scholarly journals Health system capacity and readiness for delivery of integrated non-communicable disease services in primary health care: A qualitative analysis of the Ethiopian experience

2021 ◽  
Vol 1 (10) ◽  
pp. e0000026
Author(s):  
Azeb Gebresilassie Tesema ◽  
Seye Abimbola ◽  
Afework Mulugeta ◽  
Whenayon S. Ajisegiri ◽  
Padmanesan Narasimhan ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Communicable Disease ◽  
Addis Ababa ◽  
System Capacity ◽  
World Health ◽  
Political Commitment ◽  
District Health ◽  
Primary Health

Background Non-communicable diseases (NCDs) now account for about 71% and 32% of all the deaths globally and in Ethiopia. Primary health care (PHC) is a vital instrument to address the ever-increasing burden of NCDs and is the best strategy for delivering integrated and equitable NCD care. We explored the capacity and readiness of Ethiopia’s PHC system to deliver integrated, people-centred NCD services. Methods A qualitative study was conducted in two regions and Federal Ministry of Health, Addis Ababa, Ethiopia. We carried out twenty-two key informant interviews with national and regional policymakers, officials from a partner organisation, woreda/district health office managers and coordinators, and PHC workers. Data were coded and thematically analysed using the World Health Organization (WHO) Operational Framework for PHC. Results Although the rising NCD burden is well recognised in Ethiopia, and the country has NCD-specific strategies and some interventions in place, we identified critical gaps in several levers of the WHO Operational Framework. Many compared the under-investment in NCDs contrasted with Ethiopia’s successful PHC models established for maternal and child health and communicable disease programs. Insufficient political commitment and leadership required to integrate NCD services at the PHC level and weaknesses in governance structures, inter-sectoral coordination, and funding for NCDs were identified as significant barriers to strengthening PHC capacity to address NCDs. Among the operational-focussed levers, fragmented information management systems and inadequate equipment and medicines were identified as critical bottlenecks. The PHC workforce was also considered insufficiently skilled and supported to provide NCD services in PHC facilities. Conclusion Strengthening NCD prevention and control through PHC in Ethiopia requires greater political commitment and investment at all health system levels. Prior success strategies with other PHC programs could be adapted and applied to NCD policies and practice, giving due consideration for the unique nature of the NCD program.

scholarly journals How well are non-communicable disease services being integrated into primary health care in Africa: A review of progress against World Health Organization’s African regional targets

PLoS ONE ◽  
2020 ◽  
Vol 15 (10) ◽  
pp. e0240984
Author(s):  
Azeb Gebresilassie Tesema ◽  
Whenayon Simeon Ajisegiri ◽  
Seye Abimbola ◽  
Christine Balane ◽  
Andre Pascal Kengne ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Communicable Disease ◽  
World Health ◽  
Primary Health ◽  
Non Communicable Disease

scholarly journals Implications of New Zealand’s Primary Health Care Policies for Management and Leadership

2019 ◽  
Vol 14 (2) ◽  
pp. 40-48
Author(s):  
Reuben Olugbenga Ayeleke ◽  
Nicola North ◽  
Katharine Ann Wallis ◽  
Annette Dunham
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Access To Health Care ◽  
Qualitative Content Analysis ◽  
World Health ◽  
Primary Health ◽  
Care Policies ◽  
Health Care Policies ◽  
Management And Leadership

Introduction: Reforms have been introduced since 2000 to make New Zealand’s health system primary care-led. A competent health management workforce is necessary to provide leadership for the goals of the reforms to be realised. Aim and objective : To review New Zealand’s key primary health care policies from 2000 to 2016 and consider their implications for management and leadership. Methods : A document analysis was undertaken using qualitative content analysis. Eligible documents were identified through the websites of relevant government and non-government agencies, World Health Organisation, and through Google Scholar. Findings :Two key policy trends relating to primary health care were identified. Firstly, a population health orientation to improve access to health care through community participation, and secondly, an integrated approach to promote collaboration within the health system, and between the health system and other sectors. The inferred management and leadership skillsets required to realise these policies included relationship management and collaboration, change management, and leadership. Conclusion: New Zealand’s primary health care sector underwent substantial reform between 2000 and 2016. Management and leadership capabilities need to be strengthened and developed for the benefits of the reforms to be realised.

