scholarly journals Service delivery and coverage in primary healthcare in a community-health project in Ibadan, Nigeria

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Kabiru K. Salami ◽  
William R. Brieger
Keyword(s):  
Service Delivery ◽  
Antenatal Care ◽  
Community Health ◽  
Primary Healthcare ◽  
First Trimester ◽  
Health Service Delivery ◽  
Healthcare Services ◽  
Steady Increase ◽  
Record Keeping ◽  
Health Project

Background: Standard health-service delivery aimed toward improving maternal and childhealth status remains elusive in Nigeria because of inaccuracies in data documentation leading to a lack of relatively stable evidence.Objectives: Through a community-health project, this study tested the accuracy of record keeping in primary healthcare services in nine clinics run in Ibadan, Nigeria.Methods: A validation exercise was performed through a sample of the 10 most recent names extracted from three registers maintained by each clinic.Results: A review of the register covering a period of four years showed a steady increase in: fully-immunised children, registration for antenatal care during the first trimester of pregnancy, the number of women who attended antenatal care at least three times, the overall number of women who booked for antenatal care and women who delivered in Eniosa Community-Health Project facilities over the four-year period. It was possible to trace 86% of those selected from the antenatal care register, 88.9% of those from the birth register and 81.1%of those from the immunisation register. Four women who should have been included for antenatal care, seven who had delivered (but were not in the register) and 13 who reportedlyreceived immunisation but were not listed were found during the validation exercise.Conclusion: This study concludes that the names appearing in the register are likely to represent valid events, but that the registers did not capture all such events in the community.

scholarly journals Current status of antenatal care of pregnant women—8 provinces in China, 2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wenling Hu ◽  
Huanqing Hu ◽  
Wei Zhao ◽  
Aiqun Huang ◽  
Qi Yang ◽  
...  
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Community Health ◽  
First Trimester ◽  
Community Health Services ◽  
Current Status ◽  
Categorical Variables ◽  
Chi Square ◽  
Prenatal Care Visit

Abstract Background Antenatal care (ANC) played a crucial role in ensuring maternal and child safety and reducing the risk of complications, disability, and death in mothers and their infants. The objective of this study was to evaluate the current status of ANC emphasizing the number, timing, and content of examinations on a national scale. Methods The data was collected from maternal and newborn’s health monitoring system at 8 provinces in China. After ethical approval, all pregnant women registered in the system at their first prenatal care visit, we included 49,084 pregnant women who had delivered between January 1, 2018 and December 31, 2018. Descriptive statistics of all study variables were calculated proportions and chi-square for categorical variables. Results Of the 49,084 women included in this study, the mean number of ANC visits was 6.95 ± 3.45. By percentage, 78.79% women received ANC examinations at least five times, 39.93% of the women received ANC examinations at least eight times and 16.66% of the women received ANC examinations at least 11 times. The proportion of first ANC examination in first trimester was 61.87%. The percentage of normative ANC examinations and the percentage of qualified ANC examinations were 30.98 and 8.03% respectively. Only 49.40% of the total women received all six kinds of examination items in first ANC examination: 91.47% received a blood test, 91.62% received a urine test, 81.56% received a liver function examination, 80.52% received a renal function examination, 79.07% received a blood glucose test, and 86.66% received a HIV/HBV/syphilis tests. 50.85% women received the first ANC examination in maternal and child health care (MCH) institutions, 14.07% in a general hospital, 18.83% in a township hospital, 13.15% in a community health services center, and 3.08% in an unspecified place. The proportion of women who received each of the ANC examination items in community health services center was the highest, but that in the MCH institutions was the lowest. Conclusions There is a big difference between the results of this study and the data in official reports, this study found the current status of antenatal care is not optimal in China, findings from this study suggest that the systematization, continuity and quality of ANC examinations need to be improved.

scholarly journals Implementation of Primary Healthcare Services in Community Health Stations in Highly Urbanized City

2021 ◽  
Vol 4 (3) ◽  
pp. 123-132
Author(s):  
Hanna B. Gella ◽  
Merlita V. Caelian
Keyword(s):  
Community Health ◽  
Primary Healthcare ◽  
Healthcare Providers ◽  
Well Being ◽  
Healthcare Services ◽  
Health Improvement ◽  
Patient Centeredness ◽  
Sustainable Development Goal ◽  
The Sustainable Development ◽  
Child Healthcare

