Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess ...Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess their associated factors. Study Setting: Kuwait Ministry of Health, Primary Care Centers. Study Design: Cross-sectional study. Data Collection: The study was conducted from July to September, 2017. Of 746 questionnaires distributed to all PHC physicians in the MOH, 417 questionnaires were completed. Information was collected on socio-demographic characteristics, work and health-related factors, job satisfaction (using the Warr-Cook-Wall job satisfaction scale), and mental health (using General Health Questionnaire). Principal Findings: Of participants, 40.8% were male, and 24.9% were Kuwaitis. Median overall job satisfaction was 71.4%. There were significant differences in overall job satisfaction with the physician rank (p = 0.008) and governorate (p = 0.05). The GPs were moderately satisfied with work surroundings;work freedom;recognition;degree of responsibility;salary;opportunity to use abilities;attention given to suggestions;relationship with hospital physicians, colleagues, and fellow workers;relations between management and workers;working hours;and the amount of variety in their job, but more satisfied with their immediate supervisors. Conclusions: Job satisfaction of PHC physicians is critical for the improvement of health systems. This study showed that GPs (General Practitioners) were more satisfied overall than previously reported studies done in Kuwait. They were moderately satisfied with their salary and the amount of variety in work.展开更多
The WHO project for conforming PHC to requirements of all age groups has resulted in publishing a toolkit for age-friendly PHC in 2008. The toolkit included checklists for physical environment and signage properties. ...The WHO project for conforming PHC to requirements of all age groups has resulted in publishing a toolkit for age-friendly PHC in 2008. The toolkit included checklists for physical environment and signage properties. This study matched the current physical environment properties of DHA’s PHC Health Centers against WHO’s recommendations. This is a cross sectional descriptive study that included visits to all 12 Primary Health Care Centers in Dubai city during August-September 2016 with the objective to assess the degree of fulfillment of current properties of Health Centers building to the recommendations of WHO as listed in “Age-friendly Primary Health Care Centres Toolkit” [1]. The study found that 81.86% of physical environment properties are matching the recommendation of WHO, while signage matching was 44.6%. The study concluded that most PHC properties have a physical design that met WHO’s recommendations. The two major deviations were accessibility by public transportations and presence of grab bars. Factors that had a significant impact on design were compliance with multiple international and local standards, the availability of private cars, and the availability of wheel chairs. Signage in DHA’s health centers followed a central plan that differed from WHO’s recommendations.展开更多
Objective: To ascertain that standard antenatal care (Focused antenatal care) is being received at the Primary Health Care level in urban and rural areas of Ekiti State and to determine the facilitating factors and ch...Objective: To ascertain that standard antenatal care (Focused antenatal care) is being received at the Primary Health Care level in urban and rural areas of Ekiti State and to determine the facilitating factors and challenges to the practice of FANC in urban and rural areas. Design: Cross sectional. Setting: Primary Health Centers Participants: Pregnant women and Heads of health facilities. Methods: Two hundred respondents each from urban and rural areas primary health centres were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the antenatal care exit interview form of the Safe Motherhood Needs Assessment package. In-depth Interviews were conducted with the heads of selected facilities. Data was analysed using descriptive statistics and Chi square test and content analysis for indepth interview. Results: More respondents 58 (29.3%) from the urban areas had the minimum contents compared to 41 (20.7%) of the rural respondents (p < 0.05) and 178 (90.8%) of the urban were taught a range of health education topics compared to 177 (88.5%) (p = 0.45). Urban respondents were about 1.6 times more likely to receive the minimum contents than rural respondents. In-depth interview results explicated the facilitating factors and challenges to focused antenatal care in the study areas. Conclusion: The findings of this study is consistent with other studies establishing the fact that better health service is available to urban residents than rural residents;however, this study has succeeded in comparing the documented standard of antenatal care with what was being practiced in the selected PHCs of the state. The basic contents of focused antenatal care in Ekiti state were received by a small proportion of the respondents, suggesting that focused antenatal care had not fully translated into quality service;one major challenge to the delivery of standard antenatal care was inadequate number of skilled health workers especially in the rural areas. The gap between quality and utilisation of antenatal in urban and rural areas is gradually being closed up;this success should be improved upon and maintained.展开更多
In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food short...In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food shortage, there were many food assistant programs through the government channel. With the economic developments during past years, now, there are enough foods for everyone. Thus, food assistant program, which has been the only nutrition program in the government, is no longer needed except for low-income families.Currently, there are not enough nutrition programs in the government. In 1994, about 30 public health center start nutrition programs with the help of Korean Dietetic Association.In this study, kinds of nutrition programs, age, sex and number of participants, the content of programs are studied. The effects of nutrition programs are partially evaluated.Also, problems with current nutrition programs are discussed. Finally, future directions of nutrition programs in the public health centers are discussed展开更多
Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form th...Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.展开更多
Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in P...Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community.展开更多
Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthc...Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.展开更多
文摘Objectives: To measure the level of job satisfaction among primary health care physicians Ministry of Health (MOH) Primary Healthcare Center (PHC) physicians, to evaluate the physicians’ mental health, and to assess their associated factors. Study Setting: Kuwait Ministry of Health, Primary Care Centers. Study Design: Cross-sectional study. Data Collection: The study was conducted from July to September, 2017. Of 746 questionnaires distributed to all PHC physicians in the MOH, 417 questionnaires were completed. Information was collected on socio-demographic characteristics, work and health-related factors, job satisfaction (using the Warr-Cook-Wall job satisfaction scale), and mental health (using General Health Questionnaire). Principal Findings: Of participants, 40.8% were male, and 24.9% were Kuwaitis. Median overall job satisfaction was 71.4%. There were significant differences in overall job satisfaction with the physician rank (p = 0.008) and governorate (p = 0.05). The GPs were moderately satisfied with work surroundings;work freedom;recognition;degree of responsibility;salary;opportunity to use abilities;attention given to suggestions;relationship with hospital physicians, colleagues, and fellow workers;relations between management and workers;working hours;and the amount of variety in their job, but more satisfied with their immediate supervisors. Conclusions: Job satisfaction of PHC physicians is critical for the improvement of health systems. This study showed that GPs (General Practitioners) were more satisfied overall than previously reported studies done in Kuwait. They were moderately satisfied with their salary and the amount of variety in work.
