Adolescent Friendly Health Corners (AFHCs) in selected government health facilities in Bangladesh: An early qualitative assessment

2017 ◽  
Author(s):  
Sigma Ainul ◽  
Iqbal Ehsan ◽  
Tasmiah Tanjeen ◽  
Laura Reichenbach
Keyword(s):  
Health Facilities ◽  
Qualitative Assessment ◽  
Government Health

scholarly journals Women's Use of Private and Government Health Facilities for Childbirth in Nairobi's. Informal Settlements

2009 ◽  
Vol 40 (1) ◽  
pp. 39-50 ◽  
Author(s):  
Eva S. Bazant ◽  
Michael A. Koenig ◽  
Jean-Christophe Fotso ◽  
Samuel Mills
Keyword(s):  
Informal Settlements ◽  
Health Facilities ◽  
Government Health

scholarly journals SKILLINGEN, BRODEREN OG TABLETTEN: Penge og sundhed i det østlige Uganda

2004 ◽  
Author(s):  
Hanne O. Mogensen
Keyword(s):  
Health Care ◽  
Everyday Life ◽  
Health Care System ◽  
Health Care Providers ◽  
Social Relations ◽  
Health Facilities ◽  
Care Providers ◽  
The Public ◽  
Government Health ◽  
The Government

Complaints about fees at the government health facilities in Uganda are incessant, and so are the more general statements about lack of money and problems of poverty. These complaints, however, cannot be reduced to questions of cost and the availability of resources. We also need to look at the kinds of exchanges money is made part of. Health has long been part of the economic sphere in Uganda, and people compensate healers and practitioners of different kinds for their services. The article explores why, then, people experience it as far more problematic to pay for treatment in the public health care system than to pay other health care providers. To answer this question requires a discussion of money, not as destructive to social relations, but as creative potential for relationships in all spheres of everyday life. In Uganda, as elsewhere, money can be used both to pay somebody and to give somebody something. Money is being made part of different modalities of exchange. In order to understand what takes place in various kinds of clinical interaction we need to look at the complex intersection of social relations, modalities of exchange, and the objects exchanged.

scholarly journals Health Seeking Behaviour among Past and Current Tuberculosis Patients in a Low-Income Country

2021 ◽  
Vol 9 (3) ◽  
pp. 194-203
Author(s):  
Gokul Mishra
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Health Facilities ◽  
Diagnosis And Treatment ◽  
Easy Access ◽  
Care Providers ◽  
Health Seeking Behaviour ◽  
Health Seeking ◽  
Government Health ◽  
Incident Cases

In Nepal, the estimated incident cases are 0.07 million, of them, 0.03 million people are diagnosed and enrolled in the treatment annually, and numbers of undiagnosed people living with tuberculosis (TB) might be a threat to achieving END TB strategy targets. Understanding health-seeking behaviour and care pathways is crucial to reducing missed cases and decreasing TB transmission. The objective of the study was to identify the health-seeking behavior of TB patients and understand the reasons behind TB diagnostic and treatment delays in Nepal. This was a cross-sectional, population-based survey carried out in 99 clusters of 55 districts (total of 77) of Nepal. Primary Sampling Units were Village Development Committees or Municipalities and wards selected using systematic proportional to population size method. Of the total 54,200 people who attended in the survey, 1,825 had a history of TB and asked their health-seeking practice. 62% and 72% of the TB patients utilised the government health facilities for diagnosis and treatment. 18% of the TB patients said that they received diagnosis services, and 16% of patients took their treatment from outside of the country, especially India, due to fear of stigma and easy access to the services. The majority of the TB patients utilised government health facilities to receive diagnosis and treatment services. Some of the participants sought TB services from private health care providers, and a significant proportion of participants received them from India due to difficulty in accessing local services and fear of stigma and discrimination. Keywords: Community Based Directly Observed Treatment, Health Seeking Behaviour, Prevalence Survey, Tuberculosis.

scholarly journals Uganda’s “EID Systems Strengthening” model produces significant gains in testing, linkage, and retention of HIV-exposed and infected infants: An impact evaluation

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246546
Author(s):  
Charles Kiyaga ◽  
Vijay Narayan ◽  
Ian McConnell ◽  
Peter Elyanu ◽  
Linda Nabitaka Kisaakye ◽  
...  
Keyword(s):  
Health Worker ◽  
Health Workers ◽  
Clinical Care ◽  
Implementation Fidelity ◽  
Facility Management ◽  
Health Facilities ◽  
Qualitative Assessment ◽  
Study Cohort ◽  
Cross Sectional ◽  
Hiv Exposed

Introduction A review of Uganda’s HIV Early Infant Diagnosis (EID) program in 2010 revealed poor retention outcomes for HIV-exposed infants (HEI) after testing. The review informed development of the ‘EID Systems Strengthening’ model: a set of integrated initiatives at health facilities to improve testing, retention, and clinical care of HIV-exposed and infected infants. The program model was piloted at several facilities and later scaled countrywide. This mixed-methods study evaluates the program’s impact and assesses its implementation. Methods We conducted a retrospective cohort study at 12 health facilities in Uganda, comprising all HEI tested by DNA PCR from June 2011 to May 2014 (n = 707). Cohort data were collected manually at the health facilities and analyzed. To assess impact, retention outcomes were statistically compared to the baseline study’s cohort outcomes. We conducted a cross-sectional qualitative assessment of program implementation through 1) structured clinic observation and 2) key informant interviews with health workers, district officials, NGO technical managers, and EID trainers (n = 51). Results The evaluation cohort comprised 707 HEI (67 HIV+). The baseline study cohort contained 1268 HEI (244 HIV+). Among infants testing HIV+, retention in care at an ART clinic increased from 23% (57/244) to 66% (44/67) (p < .0001). Initiation of HIV+ infants on ART increased from 36% (27/75) to 92% (46/50) (p < .0001). HEI receiving 1st PCR results increased from 57% (718/1268) to 73% (518/707) (p < .0001). Among breastfeeding HEI with negative 1st PCR, 55% (192/352) received a confirmatory PCR test, a substantial increase from baseline period. Testing coverage improved significantly: HIV+ pregnant women who brought their infants for testing after birth increased from 18% (67/367) to 52% (175/334) (p < .0001). HEI were tested younger: mean age at DBS test decreased from 6.96 to 4.21 months (p < .0001). Clinical care for HEI was provided more consistently. Implementation fidelity was strong for most program components. The strongest contributory interventions were establishment of ‘EID Care Points’, integration of clinical care, longitudinal patient tracking, and regular health worker mentorship. Gaps included limited follow up of lost infants, inconsistent buy-in/ownership of health facility management, and challenges sustaining health worker motivation. Discussion Uganda’s ‘EID Systems Strengthening’ model has produced significant gains in testing and retention of HEI and HIV+ infants, yet the country still faces major challenges. The 3 core concepts of Uganda’s model are applicable to any country: establish a central service point for HEI, equip it to provide high-quality care and tracking, and develop systems to link HEI to the service point. Uganda’s experience has shown the importance of intensively targeting systemic bottlenecks to HEI retention at facility level, a necessary complement to deploying rapidly scalable technologies and other higher-level initiatives.

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