scholarly journals Challenges, Distrust, and Understanding: Employing Communicative Action in Improving Trust in a Public Medical Sector in Uganda

SAGE Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 215824401989370
Author(s):  
Grace Akello ◽  
Ulrike Beisel
Keyword(s):  
Service Delivery ◽  
Health Workers ◽  
Communicative Action ◽  
Care Delivery ◽  
Participant Observation ◽  
Health Sector ◽  
Medical Sector ◽  
Government Hospitals ◽  
The Government

We assessed how the everyday work challenges that frontline health workers (FRHWs) face in the government health sector in northern Uganda influence their trust in the Ministry of Health (MOH). We employed qualitative research techniques, including interviews and participant observation, over a 9-month period to examine FRHWs’ viewpoints about how the MOH should address these challenges in service delivery. One hundred and sixty-five FRHWs, of whom 48 were recruited for extensive follow-up, participated in our study. Key findings include distrust in the MOH is prevalent among FRHWs, there is a lack of trust in the organization’s coordination role in service delivery and this affects health care delivery to patients, interrelations, and provider cooperation. Therefore, restoring trust in government hospitals will require a truthful non-violent response by the MOH in its contractual agreement with FRHWs. In our analysis, we employ Habermas’s Theory of Communicative Action.

Factors Influencing Utilization of Health Services in Kenya: The Case of Homa Bay County

2014 ◽  
Vol 3 (4) ◽  
pp. 213 ◽  
Author(s):  
Stephen Odiwuor Otieno ◽  
David Macharia
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Qualitative Data ◽  
Health Workers ◽  
Health Sector ◽  
Health Service Delivery ◽  
District Health ◽  
Utilization Of Health Services ◽  
Factors Influencing ◽  
The Government

In order to improve efficiency in health service delivery in Kenya, the Ministry of Health has developed structures through inter-sectoral collaboration at various levels. Despite efforts by the government and key stakeholders to improve health sector, utilization of health services still remains a major challenge. The purpose of the study was to investigate factors that influence utilization of health services in Homa Bay County, Kenya. The study employed survey design and focused on health beneficiaries, District Health Management Team and other key health stakeholders, and used both quantitative and qualitative data. Quantitative data was collected through household interviews of 384 respondents and qualitative data was generated through Key Informant Interviews of 16 respondents. The study reveals that health financing, service delivery, quality, accessibility and equity influence utilization of health services in Homa Bay County. It is for these reasons that the study recommends that the government should allocate adequate budget towards health services, avail adequate trained health workers, and improve infrastructure in health facilities as well as drugs and other supplies. There is also need for further research on cultural factors influencing utilization of health services.

scholarly journals Factors Influencing Utilization of Health Services in Kenya: The Case of Homa Bay County

2014 ◽  
Vol 3 (4) ◽  
pp. 213
Author(s):  
Stephen Odiwuor Otieno ◽  
David Macharia
Keyword(s):  
Health Services ◽  
Service Delivery ◽  
Qualitative Data ◽  
Health Workers ◽  
Health Sector ◽  
Health Service Delivery ◽  
District Health ◽  
Utilization Of Health Services ◽  
Factors Influencing ◽  
The Government

In order to improve efficiency in health service delivery in Kenya, the Ministry of Health has developed structures through inter-sectoral collaboration at various levels. Despite efforts by the government and key stakeholders to improve health sector, utilization of health services still remains a major challenge. The purpose of the study was to investigate factors that influence utilization of health services in Homa Bay County, Kenya. The study employed survey design and focused on health beneficiaries, District Health Management Team and other key health stakeholders, and used both quantitative and qualitative data. Quantitative data was collected through household interviews of 384 respondents and qualitative data was generated through Key Informant Interviews of 16 respondents. The study reveals that health financing, service delivery, quality, accessibility and equity influence utilization of health services in Homa Bay County. It is for these reasons that the study recommends that the government should allocate adequate budget towards health services, avail adequate trained health workers, and improve infrastructure in health facilities as well as drugs and other supplies. There is also need for further research on cultural factors influencing utilization of health services.

Healthcare Delivery in the Face of Economic Recession: Challenges, Prospects and Pragmatic Solutions.

