scholarly journals Assessment of Health Facilities Delivering HIV Services among Patients in Bonny, South-South Nigeria

2019 ◽  
pp. 1-11
Author(s):  
A. J. Onoja ◽  
O. N. Akoma
Keyword(s):  
Quality Of Care ◽  
Health Facility ◽  
Health Centre ◽  
Health Facilities ◽  
Hiv And Aids ◽  
Health Concern ◽  
Facility Assessment ◽  
The Impact ◽  
Hiv Aids

Background: The growing spread of HIV and AIDS among the people of Bonny Kingdom and capacity of medical facilities and service providers to respond to the dire situation have long posed public health concern of immeasurable proportion right from the inception of the Ibani-Se HIV/AIDS Baseline Survey Initiative in 2006 to the implementation of a three-year (2008-2011) intervention programme and thereafter. The impact of the provision of ART and other medical services related to HIV on the quality of care and satisfaction of all, HIV and non-HIV patients is unknown, and any available evidence is limited and arguable. The survey sought to know the number of health facility in the locality, the services they offer and most importantly the number of qualified personnel in such health facilities. Methods: A standardized questionnaire was designed for facility assessment to measure the capacity of health facilities to undertake VCT and ART services. The survey was conducted in sixteen (16) health facilities; fourteen (14) public and two (2) private health facilities located within Bonny town and in the creeks. In each facility, the manager and health providers were surveyed, with at least one provider selected from the HIV/AIDS department; 10 randomly selected persons in the Outpatients Department/Unit including 5 from the HIV/AIDS services were interviewed. A standard health facility assessment checklist was developed to measure the quality of care, capacity of providers, developmental and training needs. Others included conformity to standard of practice and quality of medical equipment. Data was entered with Census and Survey Processing System (CSPro) and exported to SPSS or Stata for analysis. Results: Of the sixteen health facilities, only seven provided both VCT and PMTCT services (Abalamabia health centre, Comprehensive health centre, NLNG RA Hospital, General Hospital, Finima health centre, Good shepherd Health medical lab and Chanel clinic) while one (Island Medical lab) provided VCT services; the others provided neither of the two services. Although, there are fairly adequate number and distribution of health facilities in the LGA, utilization of the general health services was found to have improved when compared to the previous survey. However, lack of structured unit for the provision of VCT and PMTCT services, specifically trained and designated counselors; and poorly motivated public healthcare providers have given rise to concerns about poor access of rural dwellers and inequitable distribution of the few available services, particularly to people most in need. Conclusion: Implications of this survey were highlighted for a more effective HIV prevention and control programme for wide coverage. 

scholarly journals Assessing the quality of care in a new nation: South Sudan's first national health facility assessment

2014 ◽  
Vol 19 (10) ◽  
pp. 1237-1248 ◽  
Author(s):  
Sima Berendes ◽  
Richard L. Lako ◽  
Donald Whitson ◽  
Simon Gould ◽  
Joseph J. Valadez
Keyword(s):  
Quality Of Care ◽  
Health Facility ◽  
National Health ◽  
Facility Assessment ◽  
New Nation

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 Performance and trend for quality of service in a large HIV/AIDS treatment program in Nigeria

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Ahmad Aliyu ◽  
Samer El-Kamary ◽  
Jessica Brown ◽  
Bruce Agins ◽  
Nicaise Ndembi ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Quality Management ◽  
Patient Outcomes ◽  
Health Facilities ◽  
Rate Of Change ◽  
Resource Limited Settings ◽  
Trend Line ◽  
Resource Limited ◽  
Hiv Aids

Abstract Background As antiretroviral therapy (ART) programs expand access, there is an increase in burden to a healthcare system. These results are reduced provider-patient contact time and poor programmatic and patient outcomes. Quality management offers providers a standardized approach for addressing the appropriateness of care to be applied in resource-limited settings. This study aimed to determine the trend of performance on HIV/AIDS quality management indicators of health facilities providing ART over a period of 5 years. Methods The annual performance scores of quality of care (QoC) indicators of 31 health facilities providing ART was extracted from a database covering a period of 5 years (from October 2008 to September 2012). The data are percentages that indicate scores of each health facility assessed based on compliance to National ART guidelines categorized into several indicator domains. A Chi square statistic for the trend, as well as test for departure from the trend line was determined. The p value associated with each indicator provides the significant level for testing an alternative hypothesis that the rate of change over the period considered for that indicator does not equal to zero. The slope of the regression line also gives the magnitude of the rate of change for each indicator by healthcare level across the review period. Results Generally, performance trends showed improvement across most indicator domains. The highest improvement occurred for “3 month loss to follow-up” and “1 year no-visit”, with scores declining from 37 to 3%, and 42% to 12% respectively. However, there was a sharp decline in performance between 2010 and 2012 in weight monitoring of patients (p < 0.01), adherence assessment to ARVs (p < 0.01) and hematocrit measurements (p = 0.01). The aggregate rate of change β, as obtained from the slope of the trend line is highly significant (p < 0.01) for all the quality of care indicators considered, whether improving or declining. Conclusion Periodic assessment to determine HIV/AIDS quality of care can guide rapid scale-up of services to achieve universal coverage in resource-limited settings. Determining trends to understand patterns is very useful for improving programmatic and patient outcomes.

