scholarly journals Family Medicine as a Model of Primary Health Services Delivery: A Pilot Study in Almaty, Kazakhstan

2015 ◽  
Vol 4 (1) ◽  
Author(s):  
Dilara Orynbassarova
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Pilot Study ◽  
Family Medicine ◽  
Rural Areas ◽  
Family Doctor ◽  
Family Doctors ◽  
Primary Health ◽  
Access To Primary Care

Introduction. Advanced models of delivering primary health care are being implemented in various countries of the world. This is especially true for countries undergoing a healthcare transition in Central Asia, such as Kazakhstan, which obtained independence from Soviet Union in 1991. The Kazakhstan National Program of Health Reform, implemented between 2005-2010, aimed to create an effective system of primary care. One of the key directions of healthcare reform implemented in Kazakhstan included the development of family medicine, which has become cutting-edge agenda for Kazakhstan Health Ministry over the past 10 years. While many papers have been published about the importance of family medicine and primary healthcare models, few have focused on analyzing family medicine effectiveness in Kazakhstan and its impact on access to family doctor services and patient satisfaction. The key aims of this pilot investigation were 1) to assess the model’s impact on access to primary care and patients’ satisfaction, and 2) to explore the model’s effectiveness in some Central Asian and transitional countries in the literature. Methods. This pilot study was based on semi-structured interviews and questionnaires about the perception and impact of the primary care model to 86 respondents aged 19-51 (54% females, 46% males). The majority of respondents were Almaty city residents (71%), while the rest were Almaty Province rural residents (22%) and residents of other Kazakhstan regions (7%).Results. Respondents from rural areas associated general practitioners, or family doctors, with community clinics (also referred to as feldsher posts). Even though urban area respondents use family doctor services, they were more likely to get those services in private rather than public clinics. Rural residents appear to have better access to primary care providers than urban residents participating in our study. Also, respondents from rural areas were more satisfied with services provided by family doctors than respondents from urban areas.Conclusions. This pilot study helped to improve our understanding of primary health care reforms implemented in Kazakhstan, a topic that is not traditionally covered in international literature. This pilot study suggests that primary care is more effectively implemented in rural areas of Kazakhstan (Almaty Province); however, future full-scale research in this area is needed to fully understand the complexity of primary healthcare access in Kazakhstan.

scholarly journals Integration of obstetrics and gynecology services into primary health care

2021 ◽  
Vol 4 ◽  
pp. 40-47
Author(s):  
N.Ya. Zhilka ◽  
G.O. Slabky ◽  
O.S. Shcherbinska
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Family Doctor ◽  
Stage Iv ◽  
Medical Department ◽  
Ministry Of Health ◽  
Family Doctors ◽  
Primary Health ◽  
Gynecological Care

In the historical dimension in Ukraine, family medicine (SM) was founded as a pilot project in the Lviv region in 1987. In 1992, after the successful introduction of the elements of the SM, a decision was made to reorganize the district service in the SM. This process was designed for several years and its implementation was planned in 5 stages: Stage I - UT (local therapist) perform the functions of doctors whose specialization is as close as possible to therapy; Stage II - UT replace doctors of narrower specialties; Stage III - UT provide not only primary health care (PTD), but also monitor patients with chronic diseases; Stage IV - UT provide obstetric and gynecological care, and pregnant women seek help from a family doctor; Stage V - complete retraining of UT, who must become qualified general practitioners - family medicine (GP-SM).The introduction of obstetric and gynecological services in the medical department was planned at stage IV, this process was long-awaited and provided, first of all, the training of family doctors in obstetric and gynecological technologies and skills. And only in 2002, the sectoral Order of the Ministry of Health of Ukraine No. 503 of 28.12.2002 «On the improvement of outpatient obstetric and gynecological care in Ukraine» for the first time defined the features of the functions of a family doctor to provide obstetric and gynecological care, and the Order of the Ministry of Health of Ukraine dated 15.07.2011 No. 417 “On the organization of outpatient obstetric and gynecological care in Ukraine”, the functions of the GP-SM on obstetric and gynecological care were expanded.However, taking into account the results of the analysis, the integration of obstetric and gynecological services at the PHC level is extremely imperfect, which makes it inaccessible to the population, ineffective in the preventive direction, unattainable for organizing the treatment process in cases of gynecological diseases. In addition, there are legal conflicts between the sectoral order on PMP No. 504 «On the approval of the procedure for the provision of primary health care», which does not define examination and instrumental obstetric and gynecological technologies for GP-SM, and the designated clinical protocols approved by orders of the Ministry of Health of Ukraine which do not contribute to the integration of obstetric and gynecological services at the PHC level.

