Component Of Primary Health Care Research Articles

Determinants of uptake of routine immunization among mothers of under five children in rural areas of North-Eastern Nigeria

Background: Immunization against the vaccine preventable diseases is one of components of Primary Health Care and the most cost-effective public health intervention in the history of mankind: but it has failed to meet the health needs of the majority of the people particularly in underdeveloped countries. Method: this was a cross-sectional descriptive study that utilized interviewer administered questionnaire to 313 participants through multistage sampling. Data was analyzed using SPSS and a p-value of <0.05 was considered statistically significant. Results: about half (50.5%) of the study participants had good level of aggregate knowledge scores, nearly one-third (34.2%) had positive attitude, and about one quarter (25.9%) had good uptake/practice of routine immunization. After adjusting for the confounding effects using logistic regression analysis; educational status of secondary school (AOR=1.99, 95% CI=1.43 – 33.65) and tertiary (AOR=4.04,95%CI=3.25 – 15.75), number of ANC visit of > 4 times (AOR=3.02, 95%CI= 1.76 – 41.45) monthly income of >N70,000.00 (AOR=5.01, 95%CI=3.25 – 35.77), good aggregate knowledge scores of routine immunization (AOR=4.06 95%CI=2.99-13.89), and positive aggregate scores on attitudes of routine immunization (AOR=5.03, 95%CI= 5.13-27.33) remained significant predictors of uptake/practices of routine immunization among the study participants. Conclusions: most of the study participants had negative attitude on routine immunization that led to low uptake. It was recommended that more strategies that will ensure increase in uptake like health education and provision of adequate vaccine should be employed by the state government.

Enablers and barriers of community health programs for improved equity and universal coverage of primary health care services: A scoping review

BackgroundCommunity health programs (CHPs) are integral components of primary health care (PHC) systems and support the delivery of primary care and allied health and nursing care services. CHPs are necessary platforms for delivering health services toward universal health coverage (UHC). There are limited prior studies on comprehensive evidence synthesis on how CHPs strengthen community health systems for the demand and supply of PHC services. Therefore, this scoping review synthesized existing evidence on the interlinkage between CHPs and the community health system and beyond for delivering and utilising PHC services toward UHC.MethodsWe conducted a scoping review of research articles on CHPs. We identified research articles in six databases (PubMed/Medline, CINAHL, Scopus, Cochrane, Web of Science, and Embase) and Google Scholar using search terms under three concepts: CHPs, PHC, and UHC. Of the 3836 records identified, 1407 duplicates were removed, and 2346 were removed based on titles and abstracts. A total of 83 articles were eligible for the full-text review; of them, 18 articles were removed with reasons, and the other 16 were included through hand search. Themes were identified and explained using Sacks and colleagues’ “Beyond the Building Block” framework.ResultsA total of 81 studies were included in the final review. Studies described CHPs as foundations for community health system readiness for PHC services, including decentralization in the health sector, community-controlled governance, resource mobilization, ensuring health commodities (e.g., through community pharmacies), and information evidence. These foundational inputs mediate the actions of CHPs by partnership with community organizations and health workforces (e.g., community health workers). CHPs contributed to improved access to health services by providing health services in public health emergencies, affordable and comprehensive care, and modifying social determinants of health.ConclusionsCHPs are platforms for implementing and delivering PHC services close to communities. They help to modify social determinants of health, promote health and wellbeing, reduce care costs, prevent disease progression, and reduce hospitalisation rates. CHPs are integral parts of community health systems and require investment to improve access to PHC services. Gaps and challenges of CHPs include inadequate funding, limited engagement of the private sector, poor quality of health services, and limited focus on non-communicable diseases (NCDs). Further implementation research is needed to mitigate the burden of NCDs. Health systems efforts focus on increasing resources (e.g., financial and human) required in CHPs to ensure the quality of PHC services provided through CHPs toward better service access, and reaching the unreached and achieve equity and universality of PHC services.

Cluster sampling methodology to evaluate immunization coverage.

