scholarly journals Influence of Strategic Resource Allocation by Laikipia County Government on Service Delivery in Level 3 and 4 Public Health Facilities

2021 ◽  
Vol 6 (1) ◽  
pp. 62-77
Author(s):  
Evaline Nasieku Lesiyampe ◽  
Vivian Cherono ◽  
Rosemary Muriiki
Keyword(s):  
Public Health ◽  
Resource Allocation ◽  
Service Delivery ◽  
Health Facilities ◽  
County Government ◽  
Teaching Staff ◽  
Unique Contribution ◽  
Public Health Facilities ◽  
Level 3 ◽  
Strategic Resource

Purpose: The purpose of the study was to examine the influence strategic resource allocation by Laikipia county government on service delivery in level 3 and 4 public health facilities. Methodology: The target population comprised of a sample of 74 medical practitioners. The respondents were doctors, nurses, pharmacists, lab technicians, radiologists, teaching staff and administration staff. Descriptive survey design was adopted for the study. Primary data was collected through questionnaires. Simple random sampling technique was used in guiding the selection of the study sample. A pilot study was conducted in 10 percent of the study sample from Naivasha County. Before administering the instruments, they were subjected to validity checks and reliability tests. Data analysis was done using tools in the SPSS version 25. Analysis involved computation of descriptive statistics such as frequencies, percentages, means and inferential statistics such as Pearson Correlation and regression analysis. The data was then presented in tables and narrations. Results: The study established that the connection between the strategic resource allocation services and service delivery was statistically positive and significant hence the model can be used to predict the results of level 3 and 4 public health facilities in Laikipia county. It had an R value of .851 and an R square value of .723. Explained further it indicated that strategic resource allocation model forecasted 72.3% change on service delivery. Strategic resource allocation had a β=.324, P=449. Unique contribution to theory, policy and practice: Though there were resources enough to obtain various medical supplies, there was a gap in ensuring that departments got all the requirements they were in need of. The study discovered that mis-balance between departments getting required resources in which they are dispensed to. The study recommended that there should be clear resource tracking within the departments. There should be easy and less bureaucratic replenishing of the resources since these departments have generated them. There should be policies put into place to factor in quick, reliable and quality replenishing within various departments of hospitals.

scholarly journals KNOWLEDGE OF NURSES ON SYNDROMIC MANAGEMENT OF SEXUALLY TRANSMITTED INFECTIONS IN PUBLIC FACILITIES

2020 ◽  
Vol 5 (5) ◽  
pp. 1
Author(s):  
Maina Eva Mumbi ◽  
Mwangi John Hiuhu ◽  
Njuguna Felix Tharao ◽  
Maingi Nancy Nyambura
Keyword(s):  
Public Health ◽  
Data Collection ◽  
Sexually Transmitted Infections ◽  
Health Facilities ◽  
Unique Contribution ◽  
Data Collection Tool ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Public Health Facilities ◽  
Syndromic Approach

Purpose: The main purpose of this study is to assess the knowledge of nurses on syndromic management of STIs in public health facilities within Kirinyaga west Sub County. Methodology: The study utilized descriptive cross-sectional study design, with a target population of 70 nurses working in 16 Kirinyaga west public health facilities. The dependent variable was applying syndromic approach management of sexually transmitted infections, independent variables as knowledge and practices. The study utilized purposive sampling technique to determine the sample size of 49 nurses. The study employed the use of a questionnaire as a data collection tool and check list. A pretest of the data collection tool was conducted at Karatina sub county hospital MCH/FP Findings The study findings showed that 90% of the respondents had general knowledge of what syndromic approach is though 38% were not able to identify the common STIs syndromes and 39% couldn’t correctly identify the STIs that present a genital ulcer. 45% depended on laboratory investigations to diagnose and manage STIs, while 74% had not undergone any training or CME in the last 2 years on syndromic management of STIs and 96%reported that the health facilities they were stationed did not have readily available WHO/NASCOP 2015 guidelines. The respondents did not apply the syndromic approach in managing STIs and that, knowledge and practice on syndromic management of STIs among nurses in Kirinyaga west Sub County is low at 41%. Unique contribution to theory, practice and policy: There is need for more awareness through capacity building among health workers managing sexually transmitted infections in the communities and therefore the study recommends county Governments to organize for trainings and CMEs on STIs/syndromic approach and identify an STIs management focal person in public health facilities.

scholarly journals Quality of maternal and newborn healthcare services in two public hospitals of Bangladesh: identifying gaps and provisions for improvement

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Taposh Kumar Biswas ◽  
Hasnat Sujon ◽  
M. Hafizur Rahman ◽  
Henry B. Perry ◽  
Mahbub Elahi Chowdhury
Keyword(s):  
Public Health ◽  
Service Delivery ◽  
Healthcare Service ◽  
Infection Prevention ◽  
Health Facilities ◽  
Quality Monitoring ◽  
Public Health Facilities ◽  
Care Services ◽  
Maternal And Newborn