Nursing Profession’s Contribution to Person- and People-Centered Primary Health Care

2015 ◽  
Vol 5 (4) ◽  
pp. 197-203
Author(s):  
Yukiko Kusano ◽  
Erica Ehrhardt
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Policy Development ◽  
Workforce Planning ◽  
Policy Decision ◽  
Well Being ◽  
World Health ◽  
Integration Of Care ◽  
Primary Health ◽  
Strategic Role

Background: Equity and access to primary health care (PHC) services, particularly nursing services, are key to improving the health and well-being of all people. Nurses, as the largest group of healthcare professionals delivering services wherever people are, have a unique opportunity to put people at the centre of care, making services more effective, efficient and equitable.Objectives: To assess contributions of nurses to person and people-centered PHC. Methods: Analysis of nursing contributions under each of the four sets of the PHC reforms set by the World Health Organization.Results: Evidence and examples of nursing contributions are found in all of the four PHC reform areas. These include: expanding access;addressing problems through prevention; coordination and integration of care; and supporting the development of appropriate, effective and healthy public policies; and linking field-based innovations and policy development to inform evidence-based policy decision making.Conclusions:Nurses have significant contributions in each of the four PHC reform areas. The focus of nursing care on people-centeredness, continuity of care, comprehensiveness and integration of services, which are fundamental to holistic care, is an essential contribution of nurses to people-centered PHC. Nurses’ contributions can be optimised through positive practice environments, appropriate workforce planning and implementation andadequate education and quality control though strong regulatory principles and frameworks. People-centered approaches need to be considered both in health and non-health sectors as part of people-centered society. A strategic role of nurses as partners in services planning and decision-making is one of the key elements to achieve people-centered PHC.

scholarly journals Management of pharmaceutical services in the Brazilian primary health care

2017 ◽  
Vol 51 (suppl.2) ◽  
Author(s):  
Letícia Farias Gerlack ◽  
Margô Gomes de Oliveira Karnikowski ◽  
Camila Alves Areda ◽  
Dayani Galato ◽  
Aline Gomes de Oliveira ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Pharmaceutical Services ◽  
Limiting Factors ◽  
Health Board ◽  
Complex Samples ◽  
Financial Autonomy ◽  
Unified Health System ◽  
Primary Health

OBJECTIVE: To identify limiting factors in the management of pharmaceutical services in the primary health care provided by the Brazilian Unified Health System (SUS). METHODS: This study was based on the data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), and it was conducted by interviews with professionals responsible for pharmaceutical services in Brazilian cities, in 2015. To identify the management limiting factors, we considered the organizational, operational, and sustainability indicators of the management. For the analyses, we included the weights and structure of analysis plan for complex samples. The results were expressed by frequencies and measures of central tendency with 95% confidence interval, considering the Brazilian geographic regions. RESULTS: We identified the following limiting factors: lack of pharmaceutical services in the Municipal Health Secretariat organization chart (24%) and in the health plan (18%); lack of participation of managers in the Health Board and the absence of reference to this topic in the agenda of meetings (58.4%); lack of financial autonomy (61.5%) and lack of knowledge on the available values (81.7%); lack of adoption of operational procedures (about 50%) for selection, scheduling, and acquisition; and the fact that most professionals evaluate the organization of pharmaceutical services as good and great (58.8%), despite the worrisome indicators. CONCLUSIONS: Pharmaceutical services management is currently supported by a legal and political framework that should guide and contribute to improve the pharmaceutical services in the Brazilian Unified Health System primary health care. However, there is a mismatch between the goals established by these guidelines and what is actually happening

scholarly journals Access to medicines by patients of the primary health care in the Brazilian Unified Health System

2017 ◽  
Vol 51 ◽  
pp. 20s ◽  
Author(s):  
Juliana Álvares ◽  
Augusto Afonso Guerra Junior ◽  
Vânia Eloisa de Araújo ◽  
Alessandra Maciel Almeida ◽  
Carolina Zampirolli Dias ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Developed Countries ◽  
Access To Medicines ◽  
Essential Medicines ◽  
Unified Health System ◽  
Primary Health ◽  
Significant Difference ◽  
Good For

