Dataset Information

Infrastructure and work process in primary health care: PMAQ in Ceara.

ABSTRACT: OBJECTIVE To analyze the quality of the infrastructure and work process of the Family Health Strategy in the municipalities of Ceará between 2012 and 2014. METHODS Cross-sectional study, using secondary data from the external evaluation of the 1st (2012) and 2nd (2014) cycle of the National Program for Improvement of Access and Quality of Primary Care in Ceará. A total of 20 composite indicators were used to verify the quality of infrastructure and work process. RESULTS Data from 183 (99.4%) of the 184 municipalities of Ceará were collected in both cycles. A total of 1,441 teams were evaluated for the infrastructure and 800 for the work process. Among the 20 composite indicators evaluated, 18 presented an improvement, but in a non-homogeneous way, ranging between 0.0 and 413.5%. We observed that the lower the initial value of the indicator, the greater the variation in quality between 2012 and 2014. The indicators of infrastructure and work process were influenced by the regional health system and population size of the municipality, being more evident the influence on the variables of the work process. CONCLUSIONS We identified that quality improvements related to infrastructure and work process occurred in the period of implementation of the program in the state of Ceará in an equitable manner, being influenced by population size and regional health system, showing the influence of the context in the implementation of public policies of this nature.

SUBMITTER: Vieira-Meyer APGF

PROVIDER: S-EPMC7274211 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Infrastructure and work process in primary health care: PMAQ in Ceará.

Vieira-Meyer Anya Pimentel Gomes Fernandes APGF Morais Ana Patrícia Pereira APP Guimarães José Maria Ximenes JMX Campelo Isabella Lima Barbosa ILB Vieira Neiva Francenely Cunha NFC Machado Maria de Fátima Antero Sousa MFAS Nogueira Paula Sacha Frota PSF Nuto Sharmênia de Araújo Soares SAS Freitas Roberto Wagner Júnior Freire de RWJF

Revista de saude publica 20200610

OBJECTIVE To analyze the quality of the infrastructure and work process of the Family Health Strategy in the municipalities of Ceará between 2012 and 2014. METHODS Cross-sectional study, using secondary data from the external evaluation of the 1st (2012) and 2nd (2014) cycle of the National Program for Improvement of Access and Quality of Primary Care in Ceará. A total of 20 composite indicators were used to verify the quality of infrastructure and work process. RESULTS Data from 183 (99.4%) of ...[more]

PMID: 32555977

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Project description:BackgroundOver two-thirds of Africans have no access to eye care services. To increase access, the World Health Organization (WHO) recommends integrating eye care into primary health care, and the WHO Africa region recently developed a package for primary eye care. However, there are limited data on the capacities needed for delivery, to guide policymakers and implementers on the feasibility of integration. The overall purpose of this study was to assess the technical capacity of the health system at primary level to deliver the WHO primary eye care package. Findings with respect to service delivery, equipment and health management information systems (HMIS) are presented in this paper.MethodsThis was a mixed-methods, cross sectional feasibility study in Anambra State, Nigeria. Methods included a desk review of relevant Nigerian policies; a survey of 48 primary health facilities in six districts randomly selected using two stage sampling, and semi-structured interviews with six supervisors and nine purposively selected facility heads. Quantitative study tools included observational checklists and questionnaires. Survey data were analysed descriptively using STATA V.15.1 (Statcorp, Texas). Differences between health centres and health posts were analysed using the z-test statistic. Interview data were analysed using thematic analysis assisted by Open Code Software V.4.02.ResultsThere are enabling national health policies for eye care, but no policy specifically for primary eye care. 85% of facilities had no medication for eye conditions and one in eight had no vitamin A in stock. Eyecare was available in < 10% of the facilities. The services delivered focussed on maternal and child health, with low attendance by adults aged over 50 years with over 50% of facilities reporting ≤10 attendances per year per 1000 catchment population. No facility reported data on patients with eye conditions in their patient registers.ConclusionA policy for primary eye care is needed which aligns with existing eye health policies. There are currently substantial capacity gaps in service delivery, equipment and data management which will need to be addressed if eye care is to be successfully integrated into primary care in Nigeria.

