scholarly journals Accessibility Analysis of Primary Healthcare Services in Mysore District Using Geospatial Techniques

2021 ◽  
pp. 62-69
Author(s):  
Dr. Minutha. V
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Rural Areas ◽  
Health Centre ◽  
Healthcare Services ◽  
Service Area ◽  
Health Centers ◽  
Primary Health ◽  
Thiessen Polygon ◽  
The Impact

The accessibility of healthcare centers is one of the most important indicators for measuring the efficiency of a healthcare system. Accessibility is a complex indicator that reflects the number of health care institutions, their geographical distribution and the impact of different types of barriers social, Economic and culture (1). Primary health centre which acts as the first level of contact between the population and health centers. It acts has a cornerstone of rural health services. Primary healthcare is affordable, accessible and appropriate care for the particular needs of a given population especially in rural areas. The main objectives of the study are to study the spatial distribution pattern and delineation of service area of primary health centers; to identify the gap between the availability and accessibility of health services. The base map of study area has been geo-referenced and digitized using ARC GIS software. The Global positioning system (GPS) was adopted to take the coordinate of all the existing primary health centers in the study area. Simple Euclidean buffers are mapped and analyzed to define the service area, Thiessen polygon and Nearest Neighbour Technique was used here to identify the availability of health services in Mysore district. The results reveal that, the spatial variation in the distribution of PHC’s, which were not evenly distributed across the study area and there is scarcity in the availability of workforce among the study area.

scholarly journals Comprehensive primary health facilities are more efficient in delivering primary care: Efficiency analysis of primary healthcare facilities in Afghanistan

2020 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Relative Efficiency ◽  
Healthcare Services ◽  
Efficiency Score ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Average Efficiency ◽  
Primary Health

Abstract Background: The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan. Method: Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level. Results: The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement. Conclusions: Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.

scholarly journals Comprehensive primary health facilities are more efficient in delivering primary care: Efficiency analysis of primary healthcare facilities in Afghanistan

2019 ◽  
Author(s):  
Farhad Farewar ◽  
Khwaja Mir Ahad Saeed ◽  
Abo Ismael Foshanji ◽  
Said Mohammad Karim Alawi ◽  
Mohammad Yonus Zawoli ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Relative Efficiency ◽  
Healthcare Services ◽  
Efficiency Score ◽  
Health Facilities ◽  
Health Centers ◽  
Healthcare Facilities ◽  
Average Efficiency ◽  
Primary Health

Abstract Background The Afghan health system is unique in that primary healthcare is delivered by donor-funded implementing partners, not the government. Given the wide range of implementers providing the basic package of health services, there may exist performance differences in primary healthcare. This study assessed the relative efficiency of different levels of primary healthcare services and explored its determinants in Afghanistan.Method Data on personnel and capital expenditure (inputs) and the number of facility visits for six primary healthcare services (outputs) were obtained from national health information databases for 1,263 healthcare facilities in 31 provinces. Data envelopment analysis was used to assess the relative efficiency of three levels of primary healthcare facilities (comprehensive, basic, and sub health centers). Bivariate analysis was conducted to assess the correlation of various elements with efficiency scores. Regression models were used to identify potential factors associated with efficiency scores at the health facility level.Results The average efficiency score of health facilities was 0.74, when pooling all 1,263 health facilities, with 102 health facilities (8.1%) having efficiency scores of 1 (100% efficient). The lowest quintile of health facilities had an average efficiency score of 0.36 while the highest quintile had a score of 0.96. On average, efficiency scores of comprehensive health centers were higher than basic and sub health centers by 0.108 and .071 respectively. In addition, the difference between efficiency scores of facilities in the highest and lowest quintiles was highest in facilities that offer fewer services, so that they have the largest room for improvement.Conclusions Our findings show that public health facilities in Afghanistan that provide more comprehensive primary health services, use their resources more efficiently, and that smaller facilities have more room for improvement. A more integrated delivery model would help improve the efficiency in providing primary healthcare in Afghanistan.

scholarly journals Reduced health services at under-electrified primary healthcare facilities: Evidence from India

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252705
Author(s):  
Vivek Shastry ◽  
Varun Rai
Keyword(s):  
Health Services ◽  
Primary Healthcare ◽  
Fixed Effects ◽  
Negative Binomial ◽  
State Level ◽  
Quality Of Healthcare ◽  
Healthcare Services ◽  
Health Centers ◽  
Primary Health ◽  
Electricity Access

