Basic Health Services Research Articles

Interventions for improving health literacy among older people: a systematic review

BackgroundHealth literacy(HL) is defined as the degree to which individuals have the capacity to obtain process and understand basic health information and services required for making appropriate health decisions. Effective interventions to improve older people’s HL have become increasingly important. The purpose of this study is to conduct a review of interventions aimed at enhancing the HL of older people.MethodologyRelevant information was gathered from various databases including PubMed, Scopus, Cochrane Library, Science Direct, and Web of Science. Additionally, a manual search of related journals and Google Scholar, a search of the reference lists of selected articles, and a search of unpublished sources were also conducted up to 30 August 2024. Reporting quality assessment was performed using CONSORT: 2010, JBI Critical Appraisal Checklist for Quasi-Experimental Studies, and “Quality Assessment Criteria for Survey Research Reports”.ResultsA total of 21 articles were included in this study. The interventions conducted in high-income countries were found to be more effective compared to those conducted in middle and low-income countries. Furthermore, interventions carried out at the community level were more effective than those performed in nursing homes. Educational interventions were more effective than lifestyle modification interventions, and interventions carried out in a single dimension were more effective than multidimensional interventions. Additionally, interventions that utilized technology were found to be more effective.ConclusionBased on the findings, community-based interventions that encompass a one-dimensional approach, incorporating the use of technology and considering the duration of the intervention, are more recommended.

The Curious Persistence of Site-Dependent Payments

This Viewpoint considers supply- instead of buy-side pressure to address the inflated cost of basic health services provided by hospitals.

Promoting equality in utilization of basic public health services in China: the role of the family doctor contract service

Background The Family Doctor Contract Service (FDCS) system is a service model for primary care reform launched in 2016 to offer families and individuals active and continuous health care by a team of family doctors within primary care institutions in China. Objectives This study aimed to estimate socioeconomic-related inequalities in the utilization of basic public health services, and to identify the contribution of FDCS to promoting equality. Methods Data for the study were collected from a 2023 cross-sectional household health survey in western China, involving 39,456 participants. The concentration index (C) was employed for analyzing the extent of socioeconomic-related inequalities in the utilization of basic public health services and the coarsened exact matching technique was employed for sensitivity analysis in order to reduce selection bias. Results Our results indicated pro-poor inequalities in the utilization of health records (C = −0.046), free health check-ups (C = −0.009), and follow-ups for hypertension (C = −0.051). Additionally, a more equitable distribution across the economic spectrum was observed within the FDCS group (people who voluntarily contracted for services) compared to the non-FDCS group. The FDCS demonstrated more favorable positive impacts among individuals with higher (quintiles 60–80%) and the highest (top 20%) socioeconomic status. The FDCS contributed 83.94%, 59.24%, and 36.92% to pro-poor inequalities in the utilization of three basic public health services. These contributions reflected the positive impact of the FDCS on utilization. Conclusions Government policy and service delivery models require a paradigm shift to promote a stronger primary healthcare approach to practice, as evidenced by the effectiveness of the FDCS in promoting equality.

Public Services in the Field of Basic Health for Mothers and Children in Talawaan District, North Minahasa Regency, North Sulawesi Province

