limited access to health care may be more likely to present with pituitary apoplexy than those with adequate access.


2017 ◽  
Vol 19 (1) ◽  
pp. 32-36
Author(s):  
Mikhail G Karaylanov ◽  
Iliya T Rusev ◽  
Dmitriy N Borisov ◽  
Oleg Yu Bakanev ◽  
Igor G Prokin

Explore the historical domestic experience of primary health care to the population of major cities, the establishment of this type of medical care as the main and the largest national healthcare system partition stages of the reform of primary health care to date, with a gradual transition to a system of health insurance in order to further increase the availability of and quality of care. Due to the recent modernization of the health system outpatient offices were equipped with modern innovative medical devices for the delivery of primary health care at a high level. In addition, historically proved the effectiveness of medical care at the district territorial principle, which defines and improves access to health care, with subsequent referral to narrow specialists (bibliography: 20 refs).


Author(s):  
Keri Elizabeth Zug ◽  
Silvia Helena De Bortoli Cassiani ◽  
Joyce Pulcini ◽  
Alessandra Bassalobre Garcia ◽  
Francisca Aguirre-Boza ◽  
...  

Abstract Objective: to identify the current state of advanced practice nursing regulation, education and practice in Latin America and the Caribbean and the perception of nursing leaders in the region toward an advanced practice nursing role in primary health care to support Universal Access to Health and Universal Health Coverage initiatives. Method: a descriptive cross-sectional design utilizing a web-based survey of 173 nursing leaders about their perceptions of the state of nursing practice and potential development of advanced practice nursing in their countries, including definition, work environment, regulation, education, nursing practice, nursing culture, and perceived receptiveness to an expanded role in primary health care. Result: the participants were largely familiar with the advanced practice nursing role, but most were unaware of or reported no current existing legislation for the advanced practice nursing role in their countries. Participants reported the need for increased faculty preparation and promotion of curricula reforms to emphasize primary health care programs to train advanced practice nurses. The vast majority of participants believed their countries' populations could benefit from an advanced practice nursing role in primary health care. Conclusion: strong legislative support and a solid educational framework are critical to the successful development of advanced practice nursing programs and practitioners to support Universal Access to Health and Universal Health Coverage initiatives.


BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Miriam Evensen ◽  
Søren Toksvig Klitkou ◽  
Mette C. Tollånes ◽  
Simon Øverland ◽  
Torkild Hovde Lyngstad ◽  
...  

Abstract Background Disparities in health by adult income are well documented, but we know less about the childhood origins of health inequalities, and it remains unclear how the shape of the gradient varies across health conditions. This study examined the association between parental income in childhood and several measures of morbidity in adulthood. Methods We used administrative data on seven complete Norwegian birth cohorts born in 1967–1973 (N = 429,886) to estimate the association between parental income from birth to age 18, obtained from tax records available from 1967, linked with administrative registries on health. Health measures, observed between ages 39 and 43, were taken from registry data on consultations at primary health care services based on diagnostic codes from the International Classification of Primary Care (ICPC-2) and hospitalizations and outpatient specialist consultations registered in the National Patient Registry (ICD-10). Results Low parental income during childhood was associated with a higher risk of being diagnosed with several chronic and pain-related disorders, as well as hospitalization, but not overall primary health care use. Absolute differences were largest for disorders related to musculoskeletal pain, injuries, and depression (7–9 percentage point difference). There were also differences for chronic disorders such as hypertension (8%, CI 7.9–8.5 versus 4%, CI 4.1–4.7) and diabetes (3.2%, CI 3.0–3.4 versus 1.4%, CI 1.2–1.6). There was no difference in consultations related to respiratory disorders (20.9%, CI 20.4–21.5 versus 19.7%, CI 19.2–20.3). Childhood characteristics (parental education, low birth weight, and parental marital status) and own adult characteristics (education and income) explained a large share of the association. Conclusions Children growing up at the bottom of the parental income distribution, compared to children in the top of the income distribution, had a two- to threefold increase in somatic and psychological disorders measured in adulthood. This shows that health inequalities by socioeconomic family background persist in a Scandinavian welfare-state context with universal access to health care.


Author(s):  
Maribel Tercedor-Sánchez ◽  
Clara I. López-Rodríguez

Medical concepts can often be lexicalized in several ways depending on aspects such as the facet of the concept being underlined or the particular communicative setting in which the concept is being used. This feature of terminology is known as terminological variation. In this paper we consider terminological variation as a tool to improve interlinguistic and intercultural communication, a key issue in the provision of universal access to health care. To facilitate the identification and analysis of terminological variation, the paper also proposes some search strategies to highlight this phenomenon in corpora, the main source of terminological information. Finally, images are proposed as a key issue in the localization process needed to bridge communication gaps between health care providers and lay audiences. The data used in the paper are taken from an international cooperation project aimed at providing health providers in Yucatan, Mexico, with materials and training in intercultural communication for healthcare mainly in Spanish and Mayan, and from a research project on lexical variation .  


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Elizabeth Hyde ◽  
Matthew H. Bonds ◽  
Felana A. Ihantamalala ◽  
Ann C. Miller ◽  
Laura F. Cordier ◽  
...  

Abstract Background Reliable surveillance systems are essential for identifying disease outbreaks and allocating resources to ensure universal access to diagnostics and treatment for endemic diseases. Yet, most countries with high disease burdens rely entirely on facility-based passive surveillance systems, which miss the vast majority of cases in rural settings with low access to health care. This is especially true for malaria, for which the World Health Organization estimates that routine surveillance detects only 14% of global cases. The goal of this study was to develop a novel method to obtain accurate estimates of disease spatio-temporal incidence at very local scales from routine passive surveillance, less biased by populations' financial and geographic access to care. Methods We use a geographically explicit dataset with residences of the 73,022 malaria cases confirmed at health centers in the Ifanadiana District in Madagascar from 2014 to 2017. Malaria incidence was adjusted to account for underreporting due to stock-outs of rapid diagnostic tests and variable access to healthcare. A benchmark multiplier was combined with a health care utilization index obtained from statistical models of non-malaria patients. Variations to the multiplier and several strategies for pooling neighboring communities together were explored to allow for fine-tuning of the final estimates. Separate analyses were carried out for individuals of all ages and for children under five. Cross-validation criteria were developed based on overall incidence, trends in financial and geographical access to health care, and consistency with geographic distribution in a district-representative cohort. The most plausible sets of estimates were then identified based on these criteria. Results Passive surveillance was estimated to have missed about 4 in every 5 malaria cases among all individuals and 2 out of every 3 cases among children under five. Adjusted malaria estimates were less biased by differences in populations’ financial and geographic access to care. Average adjusted monthly malaria incidence was nearly four times higher during the high transmission season than during the low transmission season. By gathering patient-level data and removing systematic biases in the dataset, the spatial resolution of passive malaria surveillance was improved over ten-fold. Geographic distribution in the adjusted dataset revealed high transmission clusters in low elevation areas in the northeast and southeast of the district that were stable across seasons and transmission years. Conclusions Understanding local disease dynamics from routine passive surveillance data can be a key step towards achieving universal access to diagnostics and treatment. Methods presented here could be scaled-up thanks to the increasing availability of e-health disease surveillance platforms for malaria and other diseases across the developing world.


Sign in / Sign up

Export Citation Format

Share Document