Immunization is a key component of primary health care and an indisputable human right. Vaccines are critical to the prevention and control of infectious disease outbreaks. The coronavirus disease 2019 (COVID-19) pandemic and associated disruptions over the past two years have strained the health systems, with many children missing out on essential childhood vaccines. To evaluate the immunization coverage among 12-23-month-old children in the rural areas of Community Health Centre (CHC) Dighal and to determine the factors influencing the existing immunization coverage. A coverage evaluation survey was conducted according to the 30-cluster sampling technique, which is the standard methodology for such surveys devised by World Health Organization. A total of 300 children aged 12-23 months were included, whose immunization details were noted from their immunization cards. Full immunization rate was noted in 86.7% of the children, with partial and non-immunized children accounting for 9% and 4.3% respectively. The full immunization dropout rate was 4.2%. The common reasons for partial or non-immunization were family problem including illness of mother, vaccine not being available and child being ill. Place of birth (P = 0.014) and availability of immunization card (P < 0.001) were significant predictors of the immunization status. Since the study was conducted in 2020/2021, health services were disrupted due to the COVID-19 lockdown. Due to the coverage being higher than the national average, it was concluded that the immunization coverage was optimal and not affected by the COVID-19 pandemic.

Factors influencing utilization of physiotherapy services by health care providers at Busia County Referral Hospital in Kenya

BackgroundThe surging trend of noncommunicable diseases complicated by trauma and infectious diseases has left many with marked physical limitations. Physiotherapy component of primary health care could be utilized for management of both communicable and noncommunicable diseases to restore physical functions.ObjectivesTo establish the health care providers’ level of knowledge and factors that influence the utilization of physiotherapy services among community members of Busia County in Kenya. The association between level of knowledge and demographic profile of health care providers at BCRH was also established.MethodDescriptive cross-sectional quantitative study involved 192 participants (nurses, doctors, and clinical officers) who were purposively selected. They completed self-administered questionnaire between August and November 2019. They were both sexes above 18 years of age, drawn from Busia County Referral Hospital. Data was analysed by Microsoft Excel and SPSS version 25.ResultsThe majority (92%) of the health care service providers had adequate knowledge about physiotherapy from their training to working with likelihood ratio chi-square of 7.714 with p-value at 0.01 at 5% level of significant. They had excellent communication (86.03%) with physiotherapists and helped to refer patients at BCRH for physiotherapy (χ2 = 52.02 and p-value = 0.01) at 5% level of significant. They had trust (91.56%) that physiotherapists were knowledgeable enough to handle patients on their own.ConclusionThe health care service providers are knowledgeable about the importance of physiotherapy and have supported its utilization. However, there is need to integrate physiotherapy service at all levels of training and practice of the components of primary health care. This will lead to a holistic patient’s care in terms of preventive, curative, and rehabilitative. Quality of life for the community members will be enhanced for appropriate functionality to meet the population needs. Lower utilization of physiotherapy services in Busia County could be due to factors associated with dynamics within the community and the health care service providers.

Strategies for improving the financing of family medicine program: Evidence from Iran.

The impact of health financing on the performance of the entire health system, including access, quality, and efficiency of healthcare, has been emphasized in the Astana Declaration, and the need to strengthen primary healthcare (PHC) and policy integration has been emphasized. After about two decades, the family medicine (FM) program in Iran is still facing great challenges. The aim of this study is to explore strategies for strengthening financing of the FM program in Iran, a vital component of PHC. A qualitative study was conducted in 2021. Purposeful sampling was used to select 34 policymakers, managers, and experts from various levels of the Ministry of Health, Iran universities of medical sciences, plan and budget organization of Iran, and health insurance organization in Iran. Thirty-four semistructured interviews were conducted to collect data, which were analyzed by content analysis. Through the analysis of interviews, our study has identified five strategies (identification and management of sustainable resources, pooling of sustainable resources, modeling of service provision, payment system model and its implementation process, and FM management structure), and 13 actions for strengthening financing of the FM program in Iran. Our study has identified five strategies and 13 actions for strengthening the financing of the FM program in Iran. These strategies and actions should be considered by policymakers during the review of the FM program in Iran. Without implementation of the suggested strategies and action, allocated resources may be wasted.

