POLICY OPTIONS FOR INCREASING UTILIZATION OF COMMUNITY CLINIC SERVICES: A STUDY IN RURAL BANGLADESH

2021 ◽  
Vol 9 (1) ◽  
pp. 73-90
Author(s):  
Tahmina Sultana
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Policy Options ◽  
Care Providers ◽  
Community Clinic ◽  
Rural Bangladesh ◽  
Directorate General ◽  
Document Review ◽  
Policy Elites

This paper aims to identify the problems of Community Clinic (CC) services in rural Bangladesh and to provide some policy options to increase the utilization. Here qualitative methods have been used, including document review, observation, fact check and key informant interviews with policy elites. Among those, the option relating to the absenteeism of health care providers at CC, scored the highest total value of 2.7 in multi criteria analysis as well as viable in PESTLE analy-sis. Therefore, the recommended option is introduction of biometric system at the CCs. This system is necessary in the CCs to ensure timely presence of the service providers to promote quality and safety in health care towards healthy communities. This system will also assist in implementing the plan of Digital Bangladesh by directly connecting the CCs with the main serv-er of Management Information System of Directorate General of Health Services.

scholarly journals Mandatory HIV testing in China: the perception of health-care providers

2007 ◽  
Vol 18 (7) ◽  
pp. 476-481 ◽  
Author(s):  
Li Li ◽  
Zunyou Wu ◽  
Sheng Wu ◽  
Sung-Jae Lee ◽  
Mary Jane Rotheram-Borus ◽  
...  
Keyword(s):  
Health Care ◽  
Hiv Testing ◽  
Health Care Providers ◽  
Perceived Risk ◽  
Ethical Issues ◽  
Service Providers ◽  
Risk Behaviour ◽  
People Living With Hiv ◽  
Care Providers ◽  
Hiv Aids

Health-care providers in China are facing an exponential increase in HIV testing and HIV-positive patients. A total of 1101 service providers were recruited to examine attitudes toward people living with HIV/AIDS (PLWHA) in China. Logistic regression models were used to assess factors associated with providers' attitudes toward mandatory HIV testing. Providers were most likely to endorse mandatory HIV testing for patients with high-risk behaviour and for all patients before surgery. Over 43% of providers endorsed mandatory testing for anyone admitted to hospital. Controlling for demographics, multivariate analyses indicated that providers with higher perceived risk of HIV infection at work, higher general prejudicial attitudes toward PLWHA, and previous contact with HIV patients were more likely to endorse mandatory HIV testing for anyone admitted to hospital. Results underscore the importance of implementing universal precautions in health-care settings and call attention to social and ethical issues associated with HIV/AIDS control and treatment in China.

scholarly journals FRONTLINE HEALTH PROVIDER'S PERSPECTIVE IN REDUCING CHILD DEATHS DUE TO MALNUTRITION IN A TRIBAL DISTRICT OF MAHARASHTRA: A QUALITATIVE STUDY

2021 ◽  
pp. 246-249
Author(s):  
Lalit Sankhe ◽  
Chhaya Rajguru ◽  
Monali Kadam
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Workers ◽  
Health Care Service ◽  
Care Providers ◽  
Child Deaths ◽  
Primary Health ◽  
Refresher Training

Background: Malnutrition is a complex problem with double burden of undernutrition and overweight. India is no exception to it but there is a higher level of malnutrition in tribal blocks and to curb this situation,various activities have been undertaken but the slow pace of decline in malnutrition is a concern.The role of frontline health workers is crucial in strengthening primary health care.They serve as the bridge between the formal government health-care system and the community.The present study helps to seek the perception of primary health care service providers and challenges faced by them in reducing child deaths due to malnutrition. Method: A descriptive cross sectional qualitative study was conducted during August 2019 - February 2020 in three talukas of a tribal district. Focus group discussions (FGD) for each service providers Auxiliary Nurse midwife (ANM), Anganwadi worker (AWW) and Accredited Social Health activist (ASHA) were conducted. All the FGDs were audio recorded and transcripts were prepared,a thematic analysis framework was used for doing the analysis. Results: Most of the service providers were aware regarding their roles and responsibilities in implementation of schemes/ services related to malnutrition. The important factors influencing their performance were superstitions, more reliance on health seeking from unqualified health care providers and faith healers, poor road connectivity, network issues,lack of refresher training,overburdening with work,poor incentives. Conclusion: Specific training programs to tackle malnutrition along with frequent refresher training of the service providers,better infrastructure and human resources will help in achieving the desired results in future in dealing with child malnutrition.