2019 ◽  
Vol 1 (1) ◽  
pp. 1-12
Author(s):  
Moses C Ohamaeme ◽  
Jude Egwurugwu ◽  
C.R. Ohamaeme ◽  
Jude Egwurugwu ◽  
Ugonne Ogunnaya ◽  
...  
Keyword(s):  
Health Workers ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Health Sector ◽  
Economic Recession ◽  
Empirical Literature ◽  
Health Coverage ◽  
The Face ◽  
The Government ◽  
Policy Direction

Introduction: The Nigerian health sector faces several challenges especially during economic recession. These encumbrances have led to low productivity, worsened out-of-pocket expenditure with its attendant "health shock” and poor service delivery. Methodology: A didactic empirical literature review of articles bordering on key terminologies in the title was perused to guide this article. Results Economic recession hampers productivity of both professional personnel and the government in rendering services to the populace on one hand while it may be difficult for the people to access care on the other hand. These bring to the fore, the problems of escalated prices of drugs, low patronage of accredited hospitals, rapid migration of professionals in search of “greener pastures”, and increase in morbidity and mortality in the populace. When these occur, to achieve health for all and Universal Health Coverage becomes a mirage. Discussion: Prospects and pragmatic solutions have been suggested such as funding and financing mechanisms especially Health Insurance Schemes, limiting of medical tourisms to only when it is expressly needed, adequate remuneration of health workers, healthy government policies with policy direction, and needs assessment among other solutions. Conclusion: Healthcare during recession will be better improved when economic indicators are thematically addressed to yield palpable impacts as these will go a long way to alleviate the dwindling health care delivery in a recessed economy. Keywords: Healthcare, Challenges, Recessed economy, Prospects, Solutions, Nigeria.

Eliminating Hepatitis B from Bangladesh by the Year 2030

2020 ◽  
Vol 38 (3) ◽  
pp. 145-149
Author(s):  
Md Golam Mustafa ◽  
Md Shahinul Alam ◽  
Md Golam Azam ◽  
Md Mahabubul Alam ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Health Workers ◽  
Health Sector ◽  
Public Health Problem ◽  
Integrated System ◽  
Hbv Infection ◽  
Diagnosis And Treatment ◽  
Major Public Health Problem ◽  
Medical Institutions ◽  
The Government

Worldwide, hepatitis B virus (HBV) infection is still a major public health problem. Bangladesh having a large burden of HBV infection, should be a major contributor towards it’s elimination by 2030. The country has been making progress in reducing incidence of HBV infection during the past decades. The progresses are mainly due to large vaccination coverage among children and large coverage of timely birthdose vaccine for prevention of mother-to-child transmission of HBV. However, Bangladesh still faces challenges in achieving target of reduction in mortality from HBV. On the basis of targets of the WHO’s Global health sector strategy on viral hepatitis 2016–2021, we highlight priorities for action towards HBV elimination. To attain the target of reduced mortality we propose that, the service coverage targets of diagnosis and treatment should be prioritized along with vaccination. Firstly, improvements are needed in the diagnostic and treatment abilities of medical institutions and health workers. Secondly, the government needs to reduce the costs of health care. Thirdly, better coordination is needed across existing national program and resources to establish an integrated system for prevention, screening, diagnosis and treatment of HBV infection. In this way, we can make progress towards achieving the target of eliminating HBV from Bangladesh by 2030 J Bangladesh Coll Phys Surg 2020; 38(3): 145-149

scholarly journals The Role of The Community in Combating The Covid-19 Pandemic in Indonesia

2021 ◽  
Vol 1 (1) ◽  
pp. 159-168
Author(s):  
Djufri Nurachman ◽  
Goddess Purnamawati
Keyword(s):  
Health Education ◽  
Small Businesses ◽  
Teaching And Learning ◽  
Health Workers ◽  
Health Sector ◽  
Economic Downturn ◽  
The Government ◽  
Curriculum Policies ◽  
Global Threat

