scholarly journals Effectivity of Indonesia Chronic Disease Management Program (PROLANIS) to Control Hypertension and its Comorbidities at Primary Health Care

2020 ◽  
Vol 8 (E) ◽  
pp. 224-227
Author(s):  
Firas Farisi Alkaff ◽  
William Putera Sukmajaya ◽  
Ryan Enast Intan ◽  
Sovia Salamah
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Secondary Data ◽  
Care Program ◽  
Management Program ◽  
Primary Health ◽  
Study Population ◽  
National Prevalence

BACKGROUND: National prevalence of hypertension in Indonesia is increasing in the past few years. One of the reasons is because of the weaknesses in health systems, particularly at the primary care level. To resolve this issue, Indonesian government launched a chronic disease care program (PROLANIS) designed to be done at primary health care with the aim to control hypertension. Wates primary health care routinely conducts the program from April 2018. AIM: This study aims to evaluate the effectivity of PROLANIS in controlling hypertension and its comorbidities at Wates primary health care. METHODS: This study was an observational retrospective cohort study using secondary data from PROLANIS report at Wates primary health care in Mojokerto city, Indonesia. The study population was hypertensive patients that voluntarily joined the program on April 2018 and routinely attend evaluation follow-up every 6 months. Follow-up evaluation including blood pressure (BP), body mass index (BMI), total cholesterol (TC), high-density lipid (HDL), low-density lipid (LDL), triglyceride, and estimated glomerular filtration rate (eGFR). RESULTS: There were 44 participants included for the analysis. Median systolic and diastolic BP were always within normal range. Triglyceride serum level showed an improvement in every follow-up evaluation. BMI and LDL showed an improvement in the first follow-up but deteriorated afterward. TC only showed a remarkable improvement in the last follow-up evaluation, while HDL and eGFR result were fluctuate. CONCLUSION: PROLANIS was effective to control BP at Wates primary health care, but not effective to control all comorbidities. Future study needs to be done to elucidate the effectivity of this program countrywide.

scholarly journals A Protocol on Using the RE-AIM Framework in the Process Evaluation of the Primary Health Integrated Care Project for Four Chronic Conditions in Kenya

2022 ◽  
Vol 9 ◽  
Author(s):  
Violet Naanyu ◽  
Hillary Koros ◽  
Beryl Maritim ◽  
Jemima Kamano ◽  
Kenneth Too ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Integrated Care ◽  
Process Evaluation ◽  
Secondary Data ◽  
Management Program ◽  
Primary Data ◽  
Breast Cancers ◽  
Structured Interviews ◽  
Primary Health

Background: There has been a rapid increase in morbidity and mortality arising from non-communicable diseases (NCDs). The Academic Model Providing Access to Healthcare (AMPATH) program has established a chronic disease management program in collaboration with the Ministry of Health (MoH) in Kenya at over 150 health facilities in western Kenya. The primary health integrated care for chronic (PIC4C) disease project seeks to deliver preventive, promotive, and curative care for diabetes, hypertension, cervical and breast cancers at the primary health care level. We apply the RE-AIM framework to conduct a process evaluation of the integrated PIC4C model. This paper describes the protocol we are using in the PIC4C process evaluation planning and activities.Methods and Analysis: This evaluation utilizes clinic reports as well as primary data collected in two waves. Using mixed methods (secondary data, observation, semi-structured interviews, and focus group discussions), the process evaluation assesses the reach, effectiveness, adoption, implementation and maintenance of the PIC4C model in Busia and Trans Nzoia Kenya. The evaluation captures the PIC4C process, experiences of implementers and users, and the wishes of those using the PIC4C services. We will analyse our data across the RE-AIM dimensions using descriptive statistics and two-sample t-test to compare the mean scores for baseline and end line. Qualitative data will be analyzed thematically.Discussion: The process evaluation of the PIC4C model in Kenya allows implementers and users to reflect and question its implementation, uptake and maintenance. Our experiences thus far suggest practicable strategies to facilitate primary health care can benefit extensively from deliberate process evaluation of the programs undertaken. Furthermore, integrating the RE-AIM framework in the process evaluation of health programs is valuable due to its pragmatic and reporting usefulness.

An Alternative Approach To User Fee Policy In The Primary Health Care Setting Of Bangladesh.

