Quality of Care in Primary Health Centres of Tafa Local Government Area of Niger State, North Central Nigeria; The Clients' Perspective

2010 ◽  
Vol 19 (2) ◽  
Author(s):  
MN Sambo ◽  
I Lewis ◽  
SH Idris
Keyword(s):  
Quality Of Care ◽  
Local Government ◽  
Local Government Area ◽  
North Central ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres

scholarly journals Improving quality of care during childbirth in primary health centres: a stepped-wedge cluster-randomised trial in India

2018 ◽  
Vol 3 (5) ◽  
pp. e000907 ◽  
Author(s):  
Ramesh Agarwal ◽  
Deepak Chawla ◽  
Minakshi Sharma ◽  
Shyama Nagaranjan ◽  
Suresh K Dalpath ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Management Strategy ◽  
Randomised Trial ◽  
Cluster Randomised Trial ◽  
Stepped Wedge ◽  
Primary Health ◽  
Cluster Randomised ◽  
Primary Health Centres ◽  
Health Centres

BackgroundLow/middle-income countries need a large-scale improvement in the quality of care (QoC) around the time of childbirth in order to reduce high maternal, fetal and neonatal mortality. However, there is a paucity of scalable models.MethodsWe conducted a stepped-wedge cluster-randomised trial in 15 primary health centres (PHC) of the state of Haryana in India to test the effectiveness of a multipronged quality management strategy comprising capacity building of providers, periodic assessments of the PHCs to identify quality gaps and undertaking improvement activities for closure of the gaps. The 21-month duration of the study was divided into seven periods (steps) of 3  months each. Starting from the second period, a set of randomly selected three PHCs (cluster) crossed over to the intervention arm for rest of the period of the study. The primary outcomes included the number of women approaching the PHCs for childbirth and 12 directly observed essential practices related to the childbirth. Outcomes were adjusted with random effect for cluster (PHC) and fixed effect for ‘months of intervention’.ResultsThe intervention strategy led to increase in the number of women approaching PHCs for childbirth (26 vs 21 women per PHC-month, adjusted incidence rate ratio: 1.22; 95% CI 1.17 to 1.28). Of the 12 practices, 6 improved modestly, 2 remained near universal during both intervention and control periods, 3 did not change and 1 worsened. There was no evidence of change in mortality with a majority of deaths occurring either during referral transport or at the referral facilities.ConclusionA multipronged quality management strategy enhanced utilisation of services and modestly improved key practices around the time of childbirth in PHCs in India.Trial registration numberCTRI/2016/05/006963.

scholarly journals Where there is no nurse: an observational study of large-scale mentoring of auxiliary nurses to improve quality of care during childbirth at primary health centres in India

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e027147 ◽  
Author(s):  
Krishna D Rao ◽  
Swati Srivastava ◽  
Nicole Warren ◽  
Kaveri Mayra ◽  
Aboli Gore ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Postpartum Haemorrhage ◽  
Neonatal Resuscitation ◽  
Staff Nurses ◽  
Normal Delivery ◽  
Primary Health ◽  
Primary Health Centres ◽  
Significant Difference ◽  
Health Centres

ObjectiveClinician scarcity in Low and Middle-Income Countries (LMIC) often results in de facto task shifting; this raises concerns about the quality of care. This study examines if a long-term mentoring programme improved the ability of auxiliary nurse-midwives (ANMs), who function as paramedical community health workers, to provide quality care during childbirth, and how they compared with staff nurses.DesignQuasi-experimental post-test with matched comparison group.SettingPrimary health centres (PHC) in the state of Bihar, India; a total of 239 PHCs surveyed and matched analysis based on 190 (134 intervention and 56 comparison) facilities.ParticipantsAnalysis based on 335 ANMs (237 mentored and 98 comparison) and 42 staff nurses (28 mentored and 14 comparison).InterventionMentoring for a duration of 6–9 months focused on nurses at PHCs to improve the quality of basic emergency obstetric and newborn care.Primary outcome measuresNurse ability to provide correct actions in managing cases of normal delivery, postpartum haemorrhage and neonatal resuscitation assessed using a combination of clinical vignettes and Objective Structured Clinical Examinations.ResultsMentoring increased correct actions taken by ANMs to manage normal deliveries by 17.5 (95% CI 14.8 to 20.2), postpartum haemorrhage by 25.9 (95% CI 22.4 to 29.4) and neonatal resuscitation 28.4 (95% CI 23.2 to 33.7) percentage points. There was no significant difference between the average ability of mentored ANMs and staff nurses. However, they provided only half the required correct actions. There was substantial variation in ability; 41% of nurses for normal delivery, 60% for postpartum haemorrhage and 45% for neonatal resuscitation provided less than half the correct actions. Ability declined with time after mentoring was completed.DiscussionMentoring improved the ability of ANMs to levels comparable with trained nurses. However, only some mentored nurses have the ability to conduct quality deliveries. Continuing education programmes are critical to sustain quality gains.