HOPE—A UNIQUE MODEL TO PROVIDE ORAL HEALTH SERVICES FOR NURSING HOME RESIDENTS

Abstract Optimal oral health care is an essential component of primary health care for all individuals but especially among the older adults due to chronic health issues and polypharmacy. Moreover, there are several barriers to oral health care for the older adults that include but are not limited to cost of dental care, lack of perceived need for care, dearth of transportation, and fear for dental care. To address these barriers to access, UT Health San Antonio School of Dentistry launched Holistic Oral Health Program for Elders (HOPE) program that aims to address oral health needs of nursing home residents living within a 65-mile radius of San Antonio, TX. The HOPE team is formed of trained dental and public health professionals who work together as a group to ensure that preventive, palliative, and clinical oral health services are provided to all eligible residents of the nursing home. For successful implementation of the HOPE program, the team efficaciously completed several critical steps while planning and developing the program, such as- establishing a relationship and procuring contracts with several nursing homes, collaborating with social workers and nurses, and following an interprofessional approach to provide oral health care to the nursing home residents. Since its inception, the HOPE program has successfully signed contract agreements with several nursing homes and has addressed the oral health needs of more than 300 nursing home residents. The HOPE program aims to continue serving this vulnerable and underserved population to address their oral health needs.

Family planning integration in Ethiopia’s primary health care system: a qualitative study on opportunities, challenges and best practices

BackgroundFamily planning (FP) service integration into primary health care (PHC) is an effective approach to realize reproductive autonomy, increase the use of contraceptives, and improve maternal and child health outcomes. The Ethiopian government promotes integration of FP services into primary health care (PHC). However, there is paucity of evidence on the status of FP service integration. The aim of this study is to explore the state of FP integration into PHC services and identify facilitators and barriers to integration.MethodsA qualitative study nested with a larger national study was conducted from July to October 2022. A total of 60 interviews were conducted with FP stakeholders including, government organizations, non-governmental organizations, donors, service providers, and clients. Interviews were audio recorded, transcribed, and coded using OpenCode 4.03. The coded data were analyzed using framework analysis approach, using the Primary Health Care Performance Initiative (PHCPI) framework. Direct quotes and results from the coding and categorization were used to develop the report.ResultsFamily planning is largely provided in designated units by dedicated staff within PHC facilities. The provision of integrated FP service within each service unit is in its early stage. Successful examples of integration include integration of FP with postnatal care, abortion care, and youth-friendly service centers. Facilitators of integration include commitment of the government and partners, the presence of policies and guidelines, and positive attitude of service providers and clients. However, integration of FP also faces challenges that are largely related to challenges of the FP program even before integration. These include resource shortage, health workers shortage, health workers’ capacity/skill gaps, misconceptions about FP, religious and socio-cultural norms, and lack of awareness.ConclusionsIntegration of FP with PHC services in the Ethiopian public health facilities is viable. Pre-existing challenges of the FP program continued to be barriers to integration. Expanding the experiences of good practices in the integration of FP with post abortion care, post-natal care, and youth-friendly service centers to other components of PHC warrants attention. Addressing both supply- and demand-side challenges of the FP program is needed to facilitate the integration of FP with other PHC services.

Evaluation of family physicians’ attitude towards primary healthcare consultations

Abstract Background The quality of services in the health care system is very important for both patients’ health and health care providers. In the past decade, good service ratings from the patient's perspective have become crucial in evaluating the work of medical professionals and health care institutions. However, it is also important to consider the opinions of health care specialists, especially when it comes to medical consultation, which is one of the most important components of primary health care (PHC) chain. Aim To evaluate the attitude of family physicians (FP) towards consultations provided in PHC. Methods The study was conducted in 2022. December - 2023 in February. The research contingent is FP of Lithuania. Research method - quantitative momentary research, anonymous questionnaire survey, 206 subjects were interviewed. Calculated chi-square (χ2) and z-criterion. Results The majority of FP indicated that they involve the patient in the decision-making process (68.0%), those working in private institutions said so more often than those working in public institutions (p &amp;lt; 0.05). 89.3% of the subjects stated that the consultation time with the patient is not enough, and 70.4% respondents receive many unregistered patient visits per day. E-health makes it difficult for 81.1%, 86.4% of the respondents indicated that there is too much of a workload and this was mostly said by respondents working in public institutions (p &amp;lt; 0.05). Remote consultations facilitate the workflow (76.2%). The older age of the respondents and greater work experience lead to lower self-confidence during remote consultation, longer consultation time and less belief in the benefits of remote consultation (p &amp;lt; 0.05). Conclusions Most FP positively evaluate the consultation they provide, but they also said that the consultation time is insufficient, they must consult a number of unregistered patients, e-health complicates the work. Remote consultations facilitate the workflow. Key messages • The consultation time is insufficient. • Remote consultations facilitate the workflow.