Project description:BackgroundQuality circles (QCs) are commonly used in primary health care in Europe to consider and improve standard practice over time. They represent a complex social intervention that occurs within the fast-changing system of primary health care. Numerous controlled trials, reviews, and studies have shown small but unpredictable positive effect sizes on behavior change. Although QCs seem to be effective, stakeholders have difficulty understanding how the results are achieved and in generalizing the results with confidence. They also lack understanding of the active components of QCs which result in changes in the behavior of health care professionals. This protocol for a realist synthesis will examine how configurations of components and the contextual features of QCs influence their performance.Methods/designStakeholder interviews and a scoping search revealed the processes of QCs and helped to describe their core components and underlying theories. After clarifying their historical and geographical distribution, a purposive and systematic search was developed to identify relevant papers to answer the research questions, which are: understanding why, how, and when QCs work, over what time frame, and in what circumstances. After selecting and abstracting appropriate data, configurations of contexts and mechanisms which influence the outcome of QCs within each study will be identified. Studies will be grouped by similar propositional statements in order to identify patterns and validation from stakeholders sought. Finally, theories will be explored in order to explain these patterns and to help stakeholders maintain and improve QC performance.DiscussionAnalyzing context-mechanism-outcome (CMO) patterns will reveal how QCs work and how contextual factors interact to influence their outcome. The aim is to investigate unique configurations that enable them to improve the performance of health care professionals. Using a standardized reporting system, this realist review will allow the research questions to be answered to the satisfaction of key stakeholders and enable on-going critical examination and dissemination of the findings.Study registrationPROSPERO registration number: CRD42013004826.

Project description:Objectives The prevalence of unmet mental healthcare needs is a common challenge faced by many developing countries. This situation may worsen if more attention is not paid to the dramatic changes in the industrial workplace because of the diffusion of new automation and robotisation in the process of production.We aim to examine whether mental health problems are associated with frontline workers' direct experience of process innovation in the firms where they operate and verify whether/which of these mechanisms are involved in this relationship. Methods Our data were obtained from the Foshan Workplace Employee Survey (FWES). Mental health was proxied by the subjective assessment of workers' need to receive psychological counselling or treatment. To address endogeneity concerns, this study employed an extended ordered probit model and the two-stage least squares (2SLS) method. Results Frontline workers employed in innovative manufacturing firms are significantly more likely than those in firms taking no such action to experience psychological difficulties and to seek psychological counselling or treatment. Firms with a higher likelihood of upgrading their production process are more capable of taking a range of measures to significantly but not sufficiently mitigate the psychological problems of their workers induced by process innovation. In workplaces with a new advanced automation environment, workers believe that they face higher job insecurity (JI) and work stress, which in turn is partially and effectively linked to the deterioration in their mental health and further increases treatment-seeking behaviours. Conclusion This study suggests that carrying out process innovation is associated with increased psychological distress and, hence, more needs for mental healthcare services. To narrow the treatment gap originally subject to existing obstacles, it is necessary to face the new challenges posed by automation-induced change in the workplace, which policies should be particularly attentive to. Highlights • Carrying out process innovation causally increases treatment-seeking behaviours.• Innovative manufacturers insufficiently mitigate mental problems of their workers.• Job insecurity and work stress are two effective channels.

Project description:BackgroundPaper-based Aboriginal and Torres Strait Islander health checks have promoted a preventive approach to primary care and provided data to support research at the Inala Indigenous Health Service, south-west Brisbane, Australia. Concerns about the limitations of paper-based health checks prompted us to change to a computerised system to realise potential benefits for clinical services and research capability. We describe the rationale, implementation and anticipated benefits of computerised Aboriginal and Torres Strait Islander health checks in one primary health care setting.MethodsIn May 2010, the Inala Indigenous Health Service commenced a project to computerise Aboriginal and Torres Strait Islander child, adult, diabetic, and antenatal health checks. The computerised health checks were launched in September 2010 and then evaluated for staff satisfaction, research consent rate and uptake. Ethical approval for health check data to be used for research purposes was granted in December 2010.ResultsThree months after the September 2010 launch date, all but two health checks (378 out of 380, 99.5%) had been completed using the computerised system. Staff gave the system a median mark of 8 out of 10 (range 5-9), where 10 represented the highest level of overall satisfaction. By September 2011, 1099 child and adult health checks, 138 annual diabetic checks and 52 of the newly introduced antenatal checks had been completed. These numbers of computerised health checks are greater than for the previous year (2010) of paper-based health checks with a risk difference of 0.07 (95% confidence interval 0.05, 0.10). Additionally, two research projects based on computerised health check data were underway.ConclusionsThe Inala Indigenous Health Service has demonstrated that moving from paper-based Aboriginal and Torres Strait Islander health checks to a system using computerised health checks is feasible and can facilitate research. We expect computerised health checks will improve clinical care and continue to enable research projects using validated data, reflecting the local Aboriginal and Torres Strait Islander community's priorities.

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Infrastructure and work process in primary health care: PMAQ in Ceara.

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Infrastructure and work process in primary health care: PMAQ in Ceará.

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