scholarly journals Health facility-based counselling and community outreach are associated with maternal dietary practices in a cross-sectional study from Tanzania

BMC Nutrition ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kirk A. Dearden ◽  
Ramu Bishwakarma ◽  
Benjamin T. Crookston ◽  
Benesta T. Masau ◽  
Generose I. Mulokozi
Keyword(s):  
Health Services ◽  
Antenatal Care ◽  
Community Health ◽  
Health Worker ◽  
Health Facility ◽  
Dietary Behaviors ◽  
Access To Health Services ◽  
Dietary Practices ◽  
Cross Sectional ◽  
Access To Health

Abstract Background Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania. Methods Data come from a cross-sectional baseline survey among 5000 female primary caregivers who were randomly selected via two-stage sampling, prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression. Results A third of the sample (34.1%) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0%). 68.0% had never had a community health worker (CHW) speak to them about their children’s health and 9.4% had participated in a women’s group. Only 8.0% of mothers ate more than usual during pregnancy and 7.1% ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95% CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving antenatal care (ANC) and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 h. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 h. Conclusions Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

scholarly journals Health Facility-based Counselling and Community Outreach are Associated with Maternal Dietary Practices in a Cross-sectional Study from Tanzania

2021 ◽  
Author(s):  
Kirk A. Dearden ◽  
Ramu Bishwakarma ◽  
Benjamin T. Crookston ◽  
Benesta T. Masau ◽  
Generose I. Mulokozi
Keyword(s):  
Health Services ◽  
Community Health ◽  
Health Worker ◽  
Health Facility ◽  
Community Health Worker ◽  
Children's Health ◽  
Dietary Behaviors ◽  
Access To Health Services ◽  
Dietary Practices ◽  
Access To Health

Abstract Background: Anemia and underweight among women are major public health challenges. Access to health services can improve dietary behaviors and women’s nutritional status. We examined whether exposure to health services is associated with women’s dietary practices in Tanzania.Methods: Data come from a two-stage, randomized baseline survey among 5,000 female primary caregivers prior to implementing a maternal and child nutrition program. We ran frequencies on women’s exposure to existing health facility-based counselling, community health worker visits, and attendance at women’s support groups. We examined associations between exposure to these interventions and maternal diets and adjusted for sociodemographic covariates using ordinary least squares regression and ordered logistic regression.Results: A third of the sample (34.1 percent) had received any antenatal care (ANC) during their most recent pregnancy or had been advised by anyone about nutrition (37.0 percent). 68.0 percent had never had a community health worker (CHW) speak to them about their children’s health and 9.4 percent had participated in a women’s group. Only 8.0 percent of mothers ate more than usual during pregnancy and 7.1 percent ate more types of foods. After adjusting for mother’s age, education and household assets, women who received nutrition advice were 1.3 times (95 percent CI: 1.1, 1.7) more likely than mothers who did not to eat more during pregnancy. Receiving ANC and advice on nutrition before, during, and after pregnancy and delivery were highly associated with the mother eating more types of foods. Hearing from a CHW about children’s health but not support group attendance was often associated with various dietary practices. Almost all measures of access to health services were significantly associated with mothers’ frequency of eating in the previous 24 hours. Receiving advice on nutrition during pregnancy and after giving birth and CHW contact were associated with mothers’ dietary diversity in the previous 24 hours. Conclusions: Several program exposure variables—especially being counselled about nutrition—were associated with improved dietary practices. Improving service delivery at scale may contribute to improved dietary behaviors in larger populations, given the associations we describe, along with findings from the existing literature.

scholarly journals The effects of medicines availability and stock-outs on household’s utilization of healthcare services in Dodoma region, Tanzania

2020 ◽  
Vol 35 (3) ◽  
pp. 323-333 ◽  
Author(s):  
August Kuwawenaruwa ◽  
Kaspar Wyss ◽  
Karin Wiedenmayer ◽  
Emmy Metta ◽  
Fabrizio Tediosi
Keyword(s):  
Health Services ◽  
Health Facility ◽  
Healthcare Utilization ◽  
Low Income ◽  
Essential Medicines ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Catchment Areas ◽  
Medicine Availability