scholarly journals Management of services in total quality management implemented and non-implemented health facilities

2021 ◽  
Vol 6 (4) ◽  
pp. 689-696
Author(s):  
Muhsina Begum ◽  
Ashees Kumar Saha ◽  
Sheuly Begum ◽  
Nasima Akhter ◽  
Pritikona Borua ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Management ◽  
Total Quality Management ◽  
Health Care Providers ◽  
Service Providers ◽  
Health Facilities ◽  
Working Environment ◽  
Care Providers ◽  
Total Quality ◽  
Medical College

5S-CQI-TQM is a management technique that is aimed at bringing satisfaction of staff as well as the patients through improvement of working environment. A cross-sectional comparative study was carried out among 226 respondents who were selected purposively from the selected study place from 1st January to 31st December 2017. Among 226 respondents, 113 were taken from Dhaka Medical College and another 113 were taken from Mugdha Medical College. Among 113 respondents, 56 respondents were health care providers and 57 respondents were health care receivers. The purpose of this study to compare the management of services in Total Quality Management implemented (Dhaka Medical College and Hospital) and non-implemented (Mugdha Medical College and Hospital) health facilities. A Semi-structured interviewer administered questionnaire and an observational check list were developed to collect the data. Separate questionnaire was used for health care providers and health care receivers. The statistical analysis was conducted using SPSS (statistical package for social science) version 20 statistical software. Significant statistical differences were found between TQM implemented and TQM non-implemented hospital regarding workload (p=0.043), hospital authority always seriously consider staff’s suggestions for the improvement of quality of service (p<0.001), employees always respect to each other in the hospital (p<0.001) and 35 (62.5%) service providers expressed satisfactory opinion regarding management of the hospital. Asian J. Med. Biol. Res. December 2020, 6(4): 689-696

scholarly journals Attitude of Health Care Providers on Snake Bite in Rural Community of Bangladesh

2018 ◽  
Vol 4 (1) ◽  
pp. 28-32
Author(s):  
Hafez Mohammad Nazmul Ahsan ◽  
Md Ridwanur Rahman ◽  
Robed Amin ◽  
Syed Mahbub Morshed ◽  
Md Amzad Hossain ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Rural Community ◽  
Service Providers ◽  
Target Population ◽  
Snake Bite ◽  
Survey Study ◽  
Effective Management ◽  
Care Providers ◽  
Attitude And Practice

Background: Health care providers have different attitude and practice about the snake bite in rural community of Bangladesh.Objective: The purpose of the present study was to know the attitude and practice about the snake bite in rural community of Bangladesh.Methodolgoy: The findings from survey study on snake bite have been elicited from face to face interview with 243 number of medical professionals/health service providers consisting of 113 number of MBBS doctors, 86 number of nurses and 46 number of other health practitioners. The study area consisted of 5 zillasadar hospitals and 15 upazilla health complexes. This study aims to assess the Attitude and Practice of snakebite in rural community and effective management of snake bite through community engagement and using health care system of Bangladesh approach for prevention of snakebite in rural community and effective management of snake bite for the rural Bangladeshi people. It uses the methodological triangulation qualitative and quantitative approach as well as a case study design in analyzing data, whereby the exploratory-descriptive design is followed.Result: We purposively select the 243 sample (Doctors, Nurses, Paramedics ,Others) from the selected districts and its consisting random upazillas from the govt. sector hospitals keeping in mind gender balance (Male-Female) as a primary total target population. So in total, 5 division and its consisting random upazilas hospital including union health complex hospital personnel (From District, Upazilla& Community Hospitals)will be interviewed throughout mention areas of Bangladesh. The findings show that 60.1% of doctors, 50.0% of nurses and 56.8% of practitioners have a notion that the snake bite victims would go to Ozha followed by 11.5% of doctors, 4.7% of nurses and 11.4% of practitioners have a notion that they would go to the local healers and that of 26.5% of doctors, 41.9% of nurses and 32.9% of practitioners mentioned that the snake bite victims would go to doctors. The findings show that 69.0% of doctors, 64.0% of nurses and 56.8% of practitioners will recommend not to apply ‘ tight bandage’ to victim’s snake bite spot and 67.3% of doctors, 65.1% of nurses and 13.6% of practitioners will recommend not to apply ‘Suction by mouth or chick’ to victim’s snake bite spot. The findings show that 82.3% of doctors, 90.7% of nurses and 70.5% of practitioners applied first aid to the snake bite victim as their common practice.Conclusion: Majority of health professionals are well informed regarding harmful traditions and measuresJournal of National Institute of Neurosciences Bangladesh, 2018;4(1): 28-32

