Strategies for integrating primary health services in middle- and low-income countries: effects on performance, costs and patient outcomes

2001 ◽  
Author(s):  
CJ Briggs ◽  
P Capdegelle ◽  
P Garner
Keyword(s):  
Health Services ◽  
Patient Outcomes ◽  
Low Income ◽  
Low Income Countries ◽  
Primary Health ◽  
Primary Health Services

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.

scholarly journals Three models of community mental health services In low-income countries

2011 ◽  
Vol 5 (1) ◽  
pp. 3 ◽  
Author(s):  
Alex Cohen ◽  
Julian Eaton ◽  
Birgit Radtke ◽  
Christina George ◽  
Bro Manuel ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Low Income ◽  
Community Mental Health Services ◽  
Low Income Countries

scholarly journals Results From Screening Immigrants of Low‐Income Countries: Data From a Public Primary Health Care

2014 ◽  
Vol 21 (2) ◽  
pp. 92-98 ◽  
Author(s):  
Olga Hladun ◽  
Albert Grau ◽  
Esther Esteban ◽  
Josep M. Jansà
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Low Income ◽  
Low Income Countries ◽  
Primary Health

scholarly journals Awareness of physicians from primary health services about standards of examination of patients with suspected respiratory tuberculosis

2020 ◽  
Vol 98 (2) ◽  
pp. 20-24
Author(s):  
P. N. Novoselov ◽  
V. V. Tinkova ◽  
M. V. Lekhlyayder ◽  
I. A. Denisenko ◽  
T. P. Dudarova ◽  
...  
Keyword(s):  
Health Services ◽  
Primary Health ◽  
Primary Health Services

Utilization of Primary Health Services in Hong Kong

2015 ◽  
pp. 1159-1176
Author(s):  
Raymond K. H. Chan ◽  
Kang Hu
Keyword(s):  
Health Care ◽  
Hong Kong ◽  
Health Insurance ◽  
Health Services ◽  
Private Insurance ◽  
Public Health Services ◽  
Public And Private ◽  
The Public ◽  
Primary Health ◽  
Primary Health Services

This chapter analyzes the issue of primary health care utilization in Hong Kong and introduces the case of Hong Kong where a special division between public and private sectors has developed in the field of primary health services. The chapter argues that in the foreseeable future, it is likely that the division of health care between the public and private sector will be maintained. In recent years, more and more individuals and families have purchased private health insurance so as to gain more options. The idea of universal health insurance was rejected by the public in recent consultations; the current alternative is government-regulated private insurance. Although private primary health services will continue as usual in the near future, public primary health services should be maintained or even expanded. Given the costliness of private services (especially specialist services), it is recommended that more resources should be invested in corresponding public health services.

scholarly journals Implementing Antimicrobial Stewardship in Two Community Nepali Hospitals

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S20-S20
Author(s):  
Michael P Veve ◽  
Linda M Kaljee ◽  
Tyler Prentiss ◽  
Rajesh Dhoj Joshi ◽  
Shankar Man Rai ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Antimicrobial Stewardship ◽  
Low Income ◽  
Effective Means ◽  
Low Income Countries ◽  
Successful Implementation ◽  
E Coli ◽  
Grant Recipient ◽  
Post Test ◽  
Research Grant

Abstract Background Antimicrobial stewardship programs (ASP) are crucial to improving patient outcomes and decreasing resistance, but the effectiveness and the presence of ASP in low-income countries, like Nepal, are unknown. Nepal has no formal ASP efforts or antimicrobial regulations, which has lead to an increased prevalence of resistance in the community. We developed and implemented an educational ASP training program to identify areas for ASP in two community hospitals in Kathmandu. With a multidisciplinary team of clinicians and Nepal stakeholders, we developed an ASP toolkit aimed to improve patient outcomes through antimicrobial optimization. Methods A 1-day conference on ASP and resistance was held at a community hospital in Kathmandu, with subsequent field observations, microbiologic hospital surveillance, and 2,016 antibiogram review. Eleven physician champions (PC) from the two hospitals were selected for formal ASP instruction. ASP protocols were developed with stakeholders and included (i) empiric and definitive antibiotic selection recommendations, (ii) renal dose-adjustment guidelines, (iii) evidence-based duration of therapy recommendations, and (iv) an intravenous-to-oral antimicrobial conversion policy. Two days of fieldwork and stakeholder feedback occurred. A post-test PC evaluation was performed with the intent to gather feedback for implementation of a post-prescription review and feedback (PPRF) system incorporating AMS protocols related to antimicrobial optimization. Results The most prevalent infectious organism isolated was Escherichia coli (51%). Most E. coli isolates were commonly resistant to first-line or broad-spectrum antibiotics: 49% ceftriaxone, 46% ciprofloxacin, 22% piperacillin/tazobactam, and 32% meropenem. The overall PC response to ASP toolkit was positive: 73% of PC felt the guidelines would be useful in making decisions about antimicrobials. Cost and availability of antimicrobials were identified as barriers to successful implementation. Conclusion Development of a simple ASP toolkit can be an effective means to bring awareness appropriate antimicrobial use, and may be extrapolated to other low-income countries. Stakeholder buy-in is necessary for a successful international interventional program. Disclosures L. M. Kaljee, Merck: Grant Investigator, Grant recipient; T. Prentiss, Merck, Inc.: Investigator, Research grant; R. D. Joshi, Merck: Grant Investigator, Grant recipient; B. Shrestha, Merck: Grant Investigator, Research grant; D. C. Bajracharya, Merck: Grant Investigator, Grant recipient; M. J. Zervos, Merck: Grant Investigator, Grant recipient; Genentech: Grant Investigator, Grant recipient; Cempra: Grant Investigator, Grant recipient; Medicines Company: Consultant, Consulting fee

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