scholarly journals Patient and health system determinants of experiences of care at primary health care clinics in eThekwini, KwaZulu-Natal, 2018

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Avashri Harrichandparsad ◽  
Ozayr H. Mahomed
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Positive Association ◽  
Health Care Facilities ◽  
Community Healthcare ◽  
Health Care Clinics ◽  
Primary Health ◽  
Excellent Health ◽  
Patients Experience

Background: Respect for persons includes three sub-elements: dignity, autonomy and confidentiality, whilst client orientation has four sub-elements: prompt attention, quality of basic amenities, access to social support for hospitalised individuals and choice of health providers.Aim: This study sought to determine patient and health system determinants of experiences of care.Setting: Study was conducted at primary health care clinics in eThekwini, KwaZula-Natal.Methods: A self-administered questionnaire was used to collect data from 384 patients who received ambulatory care at six primary health care facilities (three community healthcare centres and three clinics) between June 2018 and November 2018.Results: Three hundred and sixty nine respondents were included in the study. Eighty one percent (299) of the respondents were female, 67.2% (248) were single and 89.7% (331) were black Africans. Fifty (13.6%) respondents reported their health status to be poor, whilst 47 (12.5%) reported excellent health, with the majority (72.0%) reporting ‘good’ or ‘fair’ health. The patients’ experience score for the study population was 89.0% (IQR 81% – 98%). Patients who attended clinics had a 6.53 (p 0.001) times increased odds of reporting good patients’ experience score compared with patients who attended community healthcare centres. Although ideal clinic status had a positive association with patients’ experience score (odds ration [OR]: 1.75; p 0.05) this was not significant.Conclusion: Patients attending clinics had a better experience compared with community health centres. Ideal clinic status showed a positive but not statistical significant association with good patient experiences. This may suggest that factors other than structural improvements play an important role in patients’ experience.

scholarly journals WASH infrastructure and practices in primary health care clinics in the rural Vhembe District municipality in South Africa

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
N. Potgieter ◽  
N. T. Banda ◽  
P. J. Becker ◽  
A. N. Traore-Hoffman
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Facilities ◽  
World Health ◽  
Primary Health Care System ◽  
E Coli ◽  
Health Care Clinics ◽  
Primary Health ◽  
Vhembe District

Abstract Background South Africa has unique and diverse social and economic factors that have an impact on the provision of basic water, sanitation, hygiene and waste management infrastructure and practices at health care facilities in ensuring patient safety and prevent the spread of diseases. Methods The aim of this study was to evaluate water, sanitation and hygiene access and standards at 50 government owned public health care clinics in the rural region of the Vhembe district of South Africa during 2016/2017, using self-observation, an observation checklist, record reviews and interviews with clinic managers. Water quality from all available water sources on the clinic compound was analysed for Total coliform and E. coli counts using the Colilert Quanti-tray/2000 system. The prevalence of pathogenic diarrhea causing E. coli strains was established using multiplex-Polymerase Chain Reaction. Results The health care clinics in the Vhembe District generally complied with the basic WASH services guidelines according to the World Health Organisation. Although 80% of the clinics used borehole water which is classified as an improved water source, microbiological assessment showed that 38% inside taps and 64% outside taps from the clinic compounds had TC counts higher than guideline limits for safe drinking. Similarly, EC counts above the guideline limit for safe drinking water were detected in 17% inside taps and 32% outside taps from the clinic compounds. Pathogenic EAEC, EPEC, ETEC and EHEC strains were isolated in the collected water samples. Although improved sanitation infrastructures were present in most of the clinics, the sanitary conditions of these toilets were not up to standard. Waste systems were not adequately managed. A total of 90% of the clinics had hand washing basins, while only 61% of the clinics had soap present and only 64% of the clinics had adequate signs and posters reminding the staff, care givers and patients to wash their hands. Conclusions Various WASH aspects within the primary health care system in South Africa needs to be improved and corrected. A more rigorous system that is inclusive of all role players in the WASH sectors, with regular monitoring and training sessions, should be used.

scholarly journals Quality of nutrition services in primary health care facilities: Implications for integrating nutrition into the health system in Bangladesh

PLoS ONE ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. e0178121 ◽  
Author(s):  
Sk Masum Billah ◽  
Kuntal Kumar Saha ◽  
Abdullah Nurus Salam Khan ◽  
Ashfaqul Haq Chowdhury ◽  
Sarah P. Garnett ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Health Care Facilities ◽  
Nutrition Services ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

scholarly journals Health System Adaptability at Primary Level Care in the Time of COIVD-19: Experiences From Ethiopia