Abstract Low- and middle-income countries have been undertaking health finance reforms to address shortages of medicines. However, data are lacking on how medicine availability and stock-outs influence access to health services in Tanzania. The current study assesses the effects of medicine availability and stock-outs on healthcare utilization in Dodoma region, Tanzania. We conducted a cross-sectional study that combined information from households and healthcare facility surveys. A total of 4 hospitals and 89 public primary health facilities were surveyed. The facility surveys included observation, record review over a 3-month period prior to survey date, and interviews with key staff. In addition, 1237 households within the health facility catchment areas were interviewed. Data from the facility survey were linked with data from the household survey. Descriptive analysis and multivariate logistic regressions models were used to assess the effects of medicine availability and stock-outs on utilization patterns and to identify additional household-level factors associated with health service utilization. Eighteen medicines were selected as ‘tracers’ to assess availability more generally, and these were continuously available in ∼70% of the time in facilities across all districts over 3 months of review. The main analysis showed that household’s healthcare utilization was positively and significantly associated with continuous availability of all essential medicines for the surveyed facilities [odds ratio (OR) 3.49, 95% confidence interval (CI) 1.02–12.04; P = 0.047]. Healthcare utilization was positively associated with household membership in the community health insurance funds (OR 1.97, 95% CI 1.23–3.17; P = 0.005) and exposure to healthcare education (OR 2.75, 95% CI 1.84–4.08; P = 0.000). These results highlight the importance of medicine availability in promoting access to health services in low-income settings. Effective planning and medicine supply management from national to health facility level is an important component of quality health services.

Trends in access to health services and financial protection in China between 2003 and 2011: a cross-sectional study

The Lancet ◽  
2012 ◽  
Vol 379 (9818) ◽  
pp. 805-814 ◽  
Author(s):  
Qun Meng ◽  
Ling Xu ◽  
Yaoguang Zhang ◽  
Juncheng Qian ◽  
Min Cai ◽  
...  
Keyword(s):  
Health Services ◽  
Cross Sectional Study ◽  
Financial Protection ◽  
Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health

scholarly journals HUBUNGAN PENDIDIKAN, AKSES PELAYANAN KESEHATAN DAN DUKUNGAN KELUARGA DENGAN PEMANFAATAN PELAYANAN KESEHATAN PENDERITA TB PARU BTA+ DI PUSKESMAS JANTI KOTA MALANG

2019 ◽  
Vol 4 (1) ◽  
pp. 1
Author(s):  
Alfreda Dinayu Purbantari ◽  
Roesdiyanto Roesdiyanto ◽  
Nurnaningsih Herya Ulfah
Keyword(s):  
Public Health ◽  
Health Service ◽  
Health Services ◽  
Health Center ◽  
Family Support ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Education Access ◽  
Utilization Of Health Services ◽  
Access To Health

