scholarly journals A situational analysis of eye care services in Swaziland

2018 ◽  
Vol 9 (3) ◽  
Author(s):  
Velibanti Nhlanhla Sukati ◽  
Vannesa Raquel Moodley ◽  
Khathutshelo Percy Mashige
Keyword(s):  
Health Care ◽  
Low Income ◽  
Health Care Service ◽  
World Health ◽  
Low Income Countries ◽  
Situational Analysis ◽  
Eye Care ◽  
Care Services ◽  
Eye Health ◽  
Key Informant

Compared to other African countries, Swaziland performs the worst in terms of providing eye health care services. A priority goal of the World Health Organization (WHO) is to alleviate childhood blindness, particularly in low-income countries such as Swaziland, where many people live in poverty, which is a contributor to poor health outcomes. A mixed method approach that entailed a document review, key informant interviews and clinical facility assessment questionnaires was used. Hospitals and mission clinics offering ophthalmic services were identified through the website of the Ministry of Health and verified during key informant interviews. A saturated sampling procedure was applied due to the few facilities that offer eye care services. Six framework components from the WHO for analysing health systems were utilised in an eye health care service context: leadership and governance, eye health services, eye health workforce, eye health financing systems, eye health medical supplies and technologies, and eye health information systems. Poor management, lack of accountability, poor monitoring and evaluation mechanisms, weak coordination and ineffective private-public sector regulations were identified as factors that lead to poor eye care in the country. The optometrists indicated that refractive services are the most rendered ophthalmic services. The exodus of healthcare practitioners has contributed to the downfall of the public health sector in the country. Five government eye care facilities, 3 government hospitals, 1 non-governmental organization (NGO) and a church mission clinic were included in this analysis. The eye services distribution favors the more affluent areas, particularly the more urban Hhohho Region, which is also where most of the eye health professionals are located. No campaigns have been conducted to prevent childhood blinding diseases or create awareness about getting children’s eyes tested for refractive correction. The burden of eye diseases among children in Swaziland remains unknown. More eye health care personnel and equipped facilities are needed throughout the country, and the eye health care program needs to be adopted.

scholarly journals Knowledge and practices of eye health professionals about the availability and accessibility of child eye care services in the public sector in Swaziland

2019 ◽  
Vol 78 (1) ◽  
Author(s):  
Velibanti Sukati ◽  
Vanessa R. Moodley ◽  
Khathutshelo P. Mashige
Keyword(s):  
Health Care ◽  
Public Sector ◽  
Health Professionals ◽  
Negative Impact ◽  
Health Care Service ◽  
Eye Care ◽  
The Public ◽  
Care Services ◽  
Eye Health ◽  
Health Practitioners

Background: International and African rights instruments stipulate that children have the right to access quality general and eye health care. Lack of access to quality eye care can have a significant negative impact on the child, family and society in general.Aim: To determine the knowledge and practices of eye care professionals about the availability and accessibility of child eye care services in the public sector in Swaziland.Setting: The study was conducted in Swaziland.Methods: This was a quantitative study design, and 15 public eye health professionals completed and returned the Questionnaire for Eye Health Professionals (QEHP).Results: Thirteen (86.7%) eye health practitioners reported that both standard practice guidelines and paediatric national guidelines for ophthalmic services were unavailable. The majority (66.7%) identified cost and unawareness of available services by parents as the most common barrier to accessing eye care services. Nine (60%) felt that they were less informed about eye health problems and 6 (40%) reported being well informed. Eight (53.3%) respondents indicated that there were no outreach programmes and 7 (46.7%) reported that their clinics offered these services. Thirteen (86.7%) eye health practitioners indicated that they were not part of teachers’ training for supporting visually impaired children, while 2 (13%) reported that they were.Conclusion: Formulation of guidelines to support eye health care service delivery in Swaziland is essential in order to improve availability, accessibility, affordability and effectiveness in the public health system.

scholarly journals Using Prospective Methods to Identify Fieldwork Locations Favourable to Understanding Divergences in Health Care Accessibility

2021 ◽  
Vol 10 (8) ◽  
pp. 506
Author(s):  
Jan Ketil Rød ◽  
Arne H. Eide ◽  
Thomas Halvorsen ◽  
Alister Munthali
Keyword(s):  
Health Care ◽  
Low Income ◽  
Access To Health Care ◽  
Health Care Services ◽  
Good Health ◽  
Low Income Countries ◽  
Care Services ◽  
Health Care Accessibility ◽  
Barriers To Health ◽  
Walking Time