Primary healthcare systems worldwide suffer from major gaps in infrastructure and human resources. One key infrastructure gap is access to reliable electricity, absence of which can significantly affect the quantity and quality of healthcare services being delivered at rural primary health facilities. However, absence of granular empirical evidence is a barrier for quantitatively understanding the significance of electricity access as one of the determinants of access to reliable primary healthcare. Using data from India’s District Level Household and Facility Survey, we develop zero-inflated negative binomial models with co-variates and state-level fixed effects to estimate the relationship between levels of electricity access and the quantity of basic health services delivered at Primary Health Centers (PHCs). We find that lack of electricity access is associated with a significant and large decrease in the number of deliveries (64 percent), number of in-patients (39 percent), and number of out-patients (38 percent). We further find that lower level of electricity access at primary health centers is disproportionately associated with adverse effects on women’s access to safe and quality healthcare.

scholarly journals What was the impact of a participatory research project in Australian Indigenous primary healthcare services? Applying a comprehensive framework for assessing translational health research to Lessons for the Best

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040749
Author(s):  
Shanthi Ann Ramanathan ◽  
Sarah Larkins ◽  
Karen Carlisle ◽  
Nalita Turner ◽  
Ross Stewart Bailie ◽  
...  
Keyword(s):  
Learning Community ◽  
Primary Healthcare ◽  
Health Research ◽  
Return On Investment ◽  
Health Centre ◽  
Healthcare Services ◽  
Secondary Outcome ◽  
Cost Consequence ◽  
Comprehensive Framework ◽  
The Impact

ObjectivesTo (1) apply the Framework to Assess the Impact from Translational health research (FAIT) to Lessons from the Best to Better the Rest (LFTB), (2) report on impacts from LFTB and (3) assess the feasibility and outcomes from a retrospective application of FAIT.SettingThree Indigenous primary healthcare (PHC) centres in the Northern Territory, Australia; project coordinating centre distributed between Townsville, Darwin and Cairns and the broader LFTB learning community across Australia.ParticipantsLFTB research team and one representative from each PHC centre.Primary and secondary outcome measuresImpact reported as (1) quantitative metrics within domains of benefit using a modified Payback Framework, (2) a cost-consequence analysis given a return on investment was not appropriate and (3) a narrative incorporating qualitative evidence of impact. Data were gathered through in-depth stakeholder interviews and a review of project documentation, outputs and relevant websites.ResultsLFTB contributed to knowledge advancement in Indigenous PHC service delivery; enhanced existing capacity of health centre staff, researchers and health service users; enhanced supportive networks for quality improvement; and used a strengths-based approach highly valued by health centres. LFTB also leveraged between $A1.4 and $A1.6 million for the subsequent Leveraging Effective Ambulatory Practice (LEAP) Project to apply LFTB learnings to resource development and creation of a learning community to empower striving PHC centres.ConclusionRetrospective application of FAIT to LFTB, although not ideal, was feasible. Prospective application would have allowed Indigenous community perspectives to be included. Greater appreciation of the full benefit of LFTB including a measure of return on investment will be possible when LEAP is complete. Future assessments of impact need to account for the limitations of fully capturing impact when intermediate/final impacts have not yet been realised and captured.

scholarly journals Integrative literature review: access to primary healthcare services

2018 ◽  
Vol 71 (3) ◽  
pp. 1178-1188 ◽  
Author(s):  
Maura Cristiane e Silva Figueira ◽  
Wellington Pereira da Silva ◽  
Eliete Maria Silva
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Healthcare Services ◽  
Health Plans ◽  
Access To Health Services ◽  
Primary Health ◽  
Study Selection ◽  
Access To Health ◽  
Access To Primary Care

ABSTRACT Objective: Analyze the scientific production that describes the type of access to primary healthcare services and identify specific populations that have differentiated access to health services. Method: An integrative review. For study selection, the following databases were used: PubMed, Scopus, Bireme, and Cinahl. The sample included 22 national and international articles. Results: The results describe the access of specific populations to health services, the access to primary care through health plans and proposed improvements to the access to primary care. Conclusion: The access to services is a challenge in many countries and some strategies and policies are implemented to solve and improve primary health care.

