scholarly journals Moral Hazard on Free Health Care Services:A Study from Consumer's Side

2020 ◽  
Vol 10 (2) ◽  
pp. 1-5
Author(s):  
Sushila Baral ◽  
Sony Pandey ◽  
Rajesh kumar Yadav ◽  
Sudarshan Subedi
Keyword(s):  
Health Care ◽  
Moral Hazard ◽  
Health Care Services ◽  
Health Workers ◽  
Education Level ◽  
Health Facilities ◽  
Normal Behaviour ◽  
Care Services ◽  
Free Health Care ◽  
At Home

Free Health Service is a priority program and a boon to all citizens mostly for the poor and marginalized groups. It is a timely and exemplary program of government but some people have deviation in their normal behaviour as services have been provided free. A descriptive cross-sectional approach was done to assess moral hazard on free health care services by consumers. An interview schedule was used to collect quantitative data and in depth interview with health workers for qualitative data in selected eleven health facilities. The study showed the prevalence of moral hazards of free health care services by the consumers. Two-third (65%) respondents had medicines at home. Around one-third (33%) of respondent had self demanded for the medicines. Two-third (67.6%) doesn't seek for health services during health problems. One-fourth (23.6%) had poster at home for non IEC purpose. Age, education level, travelling time to health facility, occupation, and satisfaction towards services were significantly associated with availability of medicines at home. Age, education level, health workers behaviour were significantly associated with self demand of medicines. Peoples are misutilizing the services as, government bear the burden of cost. There was deviation in the normal behaviour of the peoples due to no registration fees and free drugs availability. Many people like to take medicines and have a notion that there is a pills for every ill as a result they self demand for the medicines and mostly don’t consume full dose which can develop drug resistance. Visit to health facilities to collect medicines at home have increase unnecessary burden to health facilities and also increase in morbidity status. The result can inform developing proper policy and safety measures to drop off moral hazard on free health care services.

scholarly journals Existing barriers to utilization of health services for maternal and newborn care in rural Western Kenya

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
George Ayodo ◽  
George O. Onyango ◽  
Salome Wawire ◽  
Nadia Diamond-Smith
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Western Kenya ◽  
Care Services ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Understanding the existing barriers to utilization of maternal and newborn health care services can inform improvement of care services in the rural settings in sub-Saharan Africa. However, how unintended pregnancy relates to the uptake of antenatal care (ANC) services and also how gaps in the role of the community health workers and health facilities affect maternal and newborn care and referral services are poorly understood. Methods This was a formative ethnographic study design to determine barriers to the utilization of health care services for maternal and newborns in rural Western Kenya. We interviewed 45 respondents through in-depth interviews in rural Bondo Sub- County, Western Kenya: Mothers and Fathers with children under 5 years), 2 Focus Group Discussions (FGDs) with Traditional Birth Attendants (TBA), and 2 FGDs with Skilled Birth Attendants (SBAs). The data were analyzed using Atlas-ti. Results We found that unintended pregnancy results into poor uptake of antenatal care (ANC) services due to limited knowledge and poor support system. The respondents appreciated the role of community health workers but poor government infrastructure exists. Also, perceived harshness of the health care providers, poor management of high-risk pregnancies, and unavailability of supplies and equipment at the health facilities are of concern. Conclusions The findings of this study highlight barriers to the utilization of maternal and newborn services that if addressed can improve the quality of care within and outside health facilities.

scholarly journals Caring for One’s Wife With Dementia—at Home: Older Husbands’ Experiences With Managing Challenges of Everyday Life

SAGE Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. 215824401983445
Author(s):  
Linda Rykkje ◽  
Oscar Tranvåg
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Qualitative Interviews ◽  
Care Services ◽  
People With Dementia ◽  
Memory Clinics ◽  
Male Caregivers ◽  
Caregiving Roles ◽  
Caregiver Role ◽  
At Home

More than 80,000 Norwegians live with dementia. Most caregivers for people with dementia are spouses, and women outnumber men. Due to an aging population, and women’s higher risk of dementia as well as men’s increased life expectancy, the number of male caregivers will rise. There are some differences in the caregiving roles of men and women. Research suggest that males report lower burden and depression than female caregivers, but some men struggle to adjust to the caregiver role, and men are less likely to access health care services. The aim of this study is to explore the experiences of husbands engaged in caregiving for their home-dwelling spouse with dementia. This knowledge will add to the growing body of research about men in the context of dementia care and may raise gender awareness. The method is qualitative interviews with hermeneutical interpretation. The participants are five husbands recruited from two Hospital Memory Clinics in Norway. The results portray how the husbands managed their everyday challenges, and how they adapted to changes, experiences of loss and bereavement, and how they redefined personal freedom and expanded their responsibilities. Acknowledging the rewards of caregiving, the husbands found their life meaningful and they were thriving in their caregiving role. Health care personnel should recognize and respect the challenging life situation caregiving husbands may experience, calling for personnel to learn from, care for, and collaborate with them, enabling the couple to live a meaningful life together at home as long as possible.