Maternal mortality rate and infant mortality rate are an indication of the low level of population welfare. Likewise, the high disparity in socio-economic levels - rich and poor, between regions and between urban and rural areas. Therefore, health services for mothers and children are the main priority in health development. The government at all levels of government has established and implemented health programs for mothers and children. However, it has not provided a good impact on the aspect of basic public services. Health services for mothers and children through integrated service posts are more visible at the village level and require serious attention from the government because they are very far from health service centers such as regional hospitals. Therefore, this study was conducted to describe and explain basic public health services for mothers and children in Talawaan District, North Minahasa Regency. This study is considered important from the aspect of public health and related to strengthening social capital in the superior fields of social humanities, arts and culture as well as the development and strengthening of institutional systems, health policies, and community empowerment in the superior fields of health and medicine in the Sam Ratulangi University research strategy plan. Data were collected through interviews with the Head of the Health Service and Health Center, Posyandu officers and pregnant mothers and those with toddlers. Observations were made by looking directly at basic health services in Talawaan District. Secondary data were collected during health service activities and conducting electronic searches on Google Scholar and ResearchGate. The analysis was carried out based on the stages of reduction, interpretation, drawing conclusions and verification/triangulation. The research findings that public services in the field of basic health are accessible, acceptable, fair and safe for mothers and children but are not yet fully efficient and effective in their implementation. The concept found from this study is that the community needs basic health services for mothers and children that are easy to access and accept, fair to all levels of society and medically safe. While the principles of efficiency and effectiveness are more about the interests of the organization in the use of resources and achieving goals.

Armed conflict and maternal health service utilization in Ethiopia’s Tigray Region: a community-based survey

BackgroundEvidence generated on utilization of maternal health services during times of conflict can inform the development of targeted interventions. The deadly war in Tigray caused the health system to collapse. However, utilization of maternal health services is not well documented that might help in design effective interventions applicable during armed conflict. Thus, this study aimed to assess maternal health service utilization and bridge the gap in healthcare provision and support during conflict. .MethodsA community-based cross-sectional survey was conducted among mothers of children under the age of 1 year in six accessible zones of Tigray from August 4–20, 2021. The study participants were selected through a random sampling method. The study was conducted during the armed conflict where the access to health services was limited due to the damaged and looted health facilities. A descriptive study was used to characterize the study population and data were presented using proportions and percentages. A Chi-square test was used for categorical variables and a P-value of 0.05 was considered significant. .ResultsA total of 4,381 participants were included in the study. Modern contraceptives were used by 1002 (22.9%) of women, and injectable contraceptives were the most common method used by 472 (47.1%) women. Likewise, only 830 (36.5%),1956 (47.1%), and 623 (15.0%) respondents reported the use of optimal antenatal care (ANC), skilled delivery, and postnatal care (PNC) in the first 24 h by mothers, respectively. About 34% of women received comprehensive abortion care services. Most delivery services took place in hospitals. Residence has shown a significant difference in using maternal health services at p-value < 0.001.ConclusionThe conflict in Tigray has had a profound impact on maternal health services, resulting in a significant disruption that is disproportionately high in rural areas. Immediate action is required to provide access to lifesaving interventions for basic maternal health services. The timely initiation of these services is crucial in addressing the pressing needs of pregnant women and their infants. By implementing comprehensive and targeted interventions, we can mitigate the potential long-term consequences and ensure that maternal health services are effectively reinstated.

Expanded roles of community health workers beyond malaria in the Asia-Pacific: A systematic review.

In the Greater Mekong Subregion (GMS), community health workers (CHWs) are a key component of malaria elimination strategies. As malaria declines, support for, and uptake of, malaria services may also subsequently decrease. Expanding their roles beyond malaria has been proposed to sustain the services. A systematic review was conducted to identify and characterize programmes with CHWs providing services in addition to those for malaria in the Asia Pacific. This review describes the expanded roles, identifies evidence of impact or success of the programmes, and explores strategies to ensure sustainability and factors for effective implementation to inform the design of malaria CHW programmes. Searches were conducted in 6 databases, for grey literature, and in bibliographies of retrieved articles. Data were extracted from 38 published articles, 12 programme reports, and 4 programme briefs and analysed using thematic coding and descriptive analysis. Twenty-nine programmes were identified with CHWs performing both malaria and non-malaria roles in the Asia Pacific. There was evidence of impact on malaria incidence in 4 of these, none on malaria mortality, and 4 on other diseases. Monitoring and evaluation mechanisms, multi-sectoral stakeholder collaborations, and adequate training and consistent supervision of CHWs were key to effective programme implementation. Integration of programmes into broader health services, ongoing political and funding support, and engagement with local communities were found to contribute to sustaining provision of health services by CHWs. Expanding CHW roles depends on programme management and strengthening linkages with local health systems. To sustain malaria CHW services, countries need adequate policies and financing, and sufficiently strong health systems to deliver basic health services that are adapted to the health needs of the community which means transitioning away from vertical disease programs. Further research should explore programmes that have not been captured in this review and address gaps in measuring malaria outcomes.