Knowledge, Perception and Feasibility of Community Health Influencers, Promoters and Service (CHIPS) Program Among Community Health Workers in Nkanu West and Awgu Local Government Areas, Enugu State, Nigeria

Background: Primary health care (PHC) is the bedrock of our National Health Policy. PHC has two components: Community level and Primary health care facility level. Universal Health Cover cannot be achieved without significant investment in the community level component. Hitherto, the community component of PHC remains a neglected area of PHC program. CHIPS, a community-based programme was designed to allow traditional institution to select individuals who will administer basic medical needs and referring people in their communities to designated medical facilities when necessary. Method: This is a cross-sectional descriptive community-based study that was conducted among community health workers in Nkanu West and Awgu Local Government Areas of Enugu State Nigeria using self-administered questionnaire. Convenience sampling technique was used to select community health workers in the two local government areas. Results: 77.4% of the study population were not aware of the program. 26.9% are of the opinion that the families in the communities will welcome the idea of home visits. 23.3% perceived the implementation process to be slow, there was poor community awareness (22.0%), poor community participation (19.3%) and no community mobilization (19.3%) yet. Conclusion: From our study, the response rate on how best to organize CHIPS and the challenges it may face, is low. The striking thing is that the challenges of the past community health workers are still that of the present. So it is of utmost importance to constructively look at the content of the planning, implementation and its evaluation, and then draw strength from the weaknesses of the already existing community health programs.

Nurses' and patients' experiences of family planning services in a rural district, South Africa.

Family planning (FP) is a key component of primary health care (PHC). Nurses are the first source of FP information to women outside their social context. There is a paucity of research regarding clients' lived experiences of FP, particularly understanding both the client's and the healthcare worker's experiences in the same clinical context and community. This study aims to explore the lived experiences of nurses and female clients regarding FP services at PHC clinics. Two PHC clinics in a rural sub-district in South Africa. A descriptive qualitative study using semi-structured interviews was conducted. Clients and nurses were selected using criterion-based purposive sampling and interviewed by female research assistants in a home language in a private setting. Transcription and translation of audio recordings were done. Data were analysed inductively using the framework method. Ten clients and eight nurses were interviewed, with an equal number from each clinic. The median age of clients was 28.5 years and of nurses was 47.5 years. Four themes emerged: (1) Stigma, culture and the teenage girl; (2) Bad effects - the Big Five, clustered around weight changes, blood blockages and abnormal bleeding, pain, fertility and cancer; (3) FP social dynamics; and (4) FP and the health system. Family planning is highly moralised and stigmatised. Negative effects of FP were not adequately recognised by the health system. Family planning outreach into the community and dedicated FP resources at clinics were suggestions to improve the service.Contribution: This work helps to better understand patients' experiences of family planning services.

Acesso equitativo a vacinas: lições aprendidas e perspectivas futuras

Abstract Vaccination is an essential component of primary health care and coping with health emergencies. However, despite the progress from the last decades, important barriers persist resulting in lower access and disparities between the countries in the access to new vaccines. In this scenario, the World Health Organization (WHO) launched, in 2020, the Immunization Agenda for the 2021-2030 decade (AI2030). This article aims to discuss the main factors that affect access to vaccines and strategies to promote equity in access to them at global and national levels. These factors are multi-sectoral and need to be considered in both levels, with emphasis on financial and geographic barriers, infrastructure challenges, socioeconomic and cultural factors, public policies, and governance. The text points the need to remodel the global architecture of production chains and research and innovation centers, creating and/or strengthening existing ones in low- and middle-income countries. In addition, establishing new mechanisms and models for the production and commercialization of vaccines is necessary. The strategies adopted for accessing vaccines and other health technologies are at the center of the global health agenda debate.

