scholarly journals Decentralisation and urban primary health services: a case study of Delhi’s Mohalla Clinics

2020 ◽  
Author(s):  
Sejal Patel ◽  
Priyankita Pant
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Urban Poor ◽  
Current Form ◽  
Healthcare Facilities ◽  
Primary Health ◽  
National Capital ◽  
Primary Health Services ◽  
The Government ◽  
City State

The Indian political party Aam Aadmi, which assumed power in the city-state of Delhi in 2015, introduced Mohalla Clinics (i.e. neighbourhood clinics) to provide free primary health services for all, as a response to the rising inaccessibility of primary healthcare facilities for the urban poor. These clinics were to be governed through Mohalla Sabhas (i.e. neighbourhood committees), which are instruments of participatory governance within the neighbourhood. The research compares promises and practice for Mohalla Clinics, especially focusing on governance and the politics surrounding it. The authors find that in their current form Mohalla Clinics are limited to providing primary curative healthcare and have shown limited success, although Mohalla Clinic users do save time and expenditure on primary healthcare, and the clinics have led to a more comprehensive form of primary healthcare than in the past. However, Mohalla Clinics are governed in a top-down fashion by the Government of the National Capital Territory-Delhi, and not by urban local bodies or the envisaged neighbourhood committees. As a result, they face problems that may inhibit their functioning in the long term.

scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

scholarly journals IMPROVING THE QUALITY OF PRIMARY HEALTH SERVICES IN THE PERSPECTIVE OF PARTICIPATORY GOVERNANCE

2021 ◽  
Author(s):  
Andi Agustang
Keyword(s):  
Public Policy ◽  
Health Services ◽  
Good Governance ◽  
Health Workers ◽  
Cultural Barriers ◽  
Participatory Governance ◽  
Primary Health ◽  
Primary Health Services ◽  
The Government ◽  
Or Organization

The application of good governance within governance prerequisite that cannot be left out is the participation of the community in public policy. The main prerequisites were when the Government implemented the autonomous region with the principle of decentralization, community participation. It involves all aspects of the implementation of the development in areas starting from planning to supervision. Participatory governance is governance putting citizens or non-government as an individual or organization as a viable social stakeholder in making public policy that has just dominated the Government. Model of participatory governance policy in the primary health services is eligible to be developed by optimizing and strengthening cooperation intersectional, increasing the motivation of health workers as well as eliminating social and cultural barriers in the community.

scholarly journals Comprehensive primary health facilities are more efficient in delivering primary care: Efficiency analysis of primary healthcare facilities in Afghanistan

2020 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Relative Efficiency ◽  
Healthcare Services ◽  
Efficiency Score ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Average Efficiency ◽  
Primary Health

Abstract Background: The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan. Method: Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level. Results: The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement. Conclusions: Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.

scholarly journals Comprehensive primary health facilities are more efficient in delivering primary care: Efficiency analysis of primary healthcare facilities in Afghanistan

2019 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Relative Efficiency ◽  
Healthcare Services ◽  
Efficiency Score ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Average Efficiency ◽  
Primary Health

Abstract Background The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan.Method Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level.Results The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement.Conclusions Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.

scholarly journals Primary Health Services Utilization in Greece: Studying the Past for Planning the Future

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Dimitris Zavras ◽  
Mary Geitona ◽  
John Kyriopoulos
Keyword(s):  
Chronic Disease ◽  
Health Services ◽  
Healthcare Utilization ◽  
Primary Healthcare ◽  
Health Condition ◽  
Perceived Threat ◽  
Services Utilization ◽  
Primary Health ◽  
Primary Health Services ◽  
Health Need

The objective of this paper is to study healthcare utilization in Greece. The<br />data were derived from a national survey conducted in 2006, and analysed through Logistic and Linear Regression. The likelihood of primary healthcare utilization is determined by the gender, the existence of a chronic disease, the self-rated health and the age, while the logarithm of the visits<br />to primary health services is determined by the gender, the existence of a chronic disease, the income, the geographical region and the perceived threat from the health condition. Thus, primary healthcare utilization is determined by beliefs, health need as well as socioeconomic factors.

scholarly journals "Going the Extra Mile": A descriptive exploratory study of Primary Health Services based on the experiences of Pacific Primary Health Organisation Service managers and providers

2018 ◽  
Vol 30 (2) ◽  
pp. 57-67
Author(s):  
Margaret Pack
Keyword(s):  
New Zealand ◽  
Health Services ◽  
Primary Healthcare ◽  
Exploratory Study ◽  
Service Providers ◽  
Research Approach ◽  
Health Providers ◽  
Primary Health ◽  
Primary Health Services ◽  
Service Managers

INTRODUCTION: This exploratory study is part of a larger evaluation of the primary health care strategy (PHCS) in Aotearoa New Zealand, using a mixed methods research approach. The aims of this qualitative arm of the research were to explore the extent of use and satisfaction with the PHCS through the operation of Pacific-led Primary Health Organisations (PHOs) in relation to service provision and delivery from the service providers’ and managers’ perspectives.METHOD: The exploratory study was conducted using a case study design and in-depth interviews with service managers and health providers at six Pacific-led PHOs. A review of the literature on primary healthcare was conducted prior to undertaking the research. In this literature review, several themes were noted from the review of policy documents providing background to the development of primary healthcare in New Zealand. CONCLUSION: The themes from interviews suggest a core tension between the business model, Ministry reporting requirements, and more altruistic values of both managers and service providers in their delivery of services. Overall, there was a positive response to the lowered cost of healthcare from the providers and managers interviewed in the Pacific-led primary health services, mirroring the findings of the larger evaluation report of PHOs (Cumming et al., 2005). The availability of wrap-around, holistically based, accessible services delivered by culturally responsive health providers who were considered to “go the extra mile” for their clients was the predominant theme accounting for an increased uptake and use of the services. The implications for health social work are discussed.

scholarly journals Awareness of physicians from primary health services about standards of examination of patients with suspected respiratory tuberculosis

2020 ◽  
Vol 98 (2) ◽  
pp. 20-24
Author(s):  
P. N. Novoselov ◽  
V. V. Tinkova ◽  
M. V. Lekhlyayder ◽  
I. A. Denisenko ◽  
T. P. Dudarova ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Health ◽  
Primary Health Services
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