scholarly journals Cost of treatment among self-referred outpatients in referral hospitals compared to primary health care facilities in East Wollega, western Ethiopia: A comparative cross-sectional study

2019 ◽  
Vol 10 (1) ◽  
Author(s):  
Edosa Tesfaye Geta ◽  
Yibeltal Siraneh Belete ◽  
Elias Ali Yesuf
Keyword(s):  
Health Care ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Cost Of Treatment ◽  
Cross Sectional ◽  
Outpatient Visits ◽  
Primary Health ◽  
Referral Hospitals ◽  
Primary Health Facilities

Patient self-referral is a condition when patients refer themselves to higher level health facilities without having to see anyone else first. Despite the expansion in the number of health facilities, it has been seen when patients routinely accessed referral hospitals without a formal referral. The study aims to evaluate cost of treatment among self-referred outpatients at referral hospitals compared to primary health care facilities. Comparative cross-sectional study design was used and the required sample size for the study was determined by using formula of double populations mean comparison cost of treatment for diseases leading to outpatient visits. A total of 794 participants (397 from referral hospital and 397 from primary health facilities) were included in the study. Data was collected using face-to-face interview from December 1 to 30, 2017. Data entry and analysis were made using SPSS version 20. Descriptive statistics and independent samples t-test were performed. A total of 783 outpatients responded to the interview of the study and 391 of them were from referral hospital and 392 from primary health facilities. The mean of outpatient visit cost per visit for the treatment of diseases leading to outpatient visits was significantly higher at referral hospitals compared to primary health facilities [95% CI=6.13 (5.07-7.18)] USD. The mean cost of outpatient visits for the treatment of all type of diseases leading to outpatient visits was significantly higher at referral hospitals and at least two times of primary level health facilities. Health care providers should create awareness in the community about referral linkages to inform patients and their families the additional costs they incur when they bypass the proximal primary health facilities.

scholarly journals Effect of COVID-19 Pandemic on Provision of Sexual and Reproductive Health Services in Primary Health Facilities in Nigeria: a Cross-sectional Study

2021 ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Health Services ◽  
Sexual And Reproductive Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

Abstract BackgroundNigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive health, maternal and child health, and adolescent health services in primary health care facilities across the Nigerian States.MethodsThis was a cross-sectional study of 307 primary health facilities in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and service provision before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using non-parametric statistics.ResultsThe results show that a large proportion of the primary health facilities in the selected states opened for the provision of essential sexual and reproductive health and rights services during the COVID-19 pandemic lockdown. However, there was a significant reduction in clients’ utilization of services due to challenges experienced in service implementation such as stock-outs, and low demand for services by clients. Although the health facilities reported identifying cases of COVID-19, there was limited provision for primary protective equipment and other special offers that would motivate the health workers to optimize services for clients. ConclusionsWe conclude that efforts made to address these challenges by governments, non-governmental agencies, the private sector, and donor agencies working in low resource settings would reduce the health and social burden posed by COVID-19 in Nigeria.

scholarly journals Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Babatunde Adelekan ◽  
Erika Goldson ◽  
Zubaida Abubakar ◽  
Ulla Mueller ◽  
Audu Alayande ◽  
...  
Keyword(s):  
Health Care ◽  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Cross Sectional Study ◽  
Health Care Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres

Abstract Background Nigeria, like many other countries, has been severely affected by the COVID-19 pandemic. While efforts have been devoted to curtailing the disease, a major concern has been its potential effects on the delivery and utilization of reproductive health care services in the country. The objective of the study was to investigate the extent to which the COVID-19 pandemic and related lockdowns had affected the provision of essential reproductive, maternal, child, and adolescent health (RMCAH) services in primary health care facilities across the Nigerian States. Methods This was a cross-sectional study of 307 primary health centres (PHCs) in 30 Local Government Areas in 10 States, representing the six geopolitical regions of the country. A semi-structured interviewer-administered questionnaire was used to obtain data on issues relating to access and provision of RMCAH services before, during and after COVID-19 lockdowns from the head nurses/midwives in the facilities. The questionnaire was entered into Open Data Kit mounted on smartphones. Data were analysed using frequency and percentage, summary statistics, and Kruskal–Wallis test. Results Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. During the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients’ utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19. Conclusions The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.

scholarly journals Work motivation and job satisfaction among health workers at primary health facilities: a cross-sectional study from Nepal

2020 ◽  
Author(s):  
Pratik Khanal ◽  
Bishnu P Choulagai ◽  
Pawan Acharya ◽  
Sharad Onta
Keyword(s):  
Job Satisfaction ◽  
Career Development ◽  
Work Motivation ◽  
Health Workers ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Primary Health ◽  
Primary Health Facilities

Abstract BackgroundWork motivation and job satisfaction are linked with the performance and retention of health workforce. Primary health facilities, mostly comprising mid-level health workers, serve the majority of the population in Nepal. The aim of the study was to assess the determinants of job satisfaction in relation to socio-demographics, job characteristics and work motivation status among health workers working in primary health facilities. MethodsA cross-sectional study was conducted in Jhapa district in Eastern Nepal covering 40 primary health facilities. The data collection involved 151 self-administered questionnaire interviews and 16 in-depth interviews with health workers. Mean differences in work motivation among those satisfied and unsatisfied with their job was examined using t tests. Logistic regression with 95% confidence interval at p<0.05 was used for identifying associated factors with job satisfaction. Thematic analysis was done to analyze qualitative data. ResultsAmong the study participants, 78.2% were either auxiliary health workers or auxiliary nurse midwives. The median employment period of health workers was 174 months. On the 5-point Likert scale, the mean score of work motivation was highest for team work (3.99) and lowest for financial motivation (2.21). Higher age of health workers and satisfaction with career development, and financial motivation were significantly associated with job satisfaction. The qualitative findings also revealed that the majority of the health workers were not satisfied with the existing career development opportunities, availability of resources in health facility, or financial motivation. ConclusionSatisfaction with career development and financial motivation significantly increased job satisfaction among health workers. Resource availability in health facility, recognition of work and management support affected work motivation and job satisfaction of health workers. A focus on improving work environment through increased financial motivation and career development opportunities as well as investing in primary health facilities with increased resource support is recommended to improve job satisfaction.

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