Household’s Willingness to Pay for Safe Drinking Water: A Case Study of Abbottabad District

Drinking water is the basic need of human life. Safe drinking water is an essential component of primary health care and have vital role in poverty alleviation. There is positive correlation between increased national income and the proportion of population with access to improved water supply. An increase of 0.3 percent investment in household access to safe drinking water generates one percent increase in GDP. Whereas, provision of safe drinking water supply is an effective health intervention reduces the mortality caused by water-borne diseases by an average 70 percent. Inadequate drinking water not only resulted in more sickness and deaths, but also augments health costs, lower worker productivity and school enrolment [World Bank (1994)]. The World Health Organisation (WHO) estimate 1.8 million people in developing countries die every year from diarrhea and cholera, Out of these 90 percent are children under the age of five years. While 88 percent of diarrhoeal diseases are attributed to unsafe water supply, inadequate sanitation and hygiene [WHO (2004)]. The situation is not very different in Pakistan; the access to safe drinking water is estimated to be available to 23.5 percent of population in rural areas and 30 percent in urban areas. While every year 0.2 million children die due to diarrhoeal diseases [Rosemann (2005)].

Maternal and child health care practice of Tamang community

Health is the most important factor of human life. It is a multi-dimensional process and a quality of life which entails a dynamic interact among the physical, mental, social, emotional and spiritual aspects of life. Good health improves the quality of life. The major health problems of Nepal are highly related to maternal and child health care practices. So, MCH care is the very important component of primary health care in Nepal. Most of the women of Nepal are illiterate and ignorant regarding the high maternal and child mortality rate in Nepal. This research was based on descriptive research design with both quantitative and qualitative nature of information. The major results from the findings of this study reveals that 29.5 percent respondents had not antenatal checked up and 70.4 percent respondents had antenatal checked up. The majority of the respondent (34.1 percent) women had antenatal checked up of three times during pregnancy period, whereas 38 percent of the pregnant women had checked up for four times, few (6.9 percent) of the pregnant women had five times antenatal checked up during pregnancy period. It was found that majority of the respondents (63.6 percent) had antenatal checked in health post and most of the respondent’s (64.8 percent) first child bearing age was found to be 15-19 years of age and least of the (4.5 percent) respondent’s first child bearing age was found 25-29 years of age. Similarly, 47.7 percent of respondent mothers had taken one dose of TT injection and 31.9 percent of respondent mothers had taken non dose of TT injection.

Health promotion and disease prevention services before and during the COVID-19 pandemic: A nationwide survey from Thailand

Health promotion and disease prevention (P&P) are essential components of primary health care. This study investigated the coverage of P&P services and barriers to services among primary care units in Thailand before and during the coronavirus disease 2019 (COVID-19) pandemic. A web-based cross-sectional survey was conducted to compare the data from primary care units across the 13 health regions in two fiscal years: October 2018 to September 2019 (before the pandemic) and October 2019 to September 2020 (during the pandemic). A total of 340 primary care units responded to the questionnaire. While most participating primary care units provided basic P&P services (n = 327, 96.2%) and community-based P&P services (n = 244, 71.8%), fewer offered area-based P&P services (n = 120, 35.3%) for all target populations. The high coverage of basic P&P services remained in place during the pandemic, while coverage of community-based P&P services for vulnerable and at-risk populations improved during the pandemic. Area-based P&P services improved for pregnant and postpartum women, preschoolers, children and adolescents, adults, and older people. Lack of human resources, materials and equipment, and financial support were cited as the primary challenges to offering P&P services. The higher coverage of P&P services in several target populations during the pandemic contributed to a heavy workload. Effective resource allocation, capacity building, and support from relevant parties, such as government and local agencies, are required to maintain high P&P service coverage.