Facility-Level Determinants of Quality Routine Intrapartum Care in Afghanistan

2020 ◽  
Author(s):  
Megan Lydon ◽  
Farzana Maruf ◽  
Hannah Tappis
Keyword(s):  
Quality Of Care ◽  
Regression Model ◽  
Gender Equality ◽  
Health Facility ◽  
Health Facilities ◽  
Labor And Delivery ◽  
Intrapartum Care ◽  
Care Practices ◽  
Facility Level

Abstract Background Although there have been notable improvements in availability and utilization of maternal health care in Afghanistan over the last few decades, risk of maternal mortality remains very high. Previous studies have highlighted gaps in quality of emergency obstetric and newborn care practices, however, little is known about the quality of routine intrapartum care at health facilities in Afghanistan.Methods We analyzed a subset of data from the 2016 Afghanistan Maternal and Newborn Health Quality of Care Assessment that comprised of observations of labor, delivery and immediate post-partum care, as well as health facility assessments and provider interviews across 77 high volume public health facilities. Using the Quality of the Process of Intrapartum and Immediate Postpartum Care index, we calculated a quality of care score for each observation. We conducted descriptive and bivariate analyses and built a multivariate linear regression model to identify facility-level factors associated with quality of care scores.Results Across the 665 childbirth observations, low quality of care was observed such that no health facility type received an average quality score over 56%. The multivariate regression model indicated that availability of routine labor and delivery supplies, training in respectful maternity care, perceived gender equality for training opportunities, recent supervision and observation during supervision were significantly positively associated with quality of care. Conclusions Quality of routine intrapartum care at health facilities in Afghanistan is concerningly low. Our analysis suggests that multi-faceted interventions are needed to address direct and indirect contributors to quality of care including clinical care practices, attention to client experiences during labor and delivery and attention to staff welfare and opportunities, including gender equality within the health workforce.

scholarly journals Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal

2019 ◽  
Vol 24 (S1) ◽  
pp. 31-38 ◽  
Author(s):  
Ashish KC ◽  
Dipendra Raman Singh ◽  
Madan Kumar Upadhyaya ◽  
Shyam Sundar Budhathoki ◽  
Abhishek Gurung ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Facility ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Health Facilities ◽  
Care Services ◽  
Quality Of Delivery ◽  
Maternal And Newborn

Abstract Introduction Nepal has pledged to substantially reduce maternal and newborn death by 2030. Improving quality of intrapartum health services will be vital to reduce these deaths. This paper examines quality of delivery and newborn services in health facilities of Nepal. Methods Data were sourced from the Nepal Health Facility Survey 2015, which covered a national representative sample of health facilities. The datasets were analysed to assess service readiness, availability and quality of delivery and newborn care in a sample of 992 health facilities. Results Of the 992 facilities in the sample, 623 provided delivery and newborn care services. Of the 623 facilities offering delivery and newborn care services, 13.3% offered comprehensive emergency obstetric care (CEmONC), 19.6% provided basic emergency obstetric care (BEmONC) and 53.9% provided basic delivery and newborn service. The availability of essential equipment for delivery and newborn care was more than 80% in health facilities. Except for the coverage of vitamin K injection, the coverage of immediate newborn care was more than 85% in all health facilities. The coverage of use of chlorhexidine ointment to all newborns was more than 70% in government hospitals and primary health care centers (PHCCs) and only 32.3% in private hospitals. Conclusions These findings show gaps in equipment and drugs, especially in PHCCs and private health facilities. Improving readiness and availability of equipment and drugs in PHCCs and private health facility will help improve the quality of care to further reduce maternal and newborn mortality in Nepal.

scholarly journals Linking health facility data from young adults aged 18-24 years to longitudinal demographic data: Experience from The Kilifi Health and Demographic Surveillance System