Abstract Background Healthcare service delivery systems need to ensure standard quality of care (QoC) for achieving expected health outcomes. Although Bangladesh has a good healthcare service delivery system, there are major concerns about the quality of maternal and newborn health (MNH) care services, which is imperative for achievements in health. The study aimed to measure the QoC for different MNH services in two selected public health facilities of Bangladesh. This study also documented the specific areas of each care which needs intervention. Methods The study was conducted in two district-level public health facilities—a district hospital (DH) and a mother and child welfare centre (MCWC). A total of 228 cases of MNH services were observed by using contextualized checklist ‘Standards-based Management and Recognition (S-BMR)’ for 8 selected MNH care services. For scoring, performed activities were calculated as percentages of the total recommended activities and categorized as high (> 80%), moderate (50 to 80%), and low (< 50%). Results Overall QoC scores were moderate for each DH (54.8%), and MCWC (56.1%). In DH, the QoC score was high for blood transfusion (80.3%); moderate for maternal complications management (77.0%), caesarean section (CS) (65.6%), infection prevention (64.3%), sick newborn care (54.1%), and normal vaginal delivery (NVD) (52.6%); and low for antenatal care (ANC) (25.6%) and postnatal care (PNC) (19.0%). In MCWC, the QoC scores were high for infection prevention (83.0%); moderate for CS (76.5%) and NVD (59.8%); and low for ANC (36.9%) and PNC (24.5%). Conclusions In the study facilities, the QoC for MNH services is found to be unsatisfactory, particularly for ANC and PNC. Urgent initiative needs to be taken by introducing contextualized quality monitoring tools at health facilities, along with training of the care providers and introducing a quality monitoring system.

scholarly journals Linkage to primary-care public health facilities for cardiovascular disease prevention: a community-based cohort study from urban slums in India

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045997
Author(s):  
Abhijit Pakhare ◽  
Ankur Joshi ◽  
Rasha Anwar ◽  
Khushbu Dubey ◽  
Sanjeev Kumar ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Multivariate Analysis ◽  
Urban Slum ◽  
Primary Care Providers ◽  
Health Facilities ◽  
Care Providers ◽  
Community Based ◽  
Public Health Facilities ◽  
Care Facilities

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

scholarly journals Health facility capacity to provide postabortion care in Afghanistan: a cross-sectional study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzana Maruf ◽  
Hannah Tappis ◽  
Enriquito Lu ◽  
Ghutai Sadeq Yaqubi ◽  
Jelle Stekelenburg ◽  
...  
Keyword(s):  
Public Health ◽  
Family Planning ◽  
High Volume ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Care Services ◽  
Vacuum Aspiration ◽  
Postabortion Care ◽  
Products Of Conception ◽  
Family Planning Counseling

Abstract Background Afghanistan has one of the highest burdens of maternal mortality in the world, estimated at 638 deaths per 100,000 live births in 2017. Infections, obstetric hemorrhage, and unsafe abortion are the three leading causes of maternal death. Contraceptive prevalence rate has fluctuated between 10 and 20% since 2006. The 2016 Afghanistan National Maternal and Newborn Health Quality of Care Assessment evaluated facility readiness to provide quality routine and emergency obstetric and newborn care, including postabortion care services. Methods Accessible public health facilities with at least five births per day (n = 77), a nationally representative sample of public health facilities with fewer than five births per day (n = 149), and 20 purposively selected private health facilities were assessed. Assessment components examining postabortion care included a facility inventory and record review tool to verify drug, supply, equipment, and facility record availability, and an interview tool to collect information on skilled birth attendants’ knowledge and perceptions. Results Most facilities had supplies, equipment, and drugs to manage postabortion care, including family planning counseling and services provision. At public facilities, 36% of skilled birth attendants asked to name essential actions to address abortion complications mentioned manual vacuum aspiration (23% at private facilities); fewer than one-quarter mentioned counseling. When asked what information should be given to postabortion clients, 73% described family planning counseling need (70% at private facilities). Nearly all high-volume public health facilities with an average of five or more births per day and less than 5% of low volume public health facilities with an average of 0–4 deliveries per day reported removal of retained products of conception in the past 3 months. Among the 77 high volume facilities assessed, 58 (75%) reported using misoprostol for removal of retained products of conception, 59 (77%) reported using manual vacuum aspiration, and 67 (87%) reported using dilation and curettage. Conclusions This study provides evidence that there is room for improvement in postabortion care services provision in Afghanistan health facilities including post abortion family planning. Access to high-quality postabortion care needs additional investments to improve providers’ knowledge and practice, availability of supplies and equipment.

scholarly journals Managing pneumonia through facility-based integrated management of childhood management (IMCI) services: an analysis of the service availability and readiness among public health facilities in Bangladesh

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ahmed Ehsanur Rahamn ◽  
Shema Mhajabin ◽  
David Dockrell ◽  
Harish Nair ◽  
Shams El Arifeen ◽  
...  
Keyword(s):  
Public Health ◽  
Distribution System ◽  
Integrated Management ◽  
Child Death ◽  
Health Facilities ◽  
Family Welfare ◽  
Service Availability ◽  
District Health ◽  
Public Health Facilities ◽  
District Hospitals