2020 ◽  
Author(s):  
Nazneen Akhter
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Complex Dynamics ◽  
Quality Care ◽  
Secondary Data ◽  
User Fees ◽  
Primary Health ◽  
Alternative Approach ◽  
Benefit Principle ◽  
User Fee

The concept of ascribing user fee in health care settings always remained a policy struggle and countries experienced different learning in this regards while implementing user fee at different tiers of health settings. The most exquisite learning among the many country specific evidences related to user fee are the match and mismatch between the equity principle and benefit principle while considering the client perspective. There is an added dimension of quality care which also add more complex dynamics into this concept since the quality care consideration has a double edged perspective both for clients and providers, where which one will get superiority over whom is a great question in health care, especially in the Primary Health care (PHC) of the country. In this reality the appropriate implementation guideline, followed by an appropriate practice of the administrative and management both service oriented and financial are of great importance in this user fee implementation consideration which always remained a challenge in the health care specially in remote care of PHC. This paper attempted a secondary data searching and scoping the available documents of Bangladesh and across the world to find an alternative approach to user fees policy where equity and benefit principle and quality - these three have to be placed in a well-constructed triad in PHC implementation which has been recommended as an alternative policy imperative in approaching user fees for Bangladesh PHC settings.

scholarly journals Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elaine Thumé ◽  
Marciane Kessler ◽  
Karla P. Machado ◽  
Bruno P. Nunes ◽  
Pamela M. Volz ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cohort Study ◽  
Primary Health Care ◽  
Rio Grande ◽  
Cognitive Testing ◽  
Rio Grande Do Sul ◽  
Primary Health ◽  
The Impact

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.

Preparing nurses for primary health care futures: how well do Australian nursing courses perform?

2010 ◽  
Vol 16 (3) ◽  
pp. 211 ◽  
Author(s):  
Helen Keleher ◽  
Rhian Parker ◽  
Karen Francis
Keyword(s):  
Health Care ◽  
Health Promotion ◽  
Primary Health Care ◽  
Chronic Disease ◽  
Curriculum Reform ◽  
Community Settings ◽  
Educational Preparation ◽  
Undergraduate Nursing ◽  
Primary Health ◽  
Prevention And Health Promotion

Health reform is increasingly targeted towards strengthening and expansion of primary health systems as care is shifted from hospitals to communities. The renewed emphasis on prevention and health promotion is intended to curb the tide of chronic disease and sustain effective chronic disease management, as well as address health inequities and increase affordable access to services. Given the scope of nurses’ practice, the success of Australia’s health system reforms are dependent on a nursing workforce that is appropriately educated and prepared for practice in community settings. This article reports on the results of an Australian national audit of all undergraduate nursing curricula to examine the extent of professional socialisation and educational preparation of nurses for primary health care. The results of the audit are compared with Australian nursing standards associated with competency in primary health care. The findings indicate that Australian nursing competencies are general in their approach to skills and knowledge, not specifying any particular competencies for primary health care, while undergraduate student preparation for practice in primary health and community settings is patchy and not keeping pace with reform agendas that promote expanded roles for nurses in primary health care, prevention and health promotion. The implication for nursing curriculum reform is that attention to achieving nursing graduate capacity for primary health care and health promotion is a priority.

Evaluation of a primary health care program for the poor

1989 ◽  
Vol 14 (2) ◽  
pp. 107-120 ◽  
Author(s):  
Charles E. Begley ◽  
Lu Ann Aday ◽  
Roy McCandless
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Care Program ◽  
The Poor ◽  
Health Care Program ◽  
Primary Health

scholarly journals Difficulties in nutritional counseling and child growth follow-up: from a professional perspective

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
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Medical Model ◽  
Child Growth ◽  
Nutritional Counseling ◽  
Child Feeding ◽  
Professional Experiences ◽  
Primary Health ◽  
Professional Perspective

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.

scholarly journals Knowledge, adherence and control among patients with hypertension attending a peri-urban primary health care clinic, KwaZulu-Natal

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Olumuyiwa A. Olowe ◽  
Andrew J. Ross
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Cross Sectional Study ◽  
Related Factors ◽  
Cross Sectional ◽  
Care Clinic ◽  
Primary Health ◽  
Validated Questionnaire ◽  
Study Population ◽  
And Control

Background: Despite hypertension being a common condition among patients attending primary health care (PHC) clinics, blood pressure (BP) control is often poor. Greater insight into patient-related factors that influence the control of hypertension will assist in the development of an intervention to address the issues identified.Aim: The aim of the study was to assess patient-related variables associated with hypertension control among patients attending a peri-urban PHC clinic.Setting: The setting for this study was a peri-urban PHC clinic in KwaZulu-Natal.Method: This was an observational, descriptive and cross-sectional study with 348 patients selected over a 1-month period. A validated questionnaire was used to collect data on patients’ hypertension knowledge and self-reported adherence, and BP recordings from their medical record were recorded to ascertain control.Results: Of the 348 participants, only 49% had good BP control and 44% (152/348) had concurrent diabetes mellitus. The majority of patients had moderate levels of knowledge on hypertension and exhibited moderate adherence. There was a significant relationship between knowledge and reported adherence, between reported adherence and control, but not between reported knowledge and control.Conclusion: Despite over 90% of the study population having moderate knowledge, and 62% with moderate reported adherence, BP was well controlled in only less than 50% of the study population. These findings suggest a need to emphasise adherence and explore new ways of approaching adherence.

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