scholarly journals Establishment of an Accelerated Doctor of Family Medicine Program at Unaizah College of Medicine, Qassim University, Kingdom of Saudi Arabia

2019 ◽  
Vol 6 ◽  
pp. 238212051881884
Author(s):  
Ahmad Al-Shafei ◽  
Saleh Al-Damegh ◽  
Fahad Al-Matham ◽  
Abdulrahman Al-Mohaimeed ◽  
Abdullah Al-Nafeesah ◽  
...  
Keyword(s):  
Health Care ◽  
Saudi Arabia ◽  
Primary Health Care ◽  
Family Medicine ◽  
Rural Areas ◽  
Total Duration ◽  
Performance Outcomes ◽  
Primary Health Care System ◽  
Kingdom Of Saudi Arabia ◽  
Primary Health

Primary health care is well known to be the cornerstone for the health of the society. Furthermore, efficient health care at the secondary and tertiary levels is entirely dependent on effective primary health care. The Kingdom of Saudi Arabia (KSA) is currently building up a rigorous primary health care system with a large number of well-equipped primary health care centers. However, there is an acute shortage of Saudi family physicians throughout the country; both in urban and rural areas. There is no evidence in the literature supporting the relatively long 7 years’ traditional duration of medical programs in the KSA. Rather, several US and Canadian medical schools have established accelerated programs in Internal Medicine and Family Medicine with graduates comparable with those of the traditional curricula in terms of standardized tests, initial resident characteristics, and performance outcomes. In response to the challenges the KSA is facing in primary health care, Unaizah College of Medicine at Qassim University is proposing to establish an accelerated Doctor of Family Medicine Program that would run for total duration of 6 years. Herein, we describe a concise outline of this program.

scholarly journals ASSESSMENT OF AWARENESS OF FAMILY PHYSICIANSABOUT THE OSTEOPOROSIS AS A PROBLEM OF ELDERLY

2017 ◽  
Vol 9 (1) ◽  
pp. 79-82
Author(s):  
O Yu Kuznetsova ◽  
I E Moiseeva
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Primary Care Physicians ◽  
Age Group ◽  
Treatment Of Osteoporosis ◽  
Family Doctors ◽  
Primary Health ◽  
Prevalence Of Osteoporosis

The prevalence of osteoporosis in Russia is about 10%, and in the age group over 50 years - up to 25-35%. The role of primary care physicians in the prevention, diagnosis and treatment of this disease is high, because 80% of patients seeking medical help in primary health care. The article presents the results of the assessment of the awareness of the general practitioners (family doctors) on the preven- tion, diagnostics and treatment of osteoporosis

Collaboration between the family nurse and family doctor from the perspective of patients: a qualitative study

2019 ◽  
Author(s):  
Ewa Taranta ◽  
Ludmila Marcinowicz
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Dominant Role ◽  
Family Doctor ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
The North ◽  
Primary Health ◽  
The Family