Abstract: Tuberculosis (TB) is a contagious disease that is still the world's attention, Until now, there is not a single country that is free of TB (Kemenkes 2011). Public Health Center (puskesmas) Janti is a puskesmas where the number of TB BTA+ sufferers increases every year while the number of treatment success rate at Puskesmas Janti decreases every year. In 2013 is 96%, in 2014 is 87,50% and in 2015 is 85,37%. Increasing the number of patients and decreasing the number of success rates of treatment indicates that the utilization of health services is less. This study aims to find out the relationship of Education, Health Service Access and Family Support with Health Service Utilization of BTA+ Pulmonary TB Patients at Public Health Center (puskesmas) Janti Malang. The design of this study is quantitative correlation with samples of all patients with TB Paru + BTA who are still doing treatment at Puskesmas Janti in September 2016 until April 2017. The analysis used correlation test and logistic regression test with cross sectional approach. The results of the research analysis found that there is a significant relationship between education, access to health services and family support together with the utilization of health services of patients Tb Paru BTA+. Based on the results of determination coefficient R2 (Nagelkerke) of 0.619, this means that education (X1), access to health services (X2), and family support (X3) has contributed 61.9% to the utilization of health services of patients with TB Paru BTA+ at Puskesmas Janti.Keywords: education, access, family support, health service utilizationAbstrak: Tuberkulosis (TB) adalah penyakit menular yang masih menjadi perhatian dunia, hingga saat ini, belum ada satu negara pun yang bebas TB (Kemenkes 2011). Puskesmas Janti adalah satu puskesmas yang berada di Kota Malang dengan jumlah pasien TB Paru BTA+ yang paling tinggi dan meningkat setiap tahun diantara puskesmas yang lain di Kota Malang, sedangkan jumlah angka keberhasilan pengobatan di Puskesmas Janti mengalami penurunan setiap tahun. Tahun 2013 sebesar 96%, pada tahun 2014 sebesar 87,50% dan pada tahun 2015 sebesar 85,37%. Peningkatan jumlah penderita dan penurunan jumlah angka keberhasilan pengobatan menunjukkan bahwa pemanfaatan pelayanan kesehatan kurang. Penelitian ini bertujuan untuk mengetahui Hubungan Pendidikan, Akses Pelayanan Kesehatan dan Dukungan Keluarga dengan Pemanfaatan Pelayanan Kesehatan Penderita TB Paru BTA+ di Puskesmas Janti Kota Malang. Rancangan penelitian ini adalah kuantitatif korelasional dengan sampel seluruh penderita TB Paru BTA+ yang masih melakukan pengobatan di Puskesmas Janti pada bulan September 2016 sampai dengan April 2017. Analisis menggunakan uji korelasi dan uji regresi logistik dengan pendekatan cross sectional. Hasil analisis penelitian di dapatkan ada hubungan yang dignifikan antara pendidikan, akses pelayanan kesehatan dan dukungan keluarga secara bersama-sama dengan pemanfaatan pelayanan kesehatan penderita Tb Paru BTA+. Berdasarkan hasil koefisien determinasi R2 (Nagelkerke) sebesar 0,619, hal ini berarti bahwa pendidikan (X1), akses pelayanan kesehatan (X2), dan dukungan keluarga (X3) memiliki kontribusi sebesar 61,9% terhadap pemanfaatan pelayanan kesehatan penderita TB Paru BTA+ di Puskesmas Janti.Kata Kunci:    pendidikan, akses pelayanan kesehatan, dukungan keluarga, pemanfaatan pelayanan kesehatan penderita TB Paru BTA+

scholarly journals Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siriwan Choojaturo ◽  
Siriorn Sindhu ◽  
Ketsarin Utriyaprasit ◽  
Chukiat Viwatwongkasem
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Health Services ◽  
Self Management ◽  
Access To Health Services ◽  
Patient Factors ◽  
Cross Sectional ◽  
Knee Oa ◽  
Access To Health

Abstract Background The main purpose of health service systems is to improve patients’ quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. Methods A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. Results The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = −.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). Conclusions This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient’s background, such as socioeconomic status, disease severity, and self-management skills.

scholarly journals Expanding the use of community health workers in urban settings: a potential strategy for progress towards universal health coverage

2019 ◽  
Author(s):  
Brian Wahl ◽  
Susanna Lehtimaki ◽  
Stefan Germann ◽  
Nina Schwalbe
Keyword(s):  
Health Services ◽  
Community Health ◽  
Low Income ◽  
Urban Areas ◽  
Access To Health Services ◽  
Middle Income ◽  
Urban Settings ◽  
Middle Income Countries ◽  
Access To Health ◽  
Low And Middle Income

Abstract Community health worker (CHW) programmes have been used for decades to improve access to health services in rural settings in low- and middle-income countries. With more than half of the world’s population currently living in urban areas and this population expected to grow, equitable access to health services in urban areas is critically important. To understand the extent to which CHW programmes have been successfully deployed in low-income urban settings, we conducted a review of the literature between 2000 and 2018 to identify studies evaluating and describing CHW programmes implemented fully or partially in urban or peri-urban settings. We identified 32 peer-reviewed articles that met our inclusion criteria. Benefits have been documented in several urban settings in low- and middle-income countries including those to address TB/HIV, child health, maternal health and non-communicable diseases through a variety of study designs.

scholarly journals Barriers and Facilitators to Accessing Health Services: A Qualitative Study Amongst People with Disabilities in Cameroon and India

