Sharing Common Principles: Blending the Primary Health Care and Harm Reduction Paradigms to Meet Common Health Goals in HIV/AIDS Prevention

2006 ◽  
Vol 12 (3) ◽  
pp. 34 ◽  
Author(s):  
Christopher A Pankonin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Hiv Prevention ◽  
Disease Prevention ◽  
Harm Reduction ◽  
Care Delivery ◽  
Prevention Strategy ◽  
Primary Health ◽  
Increased Risk ◽  
Hiv Aids

HIV/AIDS continues to spread globally and deeply affecting resource-poor settings, with over 90% of cases occurring in developing countries. In these areas, primary health care remains the preferred model of health care delivery; advocating core principles including community involvement, equity, and an emphasis on disease prevention while providing basic medical treatment. The harm reduction paradigm shares key principles with primary health care, and as this paper will argue, a combined comprehensive HIV prevention strategy would provide a holistic and particularly effective approach to HIV prevention. The most important improvement achieved through a combined HIV prevention strategy is by providing the community with an increased number of social services including housing and employment services, financial counselling, mental health counselling, and referrals to additional medical services. In also addressing the social determinants of health, a combined primary health care and harm reduction approach act to provide a holistic disease prevention strategy that also seeks to address the conditions that lead to increased risk-taking behaviours. Additional evidence indicating a successful comprehensive prevention strategy remains closely tied to measures of effectiveness, including improvements in HIV prevalence and incidence rates, needle and syringe coverage, and treatment services for HIV/AIDS patients.

scholarly journals Sub-district Costs and Efficiency of the Re Mmogo Pholong (“Together in Wellness”) Combination HIV/AIDS Prevention Intervention in the North West Province of South Africa

2019 ◽  
Author(s):  
Sebastian Kevany
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Hiv Prevention ◽  
Prevention Program ◽  
Community Based ◽  
North West ◽  
The North ◽  
Primary Health ◽  
Hiv Aids

AbstractBackgroundRe Mmogo Pholong (RMP) or “Together in Wellness”), was a combination prevention program to strengthen HIV prevention programming, community support mechanisms, community-based HIV testing, referral systems, and HIV prevention integration at the primary care level, thereby sustainably reducing HIV/AIDS transmission in the North West Province of South Africa. RMP included four overlapping components: situational analysis, community engagement and mobilization, community-based biomedical and behavioral prevention, and primary health care systems strengthening. In support of the PEPFAR country-ownership paradigm, we conducted costing analysis of the RMP combination HIV prevention program to determine data needed for potential transition of to local ownership.MethodsWe used standard costing methodology for this research.ResultsWe found that cost per unit of output ranged from $63.93 (cost per person reached with individual or small group prevention interventions) to $4,344.88 (cost per health facility strengthened). The RMP intervention was primarily dependent on personnel costs. This was true regardless of the time period (Year 1 vs. Year 2) or activity (i.e. wellness days or events, primary health care strengthening, community engagement, and wellness clubs).ConclusionsThe development of labor-intensive rather than capital intensive interventions for low-income settings such as RMP was identified as being particularly important in treating and preventing HIV/AIDS and other health conditions in a sustainable manner. Costs were also observed to transition from international cost centers to in-country headquarters offices over time, in keeping with the transition of international to local responsibility required for sustainable PEPFAR initiatives. Such costing center evolution was also reflected by changes in the composition of the intervention, including (1) the redesign and re-deployment of service delivery sites according to local needs, uptake and implementation success and (2) the flexible and adaptable restructuring of intervention components in response to community needs.

scholarly journals The effect of preceptorship on nurses' training and preparation with implications for Qatar: A literature review

2018 ◽  
Vol 8 (7) ◽  
pp. 44 ◽  
Author(s):  
Hajer Arbabi ◽  
Jessie Johnson ◽  
Daniel Forgrave
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Literature Review ◽  
Organizational Support ◽  
Care Delivery ◽  
Health Centers ◽  
Primary Health ◽  
Newly Graduated Nurses ◽  
Level Of Training ◽  
High Level