Abstract Background There is increasing focus on collaboration in primary health care, but there is insufficient patient perspective on collaboration between the family nurse and family doctor. Objective To explore how patients perceive collaboration between the family nurse and family doctor in primary health care in Poland. Methods A qualitative approach and an inductive, naturalistic inquiry strategy were used. Thirty-seven patients from eight general practice clinics in the north-eastern part of Poland participated in semi-structured, face-to-face interviews. The qualitative data were examined by means of thematic analysis. The study was reported according to the consolidated criteria for reporting qualitative research (COREQ) checklist. Results Four subthemes emerged in the context of nurse–doctor collaboration, namely: (i) carrying out the doctor’s orders; (ii) visit preparation; (iii) the family nurse as a source of information and (iv) participants’ perceptions of the status of the family nurse. Nurses performing instrumental activities connected with a doctor’s orders was understood by the participants to be collaboration and prevailed in their responses. Conclusion The perception of collaboration (or lack thereof) between the family nurse and family doctor results from patients’ varied experiences and observations during their visits to a primary care clinic. The traditional model of nursing care and the hierarchical relationship, in which the doctor has the dominant role, are evident in the patients’ remarks. The autonomy of nursing could be strengthened by expanding, and highlighting, the primary care activities that a nurse can perform on her own.

Parenting Support in the Context of Primary Health Care

2017 ◽  
pp. 231-241
Author(s):  
Karen M. T. Turner ◽  
Carol W. Metzler
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Behavioral Problems ◽  
Emotional And Behavioral Problems ◽  
Primary Health Care System ◽  
Family Doctors ◽  
Parenting Support ◽  
Clinic Management ◽  
Primary Health

Primary care providers such as family doctors, pediatricians, and community child health nurses are a trusted first port of call for parents seeking advice on parenting issues, and routine well-child visits provide multiple opportunities for screening, support, and intervention. Pediatric practices and family-centered health settings are an ideal, nonstigmatized context for providing integrated care, including parenting support, as part of universal prevention and early intervention. This chapter describes how Triple P can be applied in brief interventions through the primary health care system to prevent and reduce social, emotional, and behavioral problems in children. Workforce development, clinic management support, and sustainable funding models are discussed as key implementation factors that require careful planning if there is to be widespread dissemination of evidence-based parenting support in pediatric primary care settings.

scholarly journals Children deserve adequately trained doctors

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
K Illy
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Training Programme ◽  
Scientific Discipline ◽  
Childhood And Adolescence ◽  
Family Doctors ◽  
Care Services ◽  
Rights Of The Child ◽  
Primary Health

Abstract Children treated in different European countries continue to have very variable outcomes. Among several factors that might affect these outcomes, organisation of primary care services for children and training programmes for primary care clinicians are likely to be important factors. Children have an unquestionable right to health, safety, and wellbeing. Children have the right to access the highest possible standards of health-care services and facilities, both in primary health care and when they need specialised care. Any restriction of provision of appropriate care would contradict article 24 of the UN Convention on the Rights of the Child. Paediatric primary care is an academic and scientific discipline dealing with all issues affecting the health and wellbeing of infants, children, and adolescents from birth to adulthood in the context of their family, community, and culture. The primary clinician, ideally a paediatrician, is the first contact for children until they reach adulthood and is thus responsible for provision of comprehensive and continuing care throughout infancy, childhood, and adolescence. Paediatric care in both primary care and hospital settings needs special knowledge, ethics, empathic behaviour, and access to services, including disease prevention and health promotion. These aspects are therefore mandatory for all paediatric training both for paediatricians and family doctors. There should be a structured and accountable paediatric training programme for all doctors providing first-line care to children in primary care. When family doctors provide primary health care close collaboration with paediatricians and adequate continued training in both paediatrics and primary care is advised. Moreover, all children need timely access to professional paediatric advice.

scholarly journals Reducing Disease Burden in Rural Populations: Case Studies in Europe and Africa

2021 ◽  
Author(s):  
Paulo Henrique das Neves Martins Pires
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Case Studies ◽  
Population Health ◽  
Health Indicators ◽  
Income Country ◽  
Rural Populations ◽  
Family Doctors ◽  
Primary Health