scholarly journals Availability of personnel, facilities and services in Primary Health Care Centres in a Local Government Area in Benin City, Nigeria

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Vincent Yakubu Adam ◽  
Joy Chinyere Nwaogwugwu
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Local Government ◽  
Healthcare Services ◽  
Local Government Area ◽  
Benin City ◽  
Essential Drugs ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres

Background: Effective delivery of healthcare services especially at the Primary Health Care level requires availability of adequate infrastructure, basic diagnostic medical equipment, drugs and well-trained medical personnel. Quality Primary Health Care initiatives have been recognized as fundamental to improving health outcomes. This study assessed the resources available for Primary Health Care delivery in a Local Government Area in Benin City, Nigeria. Materials and Methods: This was a descriptive cross-sectional study. All the public primary health centres in Egor LGA, Benin City, Nigeria were assessed for availability of personnel, facilities/ equipment and services using an adapted observational checklist. Results: All the 10 public primary health centres were assessed. The primary health centres had inadequate skilled-manpower: only 1 (10.0%) had a medical officer, Community Health Officers and nurse/midwives were adequate in only 2 (20.0%), and none of them (0.0%) had a medical record officer and pharmacy technician. Basic equipment for examination of clients were available in 3 of the health facilities (30.0%). All 10 of the health centres (100.0%) offered basic services but not for 24 hours. Essential drugs were not regularly available in all the facilities. Conclusions: Basic healthcare services were rendered but not for 24 hours. Several challenges such as inadequate skilled health personnel, lack of basic amenities, and shortage of essential drugs affect the primary health centres. Basic hospital facilities/equipment needed to enhance 24 hours’ service delivery at the primary health centres should be provided by the Local Government.

scholarly journals Quality of Service of Primary Health Centres: Insights from a Field Study

2004 ◽  
Vol 29 (3) ◽  
pp. 71-82 ◽  
Author(s):  
P Rameshan ◽  
Shailendra Singh
Keyword(s):  
Health Care ◽  
Quality Of Service ◽  
Primary Health Care ◽  
Local Government ◽  
Health Care Facilities ◽  
Community Members ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres

This paper provides an evaluation of the quality of services and customer orientation of Primary Health Centres (PHCs) against the backdrop of the changed environment in the country with customer focus and efficiency emerging as the cornerstones of economic transactions in private and public sectors alike. It focuses on ten selected PHCs of Uttar Pradesh and covers the following stakeholders: Customers including patients who use the health care facilities of PHCs as well as the relatives and their personal attendants. Community members covering the village public, local shopkeepers, local government functionaries, local intelligentsia such as teachers and others having an interest or stake in PHC activities. Doctors and staff of the PHCs. District Medical Officials responsible for controlling and monitoring the PHC activities. The paper draws, among others, the following conclusions: The customers and community members of the villages perceived the facilities and services of PHCs to be deficient in many respects. Neither doctors and PHC staff nor the district officials are able to refute adequately the issues raised by villagers about the quality of service of PHCs. While villagers do not like the panchayat (local government) coming into the picture for improving the services of PHCs, district officials totally discount privatization as a means for providing effective primary health care in rural areas. While it is not very easy to solve the primary health care problems of the Indian villagers, yet the policy-makers can take recourse to the following measures to improve the facilities and services of PHCs in future: Form village committees to monitor PHC facilities, resources, and services. Identify industry patrons/sponsors for each PHC for developing infrastructure, facilities, and logistics without straining the scarce government resources. Constitute district-level user committees to monitor not only the PHC activities of a district but also the activities of the District Medical Offices. Enable panchayat and district administration to perform monitoring and supporting functions to ensure multiple checks on activities of the PHCs and District Medical Offices.

scholarly journals Attitude towards Access and Utilization of Maternal Health Services by Women at Sabon-Gari Local Government Area, Kaduna, Nigeria

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Local Government ◽  
Maternal Health ◽  
Health Services ◽  
Survey Methods ◽  
Maternal Health Services ◽  
Local Government Area ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres ◽  
The Mean

