scholarly journals Facility Managers’ Perceptions of Support and Supervision of Ward Based Primary Health Care Outreach Teams in National Health Insurance Pilot Districts in KwaZulu-Natal, South Africa. A Qualitative Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1718
Author(s):  
Euphemia Mbali Mhlongo ◽  
Elizabeth Lutge
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Care Facility ◽  
Health Care Facility ◽  
Primary Health Care Facility ◽  
Primary Health ◽  
Kwazulu Natal

Introduction: Evidence from many countries suggests that provision of home and community-based health services, linked to care at fixed primary health care facilities, is critical to good health outcomes. In South Africa, the Ward-Based Primary Health Care Outreach Teams are well placed to provide these services. The teams report to a primary health care facility through their outreach team leader. The facility manager/operational manager provides guidance and support to the outreach team leader. Aim: The aim of the study was to explore and describe the perceptions of facility managers regarding support and supervision of ward-based outreach teams in the National Health Insurance pilot sites in Kwa Zulu-Natal. Setting: The study was carried out in three National Health Insurance pilot districts in KwaZulu- Natal. Methods: An exploratory qualitative design was used to interview 12 primary health care facility managers at a sub-district (municipal) level. The researchers conducted thematic analysis of data. Findings: Some gaps in the supervisory and managerial relationships between ward based primary health care outreach teams and primary health care facility managers were identified. High workload at clinics may undermine the capacity of PHC facility managers to support and supervise the teams. Field supervision seems to take place only rarely and for those teams living far away from the clinic, communication with the clinic manager may be difficult. The study further highlights issues around the training and preparation of the teams. Conclusions: Ward based primary health care outreach teams have a positive impact in preventive and promotive health in rural communities. Furthermore, these teams have also made impact in improving facility indicators. However, their work does not happen without challenges.

scholarly journals DRUG COST ANALYSIS ON NATIONAL HEALTH INSURANCE ERA IN HEALTH SUPPORT FACILITIES

2017 ◽  
Vol 10 (2) ◽  
pp. 119
Author(s):  
Satibi Satibi ◽  
Dewa Ayu Putu Satrya Dewi ◽  
Atika Dalili Akhmad ◽  
Novita Kaswindiarti ◽  
Dyah Ayu Puspandari
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
Drug Cost ◽  
National Health ◽  
Health Facilities ◽  
Drug Costs ◽  
Average Percentage ◽  
Primary Health

Objective: In national health insurance (JKN) era, pharmacy can play roles in the form of behind refer pharmacies, or networking pharmacy and clinic pharmacy pratama. Behind refer pharmacies drug cost can be claimed directly to BPJS, meanwhile for the other type of pharmacy have to negotiation first with the primary health care. Drug cost variations in the JKN era affect the profitability of the business pharmacies. This research aims to the drug percentage charges against capitation and variety of drug costs.Methods: This research is analytic observational cross-sectional. This research uses secondary data from a JKN prescription patient. This research was conducted on 6 affiliated pharmacies, 6 networking pharmacies, and 7 clinical pharmacy pratama in DIY. The sampling in this research is by purposive with 8.430 prescriptions. Data drug costs JKN era was analyzed by descriptive statistics and comparative test (Kruskal Wallis test).Results: The result showed that average percentage of drug costs for capitation fee in the networking pharmacy is 13.58% and primary health care is 15.91%. Pharmacy in JKN era has drug cost variations (p=0.000). Drug cost in JKN era depends on the pattern of play roles with the health facilities and BPJS. The average percentage of drug costs against capitation health facilities in networking pharmacy is lower than clinical pharmacy pratama.Conclusions: Drug costs in an era of JKN depending on the pattern of cooperation with health facilities pharmacies and BPJS. The average percentage of the cost of drugs to the pharmacy capitation health facilities in networking lower than clinic pharmacy pratama. Differences in drug costs JKN era influenced by the long days of drug administration, the number of prescription sheets, margin.Keywords: Drug cost analysis, National health insurance (JKN), Pharmacy, Primary health care, Capitation.

scholarly journals Retention and predictors of attrition among patients who started antiretroviral therapy in Zimbabwe’s National Antiretroviral Therapy Programme between 2012 and 2015

2019 ◽  
Author(s):  
Richard Makurumidze ◽  
Tsitsi Mutasa-Apollo ◽  
Tom Decroo ◽  
Regis C. Choto ◽  
Kudakwashe C. Takarinda ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Antiretroviral Therapy ◽  
Cox Regression ◽  
Care Facility ◽  
Health Care Facility ◽  
Health Care Facilities ◽  
Primary Health Care Facility ◽  
Primary Health

AbstractBackgroundThe last evaluation to assess outcomes for patients receiving antiretroviral therapy (ART) through the Zimbabwe public sector was conducted in 2011, covering the 2007-2010 cohorts. The reported retention at 6, 12, 24 and 36 months were 90.7%, 78.1%, 68.8% and 64.4%, respectively. We report findings of a follow up evaluation for the 2012-2015 cohorts to assess the implementation & impact of recommendations from this prior evaluation.MethodsA nationwide retrospective study was conducted in 2016. Multi-stage proportional sampling was used to select health facilities and study participants records. The data extracted from patient manual records included demographic, baseline clinical characteristics and patient outcomes (active on treatment, died, transferred out, stopped ART and lost to follow-up (LFTU)) at 6, 12, 24 and 36 months. The data were analysed using Stata/IC 14.2. Retention was estimated using survival analysis. The predictors associated with attrition were determined using a multivariate Cox regression model.ResultsA total of 3,810 participants were recruited in the study. The median age in years was 35 (IQR: 28-42). Overall, retention increased to 92.4%, 86.5%, 79.2% and 74.4% at 6, 12, 24 and 36 months respectively. LFTU accounted for 98% of attrition. Being an adolescent or a young adult (aHR 1.41; 95%CI:1.14-1.74), receiving care at primary health care facility (aHR 1.23; 95%CI:1.01-1.49), having initiated ART between 2014-2015 (aHR 1.45; 95%CI:1.24-1.69), having WHO Stage 4 (aHR 2.06; 95%CI:1.51-2.81) and impaired functional status (aHR 1.24; 95%CI:1.04-1.49) predicted attrition.ConclusionThe overall retention was higher in comparison to the previous 2007–-2010 evaluation. Further studies to understand why attrition was found to be higher at primary health care facilities are warranted. Implementation of strategies for managing patients with advanced HIV disease, differentiated care for adolescents and young adults and tracking of LFTU should be prioritised to further improve retention.

Respiratory Viruses in a Primary Health Care Facility in Amsterdam, the Netherlands

2018 ◽  
Vol 26 (4) ◽  
pp. 211-215 ◽  
Author(s):  
Andrea H.L. Bruning ◽  
Wilhelmina B. de Kruijf ◽  
Henk C.P.M. van Weert ◽  
Anja Vrakking ◽  
Menno D. de Jong ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
The Netherlands ◽  
Care Facility ◽  
Health Care Facility ◽  
Respiratory Viruses ◽  
Primary Health Care Facility ◽  
Primary Health
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