2017 ◽  
Vol 2 ◽  
pp. 51
Author(s):  
Christopher Nyundo ◽  
Aoife M. Doyle ◽  
David Walumbe ◽  
Mark Otiende ◽  
Michael Kinuthia ◽  
...  
Keyword(s):  
Young Adults ◽  
Young People ◽  
Health Facility ◽  
Surveillance System ◽  
Health Centre ◽  
Demographic Surveillance System ◽  
Health Facilities ◽  
Full Time ◽  
Data Matching ◽  
The Impact

Background: In 2014, a pilot study was conducted to test the feasibility of linking clinic attendance data for young adults at two health facilities to the population register of the Kilifi Health and Demographic Surveillance System (KHDSS). This was part of a cross-sectional survey of health problems of young people, and we tested the feasibility of using the KHDSS platform for the monitoring of future interventions. Methods: Two facilities were used for this study. Clinical data from consenting participants aged 18-24 years were matched to KHDSS records. Data matching was achieved using national identity card numbers or otherwise using a matching algorithm based on names, sex, date of birth, location of residence and the names of other homestead members. A study form was administered to all matched patients to capture reasons for their visits and time taken to access the services. Distance to health facility from a participants’ homestead was also computed. Results: 628 participated in the study: 386 (61%) at Matsangoni Health Centre, and 242 (39%) at Pingilikani Dispensary. 610 (97%) records were matched to the KHDSS register. Most records (605; 96%) were matched within these health facilities, while 5 (1%) were matched during homestead follow-up visits.  463 (75.9%) of those matched were women. Antenatal care (25%), family planning (13%), respiratory infections (9%) and malaria (9%) were the main reasons for seeking care. Antenatal clinic visits (n=175) and malaria (n=27) were the commonest reasons among women and men, respectively. Participants took 1-1.5 hours to access the services; 490 (81.0%) participants lived within 5 kilometres of a facility. Conclusions: With a full-time research clerk at each health facility, linking health-facility attendance data to a longitudinal HDSS platform was feasible and could be used to monitor and evaluate the impact of health interventions on health care outcomes among young people.

scholarly journals Linking health facility data from young adults aged 18-24 years to longitudinal demographic data: Experience from The Kilifi Health and Demographic Surveillance System

2020 ◽  
Vol 2 ◽  
pp. 51
Author(s):  
Christopher Nyundo ◽  
Aoife M. Doyle ◽  
David Walumbe ◽  
Mark Otiende ◽  
Michael Kinuthia ◽  
...  
Keyword(s):  
Young Adults ◽  
Young People ◽  
Health Facility ◽  
Surveillance System ◽  
Health Centre ◽  
Demographic Surveillance System ◽  
Health Facilities ◽  
Full Time ◽  
Data Matching ◽  
The Impact

Background: In 2014, a pilot study was conducted to test the feasibility of linking clinic attendance data for young adults at two health facilities to the population register of the Kilifi Health and Demographic Surveillance System (KHDSS). This was part of a cross-sectional survey of health problems of young people, and we tested the feasibility of using the KHDSS platform for the monitoring of future interventions. Methods: Two facilities were used for this study. Clinical data from consenting participants aged 18-24 years were matched to KHDSS records. Data matching was achieved using national identity card numbers or otherwise using a matching algorithm based on names, sex, date of birth, location of residence and the names of other homestead members. A study form was administered to all matched patients to capture reasons for their visits and time taken to access the services. Distance to health facility from a participants’ homestead was also computed. Results: 628 participated in the study: 386 (61%) at Matsangoni Health Centre, and 242 (39%) at Pingilikani Dispensary. 610 (97%) records were matched to the KHDSS register. Most records (605; 96%) were matched within these health facilities, while 5 (1%) were matched during homestead follow-up visits.  463 (75.9%) of those matched were women. Antenatal care (25%), family planning (13%), respiratory infections (9%) and malaria (9%) were the main reasons for seeking care. Antenatal clinic visits (n=175) and malaria (n=27) were the commonest reasons among women and men, respectively. Participants took 1-1.5 hours to access the services; 490 (81.0%) participants lived within 5 kilometres of a facility. Conclusions: With a full-time research clerk at each health facility, linking health-facility attendance data to a longitudinal HDSS platform was feasible and could be used to monitor and evaluate the impact of health interventions on health care outcomes among young people.

scholarly journals Facility-level determinants of quality routine intrapartum care in Afghanistan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Megan M. Lydon ◽  
Farzana Maruf ◽  
Hannah Tappis
Keyword(s):  
Quality Of Care ◽  
Regression Model ◽  
Gender Equality ◽  
Health Facility ◽  
Health Facilities ◽  
Intrapartum Care ◽  
Care Assessment ◽  
Care Practices ◽  
Facility Level