Penyuluhan Tentang Pelaksanaan Posyandu Sistem 5 Meja Pada Kader Posyandu Bergas Waras kelurahan Sumampir Kecamatan Purwokerto Utara

Posyandu is one form of Community-Based Health Effort (UKBM) managed and organized by, from, and for the community in health development, aiming to empower the community and provide easy access to basic health services to accelerate the reduction of maternal and infant mortality rates. The urgency of this Community Service activity is to optimize the role of cadres at Posyandu Bergas Waras. The objectives of this Community Service Program are: 1) To assess the level of knowledge of posyandu cadres about the 5-table system, and 2) To provide counseling to cadres about the 5-table system in posyandu. The methods used in this activity are: 1) Measuring the level of knowledge of cadres before counseling through a questionnaire, 2) Providing counseling to posyandu cadres about the 5-table system, and 3) Measuring the level of knowledge of cadres after counseling through a questionnaire. The results of this program showed a 40% increase in the cadres' knowledge. Posyandu Bergas Waras cadres are expected to implement the 5-table system in their routine posyandu activities.

Performance Assessment of Health Visitor and Family Medicine Units in Babylon's Main Health Care Centers

Background: The Ministry of Health (MoH) has developed a standardized package of basic health services for all primary healthcare (PHC) facilities to enhance service quality. This study evaluates service availability and facility needs in the family health units in Babylon. Methods: This cross-sectional study was conducted in three family healthcare sectors (the first Al-Hillah sector, Al-Musayyib sector, and Al-Hashemiyyah sector), which includes 6 out of 23 primary healthcare centers in the Babylon Governorate. The data collection started on March 3, 2022, and ended on August 27, 2022, and was randomly chosen from all sectors. Results: According to this study, the family health unit had a poor mean score of 48.03±17.97. Similarly, the health visitor indicators had an inadequate level of assessment, with a mean score of 46.87±14.09. In conclusion, this revealed a study that the primary health care centers evaluated had poor scores in all the final evaluation indicators for the family health unit and the health visitor unit.

The joint effect of cumulative metabolic parameters on the risk of type 2 diabetes: a population-based cohort study

Background and aimsThis study aimed to examine the cumulative effects of body mass index (BMI), body roundness index (BRI), pulse pressure (PP), triglycerides (TG), high-density lipoprotein cholesterol (HDL) and fasting plasma glucose (FPG) on Type 2 diabetes (T2D) morbidity.MethodsA total of 78,456 participants aged older than 45 years were extracted from basic public health services in China. During the 2-year follow-up, 6,942 individuals had developed T2D. The binary logistic regression models and multinomial logistic regression models were conducted to investigate the effects of cumulative metabolic parameters on incident T2D, prediabetes regression and progression.ResultsWe found statistically deleterious impacts of exposure to high cumulative BMI, BRI, PP, TG and low cumulative HDL on T2D morbidity and prediabetes progression. Compared to the group with low cumulative of all five parameters, the adjusted ORs for new-onset T2D for participants presenting with 1–2, 3, and 4–5 elevated metabolic parameters were 1.41(1.31,1.52), 1.93(1.74,2.13) and 2.21(1.94,2.51), respectively. There was additive interaction between FPG level and cumulative metabolic parameters with T2D. Compared with participants with the lowest quartile of FPG and low cumulative of all 5 parameters, those with the highest quartile of FPG and high cumulative of 4–5 parameters had a 14.63 [95% CI (12.27, 17.42)] higher risk of incident T2D.ConclusionsParticipants with more numbers of high-cumulative metabolic parameters were associated with a higher risk of incident T2D and prediabetes progression. A high level of normal FPG could enhance these risks.