Background and objective: The Primary Health Care Corporation in Qatar was established in 2012 and is comprised of 23 Health Centers. One of its goals is to create excellence in its workforce. A preceptorship program needs to be initiated at the Primary Health Care Corporation to ensure a high level of training for its nurses. The purpose of these preceptorship programs is to ensure nurses are equipped to carry out Qatar’s National Health Strategy and in doing so the Primary Health Care Corporation has this as its goal. This study amis to assess the effectiveness of preceptorship program models that can eventually be used for adoption as training programs for nurses in Health Centers in Qatar.Methods: A literature review of twenty articles published between 2006 and 2017 that focused on different models of preceptorship programs was conducted. The Mixed Methods Appraisal Tool was used to assess the quality of these studies. The data was analyzed by categorizing the included articles in a matrix sheet based on study design.Results and conclusions: Preceptorship programs are effective in four key areas: increasing nursing knowledge, supporting effective and safe care delivery by newly graduated nurses, increasing organizational support, and decreasing turnover rate and cost. 

scholarly journals Kendala Organisasi Berbasis Komunitas dalam Program Pencegahan dan Penanggulangan HIV/AIDS: Studi Kasus pada Dua LSM Peduli AIDS di Jakarta

2019 ◽  
pp. 163-174
Author(s):  
Ranti Suciati ◽  
Mujiati Mujiati ◽  
Novianti Novianti
Keyword(s):  
Social Support ◽  
Health Care ◽  
Content Analysis ◽  
Primary Health Care ◽  
Community Based ◽  
Purposive Sampling ◽  
Community Based Organizations ◽  
Primary Health ◽  
The Government ◽  
Hiv Aids

Abstrak Semakin meningkatnya jumlah kasus HIV/AIDS di Indonesia, berdampak tidak hanya pada masalah kesehatan, memacu pemerintah untuk melibatkan masyarakat sipil dalam Organisasi Berbasis Komunitas (OBK) untuk ikut berperan dalam upaya pencegahan dan penanggulangan HIV/AIDS. Pentingnya identifikasi kendala atau hambatan yang dihadapi oleh OBK memunculkan strategi atau alternatif solusi untuk mengatasi kendala, serta memberikan gambaran model intervensi yang lebih sinkron antara pemerintah dan masyarakat. Desain penelitian adalah kualitatif dengan melakukan studi kasus di dua LSM Peduli AIDS di Jakarta. Informan dipilih secara purposive sampling yaitu pengurus, anggota/petugas, dan dampingan dari dua OBK. Pengumpulan informasi dengan wawancara mendalam berdasarkan pedoman wawancara dan diolah menggunakan metode content analysis. Kendala yang dihadapi OBK yaitu alur rujukan BPJS yang mengikuti domisili sehingga memberatkan pasien, kurang optimalnya koordinasi dan kerjasama antara OBK dengan Puskesmas, belum meratanya kualitas dan kapasitas SDM anggota OBK, persoalan administratif organisasi, sumber dana yang tidak selalu kontinu, adanya perbedaan kepentingan antara OBK dengan pihak kepolisian, serta masih tingginya stigma masyarakat terhadap penderita HIV/AIDS. Solusi mengatasi kendala OBK dilakukan dengan peningkatan efektifitas pelaksanaan program pemerintah melalui OBK, antara lain dengan penerapan fleksibilitas pengelolaan dana berdasarkan kinerja OBK, peningkatan kapasitas SDM, pemantapan sistem manajerial, pemahaman alur layanan kesehatan di Puskesmas, serta social support bagi penderita HIV/AIDS. Kata kunci: organisasi berbasis komunitas, LSM, HIV/AIDS Abstract The increasing number of HIV/AIDS cases in Indonesia that impact not only on health issues, spur the Government to involve civil society in community-based organizations (OBK) to play a role in HIV/AIDS prevention program. Identification of constraints or obstacles faced by OBK do as they can generate alternative strategies or solutions to overcome these constraints, and provide a more synchronous model of intervention between the government and the community. This type of research is a case study at two AIDS Awareness NGOs in Jakarta. The informants were chosen by purposive sampling ie the board, members/officers, and assistants from the two NGOs. Information collection with by in-depth interview based on interview guideline and processed using content analysis method. Constraints faced by the OBK is the issue of referral flow pathways that follow the domicile so burdensome patients, less optimal coordination and cooperation between OBK with primary health care, uneven quality and capacity of human resources of NGO members, organizational administrative issues, sources of funds that are not always continuous, different interests between the OBK with the police department, and the stigma. Reduction of obstacles faced by OBK can be done by increasing the effectiveness of government program implementation through OBK, among others by applying flexibility of fund management based on OBK performance, human resource capacity building, managerial system strengthening, understanding of health service flow in primary health care, and social support for patient HIV/AIDS. Keywords: community-based organizations, NGOs, HIV/AIDS

scholarly journals Depression in older adults: prevalence and risk factors in a primary health care sample