Primary healthcare is integral to the Sustainable Development Goal (SDG) of ensuring healthy lives and promoting well-being.  A descriptive study assessed the implementation of primary healthcare services in community health stations through a researcher-made questionnaire among healthcare providers and beneficiaries of 30 community health stations.  The results revealed that, as a whole, the implementation of primary healthcare services in community health stations is great, with maternal and child healthcare implemented to a very great extent while the treatment of non-communicable diseases to a great extent only.  The major challenges encountered are the lack of medical drugs, supplies and equipment, and medical professionals.  Primary healthcare has made contributions to the community's health improvement; however, challenges imply that the quality and efficiency of the services need improvement. The study contributed to new knowledge on implementing healthcare at the lowest level of government, emphasizing patient-centeredness.

scholarly journals Making doctors stay: Rethinking doctor retention policy in a contracted-out primary healthcare setting in urban Bangladesh

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262358
Author(s):  
Farzana Bashar ◽  
Rubana Islam ◽  
Shaan Muberra Khan ◽  
Shahed Hossain ◽  
Adel A. S. Sikder ◽  
...  
Keyword(s):  
Service Delivery ◽  
Primary Healthcare ◽  
Service Provision ◽  
Urban Areas ◽  
Financial Incentives ◽  
Clinical Skills ◽  
Healthcare Services ◽  
Working Environment ◽  
Staff Retention ◽  
Contracting Out

Background “Contracting Out” is a popular strategy to expand coverage and utilization of health services. Bangladesh began contracting out primary healthcare services to NGOs in urban areas through the Urban Primary Health Care Project (UPHCP) in 1998. Over the three phases of this project, retention of trained and skilled human resources, especially doctors, proved to be an intractable challenge. This paper highlights the issues influencing doctor’s retention both in managerial as well as service provision level in the contracted-out setting. Methodology In this qualitative study, 42 Key Informant Interviews were undertaken with individuals involved with UPHCP in various levels including relevant ministries, project personnel representing the City Corporations and municipalities, NGO managers and doctors. Verbatim transcripts were coded in ATLAS.ti and analyzed using the thematic analysis. Document review was done for data triangulation. Results The most cited problem was a low salary structure in contrast to public sector pay scale followed by a dearth of other financial incentives such as performance-based incentives, provident funds and gratuities. Lack of career ladder, for those in both managerial and service delivery roles, was also identified as a factor hindering staff retention. Other disincentives included inadequate opportunities for training to improve clinical skills, ineffective staffing arrangements, security issues during night shifts, abuse from community members in the context of critical patient management, and lack of job security after project completion. Conclusions An adequate, efficient and dedicated health workforce is a pre-requisite for quality service provision and patient utilization of these services. Improved career development opportunities, the provision of salaries and incentives, and a safer working environment are necessary actions to retain and motivate those serving in managerial and service delivery positions in contracting out arrangements.

scholarly journals The role and response of primary healthcare services in the delivery of palliative care in epidemics and pandemics: A rapid review to inform practice and service delivery during the COVID-19 pandemic

2020 ◽  
Vol 34 (9) ◽  
pp. 1182-1192 ◽  
Author(s):  
Sarah Mitchell ◽  
Victoria Maynard ◽  
Victoria Lyons ◽  
Nicholas Jones ◽  
Clare Gardiner
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Service Delivery ◽  
End Of Life ◽  
Primary Healthcare ◽  
End Of Life Care ◽  
Healthcare Services ◽  
Rapid Review ◽  
Life Care ◽  
Care Providers

Background: The increased number of deaths in the community happening as a result of COVID-19 has caused primary healthcare services to change their traditional service delivery in a short timeframe. Services are quickly adapting to new challenges in the practical delivery of end-of-life care to patients in the community including through virtual consultations and in the provision of timely symptom control. Aim: To synthesise existing evidence related to the delivery of palliative and end-of-life care by primary healthcare professionals in epidemics and pandemics. Design: Rapid systematic review using modified systematic review methods, with narrative synthesis of the evidence. Data sources: Searches were carried out in Medline, Embase, PsychINFO, CINAHL and Web of Science on 7th March 2020. Results: Only five studies met the inclusion criteria, highlighting a striking lack of evidence base for the response of primary healthcare services in palliative care during epidemics and pandemics. All were observational studies. Findings were synthesised using a pandemic response framework according to ‘systems’ (community providers feeling disadvantaged in terms of receiving timely information and protocols), ‘space’ (recognised need for more care in the community), ‘staff’ (training needs and resilience) and ‘stuff’ (other aspects of managing care in pandemics including personal protective equipment, cleaning care settings and access to investigations). Conclusions: As the COVID-19 pandemic progresses, there is an urgent need for research to provide increased understanding of the role of primary care and community nursing services in palliative care, alongside hospices and community specialist palliative care providers.

