Primary Healthcare Centers
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Cureus ◽  
2021 ◽  
Author(s):  
Abdulrhman Alabdulgader ◽  
Ali O Mobarki ◽  
Ahmed AlDuwayrij ◽  
Abdullah Albadran ◽  
Mohammed I Almulhim ◽  
...  

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Rosemary C. B. Okoli ◽  
Gabriel Shedul ◽  
Lisa R. Hirschhorn ◽  
Ikechukwu A. Orji ◽  
Tunde M. Ojo ◽  
...  

Abstract Background Implementing an evidence-based hypertension program in primary healthcare centers (PHCs) in the Federal Capital Territory, Nigeria is an opportunity to improve hypertension diagnosis, treatment, and control and reduce deaths from cardiovascular diseases. This qualitative research study was conducted in Nigerian PHCs with patients, non-physician health workers, administrators and primary care physicians to inform contextual adaptations of Kaiser Permanente Northern California's hypertension model and the World Health Organization’s HEARTS technical package for the system-level, Hypertension Treatment in Nigeria (HTN) Program. Methods Purposive sampling in 8 PHCs identified patients (n = 8), non-physician health workers (n = 12), administrators (n = 3), and primary care physicians (n = 6) for focus group discussions and interviews. The Primary Health Care Performance Initiative (PHCPI) conceptual framework and Consolidated Framework for Implementation Research (CFIR) domains were used to develop semi-structured interviews (Appendix 1, Supplemental Materials) and coding guides. Content analysis identified multilevel factors that would influence program implementation. Results Participants perceived the need to strengthen four major health system inputs across CFIR domains for successful adaptation of the HTN Program components: (1) reliable drug supply and blood pressure measurement equipment, (2) enable and empower community healthcare workers to participate in team-based care through training and education, (3) information systems to track patients and medication supply chain, and (4) a primary healthcare system that could offer a broader package of health services to meet patient needs. Specific features of the PHCPI framework considered important included: accessible and person-centered care, provider availability and competence, coordination of care, and proactive community outreach. Participants also identified patient-level factors, such as knowledge and beliefs about hypertension, and financial and transportation barriers that could be addressed with better communication, home visits, and drug financing. Participants recommended using existing community structures, such as village health committees and popular opinion leaders, to improve knowledge and demand for the HTN Program. Conclusions These results provide information on specific primary care and community contextual factors that can support or hinder implementation and sustainability of an evidence-based, system-level hypertension program in the Federal Capital Territory, Nigeria, with the ultimate aim of scaling it to other parts of the country.


2021 ◽  
Vol 14 (1) ◽  
pp. 22-29
Author(s):  
Oladayo Nathaniel Awojobi ◽  
Jane Temidayo Abe ◽  
Oluwatoyin Adenike Adeniji

Primary healthcare is provided in most developing and developed countries to enhance healthcare accessibility for the population. This study accesses the impact of primary healthcare in six Sub-Saharan countries. A systematic search for qualitative and quantitative studies published before the end of 2017 was conducted online. Inclusion criteria were met by 6 studies, one each from Ghana, Malawi, Nigeria,  Tanzania, Zambia and Zimbabwe. Five studies are peer-reviewed, and one is a working paper. Three studies reported on the impact of primary healthcare on healthcare accessibility. Four studies reported on the role healthcare resources play in enhancing primary  healthcare services. Two other studies mentioned how cost-sharing mechanism led to an increase in healthcare utilization and how the reduction in user changes in all primary healthcare centers led to the reduction in out-of-pocket spending on healthcare services in a short-term. Primary healthcare offers access and utilization to healthcare services in most countries. It also offers protection against the detrimental effects of user fees. However, concerted efforts are still needed in most African countries in revitalizing the operations of primary healthcare centers for the improvement of healthcare services.


2021 ◽  
pp. 8-14
Author(s):  
Abdul Rahem ◽  
Umi Athiyah ◽  
Catur Dian Setiawan ◽  
Andi Hermansyah

Background: Pharmacists are the only people authorised to manage the medicines inventory. However, in the case of pharmacist shortage, other personnel may take over this function. This is particularly the case in most primary healthcare centers (puskesmas) in Indonesia. Aim: To compare the outcome of medicine inventory management between pharmacists and non-pharmacists in primary healthcare centres (PHCs). Methods: A survey of 146 puskesmas in East Java was conducted involving 73 pharmacists and 73 non-pharmacist staff. This study was conducted from July to January 2020. Each respondent completed a questionnaire focusing on the inventory aspects of medicine management. Results: Purchasing accuracy is higher for pharmacists (90%) than for non-pharmacists (68%). Pharmacists manage the inventory more efficiently with only 2% of the drugs expired and wasted while non-pharmacist staff wasted 16% of the drugs and 18% of the drugs expired. Conclusion: The role of pharmacists in medicine inventories is vital as they carry out more efficient and accurate medicine management.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keitly Mensah ◽  
Charles Kaboré ◽  
Salifou Zeba ◽  
Magali Bouchon ◽  
Véronique Duchesne ◽  
...  

