Community health services

Purpose. Conduct a social network analysis of the health and non–health related organizations that participate in Bogotá's Ciclovía Recreativa (Ciclovía). Design. Cross-sectional study. Setting. Ciclovía is a multisectoral community-based mass program in which streets are temporarily closed to motorized transport, allowing exclusive access to individuals for leisure activities and physical activity. Subjects. Twenty-five organizations that participate in the Ciclovía. Measures. Seven variables were examined by using network analytic methods: relationship, link attributes (integration, contact, and importance), and node attributes (leadership, years in the program, and the sector of the organization). Analysis. The network analytic methods were based on a visual descriptive analysis and an exponential random graph model. Results. Analysis shows that the most central organizations in the network were outside of the Health sector and include Sports and Recreation, Government, and S...

OBJECTIVES To assess the birth preparedness and utilisation of services in an urban union council where only the private sector provided any healthcare. METHODS Descriptive study design was adopted which had two components: 1) a cross-sectional community survey on birth preparedness and utilisation of services and 2) a provider survey with census of all eligible healthcare facilities. Door to door survey was conducted by visiting every tenth household. All allopathic healthcare facilities in the selected union council were visited for collecting information about the available services and amenities. RESULTS Knowledge regarding danger signs during pregnancy and delivery was low. Sixty four percent women received some antenatal care while 45% deliveries were conducted at home. Among those having to seek emergency care during pregnancy, delivery or postpartum, 39% approached a health facility. Lack of preparation in terms of transport was reported in 83% cases. Two of the health facil...

Work stress is widely thought to be a significant problem in the health and community services sector. We reviewed evidence from a range of different data sources that confirms this belief. High levels of psychosocial risk factors, psychological health problems and workers compensation claims for stress are found in the sector. We propose a multilevel theoretical model of work stress to account for the results. Psychosocial safety climate (PSC) refers to a climate for psychological health and safety. It reflects the balance of concern by management about psychological healthv.productivity. By extending the health erosion and motivational paths of the Job Demands-Resources model, we propose that PSC within work organisations predicts work conditions and in turn psychological health and engagement. Over and above this, however, we expect that the external environment of the sector particularly government policies, driven by economic rationalist ideology, is increasing work pressure an...

Este artigo reflete sobre o acolhimento e a produção de cuidado destinados à população em situação de rua numa perspectiva socioantropológica, a partir de uma observação participante realizada junto a uma equipe de Consultório na Rua. Observou-se que essa população, historicamente visibilizada como marginal, dificilmente consegue acessar os serviços de saúde, tornando-se invisível ao próprio Sistema Único de Saúde. Embora a Política Nacional para a População em Situação de Rua pretenda assegurar acesso à saúde, o cuidado, no entanto, nem sempre é garantido porque serviços e profissionais de saúde têm pouca experiência para acolher pessoas em situação de rua e atender as suas necessidades. Conclui-se que o desafio é hipervisibilizar as linhas de cuidado para situações impostas pela vida na rua e a construção de vínculo terapêutico desconstrutor da prática estigmatizante.

Dengue is the most important mosquito-borne disease in the Philippines, especially in Metropolitan Manila where communities are socially and economically diverse, and city governments struggle to provide basic services such as continuously available, piped water supply to residents. We examined responses to introducing water container management to control dengue vectors in two diverse communities in Masagana City: Village A (gated community) and Village B (informal settlers community). The roll out of the intervention was carried out by the study team, dengue control personnel and local health workers (BHWs). A behavioural change framework was used to describe the community responses to the introduction of a new vector control intervention - household water container management. Although, the desired outcome was not achieved during the study's timeline, observation on processes of behaviour change underscored the importance of understanding the social nature of the urban commun...

A community survey was conducted in Al awayda village, one of eight villages selected for study in the rural Gezira province of Sudan. The objective of the survey was to identify the main health, social and economic problems of people in rural areas and to set priorities as a first phase in a rural development program. The results showed a

The popularity of dual physician assistant/master of public health degree programs continues to increase within US physician assistant (PA) education. The advantages and disadvantages of pursuing dual degree training have not been fully explored in the PA literature. Potential advantages of dual training include broadening of the student's perspective on health and health care beyond the "one provider, one patient" medical model, increased training in evaluation and use of the medical literature, increased skill in assessing community factors that affect the health of patients, enhanced expertise in health care administration or policy, and improved prospects for future roles as PA faculty members. Potential drawbacks include increased duration and expense of PA/MPH education, student burnout due to prolonged training, and the lack of jobs that explicitly use both halves of the PA/MPH training.

Community pharmacies play a vital role in promoting, maintaining and improving the health of the local community. This study explored community pharmacists' activities and attitudes towards the provision of sexual health services (SHS) in North East Scotland, as well as their needs with regard to the delivery of current and future SHS. North East Scotland. A questionnaire was conducted of community pharmacists working in community pharmacies in Grampian (n = 128). Self-reported provision of sexual health services; attitudes towards current and future sexual health services; previous training and perceived training needs; respondent demographics. In total, 73% (94/128) of community pharmacists responded. The average number of SHS/products per pharmacy was six out of a possible 13 (range: 4-10). Respondents expressed positive attitudes towards the provision of current and future SHS. However, they also reported that they had received little or no sexual health training but that th...