Pelatihan Pemantauan Pertumbuhan Balita Pada Kader Kesehatan di Puskesmas Muara Tais, Kecamatan Angkola, Muara Tais Tapanuli Selatan

Stunting in Tapanuli Selah district will be 39.4 percent in 2022, and in 2023 it will decrease by 15.6 percent. Community empowerment in the health sector develops Community Resource Health Efforts (UKBM) namely Posyandu. Posyandu organizers are health cadres, elected by the community. Increasing the ability of cadres to manage posyandu activities, especially regarding basic health services to the community, is carried out by training by health workers. Muaratais Health Center was inaugurated on July 15 2023, the newest sub-district expansion in South Tapanuli Regency. The Muaratais Health Center area has 15 villages, in each village there is a posyandu, an average of 4 cadres and there are new cadres who have never attended training. The service team agreed with the Community Health Center to carry out training for posyandu cadres on monitoring the growth of toddlers. Training materials, toddler growth, measuring body length, height and weight using tools available at the posyandu, infant ruler, microtoise, portable electric body weight. The training participants consisted of 20 health cadres, appointed by the community health center to represent the posyandu in their work area. Training activities were carried out for two days in the community health center meeting room. Lecture, question and answer, simulation and demonstration methods. Trainees' knowledge about monitoring toddler growth is getting better. Skills in using the growth monitoring tools available at posyandu category are sufficient. Skills at the advanced stage are continued by the posyandu supervisor.

Posyandu's Contribution to Reducing Stunting Prevalence in the Community

The general background stunting is a health problem that can reduce the quality of human resources, and the role of posyandu is very important in its management. Specific background this research focuses on Wunut Village in Porong District, where the prevalence of stunting is a major concern. Knowledge Gap: Although many studies on stunting exist, the specific role of posyandu in the local context has been less explored. Aims this study to analyze the role of posyandu in reducing the prevalence of stunting in Wunut Village. Results this study posyandu as a motivator, facilitator, and mobilizer in increasing community awareness and access to health services related to stunting. Posyandu has successfully invited the community to actively participate in health activities and provided services such as growth monitoring and distribution of nutritional supplements. Novelty this research highlights the tangible contributions of posyandu in the local context, providing new insights into community-based approaches to addressing stunting. Implications these findings indicate the importance of strengthening posyandu as a health institution in stunting reduction efforts and the need for continuous support from the government and community to enhance the effectiveness of health programs. Highlights: Posyandu serves as a motivator, encouraging community participation in health activities. Facilitates access to basic health services and nutritional support for mothers and children. Highlights the importance of community-based approaches in addressing stunting issues. Keywords: Posyandu, Stunting, Community Health, Nutritional Support, Health Services

Awareness on obstetric fistula and associated factors among women health development army, in the South Gondar zone, Amhara region, Ethiopia: A cross sectional study.