Objective: Maternal deaths are alarmingly high globally due to relatively non-availability and non-use of maternal health services by a sizeable proportion of women in rural communities. Women in North-western Nigeria are presently experiencing the worst survival due to key components of maternal health services not being provided at Primary Health Centres (PHCs). The study, therefore, explores the attitude of women toward access and utilization of Maternal Health Services (MHS) provided by PHCs at Sabon-Gari Local Government area, Kaduna State, Nigeria. Study Design: A cross-sectional survey. Methods: A total of 392 women of reproductive ages (15-49 years) were administered questionnaires, out of which 389 were retrieved but only 385 correctly filled and were analyzed quantitatively. Quantitative method of data analysis was used to present the results. Results: It was observed that the mean age of the respondents was 29-35 years. The mean score of mothers access to maternal health services was 4.2 while the mean point for none acceptance for use of modern health services at PHCs was 2.6. Conclusion: Findings revealed that community encouraged women to access maternal health services available at primary health centres though most community members still do not fully accept the use of modern health services at primary health centres and this has posed a lot of problem to the health sector. Effective community enlightenment programmes should be put in place in the rural areas by government and non-governmental organizations to improve access and utilization of Maternal Health Services provided by Primary Health Centres.

scholarly journals Assessment of the Quality of Antenatal and Postnatal Care Services in Primary Health Centres in Rural Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 1-18
Author(s):  
Lorretta Favour C. Ntoimo ◽  
Friday E. Okonofua ◽  
Sanni Yaya ◽  
Blessing Omorodion ◽  
Wilson Imongan ◽  
...  
Keyword(s):  
Local Government ◽  
Low Income ◽  
Postnatal Care ◽  
National Bureau ◽  
Exit Interviews ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres ◽  
Antenatal And Postnatal Care

Maternal mortality ratio in Nigeria is estimated to be 512 deaths per 100,000 live births. As with other low-income countries, a higher proportion of these deaths occur among women living in rural areas and in poor communities where access to maternal health care is limited by several barriers including quality of care in health facilities. The objective of this study was to assess the quality of antenatal and postnatal care in Primary Health Centres (PHCs) in two rural Local Government Areas of Edo State in Southern Nigeria. The data were obtained from exit interviews with 177 women after completion of antenatal and postnatal care in eight randomly selected PHCs. The interview questionnaire was adapted from the 2017 results-based financing exit interviews conducted by the World Bank in collaboration with the Federal Ministry of Health and the National Bureau of Statistics. It consisted of questions on the treatment received by women. The data were analysed with descriptive statistics and logistic regression. The results showed the self-reporting by women of sub-optimal offerings of 20 signal antenatal treatments and 8 signal postnatal care treatments. Close to half (45.6%) of the respondents for antenatal care reported receiving sub-optimal antenatal treatments compared to about a third of postnatal care attendees. The predictors of sub-optimal offerings of standard PHC care included local government area, marital status and previous childbirths. We conclude that concerted actions by health providers and policymakers in the PHCs to develop policies and interventions will improve the quality of delivery of antenatal and postnatal services in rural PHCs in Nigeria.

scholarly journals Quality of Health Assistants in primary Health centres in Rural Maharashtra, India

2013 ◽  
Vol 6 ◽  
pp. HSI.S11226
Author(s):  
Enakshi Ganguly ◽  
Bishan S. Garg
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Primary Health Care System ◽  
Job Descriptions ◽  
Continuous Training ◽  
Primary Health ◽  
Primary Health Centres ◽  
Quality Assurance Mechanism ◽  
Health Centres

Introduction Health assistants are important functionaries of the primary health care system in India. Their role is supervision of field-based services among other things. A quality assurance mechanism for these health assistants is lacking. The present study was undertaken with the objectives of developing a tool to assess the quality of health assistants in primary health centres (PHCs) and to assess their quality using this tool. Methodology Health assistants from three PHCs in the Wardha district of India were observed for a year using a tool developed from primary health care management Aavancement program modules. Data was collected by direct observation, interview, and review of records for quality of activities. Results Staff strength of health assistants was 87.5%. None of the health assistants were clear about their job descriptions. A supervisory schedule for providing supportive supervision to auxiliary nurse midwives (ANMs) was absent; most field activities pertaining to maternal and child health received poor focus. Monthly meetings lacked a clear agenda, and comments on quality improvement of services provided by the ANMs were missing. Conclusion Continuous training with sensitization on quality issues is required to improve the unsatisfactory quality.

scholarly journals Trends in the development of psychiatric services in India

1996 ◽  
Vol 20 (1) ◽  
pp. 43-45 ◽  
Author(s):  
Mohan Isaac
Keyword(s):  
Mentally Ill ◽  
Service Provision ◽  
Mental Hospital ◽  
Quality Of Services ◽  
Paper Briefly ◽  
The Past ◽  
Primary Health ◽  
Primary Health Centres ◽  
Health Centres

Over the past five decades, services for the mentally ill in India have steadily improved. From a predominantly mental hospital based service, provision has now moved to general hospitals and primary health centres. A variety of factors have contributed to changes in the quality of services. This paper briefly reviews the changes and discusses the relevance of some of them.

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