scholarly journals Distribution of primary health care facilities in Mtwara District, Tanzania: availability and accessibility of services

1970 ◽  
Vol 20 (4) ◽  
Author(s):  
Irene R. Mremi ◽  
Mercy Mbise ◽  
Job A. Chaula
Keyword(s):  
Health Care ◽  
Health Facility ◽  
Low Income ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Child Health Services ◽  
Healthy Population ◽  
Care Services ◽  
Care Facilities

Background: Access to health care services is a significant factor to health seeking practices that contributes to a healthy population. Improving health care accessibility is an important health priority in low-income countries. The objective of this study was to determine distribution of health care facilities and identify the high priority areas, which require more services in Mtwara, southern Tanzania.Methods: This study was carried in Mtwara Rural district of southern Tanzania and involved health care facilities. A hand held global positioning system was used to geo-reference the coordinates of all facilities. A questionnaire with both closed and open-ended questions was used to gather information from patients who attended the respective facilities. Interviews with district health officials and facility in-charges were conducted.Results:  There were 38 health in the district. Most of them were located within southern part of the district. The majority of facilities (97%) were government owned. On average each facility was serving 2,400 population. Malaria management, reproductive and child health services, family planning and integrated management of childhood illnesses were offered by all health facilities in the district. Prevention of mother to child transmission of HIV was offered by 34 (89.5%) facilities. Tuberculosis services were offered by only 3 facilities while voluntary counselling and testing of HIV and anti-retroviral treatment services were available in 15 and 10 health facilities, respectively. Only 4 facilities had laboratory and inpatients services. The majority of the staff included Medical Attendants (39%), Nurse Midwives (34%), and Clinical Officers (20%). Assistant Medical Officers and Nursing Officers each accounted for 2% of the total staff. There were no Medical Officers, laboratory technicians or pharmaceutical technicians in the district.  A total of 408 health facility clients (≥18yrs) were interviewed. Factors influencing the choice of a health facility were the availability of special services, medicine and qualified human resources.Conclusion: The majority of facilities in Mtwara are government and there is disparity in the distribution of the facilities. Availability of medicines and qualified human resources were the major factors on the preference for accessing health care services.

scholarly journals Characteristics of Morbidity and Choice of Health Care Facilities in Nepal

2017 ◽  
Vol 2 (2) ◽  
pp. 47-55
Author(s):  
Arjun Kumar Thapa ◽  
Shiva Raj Adhikari
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Services ◽  
Acute Illness ◽  
Health Care Facilities ◽  
Seek Health Care ◽  
Care Services ◽  
Primary Health ◽  
Service Production ◽  
Care Facilities

In aftermath of People’s Movement 2008, the Government of Nepal promulgated health as a component of basic human rights. But Nepalese health consumers can seek health care services in government primary health facilities, hospitals, private clinics or do self–medication. The study intends to describe the characteristics of morbidity and factors associated in choosing particular type of health facility. For data, the study depends on a nationally representative rich cross sectional household survey data (Nepal Living Standard Survey, 2010/11) of Nepal. The findings of the study show that around one fifth of the total population reported acute illness while near about 10 percent is facing chronic illness. Around 30 percent of people reporting acute illness do not seek any health care services. Most of the rural people and poor population seek health care services in government primary health care facilities and private pharmacies. People belonging to low income quintiles are likely to seek health care services in government primary facilities. Similarly people residing in mountain & hill are likely to utilize services of government primary facilities. The study shows that urbanites are more likely to seek services in hospitals and private clinics. Therefore a homogeneous health care service production and delivery cannot address the country wide demand of health care services.

scholarly journals (A3) Health Care Facilities Affected by the Earthquake in Chile

2011 ◽  
Vol 26 (S1) ◽  
pp. s1-s2
Author(s):  
C. Bambaren
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Health Sector ◽  
Health Care Facilities ◽  
Cold Chain ◽  
Care Services ◽  
Biomedical Equipment ◽  
Care Facilities ◽  
Health Care Infrastructure ◽  
The Impact