Corona Virus Diseases 19 (Covid-19) has become a global threat. The role of the community is very much needed to break the chain of transmission of Covid-19. This study aims to determine the role of the Indonesian people in overcoming the Covid-19 pandemic in general, health, education, and the economy. Research method: using SLR. Data is collected from Scopus and indexed journals through a science direct and Garuda-based data system. Data were analyzed using content analysis techniques. Research Results: Indonesian people have implemented health protocols in the form of using masks outside the home, complying with PSBB policies, washing hands regularly. In the health sector, supporting health workers by helping to raise funds for PPE, conducting regional quarantine. In supporting education policies during the Covid-19 period, the context of which is the government, teachers, and parents, have been with all their might and dedication to provide facilities for students in the form of data packages, relaxation of curriculum policies, elimination of National Examinations, the effectiveness of teaching and learning activities in Indonesia. during the pandemic. To respond to the economic downturn itself, the community supports the return of the Indonesian economy, such as opening small businesses online, supporting policies for providing assistance and relaxing MSME loans by submitting small businesses, supporting government policies on tax relaxation. while still paying taxes. Conclusion: In general, the Indonesian people have been quite disciplined in trying to prevent the spread of COVID-19, both in the fields of health, education, and the economy.

scholarly journals Assessment of Healthcare Institutions and Socio-Economic Welfare: A Survey of Secondary and Tertiary Hospitals in Rivers State, Nigeria

2021 ◽  
pp. 11-21
Author(s):  
Dennis B. Ewubare ◽  
Kelechi C. Nnamdi
Keyword(s):  
Service Delivery ◽  
Federal Government ◽  
State Government ◽  
Health Workers ◽  
Sampling Technique ◽  
Public Hospitals ◽  
Quality Healthcare ◽  
Tertiary Hospitals ◽  
The Government ◽  
Rivers State

The purpose of this paper is to access healthcare institutions and the welfare experience of patients and workers in public Secondary and Tertiary Hospitals in Rivers State, with ownership across Federal Government, State Government and the Military. From a stratified sampling technique, a representative survey sample of 90 respondents was involved. Our findings shows that Tertiary hospitals in Rivers state relies on funding by Federal Government, State Government, internally generated funds and grants, in their decending order. Budgetary cut on health institution is perceived to reduce service delivery and health workers motivation, though a cut in funding is expected by few, as a result of the prevalent fall in global oil price. The analysis also shows that the price of health services and medicines have increased in recent times, but we could not establish the symptom of inflation on the prices of healthcare consumption. It was established that the level of qualified health workers without gainful employment has slightly increased, owing to low absorptive capacity of government owned hospital, low renumeration from non-public-owned hospitals. The study found that the populace prefers public hospitals over private hospitals, mainly because of affordability and availability of specialists. Although there is evidence of inadequate workforce, bureaucratic holdup and poor ambience. The study concludes that the government is the provider of very affordable and quality healthcare in Nigeria. It was therefore recommended that there should be proper accountability by the hospital management on the proceeds and expenses. Efforts should be made to strenghten internally generated revenue, while a public-private partnership, improved efficiency and quality of service delivery will attract funds.

scholarly journals Conflict and Conflict Resolutions Experienced by Early Career Doctors in the Nigerian Health Sector: a Qualitative Report

2020 ◽  
Vol 3 (2) ◽  
pp. 79-85
Author(s):  
O. Olaopa ◽  
O. Adebayo ◽  
I. Adufe ◽  
M.A. Adeniyi ◽  
S. Oiwoh ◽  
...  
Keyword(s):  
Health Workers ◽  
Health Sector ◽  
Early Career ◽  
Clinical Settings ◽  
Group Discussions ◽  
Tertiary Hospitals ◽  
Clinical Workplace ◽  
Perpetrators And Victims ◽  
The Government ◽  
Different Levels

