How institutional forces, ideas and actors shaped population health planning in Australian regional primary health care organisations

Objective: Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Methods: Drawing on published material relating to diabetes management, we developed a conceptual framework of access to and use of quality PHC. Using this framework we examined three recent population-based health surveys ? the 2001 National Health Survey, 2002?03 NSW Health Survey, and AusDiab ? to identify relevant information collection. Results: We identified seven domains comprising aspects of quality PHC for people with diabetes. For each domain we proposed associated indicators. In critiquing the three population health surveys in relation to these indicators, we identified strengths and weaknesses of the data collections. Conclusion: This approach could inform the development of questions and extension of population health surveys to provide a better understanding of access to and use of quality PHC in Australia. The additional information would complement other data collections with a communitybased perspective and contribute to the develop- ment of PHC policy.

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Access to primary health care among women: the role of Ghana’s community-based health planning and services policy

Primary Health Care Research & Development ◽

10.1017/s1463423619000185 ◽

2019 ◽

Vol 20 ◽

Author(s):

Joseph Asumah Braimah ◽

Yujiro Sano ◽

Kilian Nasung Atuoye ◽

Isaac Luginaah

Keyword(s):

Health Care ◽

Primary Health Care ◽

Access To Health Care ◽

Health Planning ◽

Household Wealth ◽

Considerable Proportion ◽

Wealth Status ◽

Community Based ◽

Primary Health ◽

Access To Health

AbstractBackground:Ghana in 1999 adopted the Community-based Health Planning and Service (CHPS) policy to enhance access to primary health care (PHC) service. After two decades of implementation, there remains a considerable proportion of the country’s population, especially women who lack access to basic health care services.Aim:The aim of this paper is to understand the contribution of Ghana’s CHPS policy to women’s access to PHC services in the Upper West Region (UWR) of Ghana.Methods:A logistic regression technique was employed to analyse cross-sectional data collected among women (805) from the UWR.Findings:We found that women who resided in CHPS zones (OR = 1.612;P ≤0.01) were more likely to have access to health care compared with their counterparts who resided in non-CHPS zones. Also, rural-urban residence, distance to health facility, household wealth status and marital status predicted access to health care among women in the region. Our findings underscore the need to expand the CHPS policy to cover many areas in the country, especially rural communities and other deprived localities in urban settings.

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Towards quality primary health care: the dilemma of Community-Based Health Planning and Services (CHPS) in health service provision in Ghana

Journal of Health Organization and Management ◽

10.1108/jhom-06-2021-0219 ◽

2021 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Barnabas Addi ◽

Benjamin Doe ◽

Eric Oduro-Ofori

Keyword(s):

Health Care ◽

Primary Health Care ◽

Health Planning ◽

Health Care Facilities ◽

Health Needs ◽

Community Based ◽

Content Type ◽

Primary Health ◽

Care Facilities ◽

Primary Health Care Facilities

PurposeOver the past two decades, Community-Based Health Planning and Services (CHPS) has been a pragmatic strategy towards universal Primary Health Care (PHC) in Ghana. However, the ability and capacity of these facilities to deliver quality primary health care remain an illusion as they are still crumbling in myriad challenges. These challenges are translated to the poor-quality services provision and low community utilization of CHPS facilities. The study presents a comparative analysis of three communities in the Kassena-Nankana East Municipality, Ghana.Design/methodology/approachUsing a mixed-method research design, the study gathered and analysed data from 110 households, three community health officers (CHOs) and three community leaders using semi-structured questionnaires and interview guides.FindingsThe findings indicated that the facilities do not have the requisite inputs such as drugs and supplies, logistics, appropriate health personnel, good infrastructure, funding support necessary to deliver quality and appropriate healthcare services that meet the health needs of the communities. For the CHPS to realize their full potentials as PHC facilities, it is required that the needed inputs such as logistics, drugs and appropriate staff are in place to facilitate the activities of CHOs.Research limitations/implicationsDue to the limited number of participants and selection of the study communities, the results may generalization. Also, the researchers acknowledged the inability to interview the district level health officials and the Kassena-Nankana Municipal Assembly during the field visits. This could have provided in-depth knowledge on the findings of this research as well as the validation of the results from the communities' perspective. Several attempts were made to contact and interview district-level authorities which proven futile due to the unavailability of targeted respondents. This resulted in limiting the studies at the community level. However, this limitation does not disprove the findings of this study.Practical implicationsThe article implications for planning primary health care strategies include a keen assessment of community health needs and institutional management of primary health care facilities, equip PHC facilities with adequate resources such as drugs and appropriate staffing to provide the health needs of the communities.Originality/valueThe paper fulfils the gap in the literature by providing empirical data on how the challenges of primary health care facilities affected the provision of high quality service and how this can affect community’s use of the facilities.