In 1984, Portugal was a middle-income country, developing the primary health care system, based on family doctors, health centres and health posts, reaching almost all population, with infectious diseases as one of the main health problems. In 2006, Mozambique was a low-income country, with a national health service attaining 60% of the population (40% in rural areas), with a double burden of disease (infectious and non-communicable diseases). Working in primary health care in Europe and Africa, we compare several experiences of family medicine practice in rural populations, different in context, time, and methods: Portugal 1984–2006 and Mozambique 2007–2020, all with a strong component of community health education. Our descriptive case studies, summarise strategies, interventions, and results, reviewing reports and articles. Population’ health indicators, and quality of life have improved, in different contexts with culturally tailored approaches. Participative societal diagnosis and multidisciplinary interventions are necessary to improve rural population health. Different rural populations and cultures are ready to learn and to participate in health promotion; empowering rural populations on health issues is an affordable strategy to better health indicators and services. Family Medicine is effective to extend primary health care to all rural populations, aiming universal health cover.

scholarly journals Innovation in primary health care responses to COVID-19 in Sub-Saharan Africa

2021 ◽  
Vol 22 ◽  
Author(s):  
Sunanda Ray ◽  
Robert Mash
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Health Services ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Primary Health ◽  
Lessons Learnt

Abstract Background: In May 2020, the African Journal of Primary Health Care and Family Medicine invited submissions on lessons learnt from responses to the COVID-19 pandemic from primary care providers in Africa. This included descriptions of innovations and good practices, the management of COVID-19 in district health services and responses of communities to the outbreak. Aim: To synthesise the lessons learnt from the COVID-19 pandemic in the Africa region. Methods: A thematic document analysis was conducted on twenty-seven short report publications from Botswana, Ghana, Nigeria, South Africa, Uganda and Zimbabwe. Findings: Eight major themes were derived from the data: community-based activities; screening and testing; reorganisation of health services; emergency care for COVID-19; maintenance of essential non-COVID-19 health services; caring for the vulnerable; use of information technology; and reframing training opportunities. Community health workers were a vital community resource, delivering medications and other supplies to homes, as well as following up on patients with chronic conditions. More investment in community partnerships and social mobilisation was proposed. Difficulties with procurement of test kits and turn-around times were constraints for most countries. Authors described how services were reorganised for focused COVID-19 activities, sometimes to the detriment of essential services and training of junior doctors. Innovations in use of internet technology for communication and remote consultations were explored. The contribution of family medicine principles in upholding the humanity of patients and their families, clear leadership and planning, multidisciplinary teamwork and continuity of care was emphasised even in the context of providing critical care. Conclusions: The community-orientated primary care approach was emphasised as well as long-term benefits of technological innovations. The pandemic exposed the need to deliver on governmental commitments to strengthening primary health care and universal health coverage.

scholarly journals CHALLENGES AND PROBLEM IN PRIMARY HEALTH CARE IN GEORGIA

2018 ◽  
pp. 259-262
Author(s):  
TENGIZ VERULAVA TENGIZ VERULAVA
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care System ◽  
Family Doctor ◽  
Continuous Medical Education ◽  
International Standards ◽  
Primary Health Care System ◽  
Primary Health ◽  
Care System

Primary health care has an important role in the organizational arrangement of health care system. Without a fundament of primary health care system it is impossible to build anything. The primary health care system reflects on the quality population health, the availability of health services and the cost of spending on the health care. The family doctor›s institute and primary health care system in Georgia have not been developed with regarding international standards. The lack of primary care system in Georgia indicates that the referral to outpatient medical facilities is considerably lower than the European countries. The reason for this is the lack of confidence in primary care institutions and the absence of comprehencive primary health care system in the country. It is nessesery to develop a family doctor›s institute in Georgia. This requires the promotion of continuous medical education of family doctors, optimal geographical distribution of primary health care institutions.

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