文摘The WHO project for conforming PHC to requirements of all age groups has resulted in publishing a toolkit for age-friendly PHC in 2008. The toolkit included checklists for physical environment and signage properties. This study matched the current physical environment properties of DHA’s PHC Health Centers against WHO’s recommendations. This is a cross sectional descriptive study that included visits to all 12 Primary Health Care Centers in Dubai city during August-September 2016 with the objective to assess the degree of fulfillment of current properties of Health Centers building to the recommendations of WHO as listed in “Age-friendly Primary Health Care Centres Toolkit” [1]. The study found that 81.86% of physical environment properties are matching the recommendation of WHO, while signage matching was 44.6%. The study concluded that most PHC properties have a physical design that met WHO’s recommendations. The two major deviations were accessibility by public transportations and presence of grab bars. Factors that had a significant impact on design were compliance with multiple international and local standards, the availability of private cars, and the availability of wheel chairs. Signage in DHA’s health centers followed a central plan that differed from WHO’s recommendations.
文摘Objective: To ascertain that standard antenatal care (Focused antenatal care) is being received at the Primary Health Care level in urban and rural areas of Ekiti State and to determine the facilitating factors and challenges to the practice of FANC in urban and rural areas. Design: Cross sectional. Setting: Primary Health Centers Participants: Pregnant women and Heads of health facilities. Methods: Two hundred respondents each from urban and rural areas primary health centres were proportionately selected from 18 primary health centers using simple random sampling. Exit interviews were conducted using the antenatal care exit interview form of the Safe Motherhood Needs Assessment package. In-depth Interviews were conducted with the heads of selected facilities. Data was analysed using descriptive statistics and Chi square test and content analysis for indepth interview. Results: More respondents 58 (29.3%) from the urban areas had the minimum contents compared to 41 (20.7%) of the rural respondents (p < 0.05) and 178 (90.8%) of the urban were taught a range of health education topics compared to 177 (88.5%) (p = 0.45). Urban respondents were about 1.6 times more likely to receive the minimum contents than rural respondents. In-depth interview results explicated the facilitating factors and challenges to focused antenatal care in the study areas. Conclusion: The findings of this study is consistent with other studies establishing the fact that better health service is available to urban residents than rural residents;however, this study has succeeded in comparing the documented standard of antenatal care with what was being practiced in the selected PHCs of the state. The basic contents of focused antenatal care in Ekiti state were received by a small proportion of the respondents, suggesting that focused antenatal care had not fully translated into quality service;one major challenge to the delivery of standard antenatal care was inadequate number of skilled health workers especially in the rural areas. The gap between quality and utilisation of antenatal in urban and rural areas is gradually being closed up;this success should be improved upon and maintained.
文摘In the peroid of confusion after the Korean War, there was an absolute shortage in the volume of food. The intake of energy and all other nutrients fell short of the recommended dietary intake. To solve the food shortage, there were many food assistant programs through the government channel. With the economic developments during past years, now, there are enough foods for everyone. Thus, food assistant program, which has been the only nutrition program in the government, is no longer needed except for low-income families.Currently, there are not enough nutrition programs in the government. In 1994, about 30 public health center start nutrition programs with the help of Korean Dietetic Association.In this study, kinds of nutrition programs, age, sex and number of participants, the content of programs are studied. The effects of nutrition programs are partially evaluated.Also, problems with current nutrition programs are discussed. Finally, future directions of nutrition programs in the public health centers are discussed
文摘Quality of maternal and newborn care could be improved if health care providers’ knowledge and competencies as well as system level constraints are addressed. However, due to several barriers staff nurses who form the frontline of health care workforce have limited access to enhancing their clinical knowledge and competencies. To address this gap, a new cadre of nurse mentors (NMs) for the public health system were trained by specialists from a teaching hospital in a special 5-week training course. This included 54 hours of theory and 110 hours of practical in clinical obstetric and newborn care, apart from mentoring, quality improvement and health systems issues. The nurse mentors were assigned to support staff nurses in the primary health care centres (PHCs) in eight northern Karnataka districts. Each NM covered 6-8 PHCs monthly for 2 - 3 days and thus a total of 385 PHCs were reached. They received support in the field through supportive supervision visits done by the specialists who had trained them, as well as by refresher training and clinical postings to the district hospitals. This paper presents impact of the training program on change in immediate and long term knowledge and competency scores of nurse mentors. Their baseline knowledge scores changed from 44.3 ± 12.7 to 72.1 ± 13.8 immediately after the training in obstetric and from 18.2 ± 19.1 to 66.4 ± 14.9 in newborn (p p p > 0.05). Skills score soon after training increased from 62.2 ± 13.2 to 69.6 ± 12.5 in obstetric after a 1 year period and from 52.6 ± 9.3;63.5 ± 14.4 in newborn (p < 0.001) content areas respectively. These findings have implications for those interested in improving quality of maternal and child care through nurse-dependent health delivery systems.
文摘Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community.
文摘Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness.