OBJECTIVE: To evaluate the access to medicines in primary health care of the Brazilian Unified Health System (SUS), from the patients’ perspective. METHODS: This is a cross-sectional study that used data from the Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Services, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines), conducted by interviews with 8,591 patients in cities of the five regions of Brazil. Evaluation of access to medicines used concepts proposed by Penshansky and Thomas (1981), according to the dimensions: availability, accessibility, accommodation, acceptability, and affordability. Each dimension was evaluated by its own indicators. RESULTS: For the “availability” dimension, 59.8% of patients reported having full access to medicines, without significant difference between regions. For “accessibility,” 60% of patients declared that the basic health unit (UBS) was not far from their house, 83% said it was very easy/easy to get to the UBS, and most patients reported that they go walking (64.5%). For “accommodation,” UBS was evaluated as very good/good for the items “comfort” (74.2%) and “cleanliness” (90.9%), and 70.8% of patients reported that they do not wait to receive their medicines, although the average waiting time was 32.9 minutes. For “acceptability,” 93.1% of patients reported to be served with respect and courtesy by the staff of the dispensing units and 90.5% declared that the units’ service was very good/good. For “affordability,” 13% of patients reported not being able to buy something important to cover expenses with health problems, and 41.8% of participants pointed out the expense with medicines. CONCLUSIONS: Results show 70%–90% compliance, which is compatible with developed countries. However, access to medicines remains a challenge, because it is still heavily compromised by the low availability of essential medicines in public health units, showing that it does not occur universally, equally, and decisively to the population

scholarly journals Evaluation of Access on the perspective of adult users of Primary Health Care in Fortaleza, Brazil

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Borges Costa ◽  
C Salles Gazeta Vieira Fernandes ◽  
T Custódio Mota ◽  
E Torquato Santos ◽  
M Moura de Almeida ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health System ◽  
Assessment Tool ◽  
Health Coverage ◽  
Access To Health Services ◽  
Primary Health ◽  
Care Assessment ◽  
The City

Abstract The Alma-Ata Conference promoted Primary Health Care (PHC) worldwide as a form of universal and continuous access to quality and effective health services. In Brazil, PHC, through the Family Health Strategy (FHS), aims to be the gateway to the health system and its structuring axis. For this, it is necessary to promote access, an essential condition for the quality of health care services, following the attributes systematized by Barbara Starfield. The aim of this study was to evaluate the presence of the attribute “First Contact Access” on the perspective of adult users of public PHC services in the city of Fortaleza, Ceará, Brazil. A transversal study was carried out, in 19 PHC Units, from June to December 2019, using the Primary Care Assessment Tool (PCATool) Brazil version for adult users. Kruskal-Wallis test was used for statistical analysis. 233 users participated, mostly women (69.5%), aged 30 to 59 years old (55.3%), mixed-race (69.5%), with complete high school (38.2%), without private health coverage (89.3%), homeowners (68.7%) and belonging to families of up to 4 members (87.9%). The “Accessibility” component had the lowest score, 2.83, and the “Utilization” had the highest score, 8.06. Older age was associated with higher “Accessibility” scores (p = 0,018), while lower values of “Utilization” were associated with higher education (p = 0,004). The main problems observed were: low access for acute demand consultations, lack of access at nighttime and weekends, little access through non-personal ways, bureaucratic barriers and a long time for scheduling appointments. We conclude that, although there was an improvement in PHC coverage in the city over the years, mainly due to FHS, there is still a lot to improve to ensure timely access to health services. Key messages Users consider PHC as the usual source of care, demonstrated by the high score of 'Utilization', however, they are unable to use it when necessary, demonstrated by the low score of 'Accessibility'. Expanding forms of access is essential to contribute to the strengthening of PHC in Fortaleza, Brazil, facilitating the entry to its national Universal Health System.

scholarly journals Desempenho e Importância da Atenção Básica na Prevenção e Controle da Tuberculose: Revisão de Literatura

2019 ◽  
Vol 23 (2) ◽  
pp. 80
Author(s):  
Mikaela Lopes de Caldas ◽  
Francisco Das Chagas Cardoso Filho
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Mycobacterium Tuberculosis ◽  
Primary Health Care ◽  
Communicable Disease ◽  
Control Measures ◽  
Historical Period ◽  
Tuberculosis Control ◽  
Treatment And Prevention ◽  
Primary Health