IntroductionOn February 27, 2010, a 8,8 MW earthquake struck the central and southern coast of Chile, that was followed by a tsunami that destroyed some cities such as Constitution, Ilaco, Talcahuando and Dichato. The national authorities reported 512 dead and 81,444 homes were affected. It was the one of the five most powerful earthquakes in the human modern history. The most affected regions were Maule (VII) and Bio (VIII).ResultsThe impact of the quake in the health sector was enormous especially on the health care infrastructure. The preliminary evaluations showed that 18 hospitals were out of service due severe structural and no-structural damages, interruption of the provision of water or because they were at risk to landslides. Another 31 hospitals had moderate damage. The Ministry of Health lost 4249 beds including 297 (7%) in critical care units. Twenty-two percent of the total number of beds and thirty-nine surgical facilities available in the affected regions were lost in a few minutes due to quake. At least eight hospitals should be reconstructed and other hospitals will need complex repair.ConclusionThe effect of the earthquake was significant on hospital services. It included damages to the infrastructure and the loss of furniture and biomedical equipment. The interruption of the cold chain caused loss of vaccines. National and foreign field hospitals, temporary facilities and the strengthening of the primary health care facilities had been important to assure the continuation of health care services. *Based on information from PAHO – Chile.

scholarly journals Effectiveness of Essential Health Care Services Delivery in Nepal

1970 ◽  
Vol 6 (2) ◽  
pp. 74-83 ◽  
Author(s):  
B Devkota
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Health Services ◽  
Health Facility ◽  
Health Care Services ◽  
Health Facilities ◽  
Care Services ◽  
Services Delivery ◽  
Equity And Efficiency

Background: Ensuring delivery of quality health services in a sustainable and equitable manner is a challenge in Nepal. A host of factors may have impeded the access, quality and utilization of the health services particularly by the marginalized and disadvantaged sections of the population. Review essential health care services (EHCS) provided by the public health facilities, level of progress, effectiveness, sustainability, equity and efficiency, quality of care and inclusion of marginalized and disadvantaged populations in health care servicesMethods: A total of 40 VDCs from 10 districts representing five regions and three eco-zones were covered. Altogether 800 mothers with under two year children, 40 health service providers, 145 key informants and 40 exit clients were interviewed. Forty focused group discussions were also conducted. From each district, health records of one hospital, PHCC, HP, SHP and Ayurvedic health facility each were collected.Results: More than two-third (68.2%) of the mothers received antenatal checks, highest in hills (85%) followed by terai (64.5%) and mountain districts (52.8%).Tetanus vaccine coverage (80.7%) seems higher compared to Nepal Demographic Health Survey 2001 (45%). FP use rate in mountain, hill and terai are 57.6%, 54.1% and 49.7%, higher than in DoHS 2003/2004 statistics, which were 26.8%, 36.4% and 45.3% respectively. Nine out of ten patients visiting the health facilities were outpatients. The coverage of DPT 3, Polio 3, BCG and measles are 92.8%, 93.4%, 95.2% and 90.7% respectively. From the service utilization perspective, disparities in terms of gender, ecological regions, season of the year and health facility were revealed.Conclusion: Health sector services are yet to be made responsive to the ecological and district specific health problems, and be made more inclusive linking with doable safety nets.  Key words: Essential health care services; Effectiveness; Sustainability; Equity and efficiency; Quality of care and inclusion  doi: 10.3126/jnhrc.v6i2.2188Journal of Nepal Health Research Council Vol. 6 No. 2 Issue 13 Oct 2008 Page: 74-83 

scholarly journals Planning universal accessibility to public health care in sub-Saharan Africa

2020 ◽  
Vol 117 (50) ◽  
pp. 31760-31769
Author(s):  
Giacomo Falchetta ◽  
Ahmed T. Hammad ◽  
Soheil Shayegh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Sub Saharan Africa ◽  
Public Health Care ◽  
Care Services ◽  
Universal Accessibility ◽  
Care Facilities ◽  
Sub Saharan