“Hear me out”: Experiences of mothers suffering from severe mental illness with health care providers – A qualitative perspective

2017 ◽  
Vol 41 (S1) ◽  
pp. s899-s899 ◽  
Author(s):  
D. Banerjee ◽  
G. Desai ◽  
P.S. Chandra
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Health Care Providers ◽  
Service Providers ◽  
Care Providers ◽  
Structured Interviews ◽  
Seeking Help ◽  
Competing Interest

BackgroundContrary to popular myth, majority of mentally ill women are mothers with increasing number of them seeking help. Little is known about their own experiences in this regard and the extent to which their needs are met.ObjectivesTo assess the barriers and facilitators in seeking help from mental health care providers in matters of pregnancy and parenting.MethodsThe study used qualitative design with social constructivist paradigm. A purposive sample of 30 mothers with severe mental illness was obtained. Data was collected through one-to-one in-depth semi-structured interviews. After verbatim transcription, inductive thematic analysis was used to explore transcripts.ResultsMost women considered motherhood “central” to their lives and almost all of them experienced the burden of the “dual role”. Main barriers in seeking help were stigma, treatment side effects, wrong information and time constraints. Whereas self-advocacy, early engagement, education of women and involvement of the family with service providers were the facilitating factors. The prime expectations of the mothers as identified were early and direct communication, patient audience and basic guidance in regards to child health and parenting issues.ConclusionWomen who are mothers and also users of mental health services face special challenges in managing the contradictory aspects of their dual identity. Hearing their voices are essential for service provision and ensuring adequate mental health needs. Early and direct intervention along with understanding and addressing critical areas are necessary for proper care of both the mother and child.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Optimizing Maternal Mental Health Within A Primary Health Care Centre: A Model Program

2008 ◽  
Vol 27 (2) ◽  
pp. 105-116 ◽  
Author(s):  
Angela Bowen ◽  
Marilyn Baetz ◽  
Nora Mckee ◽  
Nancy Klebaum
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Maternal Mental Health ◽  
Care Program ◽  
Postpartum Women ◽  
Care Providers ◽  
Health Care Centre ◽  
Women Health

Depression is a common problem that affects approximately 10 to 15% of pregnant and postpartum women. Health care providers often fail to recognize depression in this population, and pregnant and postpartum women may be reluctant to seek help because of the stigma associated with mental illness. This article describes the Maternal Mental Health Program, an innovative, shared care program that brings together previously fragmented services and co-locates multidisciplinary clinicians within a primary care setting. This approach shows promise with respect to improving mental health outcomes; meeting the needs of women, health care students, and service providers; and increasing awareness of and access to specialized mental health care.

scholarly journals Negotiating candidacy: ethnic minority seniors' access to care

2009 ◽  
Vol 29 (4) ◽  
pp. 585-608 ◽  
Author(s):  
SHARON KOEHN
Keyword(s):  
Health Care ◽  
Access To Care ◽  
Ethnic Minority ◽  
Health Care Providers ◽  
Service Providers ◽  
Future Research ◽  
Care Providers ◽  
Optimal Care ◽  
Barriers To Access ◽  
Recommendations For Action

ABSTRACTThe ‘Barriers to Access to Care for Ethnic Minority Seniors’ (BACEMS) study in Vancouver, British Columbia, found that immigrant families torn between changing values and the economic realities that accompany immigration cannot always provide optimal care for their elders. Ethnic minority seniors further identified language barriers, immigration status, and limited awareness of the roles of the health authority and of specific service providers as barriers to health care. The configuration and delivery of health services, and health-care providers' limited knowledge of the seniors' needs and confounded these problems. To explore the barriers to access, the BACEMS study relied primarily on focus group data collected from ethnic minority seniors and their families and from health and multicultural service providers. The applicability of the recently developed model of ‘candidacy’, which emphasises the dynamic, multi-dimensional and contingent character of health-care access to ethnic minority seniors, was assessed. The candidacy framework increased sensitivity to ethnic minority seniors' issues and enabled organisation of the data into manageable conceptual units, which facilitated translation into recommendations for action, and revealed gaps that pose questions for future research. It has the potential to make Canadian research on the topic more co-ordinated.