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Análise situacional de saúde da primeira infância

Revista de Saúde Coletiva da UEFS ◽

10.13102/rscdauefs.v11i1.5464 ◽

2021 ◽

Vol 11 (1) ◽

pp. e5464

Author(s):

Carolina Maia Menezes ◽

Ravane Vasconcelos Santos ◽

Mariana Carvalho Gavazza

Keyword(s):

Health Care ◽

Early Childhood ◽

Primary Health Care ◽

Health Services ◽

Health Planning ◽

Family Health ◽

Population Monitoring ◽

Situational Analysis ◽

Heterogeneous Distribution ◽

Primary Health

A atenção básica é a principal porta de entrada nos serviços de saúde, atuando na coordenação do cuidado e resolução dos problemas de saúde. A Estratégia de Saúde da Família trabalha com abordagem territorial e comunitária, com definição, adscrição da clientela, cadastramento e acompanhamento da população. Dessa forma, o planejamento e programação em saúde é fundamental para os processos de trabalho através da Análise Situacional de Saúde (ASIS). Este trabalho traz um relato de experiência da Residência Multiprofissional em Saúde Coletiva sobre o processo de construção e realização da ASIS da primeira infância em uma Unidade de Saúde da Família no município de Salvador, no ano 2019. Foi encontrada distribuição heterogênea de crianças na primeira infância de acordo com a microárea e subnotificação das condições de saúde, especialmente das deficiências. Nas oficinas com profissionais e usuários, foram elencados problemas semelhantes relacionados ao acesso e utilização dos serviços de saúde e questões sociais que afetam a primeira infância deste território. A assistência à saúde da criança na USF mostrou-se satisfatória, porém necessitando de melhorias quanto ao monitoramento das crianças. A realização da análise proporcionou maior conhecimento acerca da realidade local, com o recorte da primeira infância e pode ser utilizada como ferramenta o planejamento local em saúde e enfrentamento dos problemas priorizados, tanto para primeira infância quanto para outros ciclos de vida. ABSTRACTThe primary health care is the main gateway in health services system, operating on coordinate care and resolution of health problems. The Family Health Strategy (ESF) works with territorial and community approach, with definition, clientele adscription, registration, and population monitoring. Therefore, planning and programming in health care are fundamental to the work processes through the Health Situational Analysis (ASIS). This article reports an experience of Multi-Professional Residency in Public Health about the construction and conduction process of early childhood ASIS at a Family Health Unit (FHU) in the city of Salvador in 2019. It was found a heterogeneous distribution of children on early childhood according to the micro-area and health conditions underreporting, especially physical and mental deficiencies. In workshops with professionals and users, similar problems were related to access and use of health services and social matters that affect early childhood in this territory were listed. Child’s health care assistance in FHU proved to be satisfactory, however, needing improvement in the children monitoring. The conduction of ASIS provided greater knowledge about the local reality, with the cutout of early childhood. It can be used as a tool both to the local planning in health care and the coping of prioritized problems as early childhood and other life cycles.Keywords: Health Planning; Child Development; Primary Health Care. RESUMENLa atención primaria es la principal puerta de acceso a los servicios de salud, trabajando para coordinar la atención y resolver los problemas de salud. La Estrategia Salud de la Familia trabaja con un enfoque territorial y comunitario, con definición, asignación de clientes, registro y seguimiento de la población. Así, la planificación y programación de la salud es fundamental para los procesos de trabajo a través del Análisis Situacional de Salud (ASIS). Este artículo es un relato de experiencia de la Residencia Multiprofesional en Salud Pública sobre el proceso de construcción e implementación de ASIS de la primera infancia en una Unidad de Salud de la Familia (USF) en la ciudad de Salvador, en el año 2019. Se encontró una distribución heterogénea de niños en la primera infancia. niñez según el área micro y subregistro de condiciones de salud, especialmente discapacidad. En los talleres con profesionales y usuarios se enumeraron problemas similares relacionados con el acceso y uso de los servicios de salud y los problemas sociales que afectan a la primera infancia de este territorio. La atención de la salud infantil en la USF demostró ser satisfactoria, pero es necesario mejorar el seguimiento de los niños. La realización del análisis brindóun mayor conocimiento sobre la realidad local, con el corte de la primera infancia y se puede utilizar como herramienta la planificación local en salud y el afrontamiento de los problemas priorizados tanto para la primera infancia como para otros ciclos vitales.Palabras Clave: Planificación en Salud; Desarrollo Infantil; Atención Primaria de Salud.