Abstract Background Cervical cancer screening in sub-Saharan countries relies on primary visual inspection with acetic acid (VIA). Primary human papillomavirus (HPV)-based screening is considered a promising alternative. However, the implementation and real-life effectiveness of this strategy at the primary-care level in limited-resource contexts remain under explored. In Ouagadougou, Burkina Faso, free HPV-based screening was implemented in 2019 in two primary healthcare centers. We carried out a process and effectiveness evaluation of this intervention. Methods Effectiveness outcomes and implementation indicators were assessed through a cohort study of screened women, observations in participating centers, individual interviews with women and healthcare providers and monitoring reports. Effectiveness outcomes were screening completeness and women’s satisfaction. Logistic regression models and concurrent qualitative analysis explored how implementation variability, acceptability by women and the context affected effectiveness outcomes. Results After a 3-month implementation period, of the 350 women included in the cohort, 94% completed the screening, although only 26% had their screening completed in a single visit as planned in the protocol. The proportion of highly satisfied women was higher after result disclosure (95%) than after sampling (65%). A good understanding of the screening results and recommendations increased screening completeness and women’s satisfaction, while time to result disclosure decreased satisfaction. Adaptations were made to fit healthcare workers’ workload. Conclusion Free HPV-based screening was successfully integrated within primary care in Ouagadougou, Burkina Faso, leading to a high level of screening completeness despite the frequent use of multiple visits. Future implementation in primary healthcare centers needs to improve counseling and reduce wait times at the various steps of the screening sequence.


2021 ◽  
Vol 6 (1) ◽  
pp. 20-29
Author(s):  
Ni Made Hegard Sukmawati (Scopus ID: 57189732715)

The study of access to primary healthcare centers (PHCs) in the middle region of Indonesia, including Bali, is scarce. A study on primary healthcare access is worth undertaken in this region because it is usually given less attention regarding its fair distribution of healthcare facilities in relation to their population. This study aimed at determining geographical distribution and concentration of PHCs facility and demand in Bali Province. This study focused on the inpatient facility and demand of PHCs in relation to population. Data of PHCs’ inpatient facility and demand of each regency/city and population data were obtained from Bali Health Profile of 2015 to 2019. Location quotients (LQ) of inpatient facility and inpatient demand for each regency/city were calculated to determine the spatial concentration of the two variables compared to the provincial average. Our study found that there was variation in facility and demand for inpatient care in PHCs in Bali. A low level of inpatient facility and demand was seen in Regency of Buleleng, Denpasar, and Gianyar, while a high level of facility and demand for inpatient facility was observed in Regency of Jembrana, Tabanan, Klungkung, and Karangasem. A unique finding was also noticed in Bangli Regency, where the inpatient facility of PHC was high, while the inpatient demand was low. This might indicate a need for evaluation of the inpatient facility of PHC in this Regency. Keywords: Access to healthcare, Bali, inpatient care, puskesmas, primary healthcare centers.


2021 ◽  
Vol 9 (5) ◽  
pp. 60-69
Author(s):  
Alhanouf M. Alazmi ◽  
Fathi Zouheir Mbarki ◽  
Abeer Ahmed Sharahili ◽  
Amal Ahmed Ghzwany ◽  
Esra Ali Alhwsawi