scholarly journals Gambaran Faktor Penyebab Rujukan Di Puskesmas Kota Depok

2019 ◽  
Vol 22 (3) ◽  
Author(s):  
Iin Nurlinawati ◽  
Rosita Rosita ◽  
Sefrina Werni
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Center ◽  
Health Workers ◽  
Health Centre ◽  
Health Centers ◽  
Cross Sectional ◽  
Medical Needs ◽  
Primary Health

Referral System for Individual Health Services states that health services are conducted in stages according to medical needs, starting from basic, second, and then third level health . The BPJS standard on the referral ratio limitation from health center to hospital is 15%. A total of 22 out of 32 health centers (69%) in Depok have referral ratios above 15%. This study was to identify factors infl uencing high referral ratios at health centers in Depok..This study was implemented from March to October 2017 by cross sectional design. The population was 32 health centers in Depok. Samples were health centers in Depok registered by BPJS as FKTP. There were 12 health centers, each 6 with high and low referrals. The sample of health workers were providers such as: doctors and dentist, heads of health centers and health offi ces. The results showed that the most referenced disease was a refraction disorder, unspecifi ed. Most primary health care with a high referral ratio (> 15%) did not have the required compulsory services at the primary health care, especially emergency and laboratory services (66.7%). The type of health personnel was less than that at Permenkes 75 of 2014 (83.3%). Facilities and infrastructure in health center were out of standards. Less drugs supplies also affected to referral. Suggestion: The government needs to provide more types of services, numbers of health workers and infrastructure in order to support the capacity of the health centre as well as better services . Abstrak Sistem Rujukan Pelayanan Kesehatan Perorangan menyebutkan bahwa pelayanan kesehatan dilaksanakan secara berjenjang sesuai kebutuhan medis, dimulai dari pelayanan dasar ke pelayanan kesehatan tingkat kedua berlanjut ke tingkat ketiga. Standar BPJS mengenai batasan rasio rujukan puskesmas ke pelayanan kesehatan tingkat lanjut maksimal 15%. Sebanyak 22 puskesmas (69%) dari 32 puskesmas di Kota Depok yang memiliki rasio rujukan diatas 15%. Penelitian ini bertujuan untuk memberikan gambaran faktor yang mempengaruhi rasio rujukan tinggi di puskesmas Kota Depok. Penelitian dilaksanakan pada bulan Maret sampai Oktober 2017. Metode yang digunakan adalah cross sectional (potong lintang). Populasi penelitian sebanyak 32 puskesmas di Kota Depok. Sampel yang diambil adalah puskesmas Kota Depok yang telah terdaftar pada BPJS sebagai FKTP sebanyak 12 puskesmas, 6 puskesmas dengan rujukan tinggi dan 6 puskesmas dengan rujukan rendah. Sampel tenaga kesehatan yang diwawancara meliputi pemberi pelayanan (dokter dan dokter gigi), kepala puskesmas dan Kepala Bidang Yankes Dinas Kesehatan. Hasil penelitian menunjukkan bahwa penyakit yang paling banyak dirujuk adalah disorder of refraction, unspecifi ed (kelainan refraksi mata). Sebagian besar puskesmas dengan rasio rujukannya tinggi (>15%) tidak memiliki kelengkapan pelayanan yang wajib ada di puskesmas terutama pelayanan gawat darurat dan laboratorium (66,7%). Jenis tenaga kesehatan kurang dari jumlah yang ada berdasarkan Permenkes 75 tahun 2014 (83,3%). Sarana dan prasarana belum sesuai dengan standar yang harus ada di puskesmas. Obat-obatan yang tidak tersedia di puskesmas menjadi salah satu alasan melakukan rujukan. Saran: Pemerintah harus selalu berupaya melengkapi jenis pelayanan, tenaga kesehatan dan sarana prasarana di puskesmas, agar kemampuan puskesmas dalam memberikan pelayanan menjadi lebih baik lagi.  

scholarly journals 1535. Impact of Defunding Family Planning Health Centers on Gonorrhea and Chlamydia Cases in Iowa: A Spatiotemporal Analysis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S768-S768
Author(s):  
Megan L Srinivas ◽  
Eileen Yang ◽  
Weiming Tang ◽  
Joseph Tucker
Keyword(s):  
Family Planning ◽  
Low Income ◽  
Rural Areas ◽  
Spatiotemporal Analysis ◽  
Incidence Rates ◽  
Health Centers ◽  
Transmitted Infection ◽  
Missed Opportunities ◽  
Linear Regression Modeling ◽  
The Impact