scholarly journals Development and piloting of a highly tailored text and voice messaging intervention to support adherence to antihypertensive medications within the primary care setting (Preprint)

2017 ◽  
Author(s):  
Aikaterini Kassavou ◽  
Vikki Houghton ◽  
Simon Edwards ◽  
James Brimicombe ◽  
Stephen Sutton
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Delivery Mode ◽  
Care Providers ◽  
Intervention Content ◽  
Systematic Development ◽  
Voice Message ◽  
Meta Analyses

BACKGROUND Tailored automated text and voice message interventions are effective ways to increase adherence to medications. OBJECTIVE This paper describes the systematic development and piloting of a highly tailored text and voice message intervention to increase adherence to medications within primary care. METHODS Following the MRC guidance this paper describes: a) the systematic development of the theoretical framework and tailored intervention content, based on review of theories and meta-analyses of effectiveness (n=2 meta-analyses with meta-regression); b) the systematic development of the intervention delivery mode, intervention content and implementation procedures, based on consultations with telecommunication experts (n=6 experts, including industry, academics, and university service providers), face-to-face interviews using think aloud protocols (n=19 patients and n=5 health care providers), experiential focus groups (n=12 patients), stakeholders’ consultations (n=7 stakeholders, including commissioners, health care providers, and patients), systematic reviews (n=2 reviews), and PPI input (n=100 PPI members); and c) the piloting of the intervention, based on a one-month pre-post study (n=17 patients). The mixed methods analysis combined findings from the parallel studies complementarily. The target population that informed the intervention were adults above 40 years old, with a primary diagnosis of hypertension, taking multiple medications, presumed to be non-adherent to their medications, and attending primary care settings within different areas of deprivation in the East of England. RESULTS Intervention development suggested the target behaviour of the intervention to be the tablets taken at a regular time of the day. It also suggested the delivery of both INA and NINA messages and their interchange during a prescription-based month, but INA messages to be less frequent than NINA messages. It also suggested that participants could be more receptive to intervention content when they initiate medication taking or they change prescription plan. Intervention piloting suggested that the intervention is acceptable and feasible. It also suggested high intervention engagement with, and fidelity of, the intervention content, which included Behaviour Change Techniques (BCTs). The final version of the intervention aims to increase adherence to daily prescribed oral medications, is delivered using text and voice messages, and includes a combination of nine BCTs (e.g., implementation intentions, information about health consequences), is highly tailored to patients’ beliefs (e.g., beliefs about medications, self-efficacy, social norms, perceived regimens complexity), and prescription plan. During the intervention, patients can select between two BCTs to maintain medication taking (e.g., habit formation or self-monitoring). CONCLUSIONS This paper describes a theory and evidence based intervention that aims to support adherence to high blood pressure medications, as an adjunct to primary care consultations, and it is currently evaluated in a randomised controlled trial. CLINICALTRIAL ISRCTN10668149 DOI 10.1186/ISRCTN10668149.

scholarly journals Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—A cross-sectional study from Ujjain, India

2020 ◽  
Author(s):  
Isaac Gikandi Mungai ◽  
Sumit Singh Baghel ◽  
Suchi Soni ◽  
Shailja Vagela ◽  
Megha Sharma ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Evidence Based ◽  
Care Providers ◽  
Cross Sectional ◽  
Evidence Based Practices ◽  
Number Of Patients

Abstract Background More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. Methods A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The collective score per question among the respondents was calculated. The score achieved by each respondent was calculated, grouped into either “fair” or “low”, and then checked for association with the practitioners’ age and years of experience, number of patients examined per day, and whether they attended children in their practice. Results Of the 945 IHCPs approached, 830 (88%) participated in the study. Of the potential 39,840 points, only an average of 18,483 (46%) were achieved, indicating a knowledge gap. Although these providers could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations in children they attended. Fair knowledge of IHCPs was significantly associated with attending more than 10 but less than 50 patients per day and of being aged between 35 and 45 years. Offering pediatric consultations was not significantly associated with achieving a fair score. Conclusions The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that educational interventions targeting IHCPs can improve neonatal care services and is an innovative way to reach a large rural population in the study setting.

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