AbstractBackground. Conflicts across professional workgroup and hierarchies inundate the clinical workplace. Early Career Doctors (ECDs) are also affected either as victims or as a provocateur/perpetrator. The effects of conflict at their workplaces have both significant positive and negative dimensions and impacts on ECDs. Little has been reported about conflict among ECDs in Nigeria.Thus, this study explored the issue of conflict and conflict resolution among ECDs in Nigeria, in a bid to elicit information on the causes, consequences, perpetrators and victims.Method. This was a qualitative study, using Focus Group Discussions (FGD) to explore information on conflict and conflict management among purposively selected key respondents (n = 14) from seven tertiary hospitals in Nigeria. The respondents are ECDs who were leaders and representatives of other ECDs in their various hospitals. Two FGDs were conducted.Results. The result showed that conflict is inescapable in clinical settings and occurred at different levels. The perpetrators are varieties of health workers, and most are task-related conflicts, although there are relational ones. The conflicts with the government on labour-related issues are also frequent. The lack of job description and specification and power struggle among others were highlighted as the drivers of conflicts between ECDs and other health-workers. Conclusion. The findings of the study were discussed, and suggestions were made to reduce its effect, which would require structural solutions to mitigate at different levels and the diverse players in the health sectors.

scholarly journals MENGUNGKAP KEJADIAN INFEKSI KECACINGAN PADA ANAK SEKOLAH DASAR (STUDI ETNOGRAFI DI DESA TARAMANU KABUPATEN SUMBA BARAT)

2018 ◽  
Vol 21 (3) ◽  
pp. 211-217
Author(s):  
Suharmiati Suharmiati ◽  
Rochmansyah Rochmansyah
Keyword(s):  
Life Cycle ◽  
Primary School ◽  
Health Workers ◽  
Neglected Tropical Diseases ◽  
Participant Observation ◽  
Personal Hygiene ◽  
Parasite Life Cycle ◽  
Individual Level ◽  
The Government ◽  
The Individual

Helminthic disease including one of the most neglected tropical diseases present in Indonesia, can attack all ages but are more common in school aged children and primary school age. In 2014 the Central Bureau of Statistics data in West Sumba regency recorded 932 cases of worms, and the case is one of infectious diseases caused by parasites. This paper aims to reveal the incidence of worms infection in children of primary school in Taramanu Village, West Sumba regency. Collecting data in the form of participant observation and direct communication in addition to the faeces collection and examination. The result showed that the belief not to bury the faeces obtained since of the ancestors caused the people of West Sumba, especially Taramanu Village less attention to environmental conditions and personal hygiene. This has an impact on the behavior of taramanu community, especially children defecate in any place (shrubs, forests or behind the house) and the habit of not using footwear for daily activities causes the worm life cycle perfectly, and reinforced with the results of laboratory tests, positive infected earthworms, there are even 3 types of worms in 1 child. The real action that can be taken by the community, the government and health workers in reducing the disease of the worm is to break the parasite life cycle that can be done from the individual level is the use of latrine for bowel (jamban) movement and the use of footwear/sandalisasi. In addition, it should be given understanding through the traditional leaders and religious leaders about the use of latrines that the stool is not buried but directly mixed with water.  Abstrak Kecacingan termasuk salah satu penyakit tropis yang terabaikan di Indonesia, dapat menyerang semua usia namun lebih sering terjadi pada anak-anak usia belum sekolah dan usia sekolah dasar. Pada tahun 2014 data Badan Pusat Statistik di Kabupaten Sumba Barat tercatat 932 kasus kecacingan, dan kasus tersebut termasuk salah satu penyakit infeksi akibat parasit. Tulisan ini bertujuan untuk mengungkap kejadian infeksi kecacingan pada anak Sekolah dasar di Desa Taramanu Kabupaten Sumba Barat. Pengumpulan data berupa observasi partisipasi serta komunikasi langsung, di samping itu juga dilakukan pengambilan dan pemeriksaan tinja. Hasil penelitian menunjukkan masyarakat Sumba Barat khususnya Desa Taramanu mempunyai kepercayaan yang diperoleh sejak zaman nenek moyang yaitu tidak mengubur tinja manusia sehingga menyebabkan masyarakat kurang memperhatikan kondisi lingkungan dan kebersihan perorangan. Hal tersebut berdampak pada perilaku masyarakat Desa Taramanu khususnya anak-anak untuk buang air besar (BAB) di sembarang tempat (semak-semak, hutan atau di belakang rumah). Kebiasaan tidak menggunakan alas kaki untuk kegiatan sehari-hari menyebabkan siklus hidup cacing berlangsung sempurna. Hal tersebut diperkuat dengan hasil pemeriksaan laboratorium, positif terinfeksi cacing tanah, bahkan terdapat 3 jenis cacing dalam 1 orang anak. Tindakan nyata yang dapat dilakukan oleh masyarakat, pemerintah maupun tenaga kesehatan dalam mengurangi penyakit kecacingan adalah memutus lingkaran hidup parasit yang dapat dilakukan mulai dari tingkat individu adalah penggunaan jamban untuk BAB dan penggunaan alas kaki/sandalisasi. Di samping itu perlu diberikan pemahaman melalui pemuka adat dan pemuka agama tentang penggunaan jamban bahwa tinja tersebut tidak dikubur tetapi langsung bercampur dengan air.

