The covid-19 in the Primary Health Care context

This article aims to develop a reflective theoretical study with an emphasis on the actions, challenges and recommendations of practices for the prevention, control and monitoring of PHC disease. The COVID-19 pandemic has been demanding a remodeling of structures, not only in hospital care, but, especially in interventions in communities and their social, urban and structural problems. The article highlights the work process and new technical and dynamic incorporations for prevention, surveillance and monitoring imposed by SARS-CoV2 on primary health care, which must also guarantee access to essential care. As it allows thinking about the most feasible forms of action, this article recognizes the principles of action in the health system, offering to managers and health professionals, through the interlocution between related studies, several measures that can help in assistance of pandemic. The COVID-19 pandemic changed the course of some health policies in the world. Patient-centered care requires a change in perspective towards a concept of community-centered care. As the primary health care is the first level of contact for individuals, family and community in a health system, constituting the preferred gateway to the care process, it is expected that the reflections raised by this article will contribute to an analysis that answers the main public health issues from the perspective of primary health care, preserving its stability, avoiding the disintegration of its actions and maintaining its functionality with the strengthening of local and community actions.

Download Full-text

Trends in Patient-Centered Care in South West Nigeria: A Holistic Assessment of the Nurses Perception of Primary Healthcare Practice

Global Journal of Health Science ◽

10.5539/gjhs.v12n6p73 ◽

2020 ◽

Vol 12 (6) ◽

pp. 73

Author(s):

Adepeju M. Lateef ◽

Euphemia M. Mhlongo

Keyword(s):

Health Care ◽

Primary Health Care ◽

Research Study ◽

Patient Centered Care ◽

Participatory Action ◽

Patient Centered ◽

Quality Healthcare ◽

Primary Health ◽

South West ◽

Centered Care

BACKGROUND: A key dimension of a quality healthcare to patients is patient-centered care approach which is increasingly gaining recognition worldwide. However, this concept is not fully implemented in practice. AIM: The aim of this study is to provide outcomes from assessment of nurses’ perceptions about patient-centered care and the current trends in Primary Health Care system in South West Nigeria. METHODS: This study employed a qualitative participatory action research study approach and conducted a semi-structured individual interview with thirty-five nurses and four focus group discussions in Osun State South West Nigeria Primary Health Care centres. RESULTS: Primary Health Care (PHC) nurses perceived and described patient-centered care (PCC) as a global approach to improve and enhance nursing care to foster patient participation. The narratives were categorised into two: positive and negative perception. Ten main themes emerged: (I) Attitude of the nurses (ii) Lack of enforcement and implementation, (iii) Experience of the nurses, (iv) Quality-Caring, (v) Effective communication with patient, (vi) Motivated and Proactive healthcare, (vii) Sharpen the form of care, (viii) Outcome and after-effect driven healthcare, (ix) Approved support, and (x) Guarantor of service and motivation. CONCLUSION: Our participatory action research study on the assessment of nurses’ perception on the utilization of PCC at the PHC for effective and quality healthcare service revealed the importance of nurses’ role, acceptability of PCC and current nursing care practice at the Primary Health Care (PHC) rural community setting. Nurses as healthcare providers expressed PCC as a common and global approach that would enhance patient experiences and improves the quality of nursing healthcare delivery through integration of PCC and healthcare service at the PHC healthcare system.

Download Full-text

Stakeholder perceptions on patient-centered care at primary health care level in rural eastern Uganda: A qualitative inquiry

PLoS ONE ◽

10.1371/journal.pone.0221649 ◽

2019 ◽

Vol 14 (8) ◽

pp. e0221649 ◽

Cited By ~ 2

Author(s):

Everlyn Waweru ◽

Nandini D. P. Sarkar ◽

Freddie Ssengooba ◽

Marc- Eric Gruénais ◽

Jacqueline Broerse ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Patient Centered Care ◽

Qualitative Inquiry ◽

Stakeholder Perceptions ◽

Patient Centered ◽

Care Level ◽

Primary Health ◽

Centered Care ◽

Eastern Uganda

Download Full-text

Nurses’ Encountered Challenges with Patient-centered Care in Rural Primary Health Care Centers: A Case Study of Nigeria

10.21203/rs.3.rs-144186/v1 ◽

2021 ◽

Author(s):