2019 ◽  
Vol 16 (7) ◽  
pp. 1126 ◽  
Author(s):  
Maria Zuurmond ◽  
Islay Mactaggart ◽  
Nanda Kannuri ◽  
Gudlavalleti Murthy ◽  
Joseph Oye ◽  
...  
Keyword(s):  
Health Services ◽  
Access To Health Care ◽  
Social Inclusion ◽  
Service Providers ◽  
People With Disabilities ◽  
Personal Factors ◽  
Access To Health Services ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Access To Health

Background: Article 25 of the UNCRPD stipulates the right of people with disabilities to the highest attainable standard of health, and the timely uptake of appropriate health and rehabilitation services. This study seeks to explore the factors which influence access to health care among adults with disabilities in Cameroon and India. Methods: A total of 61 semi-structured interviews were conducted with a purposive sample of adults with vision, hearing or musculoskeletal impairments, using data from an earlier cross-sectional disability survey. In addition, 30 key informants were interviewed to provide contextual information about the local services and context. Results: Key themes included individual-level factors, understanding and beliefs about an impairment, and the nature of the impairment and interaction with environmental factors. At the community and household level, key themes were family dynamics and attitudes, economic factors, social inclusion and community participation. Intersectionality with gender and age were cross-cutting themes. Trust and acceptability of health service providers in India and poor understanding of referral processes in both countries were key service-level themes. Conclusions: The interaction of environmental and personal factors with the impairment and their levels of participation and inclusion in community structures, all contributed to the take up of services. This study illustrated the need for a multi-faceted response to improve access to health services for people with disabilities.

scholarly journals Satisfaction with Access to Health Services: The Perspective of Estonian Patients with Rheumatoid Arthritis

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Kaja Põlluste ◽  
Riina Kallikorm ◽  
Kersti Meiesaar ◽  
Margus Lember
Keyword(s):  
Rheumatoid Arthritis ◽  
Health Services ◽  
Negative Impact ◽  
Waiting Times ◽  
Cross Sectional Study ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Access To Health ◽  
Degree Of Satisfaction ◽  
Determinants Of Satisfaction

In this cross-sectional study we explained the possible determinants of satisfaction with access to health services in patients with rheumatoid arthritis (RA). Of the 2000 randomly selected Estonian adult patients with RA, a total 1259 completed the survey. Regression analysis was used to analyse the predictors of patients' satisfaction with access to health services. Half of the respondents were satisfied with their access to health services. Factors that had a negative impact on satisfaction included pain intensity, longer waiting times to see the doctors, as well as low satisfaction with the doctors. Transportation costs to visit a rheumatologist and higher rehabilitation expenses also affected the degree of satisfaction. Patients who could choose the date and time at which they could visit the rheumatologist or who could visit their “own” doctor were more likely to be satisfied than patients whose appointment times were appointed by a healthcare provider.

scholarly journals Polish Nurses’ Opinions on the Expansion of Their Competences—Cross-Sectional Study

2021 ◽  
Vol 11 (2) ◽  
pp. 301-310
Author(s):  
Kinga Harpula ◽  
Anna Bartosiewicz ◽  
Jerzy Krukowski
Keyword(s):  
Health Services ◽  
Medical Science ◽  
Cross Sectional Study ◽  
Advanced Practice ◽  
Access To Health Services ◽  
Cross Sectional ◽  
Significance Level ◽  
Access To Health ◽  
Survey Technique

The development of medical science creates new challenges for nurses to acquire new skills. Thanks to legal changes in Poland, nurses have gained the opportunity to independently provide health services in many areas, including consultations for patients. The aim of the survey is to analyze nurses’ opinions on the expansion of competences in their profession. This is a cross-sectional, descriptive study conducted among 798 nurses using the survey technique. The majority (65.48%) of the respondents believed that they were adequately prepared to take up new competences. Most of the respondents believed that the new competence would improve the efficiency of the healthcare system in Poland (71.06%) and facilitate patients’ access to health services (65.29%). According to the nurses, the scope of nursing advice will mainly concern the promotion of health education, wound treatment and prescribing medications. Age, seniority and education level significantly influenced the nurses’ opinions on the scope of nursing advice. The Mann–Whitney test and the Kruskal–Wallis test were used. A correlation between two quantitative variables was assessed with the Spearman’s rho coefficient. The significance level of p < 0.05 was assumed. The extension of the professional competences of nurses will increase the prestige of the profession and is another step toward introducing the role of Advanced Practice Nurse in Poland.

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