scholarly journals Screen, Notify, See, and Treat: Initial Results of Cervical Cancer Screening and Treatment in Rwanda

2021 ◽  
pp. 632-638
Author(s):  
Marie-Aimee Muhimpundu ◽  
Fidele Ngabo ◽  
Felix Sayinzoga ◽  
Jean Paul Balinda ◽  
John Rusine ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Service Delivery ◽  
Cervical Cancer Screening ◽  
Health Workers ◽  
Screening Program ◽  
Public Awareness ◽  
Cervical Lesions ◽  
District Hospitals

PURPOSE To describe the first year results of Rwanda's Screen, Notify, See, and Treat cervical cancer screening program, including challenges encountered and revisions made to improve service delivery. METHODS Through public radio broadcasts, meetings of local leaders, church networks, and local women's groups, public awareness of cervical cancer screening opportunities was increased and community health workers were enlisted to recruit and inform eligible women of the locations and dates on which services would be available. Screening was performed using human papillomavirus (HPV) DNA testing technology, followed by visual inspection with acetic acid (VIA), and cryotherapy, biopsy, and surgical treatment for those who tested HPV-positive. These services were provided by five district hospitals and 15 health centers to HIV-negative women of age 35-45 and HIV-positive women of age 30-50. Service utilization data were collected from the program's initiation in September 2013 to October 2014. RESULTS Of 7,520 cervical samples tested, 874 (11.6%) screened HPV-positive, leading 780 (89%) patients to undergo VIA. Cervical lesions were found in 204 patients (26.2%) during VIA; of these, 151 were treated with cryoablation and 15 were referred for biopsies. Eight patients underwent complete hysterectomy to treat advanced cervical cancer. Challenges to service delivery included recruitment of eligible patients, patient loss to follow-up, maintaining HIV status confidentiality, and efficient use of consumable resources. CONCLUSION Providing cervical cancer screening services through public health facilities is a feasible and valuable component of comprehensive women's health care in resource-limited settings. Special caution is warranted in ensuring proper adherence to follow-up and maintaining patient confidentiality.

scholarly journals e-Health in Developing Countries: Bangladeshi Perspective

2020 ◽  
Vol 9 (3) ◽  
pp. 908-914
Keyword(s):  
Developing Countries ◽  
Health Sector ◽  
Developed Countries ◽  
Medical Services ◽  
The People ◽  
Medical Sector ◽  
Information And Communication ◽  
The Government ◽  
Almost All ◽  
Economic Improvement

Currently, utilizing of Information and Communication technology (ICT) in medical sector has been gained a lot of interests in global community i,e. developed, developing and under developed countries. Now-a-days, ICT intervention in almost all arena of medical services is very evident in Bangladesh and stakeholders are getting its benefits with this IT-assisted medical services. As a matter of fact, the government of Bangladesh already has declared ICT as one of its priority sectors; hence a large amount of budget for enhancing ICT in medical sector have been allocated. This paper explains the present scenario of the use of IT in medical sector of Bangladesh as well as this is an initiative to provide some guidelines and recommendation for possible socio – economic improvement of Bangladesh through exploiting the potential of IT in health sector. In addition to that, this work also gives a brief summery and comparative study about the scenario of health services in developed and developing countries. Finally, this research tries to comprehensively focus on ICT potentials in medical area in order to find future visionary direction for the ICT based medical services that match the socio-economic constraint of the people at Bangladesh.

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