scholarly journals Older people living at home: experiences of healthy ageing

2021 ◽  
Vol 22 ◽  
Author(s):  
Astrid Fjell ◽  
Kristin Ådnøy Eriksen ◽  
Monica Hermann ◽  
Anne-Marie Boström ◽  
Seiger Berit Cronfalk
Keyword(s):  
Health Care ◽  
Older People ◽  
Older Persons ◽  
Health Care Services ◽  
Healthy Ageing ◽  
Group Discussions ◽  
Care Services ◽  
Manifest Content ◽  
Professional Perspective ◽  
At Home

Abstract Aim: The purpose of this study was to investigate how old persons perceived their life to be, how they viewed the ageing process and their need of health care and societal support. Background: The purpose of WHO’s Healthy Ageing strategy and development of age-friendly environments is to support physiological and psychosocial changes in old persons by facilitating basic needs. Interventions to operationalize these needs in older people living at home are often developed from a professional perspective and to a small extent involves the perceptions, experience and expectations of the older persons. Method: This qualitative study has an explorative design using focus group discussions to collect data. In all, 34 persons between 69 and 93 years of age participated in seven group discussions. The interviews were analyzed using inductive manifest content analysis. Findings: The main results suggest that most old persons enjoyed life and wished it to continue for as long as possible. Important was to sustain networks and to feel useful. Unexpected changes were described as threats and the need to use health care services was associated with illness and being dependent. The result is presented in three categories with sub-categories: ‘Embracing life’, ‘Dealing with challenges’ and ‘Considering the future’.

“Safety at Home”: Experiences From Testing of Video Communication Between Patients and Home Health Care Personnel

SAGE Open ◽  
2017 ◽  
Vol 7 (4) ◽  
pp. 215824401774490 ◽  
Author(s):  
Linda Rykkje ◽  
Gunhild H. B. Hjorth
Keyword(s):  
Health Care ◽  
Home Health Care ◽  
Health Care Services ◽  
Video Communication ◽  
Health Care Personnel ◽  
Chronic Obstructive ◽  
Second Phase ◽  
Obstructive Pulmonary Disease ◽  
Care Services ◽  
At Home

The implementation of welfare technology in Norwegian municipals is a governmental priority, but there is little research on transfer of technological solutions into regular health care services. The aim of the project “Safety at home” was to test and evaluate the use of video communication between patients and health care personnel. There were two test periods, with the initial phase focusing on patients with chronic obstructive pulmonary disease (COPD). The second phase focused on patients who most likely would benefit from video communication. Nine patients tested the equipment, and they were interviewed afterward. In addition, nursing personnel evaluated the project through focus group interviews. The results identified that the equipment was user friendly and contributed to the patients’ feelings of safety. However, there were concerns about video calls replacing the “human touch” of home visits. The personnel also experienced that the technological solution had limitations, and new tasks added to their workload. The choice of focusing on COPD patients was considered a disadvantage, and we recommend that future projects should not be restricted by diagnosis and should target the most eligible candidates.

scholarly journals Health Insurance Cards and Health Care Services Utilization: Evidence From Children in Mountainous Regions of Vietnam

2019 ◽  
Vol 6 ◽  
pp. 2333794X1984391 ◽  
Author(s):  
Nhu Van Ha ◽  
Van Thi Anh Nguyen ◽  
Bui Thi My Anh ◽  
Thanh Duc Nguyen
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Associated Factors ◽  
Health Care Services ◽  
Health Care Policy ◽  
Care Policy ◽  
Insurance Reform ◽  
Care Services ◽  
Free Health Care ◽  
Services Use

Health insurance reform for children younger than 6 years of age was implemented in 2005. The study aimed to describe the health insurance card status, health care services use, and associated factors. The cross-sectional study was conducted with 210 Hmong mothers of children younger than 6 years of age, and of those, 118 mothers having an ill child in the previous 4 weeks were selected in this study. Descriptive statistics and multiple logistic regression were applied to predict the associated factors. In all, 42.9% of children had health insurance cards and 45.8% ill children accessed public health facilities. The factors included children’s age, mothers’ knowledge of the free health care policy, mothers’ knowledge about one sign of lung infection of their children associated with health insurance status, and health care services use. In conclusion, the 2005 reform of child health insurance policy has brought a modest impact on insurance coverage of children younger than 6 years of age and health care services use. Mothers’ knowledge of free health care policy should be improved.