scholarly journals Electricity Access, Community Healthcare Service Delivery, and Rural Development Nexus: Analysis of 3 Solar Electrified CHPS in Off-Grid Communities in Ghana

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Richard Opoku ◽  
Eunice A. Adjei ◽  
George Y. Obeng ◽  
Luc Severi ◽  
Abdul-Rahim Bawa
Keyword(s):  
Rural Development ◽  
Service Delivery ◽  
Health Outcomes ◽  
Community Health ◽  
Healthcare Service ◽  
Healthcare Services ◽  
Solar Pv ◽  
Pv Systems ◽  
Time Savings ◽  
Electricity Access

Over 600 million people living in sub-Saharan Africa do not have access to electricity. Modern healthcare services, including vaccine refrigeration, which require electricity are therefore lacking in such energy-deprived communities. In this work, analysis has been conducted on how electricity access can help improve healthcare service delivery and rural development, with a case study on 3 different off-grid solar photovoltaic (PV) systems in community-based health planning and services (CHPS) in Ghana. Analysis from this study showed that for the 3.0 kWp solar PV systems installed at the various sites, the in-house electricity consumptions are between 4.30 and 7.58 kWh per day. It was found out that excess electricity generation of 148–304 kWh per month is available and can be used to provide other economic services including phone charging, torchlight battery charging, and small-sized cold storage services to generate income for the maintenance of the systems, which is critical for sustainability of solar PV installations in rural poor communities. The study results also showed that electrified health facilities which are able to provide basic healthcare services have potential impact on community health outcomes and rural development. Assessment conducted at the CHPS compounds revealed that, generally, there is improvement in healthcare service delivery resulting in time savings of 15-43 hours per month for the inhabitants which can potentially be used for productive work. The time savings were more significant in females and children than in males. In many rural agro-based communities in developing countries, female and children are usually the workforce engaged in various farming activities. This paper concludes that access to electricity in CHPS compounds helps to improve community health outcomes and increases time availability for women to engage in productive work that can potentially result in significant socioeconomic activities and rural development.

scholarly journals Regional variation in multimorbidity prevalence in British Columbia, Canada: a cross-sectional analysis of Canadian Community Health Survey data, 2015/16

2020 ◽  
Vol 40 (7/8) ◽  
pp. 225-234
Author(s):  
C. Andrew Basham
Keyword(s):  
British Columbia ◽  
Sensitivity Analysis ◽  
Health Service ◽  
Service Delivery ◽  
Community Health ◽  
Health Survey ◽  
Health Service Delivery ◽  
Canadian Community Health Survey ◽  
Valuable Source ◽  
Community Health Survey

Introduction Multimorbidity represents a major concern for population health and service delivery planners. Information about the population prevalence (absolute numbers and proportions) of multimorbidity among regional health service delivery populations is needed for planning for multimorbidity care. In Canada, health region–specific estimates of multimorbidity prevalence are not routinely presented. The Canadian Community Health Survey (CCHS) is a potentially valuable source of data for these estimates. Methods Data from the 2015/16 cycle of the CCHS for British Columbia (BC) were used to estimate and compare multimorbidity prevalence (3+ chronic conditions) through survey-weighted analyses. Crude frequencies and proportions of multimorbidity prevalence were calculated by BC Health Service Delivery Area (HSDA). Logistic regression was used to estimate differences in multimorbidity prevalence by HSDA, adjusting for known confounders. Multiple imputation using chained equations was performed for missing covariate values as a sensitivity analysis. The definition of multimorbidity was also altered as an additional sensitivity analysis. Results A total of 681 921 people were estimated to have multimorbidity in BC (16.9% of the population) in 2015/16. Vancouver (adj­OR = 0.65; 95% CI: 0.44–0.97) and Richmond (adj­OR = 0.55; 95% CI: 0.37–0.82) had much lower prevalence of multimorbidity than Fraser South (reference HSDA). Missing data analysis and sensitivity analysis showed results consistent with the main analysis. Conclusion Multimorbidity prevalence estimates varied across BC health regions, and were lowest in Vancouver and Richmond after controlling for multiple potential confounders. There is a need for provincial and regional multimorbidity care policy development and priority setting. In this context, the CCHS represents a valuable source of information for regional multimorbidity analyses in Canada.

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