Central to this article is the issue of choosing sites for where a fieldwork could provide a better understanding of divergences in health care accessibility. Access to health care is critical to good health, but inhabitants may experience barriers to health care limiting their ability to obtain the care they need. Most inhabitants of low-income countries need to walk long distances along meandering paths to get to health care services. Individuals in Malawi responded to a survey with a battery of questions on perceived difficulties in accessing health care services. Using both vertical and horizontal impedance, we modelled walking time between household locations for the individuals in our sample and the health care centres they were using. The digital elevation model and Tobler’s hiking function were used to represent vertical impedance, while OpenStreetMap integrated with land cover map were used to represent horizontal impedance. Combining measures of walking time and perceived accessibility in Malawi, we used spatial statistics and found spatial clusters with substantial discrepancies in health care accessibility, which represented fieldwork locations favourable for providing a better understanding of barriers to health access.

‘Out of Pocket Expenditure’ of Health Care Services in India: Factors, Consequences and Solution

2013 ◽  
Vol 9 (2) ◽  
Author(s):  
Shatabdi Bagchi ◽  
Priyanka Bakhshi
Keyword(s):  
Health Care ◽  
Health System ◽  
Health Care Services ◽  
Care Service ◽  
Health Care Service ◽  
Secondary Data ◽  
Critical Factor ◽  
World Health ◽  
World Health Survey ◽  
Care Services

Financing is the most crucial part of the of the health care service delivery system and health care finance is one of the most critical factor contributing in the poverty scenario of any country.  In developing countries like India where the health system should be more equitable and cost effective, the soaring problem of ‘out of pocket expenditure’ on Health System has shown a gloomy face and raises question on health equity. Evidences from several studies In India show that out of pocket expenditures on health care services intensify poverty.  In the World Health Survey of 2011, India was ranked 42nd in the list of countries with highest average of out of pocket expenditure. The survey found that 74.4 per cent of private expenditure on health was paid out of pocket. The article discusses the triggering factors which lead to the inequitable out of pocket health expenditure. Secondary Data from World Health Statistics 2010, NSSO 52nd and 60th round have been used here as evidence.

scholarly journals Strengthening Retina Eye Care Services in Nepal: Retina Eye Care of Nepal project

2020 ◽  
Author(s):  
Arjun Shrestha ◽  
Chunu Shrestha ◽  
Pratap Karki ◽  
Hara Maya Gurung ◽  
Takeshi Naito
Keyword(s):  
Low Income ◽  
Health Workers ◽  
Age Related Macular Degeneration ◽  
Low Income Countries ◽  
Public Health Issue ◽  
Hypertensive Retinopathy ◽  
Retinal Diseases ◽  
Eye Care ◽  
Care Services ◽  
Age Related

Abstract Recently causes of blindness are changing in Nepal. The number of people blind due to retinal diseases is increasing. Age-related macular degeneration (AMD), diabetic retinopathy (DR), hypertensive retinopathy, and retinal vein occlusion are the major retinal problems in Nepal. As the prevalence of vitreoretinal disorders is increasing with age, it indicates that retinal disorders will be a major public health issue with longevity in future[1].A rapid assessment of blindness conducted in 2010 had reported posterior segment problems as the second common cause of blindness, after cataract in Nepal[2]. Retinal diseases are very difficult to treat. Results from low-income countries show that many patients present only when they lose vision in both eyes. Delay in presentation was acknowledged as a significant problem and is often due to inadequate primary eye care and to misdiagnosis. Thus, it was highlighted that all ophthalmologists should be trained to recognize and manage retina problems. As blindness from DR is preventable, if caught and treated early, DR provides an excellent opportunity for secondary prevention strategies, such as screenings[3]. So, early diagnoses and preventions are very important. The projected population of Province 3 and 4 in Nepal is 60, 26,626, and 24, 72,494 respectively in the year 2016. There are altogether 6 tertiary retina care centers in Province 3 and 1 tertiary retina center in province 4 of Nepal to cover that much of the population. But, few eye doctors can treat patients with retinal diseases in Nepal. It is also necessary to train ophthalmic assistants, optometrists, ophthalmic nurses, and other health workers who can assist the treatment of retinal diseases. So, strengthening retina eye care services is very important in Nepal. Retina Eye Care of Nepal (RECON) project was a joint program of BP Eye Foundation, Kathmandu, Nepal, and Tokushima University, Japan to strengthen 3 retina centers in Province 1 and 1 retina center in province 4. The project duration was from May 2016 to February 2019. The purpose of RECON was to strengthen retina eye care services in Nepal by training ophthalmic human resources, enhancing retina eye care facilities, and conducting retina-screening camp.