Achieving universal health care coverage—a key target of the United Nations Sustainable Development Goal number 3—requires accessibility to health care services for all. Currently, in sub-Saharan Africa, at least one-sixth of the population lives more than 2 h away from a public hospital, and one in eight people is no less than 1 h away from the nearest health center. We combine high-resolution data on the location of different typologies of public health care facilities [J. Maina et al., Sci. Data 6, 134 (2019)] with population distribution maps and terrain-specific accessibility algorithms to develop a multiobjective geographic information system framework for assessing the optimal allocation of new health care facilities and assessing hospitals expansion requirements. The proposed methodology ensures universal accessibility to public health care services within prespecified travel times while guaranteeing sufficient available hospital beds. Our analysis suggests that to meet commonly accepted universal health care accessibility targets, sub-Saharan African countries will need to build ∼6,200 new facilities by 2030. We also estimate that about 2.5 million new hospital beds need to be allocated between new facilities and ∼1,100 existing structures that require expansion or densification. Optimized location, type, and capacity of each facility can be explored in an interactive dashboard. Our methodology and the results of our analysis can inform local policy makers in their assessment and prioritization of health care infrastructure. This is particularly relevant to tackle health care accessibility inequality, which is not only prominent within and between countries of sub-Saharan Africa but also, relative to the level of service provided by health care facilities.

scholarly journals Inequalities in Utilization of Maternal Reproductive Health Care Services in Urban Bangladesh: A Population-Based Study

SAGE Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. 215824402091439 ◽  
Author(s):  
Md. Nuruzzaman Khan ◽  
Pushpendra Kumar ◽  
Md. Mijanur Rahman ◽  
Md. Nazrul Islam Mondal ◽  
M. Mofizul Islam
Keyword(s):  
Health Care ◽  
Postnatal Care ◽  
Health Care Services ◽  
Concentration Index ◽  
Skilled Birth Attendant ◽  
Health Care Facilities ◽  
Wealth Status ◽  
Reproductive Health Care ◽  
Care Services ◽  
Care Facilities

This study examined inequalities in the utilization of maternal reproductive health care services in urban Bangladesh. Data of 6,617 urban women were extracted from most recent two rounds of Bangladesh Demographic and Health Survey, conducted in the years 2011 and 2014. Inequalities in the utilization of antenatal checkup, receiving care from a skilled birth attendant, delivery in health care facilities, and postnatal care were investigated through concentration index. Contributions of selected predictors to inequalities were estimated by using the regression-based decomposition method. Noticeable inequalities were observed. Concentration index for utilization of at least one antenatal care visit was 0.09, four or more antenatal visits was 0.17, care from skilled birth attendant was 0.16, delivery care in health care facilities was 0.17, and postnatal care within 2 days of delivery was 0.19. Exposure to mass media, educational status of women and their spouses, wealth status, employment, birth order, and age of pregnancy were significant determinants of inequalities. There was a gradient in the utilization of services when examined across wealth status. Those with unfavorable social determinants of health reported low levels of utilization. Alongside providing tailored health care services to urban poor women, efforts should be made to reduce inequalities in social determinants of health.

scholarly journals Communicative Development and Diffusion of Humanoid AI Robots for the Post-Pandemic Health Care System

2021 ◽  
Vol 3 ◽  
pp. 65-82
Author(s):  
Do Kyun David Kim ◽  
Gary Kreps ◽  
Rukhsana Ahmed
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Technology Development ◽  
Health Care Facilities ◽  
Ethical Concerns ◽  
Care Services ◽  
Communicative Development ◽  
Care Facilities ◽  
Near Future ◽  
And Diffusion