Obstetric fistula is a severe birth injury that profoundly impacts women's health, social well-being, economic stability, and psychological state. While it can be prevented with timely emergency obstetric care, a significant barrier in many developing regions, including the study area, is the lack of awareness among women. This study aimed to evaluate the level of awareness about obstetric fistula and the factors influencing it among the Women Health Development Army in the South Gondar zone of the Amhara region, Ethiopia, in 2020. A community-based cross-sectional study was done from July to December 2020, involving 633 women. Participants were selected using a multistage stratified sampling method. Data were collected using a pretested, interviewer-administered structured questionnaire. Data entry was performed using EpiData version 3.1, and analysis was conducted with SPSS version 23.0. Multivariable logistic regression models were employed to identify influencing factors, with a p < 0.05 considered statistically significant. This study found that 55.3% (95% CI, 51.6%-57.2%) of study participants had a good awareness of obstetrics fistula. Significantly associated factors include; no history of ANC (AOR = 0.52: 95% CI, 0.31, 0.86), living >30 min away from a health facility (AOR = 0.43: 95% CI, 0.23, 0.81), no history of abortion (AOR = 0.37: 95% CI, 0.19, 0.72), Injectable and implant users (AOR = 3.60: 95% CI, 1.98, 6.53), having four to six pregnancy (AOR = 1.87: 95% CI, 1.22, 2.87) and lack of communication material in the house (AOR = 0.19: 95% CI, 0.10, 0.37). This study found that 55.3% of women have a good awareness of obstetrics fistula. ANC follow-up history, abortion history, type of family planning, type of communication, number of pregnancies, availability of health facility, and distance of health facility were significantly associated with awareness of obstetric fistula. Hence, local and national efforts should be made to enhance access to information at home and basic maternal health services including antenatal care.

Comparative Analysis and Spatial Distribution of the Primary Health Care Centers and Health Manpower Across Saudi Arabia Using Shapiro-Wilk Test.

Due to the growing demand for better health services by the population pressure, Saudi Arabia is facing challenges in providing the required coverage in primary health care over all regions. The study aims to do a comparative analysis of the spatial distribution of the primary healthcare centers and health manpower across Saudi Arabia. This study deals with the analysis of the spatial distribution of the PHCCs and health manpower in Saudi Arabia regions during the period 2017-2021 by applying the Shapiro-Wilk test. This study relied on a dataset issued by the Ministry of Health (MoH). The variance of the spatial distribution of the dataset was also analyzed using the T-student and Binomial tests. This study found that PHCCs of 2020; the dentists of 2021; and Allied Health Personnel of 2017, 2020, and 2021 were normally distributed. However, the distribution of the population and all datasets of the other health indicators is a non-normal distribution. In addition, the correlation between the number of PHCCs and regions based on population is significant in all the regions. Moreover, The number of dentists showed a significant correlation with the population in most regions, except Riyadh, Makkah, and Jazan. However, the number of physicians, allied health personnel, nurses, and family medicine practitioners generally did not correlate significantly with the population, with exceptions for nurses in Tabuk and family medicine in the Northern Borders. Finally, the spatial distribution of the population shows the concentration in three major regions which are Riyadh, Makkah, and Eastern Province. Despite the expansion in the number of PHCCs and health workers and spread in all regions of Saudi Arabia, their spatial distribution still requires the establishment of more of them to provide the basic health services necessary to cover the actual needs of the population.

Joint Human and Animal Health Campaigns in Chad

Abstract Providing basic health services to nomadic populations is challenging mainly because of their mobility affecting geographical access to essential services but also due to their particular cultural habits and beliefs, influencing health intervention acceptance. The strategy of joint human and animal health campaigns applied in Chad for over 30 years has helped to improve coverage of childhood and livestock vaccination and increased access to disease prevention. The campaigns are organized by the Chadian ministries for public health and livestock, supported by the Swiss Tropical and Public Health Institute (Swiss TPH) and its local partners. The use of synergies across sectors intends to reduce costs compared to independent sectoral interventions. The gain lies not only in shared logistics but also in better trust in essential services by pastoralists. Planning of joint interventions should start with a careful assessment of the context through a transdisciplinary approach identifying possible access barriers. This allows multidisciplinary development of mitigation measures such as a locally adapted awareness strategy. The multi-disciplinary approach also provides information on the seasonal movements of the different pastoral groups, which is crucial for the timing and location of interventions. Administrative and technical preparation of the field visits needs concerted efforts by all ministries and partners involved to maximize the benefits. To facilitate the uptake and sustainability of joint campaigns in Chad, the involved partners together developed an implementation guide based on their long-standing experience. This case report draws on this guiding document and showcases it for other actors interested in implementing similar One Health strategies. Information © The Authors 2024