2017 ◽  
Vol 59 (2) ◽  
pp. 33
Author(s):  
Uschenka Padayachey ◽  
S Ramlall ◽  
J Chipps
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Depression Scale ◽  
Subjective Health ◽  
High Rate ◽  
Geriatric Depression ◽  
Care Clinic ◽  
Primary Health Care Clinic ◽  
Primary Health ◽  
Increased Risk

Background: Depression in the geriatric population has been identified as a significant problem in view of the associated negative outcomes regarding poor functioning, increased perception of poor health and increased utilisation of medical services. Significantly associated with increased morbidity and mortality, depression has been found to be an independent cause of disability as well as adding to disability due to primary physical illnesses. Early identification and treatment of depression reduces medical costs and lessens caregiver burden. Epidemiological data and prevalence rates of geriatric depression in Africa are limited, although such data are vital to mobilise and plan government mental health initiatives aimed at screening and early intervention. Objective: To determine the prevalence of depression and associated clinical and socio-demographic factors amongst older adult patients attending a primary health care clinic in the Ethekwini District in Kwa-Zulu Natal, South Africa. Methods: The 15-item Geriatric Depression Scale and a socio-demographic questionnaire were administered in English to 255 geriatric outpatients, randomly selected, at a local community clinic in Durban. Data analysis: Data were analysed using SPSS version 23®. Descriptive statistics were used to summarise the sample demographics and response rate and non-parametric statistics were used to test for associations and differences. Results: A Cronbach’s alpha for the GDS was calculated (p = 0.793). Some 40% of participants screened positive for depression. Female gender, widowhood and a negative subjective health status rating were significantly associated with depression and marriage appeared to be protective (p < 0.001). Participants with a poor subjective health rating were 21 times more likely to be depressed and widowhood conferred an almost fourfold increased risk of being depressed, with widows at greater risk than widowers. No association between depression and specific medical conditions was identified. Conclusion: There is a high rate of undetected depression among the elderly attending a local primary health care clinic with widowhood and poor subjective health being strong predictors of mood disorders. The findings warrant replication in bigger samples. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272250

scholarly journals Risco cardiovascular em usuários hipertensos da atenção primária à saúde

2018 ◽  
Vol 12 (5) ◽  
pp. 1303 ◽  
Author(s):  
Ludmilla Borges Santos ◽  
Wellington Luiz Lima ◽  
Josiane Maria Oliveira Souza ◽  
Marcia Cristina Da Silva Magro ◽  
Tayse Tâmara Paixão Duarte
Keyword(s):  
Diabetes Mellitus ◽  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Diseases ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Increased Risk ◽  
Diuretic Drugs ◽  
Insuficiencia Cardiaca