As humanoid robot technology, anthropomorphized by artificial intelligence (AI), has rapidly advanced to introduce more human-resembling automated robots that can communicate, interact, and work like humans, we have begun to expect active interactions with Humanoid AI Robots (HAIRs) in the near future. Coupled with the HAIR technology development, the COVID-19 pandemic triggered our interest in using health care robots with many substantial advantages that overcome critical human vulnerabilities against the strong infectious COVID-19 virus. Recognizing the tremendous potential for the active application of HAIRs, this article explores feasible ways to implement HAIRs in health care and patient services and suggests recommendations for strategically developing and diffusing autonomous HAIRs in health care facilities. While discussing the integration of HAIRs into health care, this article points out some important ethical concerns that should be addressed for implementing HAIRs for health care services.

scholarly journals Implementation of Tuberculosis Infection Control Practices in Tuberculosis Diagnostic and Treatment Health Facilities in Kampala District, Uganda, August 2015

2020 ◽  
Author(s):  
Didas Tugumisirize ◽  
Stavia Turyahabwe ◽  
Lilian Bulage ◽  
Stella Zawedde Muyanja ◽  
Robert Kaos Majwala ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Infection Control ◽  
Health Facility ◽  
Health Workers ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Tuberculosis Infection ◽  
Care Services ◽  
Tuberculosis Infection Control

AbstractBackgroundEffective implementation of Tuberculosis infection control (TB IC) measures in health facilities delivering TB care services is very critical in controlling nosocomial transmission of TB infections among health workers, patients and their attendants. The aim of the study was to assess and document the implementation of TB IC practices in TB diagnostic and treatment health facilities in Kampala District, which accounts for 15-20% of the total TB burden in Uganda.MethodsIn August 2015, we conducted a cross-sectional study in 25 health facilities including 07 Public and 18 Private healthcare facilities in Kampala. We used a modified checklist adopted from the national manual for implementing TB control measures in health care facilities. We reviewed health facility records and where necessary observed TB IC practices to triangulate our findings. We conducted univariate analysis and generated proportions in order to describe the extent of implementation of TB IC measures.ResultsOn average, 73% of both administrative and managerial, 65% environmental, and 56% personal protective TB IC measures were complied with at the health facilities visited. Private health facilities implemented 71% of both administrative and managerial TBIC measures compared to public health facilities (31%). Thirty Six percent of health facilities reported that they were regularly screening health care workers for TB. By Observation, 28% had TB IC guideline, 36% had TB IC plan, 12% had a designated area for sputum collection, 56% were regularly opening windows, 40% had fans installed in the waiting areas and/or consultation rooms and 24% had bio-safety cabinets fitted with UV light. In addition, 60% had N95 respirators but only 32% of the facilities reported that their health workers routinely wore them.ConclusionImplementation of WHO recommended TB IC measures in health facilities delivering TB care services in Kampala was sub optimal. Routine involvement of health facility management as well as increasing human resources for health is critical in implementing easy to do TBIC measures like triaging, patients’ educating on coughing etiquette and respiratory hygiene and daily window opening particularly in public health care settings where implementation of administrative TB IC measures is wanting

scholarly journals Out of pocket expenditure for availing maternal health care services in Northern India

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Singh ◽  
P Jain ◽  
S Kumar ◽  
S Singh ◽  
N Singh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Maternal Health ◽  
Health Facility ◽  
Health Care Services ◽  
Public Health Facility ◽  
Maternal Health Care ◽  
Health Care Facilities ◽  
Care Services ◽  
Maternal Health Care Services