Abstract Background Although there have been notable improvements in availability and utilization of maternal health care in Afghanistan over the last few decades, risk of maternal mortality remains very high. Previous studies have highlighted gaps in quality of emergency obstetric and newborn care practices, however, little is known about the quality of routine intrapartum care at health facilities in Afghanistan. Methods We analyzed a subset of data from the 2016 Afghanistan Maternal and Newborn Health Quality of Care Assessment that comprised of observations of labor, delivery and immediate post-partum care, as well as health facility assessments and provider interviews across all accessible public health facilities with an average of five or more births per day in the preceding year (N = 77). Using the Quality of the Process of Intrapartum and Immediate Postpartum Care index, we calculated a quality of care score for each observation. We conducted descriptive and bivariate analyses and built a multivariate linear regression model to identify facility-level factors associated with quality of care scores. Results Across 665 childbirth observations, low quality of care was observed such that no health facility type received an average quality score over 56%. The multivariate regression model indicated that availability of routine labor and delivery supplies, training in respectful maternity care, perceived gender equality for training opportunities, recent supervision, and observation during supervision have positive, statistically significant associations with quality of care. Conclusions Quality of routine intrapartum care at health facilities in Afghanistan is concerningly low. Our analysis suggests that multi-faceted interventions are needed to address direct and indirect contributors to quality of care including clinical care practices, attention to client experiences during labor and childbirth, and attention to staff welfare and opportunities, including gender equality within the health workforce.

Reduced influence of affective disorders on perioperative complication rates, length of hospital stay, and healthcare costs following spinal fusion for adolescent idiopathic scoliosis

2019 ◽  
Vol 24 (6) ◽  
pp. 722-727
Author(s):  
Aladine A. Elsamadicy ◽  
Andrew B. Koo ◽  
Megan Lee ◽  
Adam J. Kundishora ◽  
Christopher S. Hong ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Idiopathic Scoliosis ◽  
Affective Disorder ◽  
Affective Disorders ◽  
Complication Rates ◽  
Total Cost ◽  
Adolescent Patients ◽  
Perioperative Complication ◽  
The Impact

OBJECTIVEIn the past decade, a gradual transition of health policy to value-based healthcare has brought increased attention to measuring the quality of care delivered. In spine surgery, adolescents with scoliosis are a population particularly at risk for depression, anxious feelings, and impaired quality of life related to back pain and cosmetic appearance of the deformity. With the rising prevalence of mental health ailments, it is necessary to evaluate the impact of concurrent affective disorders on patient care after spinal surgery in adolescents. The aim of this study was to investigate the impact that affective disorders have on perioperative complication rates, length of stay (LOS), and total costs in adolescents undergoing elective posterior spinal fusion (PSF) (≥ 4 levels) for idiopathic scoliosis.METHODSA retrospective study of the Kids’ Inpatient Database for the year 2012 was performed. Adolescent patients (age range 10–17 years old) with AIS undergoing elective PSF (≥ 4 levels) were selected using the International Classification of Diseases, Ninth Revision, Clinical Modification coding system. Patients were categorized into 2 groups at discharge: affective disorder or no affective disorder. Patient demographics, comorbidities, complications, LOS, discharge disposition, and total cost were assessed. The primary outcomes were perioperative complication rates, LOS, total cost, and discharge dispositions.RESULTSThere were 3759 adolescents included in this study, of whom 164 (4.4%) were identified with an affective disorder (no affective disorder: n = 3595). Adolescents with affective disorders were significantly older than adolescents with no affective disorders (affective disorder: 14.4 ± 1.9 years vs no affective disorder: 13.9 ± 1.8 years, p = 0.001), and had significantly different proportions of race (p = 0.005). Aside from hospital region (p = 0.016), no other patient- or hospital-level factors differed between the cohorts. Patient comorbidities did not differ significantly between cohorts. The number of vertebral levels involved was similar between the cohorts, with the majority of patients having 9 or more levels involved (affective disorder: 76.8% vs no affective disorder: 79.5%, p = 0.403). Postoperative complications were similar between the cohorts, with no significant difference in the proportion of patients experiencing a postoperative complication (p = 0.079) or number of complications (p = 0.124). The mean length of stay and mean total cost were similar between the cohorts. Moreover, the routine and nonroutine discharge dispositions were also similar between the cohorts, with the majority of patients having routine discharges (affective disorder: 93.9% vs no affective disorder: 94.9%, p = 0.591).CONCLUSIONSThis study suggests that affective disorders may not have a significant impact on surgical outcomes in adolescent patients undergoing surgery for scoliosis in comparison with adults. Further studies are necessary to elucidate how affective disorders affect adolescent patients with idiopathic scoliosis, which may improve provider approach in managing these patients perioperatively and at follow-up in hopes to better the overall patient satisfaction and quality of care delivered.

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