iKure Techsoft: Providing Technology Enabled Affordable Health Care in Rural India

2018 ◽  
Vol 22 (02) ◽  
pp. 385-411
Author(s):  
Atanu Chaudhuri ◽  
Venkatramanaiah Saddikutti ◽  
Thim Prætorius
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Workers ◽  
Care Delivery ◽  
Rural India ◽  
Medical Team ◽  
Hub And Spoke ◽  
Care Services ◽  
Primary Health ◽  
Care Delivery Model

iKure Techsoft was established in 2010 with the main objective to provide affordable and high quality primary health care to the rural population in India and to build a sustainable for-profit business model. To that end, iKure’s cloud based, and patent pending, Wireless Health Incident Monitoring System (WHIMS) technology along with their hub-and-spoke operating model are central, but also essential to exploit and explore further if iKure is to scale-up. iKure provides primary health care services through three hub clinics and 28 rural health centres (RHCs). Each hub clinic employs between one and up to six medical teams (each consisting of 1 doctor, 1 nurse, 1 paramedic and 2 health workers stationed at the hub) & 1 mobile medical team (1 doctor, 1 paramedic, 2 health workers) for catering to the RHCs). Each medical team manages six RHCs. Paramount in iKure’s health care delivery model is their self-developed software called WHIMS, which is a cloud-based award-winning application that runs on low internet bandwidths. WHIMS allow for (a) centralized monitoring of key metrics such as doctor’s attendance, treatment prescribed, patient record management, pharmacy stock management, and (b) supports effective communication, integration and contact that connects RHCs with hub clinics, but also city-based multi-specialty hospitals with whom iKure has formal tie-ups. iKure, moreover, also works extensively with Non-Governmental Organizations (NGOs). Collaboration with local NGOs in the target areas helps to build trust with the rural villagers and their local knowledge and access helps to assess service demand. NGOs also provide the necessary local logistical support and basic infrastructure in the rural areas where iKure works. Moreover, collaboration, for example, with corporate organizations are central as they contribute with part of their corporate social responsibility (CSR) funds to support iKure initiatives. At present, iKure is planning to add diagnostic services to its six hub clinics as well as expand its presence in other parts of West Bengal and other states across India. Expanding rural health care services even with the technology support of WHIMS is challenging because, for example, health is a very local issue (due to, among other things, local customs and languages) and it requires investing significant amount of time and resources to build relationship with the rural people as well as collaborators such as NGOs and corporates. The accompanying case describes iKure’s journey so far in terms of understanding: (a) the state of health care and government health care services provided in rural India, (b) the establishment and evolution of the iKure business and health care model, (c) iKure’s operations and health care delivery model including the WHIMS technology solution and hub-and-spoke set-up of operations, (d) the collaborative model which relies on NGOs and private corporates, and (e) finally iKure’s challenges related to scaling-up.

scholarly journals Experiences of primary health care nurses regarding the provision of free health care services in the Northern region of the Limpopo Province

Curationis ◽  
2005 ◽  
Vol 28 (1) ◽  
Author(s):  
VO Netshandama ◽  
L Nemathaga ◽  
SN Shai-Mahoko
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Services ◽  
Northern Region ◽  
Limpopo Province ◽  
Care Services ◽  
Primary Health ◽  
Health Centres ◽  
Free Health Care ◽  
Primary Health Care Nurses

The purpose of the study was to explore the experiences of primary health care nurses working in the clinics and health centres involved in the provision of free health care services. The research design followed was exploratory, descriptive and qualitative. The population of the study included all primary health care nurses working at the clinics and health centres in the Vhembe (northern) region of the Limpopo Province. The sampling method used was purposive for the samples of both the clinics and the nurses. The inclusion criteria for the nurses included experience of two or more years in providing primary health care. The inclusion criteria for the selection of clinics included being a busy clinic (a minimum of 2000 patients per month) with a staff establishment of four or more primary health care nurses. In conducting this research, ethical principles were taken into account. Data was collected from 23 participants in the Northern Region. The research question read as follows: What are your experiences regarding the provision of free health care services? An open coding method consisting of eight steps provided by Tesch's (1990:140-145) eight-step method of analysing data was used. The research findings revealed that the primary health care nurses working in the clinics experience feelings of failure to provide adequate primary health care services due to the increased workload, misuse of the service, and fear associated with lack of security in the clinics and health centres. The conclusions drawn from this research are that on the one hand a poor mechanism exists for the monitoring of the implementation of free health services, and on another hand, there has been misuse of the facilities by the community. The concept “free health care service” has been misinterpreted.

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