Adepeju Lateef ◽

Euphemia Mbali Mhlongo

Keyword(s):

Health Care ◽

Primary Health Care ◽

Patient Centered Care ◽

Health Care Facilities ◽

Management Support ◽

Patient Centered ◽

Primary Health ◽

Care Facilities ◽

Centered Care ◽

Primary Health Care Facilities

Abstract BackgroundGlobally, patient-centered care has become the focus of the healthcare system. Therefore, it is imperative to note that patient-centered care seeks to empower partnering approaches to primary health care and has recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with numerous challenges in achieving the desired results and objectives related to Patient-centered care in the Primary Health Care system. Thus, the study explores the negative factors influencing the implementation of Patient-centered care in rural Primary Health Care facilities in Nigeria.MethodA qualitative participatory action research design was used. Data collection was conducted with the nurses from Primary Health Care facilities through individual interviews and focus group discussions. Data saturation was achieved with 35 participants from 30 Primary Health Care facilities in Osun State, Southwest Nigeria, using a purposive sampling technique. All interviews were audio-recorded, which were later transcribed verbatim and analyzed using a thematic content analysis approach. NVivo 12 software was used for data management.ResultsThe results from this study was categorized into two: organizational factors and individual factors. Five themes that emerged from the study include: inadequate management support, insufficient operational skills and knowledge /equipped learning, increased workload and time constraints, health personnel readiness, dearth enthusiasm for change and accountability of the staff.ConclusionThe results of this study show that nurses encountered diverse challenges in the implementation of patient-centered care. To improve healthcare delivery quality in the Primary Health Care facilities, there is a need to reinforce adequate management support, education, training, and the nurses’ internal motivation to achieve a transformative healthcare outcome.

Download Full-text

Patient participation in care safety: Primary Health Care professionals’ perception

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2020-0773 ◽

2021 ◽

Vol 74 (2) ◽

Author(s):

Pedro Rodrigues Carvalho ◽

Emannuela Sofia Dantas Ferraz ◽

Cristiane Chagas Teixeira ◽

Valéria Bertonha Machado ◽

Ana Lúcia Queiroz Bezerra ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Care Professionals ◽

Patient Involvement ◽

Federal District ◽

Structured Interview ◽

Patient Centered ◽

Primary Health ◽

Centered Care ◽

Intervening Factors

ABSTRACT Objectives: to analyze health professionals’ perception about the meaning and practice of patient involvement in care safety in Primary Health Care. Methods: this is an exploratory, qualitative study, developed with 22 professionals in the Federal District, Brazil. A semi-structured interview was conducted between October and November/2018. Content analysis was carried out according to Bardin. Results: nurses, physicians, dentists, among others, participated. The following categories emerged: Meaning of patient involvement in care safety; Factors intervening in patient involvement in care safety; Strategies for patient involvement in care safety; Qualification for patient involvement in care safety. Final Considerations: the meaning of patient involvement for care safety was associated with co-responsibility and patient-centered care. Professionals’ practice revealed intervening factors and the use of involvement strategies. A gap was identified in training on patient involvement in care safety.

Download Full-text

Challenges for Nurses in Providing Patient-Centered Care in Rural Primary Health Care Clinics in Nigeria

Open Journal of Nursing ◽

10.4236/ojn.2021.119065 ◽

2021 ◽

Vol 11 (09) ◽

pp. 772-793

Author(s):

Adepeju Lateef ◽

Euphemia M. Mhlongo

Keyword(s):

Health Care ◽

Primary Health Care ◽

Patient Centered Care ◽

Patient Centered ◽

Health Care Clinics ◽

Primary Health ◽

Centered Care

Download Full-text

A Qualitative Study on Patient-Centered Care and Perception of Nurses in Primary Healthcare Practice

10.21203/rs.3.rs-91573/v1 ◽

2020 ◽

Author(s):

Adepeju Lateef ◽

Euphemia Mbali Mhlongo

Keyword(s):