A tuberculose (TB) é uma doença infecciosa e transmissível, causada pelo Mycobacterium tuberculosis. A detecção de casos figura entre as principais medidas de controle da tuberculose, embora grandes avanços tenham ocorrido no que se relaciona ao diagnóstico, tratamento e prevenção da doença, a mesma ainda requer atenção especial, por parte dos profissionais da saúde (equipe multiprofissional) e da sociedade como um todo. A Atenção Básica se caracteriza como ferramenta primordial na suspeição e na detecção dos casos de tuberculose na comunidade. O objetivo geral do presente trabalho é identificar produções científicas que avaliem o desempenho da Atenção Básica no controle da tuberculose. Os objetivos específicos foram: ressaltar a importância da Atenção Básica na detecção dos casos suspeitos; expor a relevância da Atenção Básica como fator indispensável no controle da tuberculose. Caracteriza-se como uma pesquisa bibliográfica explicativa e explorativa, realizada no recorte histórico de 1998 a 2011, período esse definidor para a implementação de medidas de controle da tuberculose. Encontraram-se 29 referências, das quais 19 obedeciam aos critérios de inclusão. Portanto, a Atenção Básica caracterizada como principal porta de entrada ao acesso à saúde, proporciona a aproximação do cidadão às medidas de controle da tuberculose, assim como promove a educação em saúde, que visa a prevenção dos agravos e proporcionam autonomia e autoconhecimento que são indispensáveis para a manutenção da saúde frente às doenças preveníveis como a tuberculose, porém que se configuram como problemas de saúde pública. Palavras-chave: Tuberculose. Atenção Básica. Controle. AbstractTuberculosis (TB) is an infectious and communicable disease caused by mycobacterium tuberculosis. The case detection is one of the main control  measures of tuberculosis, although major advances have occurred regarding the diagnosis, treatment and prevention of the disease, the same still requires special attention on the part of health professionals (multidisciplinary team) and society as a whole. The primary care is characterized as a primary tool in suspicion and detection of tuberculosis cases in the community. The overall objective of this study is to identify scientific production to assess the performance of primary health care in tuberculosis control. The specific objectives were to highlight the importance of primary care in the detection of suspected cases; expose the relevance of primary health care as an essential factor in tuberculosis control. It is characterized as an explanatory and exploratory literature survey, conducted in historical period from 1998 to 2011, a period defined for the implementation of tb control measures. It was found 29 references, 19 of which obeyed the inclusion criteria. Therefore, the primary care characterized as the main gateway to access to health, provides the citizen’s approach to tuberculosis control measures and promotes health education aimed at prevention of injuries and provides autonomy and self-knowledge that are essential for maintenance health against preventable diseases such as tuberculosis, but which are seen as  the main  public health problems. Keywords: Tuberculosis. Primary Care. Control. 

scholarly journals 8.2. Prospects for the use of a comprehensive assessment of the resource potential of medical organizations

2020 ◽  
Author(s):  
С.С. Бударин ◽  
Ю.В. Эльбек
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health System ◽  
Comprehensive Assessment ◽  
State Health ◽  
Resource Potential ◽  
Primary Health ◽  
Potential Use

Статья посвящена рассмотрению методики комплексной оценки ресурсного потенциала медицинских организаций, оказывающих населению первичную медико-санитарную помощь. Предложена система показателей оценки эффективности использования ресурсного потенциала по трем направлениям – экономичность, продуктивность, результативность, – сформированная с использованием элементов методологии аудита эффективности. На основании данных медицинских организаций государственной системы здравоохранения г. Москвы, выбранных для исследования, рассчитана комплексная оценка их ресурсного потенциала. The article is devoted to the method of complex assessment of the resource potential of medical organizations that provide primary health care to the population. A system of indicators for evaluating the effectiveness of resource potential use in three areas: Efficiency, Productivity, and Effectiveness, formed using elements of the efficiency audit methodology. A comprehensive assessment of their resource potential is calculated, based on the data of medical organizations of the Moscow state health system selected for the study.

Seeking Solutions to the Challenges in Health Services in Developing Nations

2015 ◽  
pp. 1-51
Author(s):  
Jessica McCormack ◽  
Patrick Rawstorne ◽  
Mohamud Sheikh
Keyword(s):  
Infectious Disease ◽  
Health Care ◽  
Primary Health Care ◽  
Cardiovascular Diseases ◽  
Burden Of Disease ◽  
Communicable Disease ◽  
Developing Nations ◽  
Global Burden ◽  
Primary Health ◽  
Non Communicable Disease

The Global Burden of Disease (GBD) study, 2010, confirmed that the world's population is living longer and we are now less likely than a decade earlier to die from an infectious disease but also more likely to live our twilight years with morbidity (Murray et al., 2012). We will also most likely die from a chronic non-communicable disease (NCD) such as cardiovascular diseases, cancers, respiratory diseases, and diabetes (Beaglehole, et al., 2008). However this brief glimpse at the trends in the health of the world's population obscures massive inequalities in the burden of disease as well as variations across the globe. In this piece, we will revisit primary health care, both at its dawn, its contribution to developing nations, and the ills it struggled through over the years. Cuba and Thailand are the key examples of developing nations that have experienced the contribution of primary health care more than most other countries.

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