scholarly journals The influence of political processes of health systems reforms based on primary health care in institutional and organizational innovations and health services performance: a case study of three municipal settings in Argentina and Bolivia / La influencia

2015 ◽  
Vol 15 (8) ◽  
Author(s):  
Ernesto Báscolo ◽  
Natalia Yavich
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Systems ◽  
Political Processes ◽  
Primary Health ◽  
Organizational Innovations

Primary Health Care and Donor Dependency: A Case Study of Nongovernment Assistance in Burkina Faso

1995 ◽  
Vol 25 (3) ◽  
pp. 539-558 ◽  
Author(s):  
Richard Maclure
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Systems ◽  
Health Workers ◽  
Indigenous Health ◽  
Sub Saharan Africa ◽  
Professional Status ◽  
Primary Health ◽  
Nongovernment Organizations

Primary health care assistance has become prominent in the rural development programs of many nongovernment organizations throughout sub-Saharan Africa. By emphasizing education and the promotion of new participatory health systems, most such programs aim to enhance the conditions of women as principal community care givers. Yet village-level health assistance in Africa is not without shortcomings. This is exemplified in a case study of two nongovernment programs in Burkina Faso's Namentenga Province. Although both programs have contributed to maternal health and infant survival, they have also induced new ties of donor dependency. This appears to present a conundrum for the sponsoring agencies which espouse self-reliance as a development assistance goal. In fact, however, where the intervention of nongovernment organizations helps to improve rural health, new dimensions of dependency may prove to be a positive first stage in the mobilization of women and the development of locally managed health systems. For this to be so, much is contingent on the capacity of these organizations to integrate local participation in their own planning and management processes, and to augment the professional status of indigenous health workers.

scholarly journals Developing primary health care in Thailand

2018 ◽  
Vol 21 (1) ◽  
pp. 36-49 ◽  
Author(s):  
Phudit Tejativaddhana ◽  
David Briggs ◽  
Orapin Singhadej ◽  
Reggie Hinoguin
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Systems ◽  
Health Management ◽  
Systems Management ◽  
Ageing Society ◽  
Content Type ◽  
Primary Health ◽  
Health Systems Management

Purpose The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister’s challenge for Thailand to become the centre of learning in the sub-region in health management. Design/methodology/approach The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure. Findings The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People’s Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality. Originality/value The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.

scholarly journals The “Pasteurization Process” of Local-Grounded Strategies in the Primary Health Care in two Experiences of the Global South (Brazil and Chile)

2020 ◽  
Author(s):  
Eliezer Magno Araújo ◽  
Sebastian Medina ◽  
Esteban Figueroa ◽  
Marília de Castro
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Systems ◽  
Local Health ◽  
Collective Case Study ◽  
Post Colonial ◽  
Primary Health ◽  
The Social ◽  
Asymmetric Power

This article explores the process of two emerging local-grounded strategies born in the context of Primary Health Care, in rural locations in Brazil and Chile, using a post-colonial framework. Initially rooted in local health needs and socio-cultural characteristics, both experiences undergo a process of modelling and subsequent replication by the governance of health systems, with an asymmetric power / knowledge structure. We used a Collective Case Study as a methodological strategy and used field records, in-depth interviews and a critical literature review. As a result, we saw that the social participation experienced in community-based health systems has the potential to generate high-impact initiatives, considering local realities. At the same time, through the metaphor of "pasteurization", we emphasize that hegemonic governance can remove the "living components" of these types of local strategies, causing them to lose their emancipatory capacities.

Evaluating Access to and use of Primary Health Care: Diabetes-related Case Study using the 2002/3 NSW Health Survey

2006 ◽  
Vol 12 (3) ◽  
pp. 26 ◽  
Author(s):  
EJ Comino ◽  
O Hermiz ◽  
MF Harris ◽  
E Harris
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Survey ◽  
Population Characteristics ◽  
Computer Assisted ◽  
Proactive Management ◽  
Primary Health ◽  
Use Of Health Services

This paper investigates the use of the 2002/3 NSW Health Survey to provide information on access to and use of quality primary health care (PHC) using type 2 diabetes as a case study. The 2002/3 NSW Health Survey is a telephone survey using Computer Assisted Technology to survey a random sample of NSW residents stratified by area health services. We investigated the population characteristics that were associated with access to and use of PHC relating to the diagnosis, proactive management, complication screening and health outcomes of diabetes for participants. Older participants reported increased diabetes, but not diabetes-related risk factors, increased hospitalisation, and increased medication use, but decreased blood pressure screening. Relatively disadvantaged participants reported greater health care needs not reflected in access to and use of health services. While these participants reported increased use of medication to treat diabetes they were less likely to report using three or more accepted management strategies. This work indicates that the NSW Health Survey can provide information on access to and use of health services. Discussion is needed to identify ways in which information on access to and use of PHC can be enhanced.

scholarly journals Quality of Primary Health Care in Brazil: patients'view

2018 ◽  
Vol 71 (suppl 6) ◽  
pp. 2713-2719
Author(s):  
Daniela Cristina Moreira Marculino de Figueiredo ◽  
Helena Eri Shimizu ◽  
Walter Massa Ramalho ◽  
Alexandre Medeiros de Figueiredo ◽  
Kerle Dayana Tavares de Lucena
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Clinical History ◽  
Coordination Of Care ◽  
Primary Health ◽  
Comprehensive Health ◽  
Access And Quality ◽  
Transversal Study