PREVENTIVE BEHAVIORS FOR DENGUE HEMORRHAGIC FEVER

Dengue fever is a viral infection caused by the dengue virus which is transmitted to humans through the bite of an infected mosquito. About half of the world's population is now at risk of dengue fever with an estimated 100–400 million infections occurring annually. This study aims to determine factors related to dengue prevention behavior in the East Ogan Komering Ulu District Health Service in 2024. The design of this research is quantitative with a cross-sectional approach. The population of this study was visits to the Gumawang Health Center in 2024. The sample in this study consisted of 93 respondents. The sampling method used purposive sampling. This research was carried out on 15-26 February 2024. Data was collected using a questionnaire. Bivariate data analysis used the Chi-Square test and multivariate logistic regression. Data collection using questionnaires. Results of statistical test analysis using the Chi-Square statistical test. The results of the study knowledge (p value 0.022), draining the landfill (p value 0.047), preventive measures (p value 0.005) and ventilation (p value (0.017). Age (p value 0.35), mosquito wire installation (p value 0.47) with dengue hemorrhagic fever (DHF) prevention behaviour at the East Ogan Komering Ulu District Health Office in 2024. The most dominant factor with dengue hemorrhagic fever (DHF) prevention behaviour is DHF prevention measures (p Value = 0.003) (OR 0.252). Conclusion There is a relationship between knowledge, landfill draining, preventive measures and ventilation. For the Health Office to carry out dengue prevention activities, carried out routinely and scheduled integrated in basic health services.

Factors Affecting Health Service Utilization for Chronic Conditions: A Bibliometric Review of Primary Health Care

ABSTRACT Non-communicable diseases (NCDs) such as heart disease, diabetes and cancer are significant global health challenges, particularly in developing countries. Understanding healthcare utilization for NCDs is critical to improving healthcare outcomes and patient quality of life. This study aims to analyze trends and identify research gaps in healthcare utilization for NCDs through bibliometric analysis. With this approach, this study seeks to provide a comprehensive overview of research developments in this field and identify areas that require further attention. This study used bibliometric analysis with the Publish or Perish app and a Google Scholar search using the keywords "factors," "influences," "health service utilization," "non-communicable diseases," and "basic health services." From the search results, the top 50 journals from 2017 to 2024 were selected for analysis. The data were classified by year of publication, journal type, number of citations, and researcher country, and analyzed using VOSviewer to identify research patterns and gaps. The analysis showed that research was concentrated in highly ranked journals and developed countries, with key terms such as "non-communicable disease," "factor," "use," and "health." This research identifies gaps in implementation policies, innovative approaches, and healthcare utilization factors that are not yet fully understood. Understanding research trends and gaps can guide future research and policy development efforts to improve the effectiveness of interventions and policies in the management of NCDs globally. Keywords: Non-Communicable Diseases (NCDs), Health Service Utilization, Primary Health Care, Health Influencing Factors

Perceptions and Potential of Integrating Elderly Schools and Complementary Therapy for Enhanced Basic Health Services

The aging global population necessitates tailored health services for the elderly. Complementary therapies, such as acupressure and exercise, have shown promise in addressing elderly health needs. Integrating these therapies with elderly schools, community centers offering tailored programs, presents a holistic healthcare approach. This research aims to assess elderly perceptions and potential benefits of integrating elderly schools and complementary therapies. It explores awareness levels, acceptance, implementation barriers, and perceived impacts on overall well-being. The study provides crucial evidence for policymakers and practitioners to enhance basic health services for the elderly. A descriptive survey method was employed, utilizing self-administered questionnaires. Closed-ended Likert scale questions gauged perceptions, while open-ended questions captured qualitative insights. The sample comprised individuals aged 60 and above, drawn from elderly school attendees and complementary therapy users. Survey results indicate positive perceptions toward integration, with approximately 85% of respondents expressing favorable views. Participants believe that combining educational programs with complementary therapies could enhance physical health (76%), mental health (68%), and stress management (82%). Open-ended responses provided nuanced insights, highlighting personal transformations and concerns related to cost and accessibility. The majority of respondents perceive the integration positively, supporting theoretical frameworks emphasizing benefits. Qualitative data enriches the understanding of participants' experiences. While acknowledging limitations, such as the cross-sectional nature and potential bias, this research provides valuable knowledge. It suggests that integrating elderly schools and complementary therapy holds promise in promoting holistic healthcare, contributing to healthy aging and improved quality of life for the elderly.