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Reducing Disease Burden in Rural Populations: Case Studies in Europe and Africa

10.5772/intechopen.96559 ◽

2021 ◽

Author(s):

Paulo Henrique das Neves Martins Pires

Keyword(s):

Health Care ◽

Primary Health Care ◽

Family Medicine ◽

Case Studies ◽

Population Health ◽

Health Indicators ◽

Income Country ◽

Rural Populations ◽

Family Doctors ◽

Primary Health

In 1984, Portugal was a middle-income country, developing the primary health care system, based on family doctors, health centres and health posts, reaching almost all population, with infectious diseases as one of the main health problems. In 2006, Mozambique was a low-income country, with a national health service attaining 60% of the population (40% in rural areas), with a double burden of disease (infectious and non-communicable diseases). Working in primary health care in Europe and Africa, we compare several experiences of family medicine practice in rural populations, different in context, time, and methods: Portugal 1984–2006 and Mozambique 2007–2020, all with a strong component of community health education. Our descriptive case studies, summarise strategies, interventions, and results, reviewing reports and articles. Population’ health indicators, and quality of life have improved, in different contexts with culturally tailored approaches. Participative societal diagnosis and multidisciplinary interventions are necessary to improve rural population health. Different rural populations and cultures are ready to learn and to participate in health promotion; empowering rural populations on health issues is an affordable strategy to better health indicators and services. Family Medicine is effective to extend primary health care to all rural populations, aiming universal health cover.

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Extensionist experience of undergraduate students in medicine as part of the Mais Médicos para o Brasil [more doctors for Brazil] program

Revista Brasileira de Medicina de Família e Comunidade ◽

10.5712/rbmfc16(43)2528 ◽

2021 ◽

Vol 16 (43) ◽

pp. 2528

Author(s):

Jucier Gonçalves Júnior ◽

Sarah Cavalcante Brandão ◽

Sandra Barreto Fernandes Silva ◽

Emmanuela Quental Callou de Sá

Keyword(s):

Health Care ◽

Primary Health Care ◽

Undergraduate Students ◽

Early Stage ◽

Health Planning ◽

National Curriculum ◽

Primary Health ◽

Curriculum Guidelines ◽

Undergraduate Medicine ◽

New Perspective

Problem: The new National Curriculum Guidelines of Undergraduate Medicine in Brazil propose that academics have contact with the health system and its users at an early stage. However, practical activities in undergraduate courses proved to be insufficient for the adequate development of this new perspective. Consequently, the experiences of university extension have the proposal to fill in this gap. Method: This article aimed to report the experiences of the scholarship holders of the Extension Project in Family and Community Medicine - ProMFC (Projeto de Extensão em Medicina de Família e Comunidade) under the More Doctors for Brazil Program – PMMB (Programa Mais Médicos para o Brasil). This is a qualitative, experience-type study with lexical and content analysis from the software IRaMutTeQ, version 0.7 alpha 2, to establish an association between the terms used in the discourse of the ProMFC. Results: The opportunity to immerse in environments in which students can learn about the problems and share the daily life of the assisted community was highlighted. The exchange of knowledge and experiences among students, physicians working in Primary Health Care (fellows of the PMMB, supervisors and tutors) and local managers was also relevant, as well as the students’ ability to develop/train skills, such as teamwork, assertive communication, and health planning. Conclusion: The PMMB, tutored and integrated into an extension project, the ProMFC, is an alternative that, although embryonic, has many potentialities, as it allows the extensionists to be early inserted into the Attention Primary Health Care.

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