Background: The frontline primary healthcare centers (PHCCs) are regularly visited for different medical problems, ranging from minor situation to emergency cases. The frontline primary healthcare centers (PHCCs) are regularly visited for different medical problems, ranging from minor situation to emergency cases. Therefore, analytical cross-sectional study was conducted to assess nature of encountered acute medical emergencies, self-perception and competencies of PCH physicians dealing with them, and, sufficiency of the required PHCCs equipment in hospitals of Riyadh. Methodology: This cross-sectional study enrolled all the physicians in governmental PHCCs, Ministry of Health (cluster 1) Riyadh city during the study period. The study was conducted using modified previously validated online accessible questionnaire. Online questionnaire was distributed across the selected Primary health care centers in Riyadh by submitting it to PHC manager to distribute to all PHC physicians during study period Results: In this study, we were able to collect 206 responses for our questionnaire among primary healthcare physicians. Among these physicians 58.8 % were aged between 25-35 years old and 55.3 % were females. We found that the percentage of PHC physicians who will attempt to perform the assessed skills for all patients did not exceed 30%. The least cases seen by physicians were cardiac arrest, acute GIT bleeding, anaphylaxis and acute vaginal bleeding which never seen during the last year by 83.1 %, 72.8 %, 70.9 % and 68 % of participants respectively. Conclusion: The current study showed that emergency services at the PHC level in Riyadh, Saudi Arabia are not functioning reasonably in some terms. Therefore, the services need to be perfected, and defects revealed by the current study should be taken into consideration hand-in-hand with available resources to upgrade the quality of the emergency services provided at PHC centers in Riyadh.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Soha A. Tashkandi ◽  
Ali Alenezi ◽  
Ismail Bakhsh ◽  
Abdullah AlJuryyan ◽  
Zahir H AlShehry ◽  
...  

Abstract Background Primary healthcare centers (PHC) ensure that patients receive comprehensive care from promotion and prevention to treatment, rehabilitation, and palliative care in a familiar environment. It is designed to provide first-contact, continuous, comprehensive, and coordinated patient care that will help achieve equity in the specialty healthcare system. The healthcare in Saudi Arabia is undergoing transformation to Accountable Care Organizations (ACO) model. In order for the Kingdom of Saudi Arabia (KSA) to achieve its transformational goals in healthcare, the improvement of PHCs’ quality and utilization is crucial. An integral part of this service is the laboratory services. Methods This paper presents a pilot model for the laboratory services of PHC's in urban cities. The method was based on the FOCUS-PDCA quality improvement method focusing on the pre-analytical phase of the laboratory testing as well as the Saudi Central Board for Accreditation of Healthcare Institutes (CBAHI) gap analysis and readiness within the ten piloted primary healthcare centers. Results The Gap analysis, revealed in-consistency in the practice, lead to lower the quality of the service, which was seen in the low performance of the chosen key performance indicators (KPI's) (high rejection rates, lower turn-around times (TAT) for test results) and also in the competency of the staff. Following executing the interventions, and by using some of the ACO Laboratory strategies; the KPI rates were improved, and our results exceeded the targets that we have set to reach during the first year. Also introducing the electronic connectivity improved the TAT KPI and made many of the processes leaner. Conclusions Our results revealed that the centralization of PHC's laboratory service to an accredited reference laboratory and implementing the national accreditation standards improved the testing process and lowered the cost, for the mass majority of the routine laboratory testing. Moreover, the model shed the light on how crucial the pre-analytical phase for laboratory quality improvement process, its effect on cost reduction, and the importance of staff competency and utilization.


2021 ◽  
Vol 16 (1) ◽  
pp. 66
Author(s):  
Ni Made Mira Wahyu Astani ◽  
Ni Luh Putu Arum Puspitaning Ati ◽  
Ernawaty Ernawaty

This study used the observational quantitative method to analyze the acceptance of information technology  in the form of thee-Health. The theory of acceptance was further analyzed using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. UTAUT model is the latest unified model that is an appropriate to explain the acceptance and use of information systems. The research objective was to analyze perceptions of the use of e-Health applications in the Surabaya City Health Center. The research design method used was cross-sectional design. The selected samples of 100 people were determined by multistage sampling in primary healthcare centers in every area of Surabaya. The independent variables in this study were performance expectancy, effort expectancy, social influence and behavioral intention while the dependent variable was the use of e-Health applications. Data were collected through questionnaires delivered via interviews. The results showed that the lowest indicator of acceptance by the users  was the time needed to input data category to the e-Health application. This study concludes that the acceptance of e-Health by users primary healthcare centers in Surabaya is low. This study suggests a more widespread dissemination of information regarding the benefits of the use of e-Health along with technical assistance and guidance on the use of e-Health applications.Keywords: UTAUT Model, e-Health application, primary healthcare center, acceptance


Author(s):  
Sarmin Sultana ◽  
Marium Salwa ◽  
Muhammad Ibrahim Ibne Towhid ◽  
Syed Shariful Islam ◽  
M Atiqul Haque

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