Abstract Background With an estimated 24,000 deaths per year, pneumonia is the single largest cause of death among young children in Bangladesh, accounting for 18% of all under-5 deaths. The Government of Bangladesh adopted the WHO recommended Integrated Management of Childhood Illness (IMCI)-strategy in 1998 for outpatient management of pneumonia, which was scaled-up nationally by 2014. This paper reports the service availability and readiness related to IMCI-based pneumonia management in Bangladesh. We conducted a secondary analysis of the Bangladesh Health Facility Survey-2017, which was conducted with a nationally representative sample including all administrative divisions and types of health facilities. We limited our analysis to District Hospitals (DHs), Maternal and Child Welfare Centres (MCWCs), Upazila (sub-district) Health Complexes (UHCs), and Union Health and Family Welfare Centres (UH&FWCs), which are mandated to provide IMCI services. Readiness was reported based on 10 items identified by national experts as ‘essential’ for pneumonia management. Results More than 90% of DHs and UHCs, and three-fourths of UH&FWCs and MCWCs provide IMCI-based pneumonia management services. Less than two-third of the staff had ever received IMCI-based pneumonia training. Only one-third of the facilities had a functional ARI timer or a watch able to record seconds on the day of the visit. Pulse oximetry was available in 27% of the district hospitals, 18% of the UHCs and none of the UH&FWCs. Although more than 80% of the facilities had amoxicillin syrup or dispersible tablets, only 16% had injectable gentamicin. IMCI service registers were not available in nearly one-third of the facilities and monthly reporting forms were not available in around 10% of the facilities. Only 18% of facilities had a high-readiness (score 8–10), whereas 20% had a low-readiness (score 0–4). The readiness was significantly poorer among rural and lower level facilities (p < 0.001). Seventy-two percent of the UHCs had availability of one of any of the four oxygen sources (oxygen concentrators, filled oxygen cylinder with flowmeter, filled oxygen cylinder without flowmeter, and oxygen distribution system) followed by DHs (66%) and MCWCs (59%). Conclusion There are substantial gaps in the readiness related to IMCI-based pneumonia management in public health facilities in Bangladesh. Since pneumonia remains a major cause of child death nationally, Bangladesh should make a substantial effort in programme planning, implementation and monitoring to address these critical gaps to ensure better provision of essential care for children suffering from pneumonia.

Experiences of women receiving childbirth care from public health facilities in Kumasi, Ghana

Midwifery ◽  
2017 ◽  
Vol 55 ◽  
pp. 90-95 ◽  
Author(s):  
Veronica Millicent Dzomeku ◽  
Brian van Wyk ◽  
Jody R. Lori
Keyword(s):  
Public Health ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Experiences Of Women ◽  
Childbirth Care

Prevalence of Antenatal Depression and Its Associated Risk Factors Among Pregnant Mothers Attending Antenatal Care Service at Jinka Public Health Facilities, Southern Ethiopia

2021 ◽  
pp. IJCBIRTH-D-20-00033
Author(s):  
Aynalem Yetwale ◽  
Teklemariam Gultie ◽  
Dessalegn Ajema ◽  
Bezawit Afework ◽  
Semahegn Tilahun
Keyword(s):  
Public Health ◽  
Antenatal Care ◽  
Unplanned Pregnancy ◽  
Care Service ◽  
Antenatal Depression ◽  
Health Facilities ◽  
Southern Ethiopia ◽  
Medical Illness ◽  
Public Health Facilities ◽  
History Of

BACKGROUNDAntenatal depression is the most common psychiatric disorder during pregnancy with serious consequences for the mother and the fetus. However, there are few studies about this health issue in developing countries. This study aimed to determine the prevalence of antenatal depression and its associated risk factors among pregnant mothers attending antenatal care service at Jinka public health facilities, south Omo zone, Southern Ethiopia.METHODSInstitutional-based cross-sectional study design was conducted on 446 pregnant women at Jinka public health facilities, from June 1 to June 30, 2018. Beck Depression Inventory was used to assess women's level of depression. Statistical package for social science version 20.0 was used for analysis. Logistic regression was used to find out the association between explanatory and depression. The strength of association was evaluated using odds ratio at 95% confidence interval (CI).RESULTThe magnitude of antenatal depression in this study was 24.4% (20.2–28.5 at 95% CI) and it had statistically significant association with unmarried marital status a djusted o dds r atio (AOR) = 13.39 [(95% CI); (3.11–57.7)], chronic medical illness AOR = 3.97 [(95% CI); (1.07–14.7)], unplanned pregnancy AOR = 6.76 [(95% CI); (2.13–21.4)], history of abortion AOR = 2.8 [(95% CI); (1.14–7.02)], history of previous pregnancy complication AOR = 4.8 [(95% CI); (2.12–17.35)], and fear of pregnancy-related complications AOR = 5.4 [(95% CI); (2.32–12.4)].CONCLUSIONSNearly one pregnant woman develops antenatal depression in every four pregnant women. Variables like unmarried marital status, chronic medical illness and unplanned pregnancy, history of previous pregnancy complications, and fear of pregnancy-related complications were associated with antenatal depression. Therefore, it is recommended that these risks factors should be evaluated during antenatal care with a view to improving maternal health.

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