scholarly journals Understanding the role of lady health workers in improving access to eye health services in rural Pakistan – findings from a qualitative study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Stevens Bechange ◽  
Elena Schmidt ◽  
Anna Ruddock ◽  
Itfaq Khaliq Khan ◽  
Munazza Gillani ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Workers ◽  
Negative Impact ◽  
Care Providers ◽  
Eye Care ◽  
Care Services ◽  
Eye Health ◽  
Wide Range

Abstract Background In 1994, the Lady Health Workers (LHWs) Programme was established in Pakistan to increase access to essential primary care services and support health systems at the household and community levels. In Khyber Pakhtunkhwa (KPK) province in northern Pakistan, eye care is among the many unmet needs that LHWs were trained to address, including screening and referral of people with eye conditions to health facilities. However, despite an increase in referrals by LHWs, compliance with referrals in KPK has been very low. We explored the role of LHWs in patient referral and the barriers to patient compliance with referrals. Methods Qualitative methodology was adopted. Between April and June 2019, we conducted eight focus group discussions and nine in-depth interviews with 73 participants including patients, LHWs and their supervisors, district managers and other stakeholders. Data were analysed thematically using NVivo software version 12. Results LHWs have a broad understanding of basic health care and are responsible for a wide range of activities at the community level. LHWs felt that the training in primary eye care had equipped them with the skills to identify and refer eye patients. However, they reported that access to care was hampered when referred patients reached hospitals, where disorganised services and poor quality of care discouraged uptake of referrals. LHWs felt that this had a negative impact on their credibility and on the trust and respect they received from the community, which, coupled with low eye health awareness, influenced patients’ decisions about whether to comply with a referral. There was a lack of trust in the health care services provided by public sector hospitals. Poverty, deep-rooted gender inequities and transportation were the other reported main drivers of non-adherence to referrals. Conclusions Results from this study have shown that the training of LHWs in eye care was well received. However, training alone is not enough and does not result in improved access for patients to specialist services if other parts of the health system are not strengthened. Pathways for referrals should be agreed and explicitly communicated to both the health care providers and the patients.

scholarly journals Ecological considerations for intervention strategy in the development of eye health promotion policy in South Africa

2015 ◽  
Vol 74 (1) ◽  
Author(s):  
Hlupheka L. Sithole
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Promotion ◽  
Health Care Services ◽  
Ecological Model ◽  
Intervention Strategy ◽  
Contributory Factor ◽  
Eye Care ◽  
Care Services ◽  
Eye Health

Eye health promotion is an important component of public health. To realise the essential aspects of eye health promotion, the formulation and implementation of policy as an intervention strategy is a major contributory factor and can best be described by an ecological framework. Ecological perspectives assert that people’s health affairs cannot be neatly grouped into diagnoses, symptoms and risk factors to be targeted and eliminated; this is because the core concept of an ecological model is that behaviour has many levels of influence, often including intrapersonal, interpersonal, organisational, physical environmental, and policy. Therefore, societal and personal issues can be directly linked to an ecological model that points to issues of numerous levels of influence on certain behaviours that affect the manner in which eye care services are utilised. These behaviours are therefore termed salient beliefs. Unfortunately, there is no study in South Africa that has identified the set of beliefs that are salient in any given population that might be responsible for influencing the uptake of eye care services. However, reorienting eye health care services through direct policy reforms and advocacy may change the landscape of eye health care services in South Africa.

