scholarly journals Quality Compliance in a Remotely Located PHC in India

2021 ◽  
pp. 72-80
Author(s):  
M. R. Roopashree
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Service Quality ◽  
National Health ◽  
National Standards ◽  
Health Care Centre ◽  
Primary Health ◽  
Patient Department

Background: As the rural Indian health care sector is providing patient care to the community at large, evaluating the quality of services gives an insight into the level of care provided. The primary health care chose the audit evaluation voluntarily. Objectives: The aim of the study was to assess the service quality provided in the primary health care Centre. The study was to help understand the skill set requirements in improving the quality of care and to identify the service quality gaps and to provide the best possible solutions for the gap closures by nominating the responsible personnel. Methods: The quality of care was evaluated in three ways: staff interview, record review, and observations conducted. Six departments were chosen for evaluation: the out-patient department, in-patient department, labor room, laboratory, National health programs, and general administration. By a prepared specific checklist comprised of standards and measurable elements, an evaluation was performed. The scoring was provided as 0, 1and 2, which implied noncompliance, partial compliance, and full compliance. Results: As per evaluation, national health program areas scored the least, whereas the inpatient departments scored the highest.  There were multiple gaps in the service provision areas and manpower allocation. The average mean score was 77.48. Conclusion: Keeping the national standards and guidelines, an audit evaluation was performed. Quality has to be imbibed with the optimization of resource allocation and with the mindset to provide the best possible care in the interest of the individual's wellbeing.

Neoliberal Reforms in Swedish Primary Health Care: For Whom and for What Purpose?

2008 ◽  
Vol 38 (4) ◽  
pp. 697-715 ◽  
Author(s):  
Göran Dahlgren
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Low Income ◽  
Health Sector ◽  
High Income ◽  
Public Hospitals ◽  
Primary Health ◽  
Access And Quality

The conservative government that came to power in Sweden in 2006 has initiated major market-oriented reforms in the health sector. Its first health care policy bill changed the health legislation to make it possible to sell/transfer public hospitals to commercial providers while maintaining public funding. Far-reaching market-oriented primary health care reforms are also initiated, for example in Stockholm County. They are typically presented as “free choice models” in which “the money follows the patient.” The actual and likely effects of these reforms in terms of access and quality of care are discussed in this article. One main finding is that existing social inequities in geographic access to care not only are reinforced but also become very difficult to change by democratic political decisions. Furthermore, dynamic market forces will gradually reduce the quality of care in low-income areas while both access and quality of care will be even better in high-income areas. Public funds are thus transferred from people living in low-income areas to people living in high-income areas, even though the need for good health services is much greater in the low-income areas. Certain policy options for reversing the inverse law of care are also presented.

scholarly journals Primary Health Care and Aging

2004 ◽  
Vol 2 (3) ◽  
pp. 99-108
Author(s):  
Martha Pelaez ◽  
Marilyn Rice
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Older People ◽  
Older Persons ◽  
Interdisciplinary Teams ◽  
Healthy Ageing ◽  
Policy Statement ◽  
Primary Health

From 21-25 February 2000, in San Jose, Costa Rica, a WHO Consultative Group was held on the topic of Primary Health Care for Older Persons, with representatives from 13 countries from around the world, as well as Headquarters and Regional offices of WHO and the private sector. In the policy statement that emerged from the meeting four basic principles were highlighted: universal accessibility and coverage on the basis of need, community and individual involvement, intersectoral action for health, and appropriate use of cost effective technologies in relation to the available resources. Three complementary integration functions are mentioned: functional with an integrated approach to the health needs of individuals over their life course taking precedence over episodic management of disease; organizational, with a focus on how health centers should function with interdisciplinary teams; and educational which addresses the knowledge and skills and attitudes needed by health professionals that will facilitate communication, networking, advocacy and mediation of resources. The proceedings go on to outline the objectives to be included in national plans on health of older people, as well as the extended benefits and outcomes to be expected from PHC strategies for older people. In promoting quality of care for older persons, positive and negative factors are mentioned, as are strategies to: stimulate interest in geriatric care, motivate general practitioners to focus on the care of elders, encourage teamwork among PHC staff, and encourage multi-sectoral collaboration in promoting the health of older persons. An example is provided of healthy ageing from Canada. The recommendations include defining and measuring an ageing friendly health center (with specific indicators for the latter), defining the role of the PHC team in promoting healthy ageing, characteristics that programs should have to promote “age friendly” services in the primary care setting, and outcome indicators for quality of care of elders at the PHC level.

scholarly journals Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context

2016 ◽  
Vol 41 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Rizwanul M. Karim ◽  
M. Shaikh Abdullah ◽  
Anisur M. Rahman ◽  
Ashraful M. Alam
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Service Quality ◽  
Service Utilization ◽  
Perceived Quality ◽  
Community Clinic ◽  
Care Services ◽  
Primary Health ◽  
Curative Care

Background: Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients’ perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services.Methods: This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire.Results: About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD±4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD±2545) BDT equivalent to 95 (SD±32) US$. To measure lay peoples’ perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad’s 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach’s ?=0.89) and 22-items Community Clinic Service Satisfaction (CCSS) scale (chronbach’s ?=0.97), were constructed and validated for measuring perceived service quality and satisfaction in Bangladesh context. This study showed mothers with pre-primary education [(?2=4.20, p=0.04), AOR with 95% CI=1.89 (1.03, 3.53)] utilized the limited curative care services more than educated mothers. On the contrary, higher income families [for income group 5000-10,000 BDT ?2=8.83, p=0.003 and AOR with 95% CI=0.37(0.19, 0.71)] and [for income group above 10,000 BDT ?2= 5.02, p= 0.025 and AOR with 95% CI=0.40 (0.18, 0.89)] and families having cultivable lands [for 5-10 decimal group ?2=5.51, p=0.19, and AOR with 95% CI=0.56 (0.35, 0.91)] and [for>10 decimal group ?2=6.70, p=0.010, and AOR with 95% CI=0.50 (0.29, 0.84)] utilized the limited curative care services less than their poorer and landless counterpart. The same relationship was observed in case of health education and Antenatal Care (ANC) and Postnatal Care (PNC) services. Women who lived in their own residence used health education services more frequently than those who lived in a rental house [?2 =24.00, p=0.000 and AOR with 95% CI=1.21, (1.12, 1.30)] and they also increasingly used maternal and child health services ?2 =27.49, p=0.000 and AOR with 95% CI 1.61, (1.35, 1.93)]. Perceptions concerning skill and competence of the health care provider [?2=16.90, p=0.000 and AOR with 95% CI=1.14, (1.07, 1.22)] and satisfaction indicating interpersonal communication and attitude of the care provider [?2=7.07, p=0.008 and AOR with 95% CI=1.08, (1.02, 1.15)] were found significant predictors for limited curative care service utilization of CC. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues also played significant role on CC’s services utilization.Conclusions: Besides parental education and income, client’s perception and satisfaction played significant role in CC service utilization. Provider’s perception of service quality should be studied. The study findings will enable policy-makers to improve quality of primary health care services, realizing providers’ and patients’ ideas of CC service quality.

scholarly journals The association between culture, climate and quality of care in primary health care teams

2007 ◽  
Vol 24 (4) ◽  
pp. 323-329 ◽  
Author(s):  
M. Hann ◽  
P. Bower ◽  
S. Campbell ◽  
M. Marshall ◽  
D. Reeves
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Health Care Teams ◽  
Primary Health
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