Despite the high prevalence of mental disorders in Mexico, minimal mental health services are available and there are large gaps in mental health treatment. Community-based primary care settings are often the first contact between patients and the health system and thus could serve as important settings for assessing and treating mental disorders. However, no formal assessment has been undertaken regarding the feasibility of implementing these services in Mexico. Before tools are developed to undertake such an assessment, a more nuanced understanding of the microprocesses affecting mental health service delivery must be acquired. A qualitative study used semistructured interviews to gather information from 25 staff in 19 community-based primary care clinics in Mexico City. Semistructured interviews were analyzed by using the meaning categorization method. In a second phase of coding, emerging themes were compared with an established typology of barriers to health care access. Primar...

The limited access to oral health care in developing countries can be greatly improved by integrating oral health into the Primary Health Care (PHC) system. This study was designed to assess the views of PHC workers on integrating oral health care into the PHC system. A self-administered questionnaire survey was conducted in two selected local government areas of Lagos State. The instrument contained three sections assessing sociodemographic features, knowledge of common oral diseases and views on integration of oral health into PHC respectively. The mean knowledge score was 7.75 (SD=±1.81), while 60.4% of the respondents had average knowledge scores. Educational status (P=0.018) and designation (P=0.033) were significantly related to the mean knowledge scores. There was no significant difference in the oral health knowledge of the various cadres (P=0.393). Majority (85.4%) of the respondents were willing to include oral health education in their job schedule and 82% believed they n...

Objective: This study examines the levels of human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) related stigma among the Iranian population and the factors that contribute to the formation of stigma within the study population. Design: A quantitative research design was used in this research whereby participants completed a self-administrated questionnaire. A sample of 236 adults aged 20–65 were collected using non-probability sampling techniques. Setting: The study was carried out in the Sydney (Australia) metropolitan area and data were collected in 2007. Method: To obtain a desirable sample size, multivariate techniques including snowball were used. Herek’s (1986) functional approach to attitudes was used to analyze HIV/AIDS stigma in the study population. Results: The findings illustrate that HIV/AIDS-related stigma was dominant among the study population. Overall, participants had negative feelings toward people with HIV/AIDS (PWHA); they were in favou...

This study examined perceived satisfaction among Hispanic/Latino individuals who participated in a baseline examination for the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a large cohort study of 16,415 adults living in four selected communities. An estimated 22% (n= 3,584) of participants completed a questionnaire regarding satisfaction with staff attention, the overall experience during the study examination, and the influence of the informed consent digital video disc (DVD). The majority of participants who completed the questionnaire expressed overall satisfaction with the study. Most participants reported that staff were friendly, courteous and respectful and study test procedures were clearly explained. Participants who preferred to complete the interview in Spanish felt that the informed consent DVD positively influenced their ability to make an informed decision to enroll in the study. Participants who preferred to complete the interview in English tended to...

In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS) by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC) and management of sick children younger than five years. Service delivery quality was assessed across three dimensions; structural readiness, process and outcome. Structural readiness was assessed by observing the presence of equipment, guidelines and register/reporting forms in ANC rooms and consulting areas for sick children at 37 primary healthcare facilities in 12 sub-districts. In addition, the training and knowledge relevant to nutrition service delivery of 95 healthcare providers was determined. The process of nutrition service delivery was assessed by observing 381 ANC visits and 826 sick children consultations. Satisfaction with the service was the outcome and was determined by interviewing 54...

Background To achieve the United Nations Millennium Development Goals, particularly reduction in child mortality (Millennium Development Goal 4), effective interventions to address severe and moderate acute malnutrition (SAM and MAM) among children under 5 years of age must be implemented and brought to scale alongside preventive measures. Bangladesh has an estimated 600,000 children with SAM, for a prevalence of 4%, while 1.8 million children suffer from MAM. Objective To assess the feasibility and constraints of community-based management of acute malnutrition (CMAM), a relatively new approach, in managing SAM and MAM among children in Bangladesh. Methods The methodology involved desk reviews of documents by searching through PubMed and other databases for published literature on CMAM in Bangladesh. We also did a hand search of policy and program documents, including the draft National Nutrition Policy 2013; the Health, Nutrition, Population Sector Development Program document of ...

Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Disc...

Analyzing complex health programs by their components and sub-components serves design, documentation, evaluation, research, and gap identification and prioritization. In 2012, we developed a rapid methodology to characterize integrated community case management (iCCM) programs, by assessing benchmarks for eight health system components in three program phases. OBJECTIVE. To assess iCCM benchmarks in Ethiopia three years after scale-up commenced, and to compare the benchmarks across the geographical region. METHODS. Six national iCCM experts scored each of 70 benchmarks (no, partial, or yes) and then were facilitated to reach consensus. RESULTS. Overall, iCCM benchmark achievement in Ethiopia was high (87.3%), highest for pre-introduction (93.0%), followed by introduction (87.9%) and scale-up (78.1%) phases. Achievement by system component was highest for coordination and policy (94.2%) and lowest for costing and finance (70.3%). Six regional, countries benchmark assessments, includ...