Primary Health care and Disasters—The Current State of the Literature: What We Know, Gaps and Next Steps

2011 ◽  
Vol 26 (3) ◽  
pp. 184-191 ◽  
Author(s):  
Lynda Redwood-Campbell ◽  
Jonathan Abrahams
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Emergency Management ◽  
Low Income ◽  
Lessons Learned ◽  
World Health ◽  
Low Income Countries ◽  
Primary Health ◽  
Response And Recovery ◽  
Definition Of

AbstractIntroduction: The 2009 Global Platform for Disaster Risk Reduction/Emergency Preparedness (DRR/EP) and the Hyogo Framework for Action 2005-2015 demonstrate increased international commitment to DRR/EP in addition to response and recovery. In addition, the World Health Report 2008 has re-focused the world's attention on the renewal of Primary Health Care (PHC) as a set of values/principles for all sectors. Evidence suggests that access to comprehensive PHC improves health outcomes and an integrated PHC approach may improve health in low income countries (LICs). Strong PHC health systems can provide stronger health emergency management, which reinforce each other for healthier communities.Problem: The global re-emphasis of PHC recently necessitates the health sector and the broader disaster community to consider health emergency management from the perspective of PHC. How PHC is being described in the literature related to disasters and the quality of this literature is reviewed. Identifying which topics/lessons learned are being published helps to identify key lessons learned, gaps and future directions.Methods: Fourteen major scientific and grey literature databases searched. Primary Health Care or Primary Care coupled with the term disaster was searched (title or abstract). The 2009 ISDR definition of disaster and the 1978 World Health Organization definition of Primary Health Care were used. 119 articles resulted.Results: Literature characteristics; 16% research papers, only 29% target LICs, 8% of authors were from LICs, 7% clearly defined PHC, 50% used PHC to denote care provided by clinicians and 4% cited PHC values and principles. Most topics related to disaster response. Key topics; true need for PHC, mental health, chronic disease, models of PHC, importance of PHC soon after a natural disaster relative to acute care, methods of surge capacity, utilization patterns in recovery, access to vulnerable populations, rebuilding with the PHC approach and using current PHC infrastructure to build capacity for disasters.Conclusions: Primary Health Care is very important for effective health emergency management during response and recovery, but also for risk reduction, including preparedness. There is need to; increase the quality of this research, clarify terminology, encourage paper authorship from LICs, develop and validate PHC- specific disaster indicators and to encourage organizations involved in PHC disaster activities to publish data. Lessons learned from high-income countries need contextual analysis about applicability in low-income countries.

The Great Awakening - Digitalization in Dental Healthcare during the pandemic COVID-19

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 380-384
Author(s):  
Priyanka Paul Madhu ◽  
Yojana Patil ◽  
Aishwarya Rajesh Shinde ◽  
Sangeeta Kumar ◽  
Pratik Phansopkar
Keyword(s):  
Health Care ◽  
Task Force ◽  
Care Service ◽  
Health Care Service ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
World Health ◽  
Record System ◽  
The World

disease in 2019, also called COVID-19, which has been widely spread worldwide had given rise to a pandemic situation. The public health emergency of international concern declared the agent as the (SARS-CoV-2) the severe acute respiratory syndrome and the World Health Organization had activated significant surveillance to prevent the spread of this infection across the world. Taking into the account about the rigorousness of COVID-19, and in the spark of the enormous dedication of several dental associations, it is essential to be enlightened with the recommendations to supervise dental patients and prevent any of education to the dental graduates due to institutional closure. One of the approaching expertise that combines technology, communications and health care facilities are to refine patient care, it’s at the cutting edge of the present technological switch in medicine and applied sciences. Dentistry has been improved by cloud technology which has refined and implemented various methods to upgrade electronic health record system, educational projects, social network and patient communication. Technology has immensely saved the world. Economically and has created an institutional task force to uplift the health care service during the COVID 19 pandemic crisis. Hence, the pandemic has struck an awakening of the practice of informatics in a health care facility which should be implemented and updated at the highest priority.

scholarly journals Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

2021 ◽  
Vol 18 (5) ◽  
pp. 2439
Author(s):  
Brendon Stubbs ◽  
Kamran Siddiqi ◽  
Helen Elsey ◽  
Najma Siddiqi ◽  
Ruimin Ma ◽  
...  
Keyword(s):  
Health Survey ◽  
Low Income ◽  
World Health ◽  
Low Income Countries ◽  
Multivariable Logistic Regression Analysis ◽  
World Health Survey ◽  
Middle Income ◽  
Middle Income Countries ◽  
The World ◽  
Low And Middle Income

Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38–4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14–3.22), 4.71 (95%CI = 3.67–6.11), 6.96 (95%CI = 4.95–9.87), 10.59 (95%CI = 7.10–15.80), and 19.89 (95%CI = 11.13–35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.

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