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 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 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 Portugal's primary health care human resources assessment

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Oliveira Miranda ◽  
P Santos Luis ◽  
M Sarmento
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Human Resources ◽  
Health Professional ◽  
Health Care Services ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
The Mean

Abstract Background Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented. Methods The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated. Results National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795). Conclusions Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented. Key messages Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.

scholarly journals Using population health surveys to provide information on access to and use of quality primary health care

2006 ◽  
Vol 30 (4) ◽  
pp. 485 ◽  
Author(s):  
Elizabeth J Comino ◽  
Oshana Hermiz ◽  
Jeff Flack ◽  
Elizabeth Harris ◽  
Gawaine Powell Davies ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Population Health ◽  
Health Survey ◽  
Health Surveys ◽  
Diabetes Management ◽  
Relevant Information ◽  
Population Based ◽  
Primary Health ◽  
Data Collections

Objective: Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Methods: Drawing on published material relating to diabetes management, we developed a conceptual framework of access to and use of quality PHC. Using this framework we examined three recent population-based health surveys ? the 2001 National Health Survey, 2002?03 NSW Health Survey, and AusDiab ? to identify relevant information collection. Results: We identified seven domains comprising aspects of quality PHC for people with diabetes. For each domain we proposed associated indicators. In critiquing the three population health surveys in relation to these indicators, we identified strengths and weaknesses of the data collections. Conclusion: This approach could inform the development of questions and extension of population health surveys to provide a better understanding of access to and use of quality PHC in Australia. The additional information would complement other data collections with a communitybased perspective and contribute to the develop- ment of PHC policy.

scholarly journals Analysis of Public-Private Partnership in Providing Primary Health Care Policy: An Experience From Iran

2019 ◽  
Vol 10 ◽  
pp. 215013271988150 ◽  
Author(s):  
Hojatolah Gharaee ◽  
Jafar Sadegh Tabrizi ◽  
Saber Azami-Aghdash ◽  
Mostafa Farahbakhsh ◽  
Majid Karamouz ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Policy ◽  
Health Indicators ◽  
Study Data ◽  
Public Private Partnership ◽  
Private Partnership ◽  
The Public ◽  
Primary Health ◽  
East Azerbaijan

Background: This study aims to analyze the public-private partnership (PPP) policy in primary health care (PHC), focusing on the experience of the East Azerbaijan Province (EAP) of Iran. Methods: This research is a qualitative study. Data were gathered using interviews with stakeholders and document analysis and analyzed through content analysis. Results: Participants considered political and economic support as the most important underlying factors. Improving system efficiency was the main goal of this policy. Most stakeholders were supporters of the plan, and there was no major opponent. Implementing the health evolution plan (HEP) was an opportunity to design this policy. Participants considered the lack of provision of infrastructure as the main weakness, changing the role of the public sector as the main strength, and promoting social justice as the main achievement of policy. The results of the quantitative data review showed that following the implementation of this policy, health indicators have been improved. Conclusions: Based on the results of this study, the PPP model in EAP is a new and successful experience in PHC in Iran. Supporting and developing this policy may improve the quality and quantity of providing care.

Expanding the Role of Primary Health Care in the Provision of Mental Health Services to the Population of the Kyrgyz Republic

2017 ◽  
Vol 41 (S1) ◽  
pp. S606-S606
Author(s):  
T. Galako
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Mental Health Care ◽  
Kyrgyz Republic ◽  
Family Doctors ◽  
Primary Health

Providing comprehensive, integrated services in the field of mental health in primary health care (PHC) is a component of the state mental health program for the population of the Kyrgyz republic (KR) in the 2017–2030 biennium. In order to develop an action plan in this area a situational analysis of resources of psychiatric care at PHC level was carried out. There was revealed a significant deficit of specialists, such as family doctors, mental health care professionals. In spite of the need for 3,300 family doctors, only 1706 work, and 80% of them are of retirement age.The results of a research showed a low level of knowledge and skills of family physicians for the early detection of mental disorders and provision of appropriate medical care. There are also a limited number of psychiatrists, especially in rural regions (77% of the required quantity).During recent years, there have been implemented significant changes in the system of mental health services, aimed at improving its quality, the approach to the place of residence of the patient and the prevalence of psychosocial services.Since 2016 in 8 southern regions in the Kyrgyz Republic has been introduced a new model for the provision of comprehensive health care services. Piloting this model involves psychosocial rehabilitation of patients with mental disorders, the help of mobile teams at the place of patient residence, as well as psychoeducation, training, and support to family doctors. These and other measures will help to optimise mental health care at PHC level.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

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