RESUMOObjetivo: identificar os fatores associados ao risco de doenças cardiovasculares em usuários da atenção primária à saúde (APS) hipertensos. Método: estudo quantitativo e transversal realizado com 115 usuários hipertensos cadastrados em uma unidade básica de saúde (UBS). Os dados foram registrados em questionáriosemiestruturado. Realizou-se análise descritiva e inferencial (teste t de Student e regressão logística multivariada). Valores p < 0,05 foram considerados significativos. Resultados: houve predomínio do sexo feminino (67,8%), idosos (> 60 anos) (66,1%), em uso contínuo de diuréticos (65,2%). Ao estratificar os usuários da APS de acordo com o risco para doenças cardiovasculares, observou-se que a maioria apresentou risco elevado (59,1%), risco médio (26,1%) e baixo risco (14,8%). Estão associados ao maior risco de eventos cardiovasculares os hipertensos com diabetes mellitus (DM) (p = 0,000), infarto agudo do miocárdio (IAM) (p = 0,000), insuficiência cardíaca congestiva (ICC) (p = 0,000) e aqueles em uso de diuréticos (p = 0,001). Conclusão: usuários da APS hipertensos com DM, IAM, ICC e em uso de diuréticos evoluíram com maior risco de evento cardiovascular. Nesse contexto, faz-se necessário proporcionar uma assistência integrada e pautada na prevenção não apenas para minimizar a ocorrência de complicações, mas principalmente para prolongar qualitativamente a vida dos usuários da APS hipertensos. Descritores: Hipertensão; Doenças Cardiovasculares; Atenção Primária à Saúde; Fatores de Risco; Consulta de Enfermagem; Assistência à Saúde.ABSTRACTObjective: to identify the factors associated with risk for cardiovascular diseases in hypertensive primary health care (PHC) users. Method: quantitative and cross-sectional study conducted with 115 hypertensive users enrolled in a Brazilian primary health center (UBS). Data were recorded in a semi-structured questionnaire. A descriptive and inferential analysis was performed (Student’s t-test and multivariate logistic regression). P values < 0.05 were regarded as significant. Results: there was predominance of women (67.8%), the elderly (> 60 years) (66.1%), continuous users of diuretic drugs (65.2%). By stratifying PHC users according to the risk for cardiovascular diseases, we observed that the majority showed high risk (59.1%), medium risk (26.1%), and low risk (14.8%). Hypertensive patients with diabetes mellitus (DM) (p = 0.000), acute myocardial infarction (AMI) (p = 0.000), congestive heart failure (CHF) (p = 0.000), and those using diuretic drugs (p = 0,001) are associated with an increased risk for cardiovascular events. Conclusion: hypertensive patients with DM, AMI, CHF, and those using diuretic drugs evolved with a greater risk for a cardiovascular event. In this context, there is a need for providing an integrated and preventive care based on prevention not only to minimize the occurrence of complications, but mainly to extend the life of hypertensive PHC users on a qualitative basis. Descriptors: Hypertension; Cardiovascular Diseases; Primary Health Care; Risk Factors; Office Nursing; Delivery of Health Care.                                                       RESUMENObjetivo: identificar los factores asociados con el riesgo de enfermedades cardiovasculares en usuarios de la atención primaria de salud (APS) hipertensos. Método: estudio cuantitativo y transversal realizado con 115 usuarios hipertensos inscritos en un centro de salud primaria (UBS) brasileño. Los datos se registraron en un cuestionario semi-estructurado. Se realizó un análisis descriptivo e inferencial (prueba t de Student y regresión logística multivariable). Los valores p < 0,05 se consideraron significativos. Resultados: hubo predominio de mujeres (67,8%), ancianos (> 60 años) (66,1%), usuarios continuos de diuréticos (65,2%). Al estratificar a usuarios de la APS de acuerdo con el riesgo de enfermedades cardiovasculares, observamos que la mayoría mostraba alto riesgo (59,1%), medio riesgo (26,1%) y bajo riesgo (14,8%). Los pacientes hipertensos con diabetes mellitus (DM) (p = 0,000), infarto agudo de miocardio (IAM) (p = 0,000), insuficiencia cardíaca congestiva (ICC) (p = 0,000) y aquellos que usan diuréticos (p = 0,001) están asociados con un mayor riesgo de eventos cardiovasculares. Conclusión: pacientes hipertensos con DM, IAM, ICC y aquellos que usan diuréticos evolucionaron con un mayor riesgo de evento cardiovascular. En este contexto, existe la necesidad de proporcionar una atención integrada y preventiva basada en la prevención no solo para minimizar la aparición de complicaciones, sino principalmente para extender la vida de los usuarios de la APS hipertensos sobre una base cualitativa. Descriptores: Hipertensión; Enfermedades Cardiovasculares; Atención Primaria de Salud; Factores de Riesgo; Enfermería de Consulta; Prestación de Atención de Salud.

scholarly journals Improving primary health care delivery in Bihar, India: Learning from piloting and statewide scale-up of Ananya

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Gary L Darmstadt ◽  
Kevin T Pepper ◽  
Victoria C Ward ◽  
Sridhar Srikantiah ◽  
Tanmay Mahapatra ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Scale Up ◽  
Primary Health
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