This study sought to determine the level of satisfaction of patients with the healthcare services at Federal Medical Centre, Bida (FMCB) Nigeria and the factors associated with patients' satisfaction. The study utilized exit interview of 480 patients, sampled at the 9 service points of the Centre. The questions covered socio-demographic factors and the 3 core elements of healthcare service delivery namely quality, access and interpersonal issues. The evaluation of satisfaction on the 5 point Likert scale were categorized into dissatisfied {very dissatisfied, dissatisfied and Neutral} and satisfied {satisfied and very satisfied}, setting the threshold for satisfaction at a relatively higher level. On the overall, 78.5% of them were satisfied with the hospital services and 78.3% had their expectations met. Satisfaction was lowest (72.7%) at the revenue section and highest (96.1%) at the maternity section. Nine of every 10 respondents (91.7%) would recommend the facility to a frien...

To examine the adoption of feeding recommendations among caregivers of children recuperating from malnutrition and assess the determinants of growth of children attending a nutrition rehabilitation centre (NRC) in Accra, Ghana. Longitudinal study in which attendance and maternal programme participation were recorded daily and children's anthropometry and dietary intake were measured at four time points (admission, interim, exit, post-exit) at the NRC and participants' homes. NRCs at four polyclinics and participants' homes in Accra, Ghana. One hundred and eight caregivers and their 116 children referred to an NRC between November 1999 and July 2000. Most caregivers attended the NRC sporadically (effective length of stay was 1.4+/-0.1 months). Use of NRC-promoted foods in the home after discharge was low due to inaccessibility of the food items, lack of preparation knowledge or money, child preferences and the common practice of purchasing ready-to-eat foods. Although the...

The prevalence of malnutrition in Cambodia is among the highest in Southeast Asia. Until recently, there has been a consensus that the treatment and rehabilitation of acutely severely malnourished children should take place in hospitals; however, limited local health resources often place constraints upon the inpatient management of these children. This study reviews the outcomes of a community nutrition program designed to rehabilitate children under the age of 5 years with moderate or severe acute malnutrition living in a poor urban community in Phnom Penh, Cambodia. Clinical records of the program participants during the period from January 1999 to November 2006 were reviewed. Attainment of recovery weight-for-height z-scores, the length of time taken to achieve this recovery, rates of weight gain, mortality rate, and rate of default were determined from the data. One hundred fifty-nine children aged 4 years or younger with a mean admission weight-for-height z-score of -3.3 were ...

Hospitals can cause disease and environmental pollution if the waste from the activities in it is disposed of without prior management. The first thing to do in waste management is to separate medical and non-medical solid waste. The purpose of this study was to determine the factors that influence nurse compliance with medical and non-medical solid waste segregation in the nursing room of Syekh Yusuf Hospital, Gowa. The type of research used is quantitative analysis method with a cross sectional study approach. The sampling technique to be studied is total sampling, where the number of samples is the same as the total population, namely 118 respondents. The data obtained were analyzed using the SPSS application and a chi square test was performed. The results showed that the knowledge of nurses with a value of p = 0.037, policies with a value of p = 0.015, and supervision of the head of the room with a value of p = 0.021 were factors that influenced nurses' compliance with the sorting of medical and non-medical solid waste in the nursing room of RSUD Syekh Yusuf, Gowa Regency. While the attitude of nurses with a value of p = 0.061, the availability of facilities with a value of p = 0.061, and the motivation of nurses with a value of p = 0.071 did not affect the compliance of nurses on the separation of medical and non-medical solid waste. It is recommended to the hospital to increase the availability of facilities, especially in the provision of infectious and non-infectious waste bins in all nursing rooms, as well as for nurses to maintain or increase compliance in the sorting of medical and non-medical solid waste.

The Barangay Nutrition Scholars (BNS) Project was created in 1977 to provide an effective means of disseminating nutrition information and providing nutrition services to the barangays through a trained community worker. The BNS project was pilot tested in 1977 in 13 municipalities and by the end of 1979, 5220 BNS had been trained and deployed in their communities. BNS must have certain personal and leadership qualifications, and are chosen by the barangay captain or the barangay nutrition committee. The nutrition program is based upon 4 intervention schemes: food production, food assistance, health protection, and information, education, and communication. The BNS is the nutrition program's instrument for implementing these intervention schemes. The BNS on return from training makes a spot map of the community and measures and weighs preschool children to screen for malnutrition. The BNS also conducts mothers' classes which dispense information on nutrition and health and distributes seeds and supplementary food packets for preschoolers to target families. Support to the BNS is provided by a van equipped with a communication worker and a video playback unit. An assessment of the BNS program indicated that about 80% of the BNS surveyed were effective implementors of their programs. Program officials expect most of the problems encountered to be solved with more effort by the BNS and increased financial and logistical support from the national and local governments.