Abstract Background Fifteen states have defunded family planning health centers (FPHCs), causing thousands to be left without health services. This has accelerated in the COVID-19 era. FPHCs provide low-income individuals in rural areas with essential primary care services, including sexually transmitted infection prevention, testing, and treatment. The purpose of this analysis is to use spatiotemporal methods to examine the impact of FPHC closures in Iowa on the reported number of gonorrhea and chlamydia cases at the county level. Methods This analysis investigates the association between FPHC closures and changes in the number of gonorrhea and chlamydia cases between 2016 and 2018. Iowa implemented defunding policies for family planning clinics, resulting in four FPHC closures in June 2017. 2016 pre-closure STI incidence rates were compared to 2018 post-closure rates. Gonorrhea and chlamydia rates in the four Iowa counties with clinic closures were compared to the 95 Iowa counties without closures. T tests were used to compare changes in reported gonorrhea and chlamydia rates in the two settings. Linear regression modeling was used to determine the relationship between clinic closures and changes in gonorrhea and chlamydia cases. Results The gonorrhea burden in Iowa increased from 83 cases per 100,000 people in 2016 to 153.8 cases per 100,000 people in 2018. The four counties with clinic closures experienced a significantly larger increase (absolute 217 cases per 100,000 population) in their gonorrhea rate compared to counties without FPHC closures (absolute 121 cases per 100,000 population). There was also a significant relationship between clinic closures and increasing gonorrhea rates (p = 0.0015). Over the three-year period, there was no change in chlamydia rates (p = 0.1182). However, there was a trend towards counties with more FPHC closures having a higher number of chlamydia cases (p = 0.057). Conclusion Despite the fact that many STI diagnoses are made and reported by FPHCs, our data suggest that clinic closures may have contributed to an increase in gonorrhea and chlamydia cases. This is consistent with delayed diagnoses and missed opportunities for providing essential STI services to vulnerable and under-served rural residents. Legislative action is urgently needed to curtail this trend. Disclosures All Authors: No reported disclosures

scholarly journals Driving digital transformation of comprehensive primary health services at scale in India: an enterprise architecture framework

2021 ◽  
Vol 6 (Suppl 5) ◽  
pp. e005242
Author(s):  
Sunita Nadhamuni ◽  
Oommen John ◽  
Mallari Kulkarni ◽  
Eshan Nanda ◽  
Sethuraman Venkatraman ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Services ◽  
Primary Healthcare ◽  
Enterprise Architecture ◽  
Digital Health ◽  
Security And Privacy ◽  
Primary Health ◽  
Architecture Framework ◽  
Primary Health Services ◽  
Enterprise Architecture Framework

In its commitment towards Sustainable Development Goals, India envisages comprehensive primary health services as a key pillar in achieving universal health coverage. Embedded in siloed vertical programmes, their lack of interoperability and standardisation limits sustainability and hence their benefits have not been realised yet. We propose an enterprise architecture framework that overcomes these challenges and outline a robust futuristic digital health infrastructure for delivery of efficient and effective comprehensive primary healthcare. Core principles of an enterprise platform architecture covering four platform levers to facilitate seamless service delivery, monitor programmatic performance and facilitate research in the context of primary healthcare are listed. A federated architecture supports the custom needs of states and health programmes through standardisation and decentralisation techniques. Interoperability design principles enable integration between disparate information technology systems to ensure continuum of care across referral pathways. A responsive data architecture meets high volume and quality requirements of data accessibility in compliance with regulatory requirements. Security and privacy by design underscore the importance of building trust through role-based access, strong user authentication mechanisms, robust data management practices and consent. The proposed framework will empower programme managers with a ready reference toolkit for designing, implementing and evaluating primary care platforms for large-scale deployment. In the context of health and wellness centres, building a responsive, resilient and reliable enterprise architecture would be a fundamental path towards strengthening health systems leveraging digital health interventions. An enterprise architecture for primary care is the foundational building block for an efficient national digital health ecosystem. As citizens take ownership of their health, futuristic digital infrastructure at the primary care level will determine the health-seeking behaviour and utilisation trajectory of the nation.

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