2020 ◽  
Author(s):  
Yared Abebe ◽  
Ismael Ali Beshir ◽  
Zergu Tafese Tsegaye ◽  
Binyam Fekadu Desta ◽  
Mengistu Asnake Kibret ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Health Systems ◽  
Health Care Facilities ◽  
Effective Response ◽  
Primary Health ◽  
Care Facilities ◽  
System Resilience ◽  
Primary Health Care Facilities

Abstract BackgroundCOVID-19 is a global public health emergency, that has had massive implications on the ability of health systems to avail essential services both during and after the emergency. An effective response thus requires an agile health system that can adjust, reorganize, transform or modify in response to shocks and stress, and to recover quickly in the aftermath. This study aims to identify the major attributes that health systems needed to be adaptable in early stages of the COVID-19 pandemic, as observed in selected primary health care facilities in Ethiopia. MethodsThis study employed a retrospective cross-sectional study design based on the ‘ready, willing and able’ framework for health system resilience. The assessment used two independent, concurrently administrated instruments. A total of 163 health centers were visited from April to June 2020. ResultsThe overall mean score for COVID-19 preparedness was 73.1±16.1 standard deviation (SD) and it ranged from 28.9 to 99.9 out of 100. The mean score for the ‘ready’ dimension of preparedness was 75.1±19.1 SD, for the ‘willing’ dimension it was 61.6±24.6 SD and for the ‘able’ dimension the score was 82.8±21.0 SD. Multivariable linear regression analysis showed that levels of functionality of governing, and management systems, integration of emergency responses into the routine system, and prior experience of implementing quality improvement efforts were positively associated with COVID-19 preparedness. ConclusionHealth system resilience is a result of investments made prior to any incidents to ensure that the system is prepared for unpredicted shocks. Early adaptation required to contain the effects of COVID-19 may be considered as a litmus test to understand the capacity of primary health care facilities in Ethiopia to withstand future health system stressors.

scholarly journals A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

2015 ◽  
Vol 31 (2) ◽  
pp. 250-258 ◽  
Author(s):  
Mary-Anne Ahiabu ◽  
Britt P Tersbøl ◽  
Richard Biritwum ◽  
Ib C Bygbjerg ◽  
Pascal Magnussen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Facilities ◽  
Eastern Region ◽  
Primary Health ◽  
Retrospective Audit ◽  
Care Facilities ◽  
Primary Health Care Facilities

scholarly journals Factors affecting health care users’ first contact with primary health care facilities in north eastern China, 2008–2018

2021 ◽  
Vol 6 (2) ◽  
pp. e003907
Author(s):  
Ran Liao ◽  
Yaqian Liu ◽  
Shunzhuang Peng ◽  
Xing Lin Feng
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Eastern China ◽  
Medical System ◽  
Health Care Facilities ◽  
Factors Affecting ◽  
Primary Health ◽  
North Eastern ◽  
First Contact ◽  
Hierarchical Medical System

BackgroundChina set out the vision to establishing a hierarchical medical system, with primary health care (PHC) facilities serving health care users’ first contact. Common ailments were listed, supported by a series of auxiliary policy measures. We aim to assess whether these policies were effective to prompt users’ preference to PHCs within these contexts.MethodsUsing data from three waves of National Health Service Survey, we examined trends in care users’ first contact with PHC facilities in Jilin, a north eastern province, during 2008–2018. We analysed trends and factors affecting care users’ choices, stratified by type of diseases and urban–rural settings.ResultsFrom 38 823 respondents, the survey identified 3302 health care users who sought outpatient care. 54.92% and 82.49% with diseases recommended to PHC, in urban and rural Jilin, respectively, contacted PHC facilities first. While 33.51% and 61.19% with diseases not recommended to PHC did so. Care users’ first contact with PHC facilities followed an inverse U shape during 2008–2018. Such trends were more profound among care users with hypertension and/or diabetes. Neither social health insurance coverage nor contracting with family doctors was associated with care users’ first contacts. Only 1.25% care users had referral experiences. Low perceived quality was the main barrier to choose PHC facilities.ConclusionHealth care users sought PHC in a chaotic manner in Jilin. None of the recent efforts seemed effective in prompting their preference to PHC facilities. Without levering quality of PHC, an effective hierarchical medical system could be hardly forged in China.

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