Health Care ◽

Qualitative Research ◽

Primary Health Care ◽

Healthcare Service ◽

Patient Centered Care ◽

Primary Health Care System ◽

Patient Centered ◽

Primary Health ◽

Centered Care ◽

The Government

Abstract Background: Patient-centered care (PCC) approach has continued to gain recognition globally as the key to providing quality healthcare. However, this concept is not fully integrated into the management of primary health care (PHC) in existing nursing practice due to numerous challenges. Among these challenges is the perception of nursing on PCC in the Primary Health Care system. This study seeks to present the results of qualitative research performed at various selected PHC centers on nurses’ perceptions in PCC practice.Aim: This study aims at exploring the perception of nurses on PCC.Method: A qualitative research approach was adopted for this study. This study involved thirty local government PHC centers located in Osun State of southwest Nigeria. The sample comprised 28 female nurses and 7 male nurses. Data were collected through a semi-structured interview schedule in different sessions that were conducted on a one on one basis. Thereafter, data analysis was performed using thematic analysis and NVivo 12 software to generate themes, subthemes, and codes.Results: The findings of the study revealed a number of perceptions on PCC that were categorized into positive and negative themes. The negative themes include: Poor approach by the nurses and lack of enforcement agency. The positive themes that emerged include: Outcome-driven healthcare, valued care provider, communication to sharpen care, and driven healthcare service. In addition, the findings established a positive correlation between perception and years of working experience. 68.5 % of the participants, who had working experience in the range of 12 – 31 years, expressed a mixed perception of PCC practice. The remaining 31.5 % of the participants interviewed who had working experience in the range of 2, 6 – 11 years, expressed positive perceptions on the provision of PCC. Conclusion: From the findings of this study, there is a need for the government to enforce the utilization and provision of PCC in the PHC setting. This should be done through the provision of an enabling environment in the PHC setting. In addition, the government should provide regulations and monitoring mechanisms in the PHC institutions. Enforcement agencies should also offer opportunities for continuous training to enhance the nursing care skills of nurses to stimulate and sustain improved healthcare services. Lastly, the government should remunerate and promote nurses based on merit as another means of supporting improved healthcare service delivery by the nurses.

Download Full-text

A qualitative study on Patient-Centered Care and Perception of Nurses in Primary Healthcare Practice

10.21203/rs.3.rs-91573/v2 ◽

2021 ◽

Author(s):

Adepeju Lateef ◽

Euphemia Mbali Mhlongo

Keyword(s):

Health Care ◽

Primary Health Care ◽

Local Government ◽

Healthcare Service ◽

Patient Centered Care ◽

Primary Health Care System ◽

Patient Centered ◽

Quality Healthcare ◽

Primary Health ◽

Centered Care

Download Full-text

Management of pharmaceutical services in the Brazilian primary health care

Revista de Saúde Pública ◽

10.11606/s1518-8787.2017051007063 ◽

2017 ◽

Vol 51 (suppl.2) ◽

Cited By ~ 3

Author(s):

Letícia Farias Gerlack ◽

Margô Gomes de Oliveira Karnikowski ◽

Camila Alves Areda ◽

Dayani Galato ◽

Aline Gomes de Oliveira ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health System ◽

Pharmaceutical Services ◽

Limiting Factors ◽

Health Board ◽

Complex Samples ◽

Financial Autonomy ◽

Unified Health System ◽

Primary Health

OBJECTIVE: To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). METHODS: This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. RESULTS: We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. CONCLUSIONS: Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening

Download Full-text

Access to medicines by patients of the primary health care in the Brazilian Unified Health System

Revista de Saúde Pública ◽

10.11606/s1518-8787.2017051007139 ◽

2017 ◽

Vol 51 ◽

pp. 20s ◽

Cited By ~ 3

Author(s):

Juliana Álvares ◽

Augusto Afonso Guerra Junior ◽

Vânia Eloisa de Araújo ◽

Alessandra Maciel Almeida ◽

Carolina Zampirolli Dias ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health System ◽

Developed Countries ◽

Access To Medicines ◽

Essential Medicines ◽

Unified Health System ◽

Primary Health ◽

Significant Difference ◽

Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

Download Full-text

Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1334 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

L Borges Costa ◽

C Salles Gazeta Vieira Fernandes ◽

T Custódio Mota ◽

E Torquato Santos ◽

M Moura de Almeida ◽

...

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Services ◽

Health System ◽

Assessment Tool ◽

Health Coverage ◽

Access To Health Services ◽

Primary Health ◽

Care Assessment ◽

The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

Download Full-text