Ambient Air Quality Detection System Powered by Internet of Things-Based Sansevieria Plant (Case Study of Manduro Health Center)

Puskesmas Manduro is one of the public health service centers located at Jl. Raya Ngoro KM 14, Manduro MG Village, Ngoro District, Mojokerto Regency, East Java. As a basic health service center, it is important to monitor air quality and maintain air quality in accordance with the Environmental Quality Standard (SBMKL). This study aims to design an Internet of Things-based air quality detection system that utilizes Sansevieria plants as one of the natural solutions in absorbing air pollution levels. The method used is the research and development method which includes system design, tool making, website design, tool integration, and system testing. The sensors used are MQ-7 sensors for carbon monoxide gas, MQ-135 sensors for nitrogen dioxide gas, MQ-131 sensors for ozone gas, Dust GP2Y1010AU0F sensors for PM2.5, and DHT22 sensors for temperature and humidity. The results of testing the system for three days obtained the average temperature 30.64C, humidity 73.62%, CO 735.63 µg/m³. NO2 27.30 µg/m³, O3 32.13 30 µg/m³, and PM2.5 2.14 µg/m³. Based on the test results that have been carried out, it shows that the air quality monitoring system can provide data, graphs, and indicator levels for the Air Pollution Standard Index (ISPU). Air quality data obtained from sensors can be displayed on the LCD and also displayed in real-time through the website.

Ten Year Evaluation of JKN: Strengthening Primary Health Care for National Resilience

This study evaluates the achievements of the National Health Insurance (JKN) over the past ten years, focusing on strengthening primary healthcare for national health system resilience. Launched on January 1, 2014, JKN aims for equitable healthcare access for all Indonesians, with participants reaching over 220 million by 2023. JKN has increased basic health service coverage, including immunization, maternal and child care, and treatment of diseases. Primary healthcare's role is vital in disease prevention, early diagnosis, treatment, and chronic disease management. Case studies highlight successful outreach programs. Challenges include funding deficits, uneven service quality, and lack of medical personnel in remote areas. Recommendations include increased budget allocations, incentive policies, continuous training, integration of services, effective health information systems, and community participation

Stakeholder Perspectives on the Governance and Accountability of Nigeria's Basic Healthcare Provision Fund.

In recent decades, Nigeria has implemented a number of health financing reforms, yet progress toward Universal Health Coverage (UHC) has remained slow. In particular, the introduction of the Basic Health Care Provision Fund (BHCPF) through the National Health Act of 2014 sought to increase coverage of basic health services in Nigeria. However, recent studies have shown that health financing schemes like the BHCPF in Nigeria are suboptimal and have frequently attributed this to weak accountability and governance of the schemes. However, little is known about accountability and governance of health financing in Nigeria, particularly from the perspective of key actors within the system. This study explores perceptions around governance and accountability through qualitative, in-depth interviews with key BHCPF actors including high-level government officers, academics and Civil Society Organisations. Thematic analysis of the findings reveals broad views among respondents that financial processes are appropriately ring-fenced, and that financial mismanagement is not the most pressing accountability gap. Importantly, respondents report that accountability processes are unclear and weak in subnational service delivery, and cite low utilisation, implicit priority-setting, and poor quality as issues. To accelerate UHC progress, the accountability framework must be redesigned to include greater strategic participation and leadership from subnational governments.