ABSTRACT Objective: To describe the evaluation of patients that participated in the National Program for Improving the Access and Quality in Primary Health Care (Programa Nacional de Melhoria do Acesso e da Qualidade na Atenção Básica) for the comprehensive healthcare, the bond and the coordination of care in the country's macro-regions. Method: A descriptive, transversal study, from interviews with 65,391 patients of Primary Health Care, in 3,944 municipalities regarding the use of health services. Results: The professionals seek to solve the patients' problems in their unit (73.1%) but focused mainly on the scope of the appointment (65.6%) and offering care away from the population's reality (69.4%). Difficulties in the rescue of clinical history were referred (50.3%) and in the care performed in other health services (29.2%). Conclusion: The comprehensive health care, the bond and the coordination of care remain challenges to the Primary Health Care in the country, requiring reflections on the implementation of national policies, especially considering the regional diversities in Brazil.

scholarly journals The role of health care workers in collaborating with traditional healers in primary health care. Part 1

1997 ◽  
Vol 2 (1) ◽  
pp. 29-35 ◽  
Author(s):  
Rosemare Troskie
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Health Plan ◽  
Health Care Workers ◽  
Full Text ◽  
Traditional Healers ◽  
Primary Health ◽  
Care Workers

The Reconstruction and Development Plan as well as the National Health Plan of the ANC supports the reorganisation of health services. OpsommingDie Heropbou en Ontwikkelingsprogram sowel as die Nasionale Gesondheidsplan van die ANC staan die herorganisasie van gesondheidsdienste voor. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.

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 Integrating Mental Health Services into the Primary Health Care System: The Need for Reform in Iran

2021 ◽  
Author(s):  
Ahmad Hajebi ◽  
Vandad Sharifi ◽  
Maryam Abbasinejad ◽  
Ali Asadi ◽  
Nahid Jafari ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Health Services ◽  
Literature Review ◽  
Financial Resources ◽  
Primary Health Care System ◽  
Primary Health ◽  
Integrated Mental Health

Objective: The main objective of this study was to review aspects of the current situation and structure of the integrated mental health care services for planning a reform. Aspects of the newly designed infrastructure, along with specification of duties of the various human resources, and its relation with Iran’s Comprehensive Mental and Social Health Services (the SERAJ Program), will also be presented Method: This is a study on service design and three methods of literature review, deep interview with stakeholders, and focused group discussions. In the literature review, national and international official documents, including official reports of the World Health Organization (WHO) and consultant field visits, were reviewed. Deep semi-structured interviews with 9 stakeholders were performed and results were gathered and categorized into 3 main questions were analyzed using the responsibility and effectiveness matrix method. The Final results were discussed with experts, during which the main five-domain questions were asked and the experts’ opinions were observed. Results: In this study, the main gaps of the public mental health care (PHC) services in Iran were identified, which included reduction of risk factors for mental disorders, training the general population, early recognition and treatment of patients with mental disorders, educating patients and their families, and rehabilitation services. The new model was then proposed to fill these gaps focusing on increasing access, continuity of care, coordination in service delivery, and comprehensiveness of care. A mental health worker was placed besides general healthcare workers and general practitioners (GPs). Services were prioritized and the master flowchart for mental health service delivery was designed. Conclusion: A reform was indeed necessary in the integrated mental health services in Iran, but regarding the infrastructure needed for this reform, including human and financial resources, support of the senior authorities of the Ministry of Health (MOH) is necessary for the continuity and enhancement of services. In this model, attention has been given to the principles of integrating mental health services into primary health care. Current experience shows that the primary health care system has been facing many executive challenges, and mental health services are not exclusion to this issue. Monitoring and evaluation of this model of service and efforts for maintaining sustainable financial resources is recommended to make a reform in this system and to stabilize it.

scholarly journals 40 Years after Alma Ata: How People Trust in Primary Health Care?

2020 ◽  
Author(s):  
Homayoun Sadeghi Bazargani ◽  
Mohammad Saadati ◽  
Jafar Sadegh Tabrizi ◽  
Mostafa Farahbakhsh ◽  
Mina Golestani
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Linear Regression ◽  
Health Services ◽  
Public Trust ◽  
Health Services Delivery ◽  
Services Delivery ◽  
Trust Level ◽  
Primary Health ◽  
Individual Variables

Abstract Background: Primary Health Care (PHC) was introduced as the first level of health services delivery after Alma Ata declaration. PHC as a first level of health services delivery needs to be more trustfulness to achieve its defined goals. Public trust in PHC is one of the ignored issues in the context. The aim of this study was to explore public trust in PHC in Iran.Methods: This was a household survey study conducted in 2016 in East Azerbaijan Province, Iran. Two-stage cluster sampling method with probability proportional to size (PPS) approach was used. Totally 1178 households were enrolled in the study. PHC trust questionnaire and Ultra-short version of socio-economic status assessment questionnaire (SES-Iran) was used for data collection. Data were analyzed using STATA 15 through descriptive statistics and linear regression.Results: The mean age of the participants was 41.2, (SD: 15.1) and most of them (53.7%) were female. Mean score of PHC trust was 56.9±24.7 (out of 100). It was significantly different between inhabitants of Tabriz (the province capital city) and other cities in the province (p<0.001). Linear regression showed that younger age, gender, insurance type, being married and households higher socio-economic situation had a significant positive influence on PHC trust level with R2 = 0.14383 .Conclusions: Public trust in PHC system in Iran needs to be improved. Individual variables had a small but significant share in trust level. PHC trust not only influenced by individual variables and experience but also by health system and health providers characteristics and public sphere about PHC system. PHC trust level could be used as a public indicator in health systems especially in Low and Middle income countries to lead system strengthening policies in national and international levels.

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