Strengthening Primary Health Care in Low- and Middle-Income Countries

Rule, John; Ngo, Duc Anh; Oanh, Tran Thi Mai; Asante, Augustine; Doyle, Jason; Roberts, Graham; Taylor, Richard

doi:10.1177/1010539513503869

Cited by 15 publications

(13 citation statements)

References 34 publications

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“…29 This emphasises the importance of integration of disease-specific activities into the national health system to ensure that when CHWs are involved in additional projects or trials, this does not detract from their routine PHC activities and an appropriate balance between prevention and treatment is maintained. 13 , 41 , 42 If integration does not occur, too much focus may be put on specific diseases and this can lead to over diagnosis and treatment. 42 , 43 Furthermore, integration has been highlighted as a key way to improve CHW capacity for targeting multiple diseases.…”

Section: Discussionmentioning

confidence: 99%

Involving community health workers in disease-specific interventions: perspectives from The Gambia on the impact of this approach

Preston¹,

Okebe²,

Balen³

et al. 2019

Journal of Global Health Reports

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Back Background ground The Community Health Worker (CHW) programme is recognised as key for providing healthcare to communities, particularly in remote locations. CHWs are usually volunteers, nominated by their communities and trained to provide basic care and prevention for common illnesses. However, differences in disease-specific programmes aimed at meeting national agenda and perceived health needs of the community raises questions about the best approach to maximise the potential of this workforce. Methods Methods This was an explorative qualitative study, ancillary to a larger trial on a malaria control intervention. In July 2017, 40 semi-structured interviews were conducted with 17 village health workers (VHWs), four community health nurses who supervise VHWs, and 19 key informants from the community. Analysis was concurrent to data collection and carried out using a deductive process for thematic analysis, with the aid of NVivo 11 Qualitative Analysis Software.

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Section: Discussionmentioning

confidence: 99%

Involving community health workers in disease-specific interventions: perspectives from The Gambia on the impact of this approach

Preston¹,

Okebe²,

Balen³

et al. 2019

Journal of Global Health Reports

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“…It indicated that a lack of highly qualified GPs is still a limiting factor in gaining patients’ trust. 18 So the key issue is that most patients do not trust GPs and are not willing to contract with them even though GPs can treat a majority of common diseases. Because there are GPs with higher expertise levels, a fundamental and necessary solution would be to introduce and cultivate higher-quality GPs to gain the trust of patients.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Patients’ Contract Choice With General Practitioners in Shanghai

Jing

Shu

Sun

et al. 2014

Asia Pac J Public Health

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The general practitioner (GP) system has been widely applied around the world and experimented with in Shanghai, China. To analyze some of the influencing factors on patient-GP contracts, we developed a questionnaire and conducted site investigations in 2011 and 2012 to 1200 patients by random sampling from 6 pilot community health service (CHS) centers in Pudong, Shanghai. The t test, χ(2) test, factor analysis, and logistic regression analysis were used to analyze the data. The factors influencing patients' contract behavior were age (OR = 1.03; 95%CI = 1.02-1.04), education level (OR = 0.83; 95% CI = 0.75-0.93), social interaction of social capital (OR = 1.34; 95% CI = 1.15-1.56), acceptance of first contact in community (OR = 3.25; 95% CI = 2.07-5.12), the year of investigation (OR = 2.58; 95% CI = 1.92-3.47), and the exposure to publicity (OR = 1.60; 95% CI = 1.39-1.85). Elderly patients formed a focus group to sign contracts with GPs. To increase trust in GPs by patients, it is recommended to improve the level of CHSs, strengthen publicity, and cultivate social capital among patients.

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“…Providing evidence on the importance of addressing systems, a recent systematic review and meta-analysis of QI interventions for diabetes care in rural areas of Organisation for Economic Cooperation and Development countries found that successful QI interventions targeted both the health system and clinicians [ 8 ]. Nevertheless, a review by Rule et al addressing the strengthening of PHC in low- and middle-income countries found no consistent approach for assessing the effectiveness of PHC delivery in those countries [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study

Cunningham

Ferguson-Hill

Matthews

et al. 2016

BMC Health Serv Res

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BackgroundAssessment of the quality of primary health care health delivery systems is a vital part of continuous quality improvement (CQI) processes. The Systems Assessment Tool (SAT) was designed to support Indigenous PHC services in assessing and improving their health care systems. It was based on the Assessment of Chronic Illness Care scale, and on practical experience with applying systems assessments in quality improvement in Indigenous primary health care. We describe the development and application of the SAT, report on a survey to assess the utility of the SAT and review the use of the SAT in other CQI research programs.MethodsThe mixed methods approach involved a review of documents and internal reports relating to experience with use of the SAT since its development in 2002 and a survey of key informants on their experience with using the SAT.ResultsThe paper drew from documents and internal reports to describe the SAT development and application in primary health care services from 2002 to 2014. Survey feedback highlighted the benefit to the whole primary health care team from participating in the SAT, bringing to light issues that might not emerge with separate individual tool completion. A majority of respondents reported changes in their health centres as a result of using the SAT. Good organisational and management support assisted with ensuring allocation of time and resources for SAT conduct. Respondents identified the importance of having a skilled, external facilitator.ConclusionsOriginally designed as a measurement tool, the SAT rapidly evolved to become an important development tool, assisting teams in learning about primary health care system functioning, applying best practice and contributing to team strengthening. It is valued by primary health care centres as a lever in implementing improvements to strengthen centre delivery systems, and has potential for further adaptation and wider application in Australia and internationally.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1810-y) contains supplementary material, which is available to authorized users.

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Strengthening Primary Health Care in Low- and Middle-Income Countries

Cited by 15 publications

References 34 publications

Involving community health workers in disease-specific interventions: perspectives from The Gambia on the impact of this approach

Involving community health workers in disease-specific interventions: perspectives from The Gambia on the impact of this approach

Factors Influencing Patients’ Contract Choice With General Practitioners in Shanghai

Leveraging quality improvement through use of the Systems Assessment Tool in Indigenous primary health care services: a mixed methods study

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