Abstract Introduction Maternal and child health comprise one of the most important parameters of the health situation in a country at any given time. Maternal and new born child's health are inter-related to a great extent and while improving one, we might greatly affect the other; hence, joint efforts are required to cope with the rising demands of better healthcare for both. Out-of-pocket expenditure act as a major deterrent, especially to underprivileged communities, in accessibility to maternal health care services and knowledge of the determinants of maternity related expenses helps in outlining policies. Material and Methods This is a community based cross sectional study conducted in state of Uttar Pradesh between July 2019 to December 2019 among 848 women who delivered in past six months at a public health facility. A pretested, semi structured questionnaire was used to collect data. The data thus collected was entered into Microsoft Excel spreadsheet and was analysed using Statistical Package for Social Sciences (SPSS) version 24.0, IBM Inc. Chicago, USA software. Results The analysis showed that the median OOPE was INR 1000 (US$ 13.89) which varied between INR 950 (US$ 13.19) for normal delivery and INR 4900 (US$ 68) for caesarean section. OOPE for availing diagnostic facilities especially ultrasound with a median value of INR 500 (US$ 6.94) contributed to the major share. Women from households with income more than INR 7500 (US$ 104.17) per month, education higher than high school, primi-gravida, occupation of mother and type of delivery were significant predictors for high OOPE. Awareness level about various free entitlements in public health facility was significantly associated with overall out of pocket expenditure. Conclusions Although services at the public health facility in India are supposedly provided free of cost, considerable out of pocket expenditure is still incurred on beneficiaries while availing maternity services. Key messages Out of pocket expenditure is a major deterrent in availing institutional deliveries in public health facilities. Zero-cost, equitable and accessible maternal health care services through timely access to health care facilities is of paramount importance for reducing MMR and IMR in every country.

scholarly journals A Novel Method for Defining Health Facility Catchment Areas in a Low Income Country

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Kate Zinszer ◽  
Ruth Kigozi ◽  
Katia Charland ◽  
Dr. Grant Dorsey ◽  
Dr. Moses Kamya ◽  
...  
Keyword(s):  
Health Care ◽  
Health Facility ◽  
Low Income ◽  
Health Care Facilities ◽  
Statistical Measure ◽  
Low Income Country ◽  
Catchment Areas ◽  
Care Facilities ◽  
Novel Method ◽  
Administrative Units

The catchment areas of six health-care facilities in Uganda were determined using the cumulative case ratio: the ratio of the observed to expected utilization of a facility for a particular condition by patients from small administrative areas. Our approach is simple, reproducible, and is based on a statistical measure to decide which administrative units should be included in catchment areas. 

scholarly journals Factors influencing successful implementation of the basic antenatal care approach in primary health care facilities in eThekwini district, KwaZulu-Natal

Curationis ◽  
2013 ◽  
Vol 36 (1) ◽  
Author(s):  
Thembelihle S.P. Ngxongo ◽  
Maureen N. Sibiya
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antenatal Care ◽  
Health Care Services ◽  
Health Care Facilities ◽  
Successful Implementation ◽  
Care Services ◽  
Primary Health ◽  
Care Facilities ◽  
Primary Health Care Facilities

Background: In a move to alleviate the burden of consistently high maternal and perinatal mortality rates, the South African National Department of Health (DoH) introduced Basic Antenatal Care (BANC) in all Primary Health Care facilities that were providing antenatal care services. However, not all facilities in the eThekwini district have successfully implemented the approach. The aim of the study was to identify the factors that influence successful implementation of the BANC approach.  Objectives: The objectives were to identify facilities that had successfully implemented the BANC approach and the factors that influenced successful implementation of the BANC approach, in order to make recommendations on these factors.Method: A descriptive quantitative design was used. Firstly, primary health care facilities that were successful in implementing the BANC approach were identified through a retrospective record auditing. A total of 27 facilities were identified, of which 18 facilities were included in the study. This was followed by data collection from 59 midwives in order to identify the factors that influenced successful implementation of the BANC approach. The data was analysed using version 19 of the Statistical Package for the Social Sciences.Results: The positive factors that influenced successful implementation of the BANC approach included: the availability and accessibility of BANC services, policies, guidelines and protocol; various means of communication; a comprehensive package of and the integration of primary health care services; training and in-service education; human and material resources; the support and supervision offered to the midwives by the primary health care supervisors; supervisors’ understanding of the approach and the levels of experience of midwives involved in implementation of the BANC approach.Conclusion: The success that the facilities had achieved in implementing BANC approach was attributed to these positive factors. 

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