Explaining the experiences of health care providers regarding organizational factors affecting health education: a qualitative study

BackgroundHealth education is considered the most important component of primary health care. Paying attention to organizational factors can help to improve the quality of health education. Therefore, the present study was conducted to explain organizational factors affecting health education among health care providers.MethodThis is a qualitative, descriptive, and phenomenological study that was conducted between 2020 -2022 on 50 health care workers who had been selected by purposeful sampling method in different settings including hospitals, GP office, behavioral disease counseling center, universities, and comprehensive health centers in the south and the center region of Iran. Data were collected by in-depth, semi-structured, and individual interviews, as well as focus group discussion, and continued until data saturation. Data were analyzed by MAXQDA software using qualitative content analysis in three stages: preparation, organization, and reporting. To evaluate the scientific accuracy of the findings in this study, 4 criteria of Lincoln & Guba were used.ResultsThe results revealed that every practice and policy in a health care organization from assessing needs, setting goals, planning activities, implementations and measurement outcome could affect health education practice and subsequently the health of population; nevertheless, the crucial role of health education practice is being neglected in health organizations. Organizational factors affecting health education were classified into three categories of planning, organizing, and also monitoring and evaluating. The category of planning had three subcategories of infrastructure planning, manpower planning, and design and planning for implementation of health education programs. The categories of organizing had two subcategories of coordination between different units of the Minister of Health and coordination between the health sector and other sectors of society. The categories of monitoring and evaluation had three subcategories of proper feedback, bureaucracy system, reward or reinforcement, failure to define health education as part of the job description, and the impact of electronic health records on the quality of evaluation.ConclusionThe results offer expertise and preliminary tools to help with evidence-based health education program planning and evaluation. The Support of managers, like providing manpower in accordance with the target population and infrastructure, can improve health education in the health system. In addition, intra- and inter-sectoral coordination at different levels of the health system to implement tailored programs according to the needs of clients by health education professionals, and the use of health education theories seem necessary. It is also recommended to review the monitoring system with appropriate feedback, define health education as a healthy activity, and develop appropriate criteria for better implementation of health education.

Seedling performance, phenotypic traits and growing media for domestication of Lilium polyphyllum

Societal Impact StatementMedicinal plants are a key component of primary health care for much of the world's population. However, overharvesting and indiscriminate collection from the wild threatens medicinal plant populations with extinction. One conservation solution to preserve biodiversity is to domesticate and cultivate threatened medicinal plants, in order to provide a sustainable source close to the local populations who use the species. Here, we present work to cultivate the critically endangered (CR) medicinal herb, Lilium polyphyllum. To reduce unsustainable wild harvesting, we identify different climatic zones, habitats and growing media, which will aid domestication of this endangered species and help local populations to cultivate the plant near its natural habitat.Summary Lilium polyphyllum (Liliaceae) is a perennial, bulbous medicinal herb, used in more than 30 Ayurvedic medicinal formulations as an aphrodisiac, galactagogue and anti‐ageing agent. The species is categorized as critically endangered on the IUCN (International Union for Conservation of Nature) Red List due to habitat degradation and unregulated collection. To alleviate the pressure on wild populations and increase conservation, the IUCN Red List recommends its domestication in suitable habitats. The present study was carried out over three consecutive years to evaluate the performance and survival of the species in two agro‐climatic zones in Garhwal Himalaya, Uttarakhand, India. L. polyphyllum seedlings were raised and transplanted into different growing mediums and treatments (control, manure, litter and polyhouse) in both temperate (Pothivasa, 2200 m a.s.l.) and alpine (Tungnath, 3600 m a.s.l.) regions to identify a suitable site and or habitat for future mass production. Experiments revealed yield and performance in polyhouse beds were greatest in the temperate region. Plant survival was also high in polyhouse beds in both the temperate (81%) and alpine (40%) sites. Phenotypic and growth traits of plants grown from bulbs collected from the wild population of the temperate site performed better in both morphology and in yield than those in the alpine site after one growing season. Cocopeat and sand may be responsible for the improved growth of plants. In conclusion, plant survival rate, growth performance and yield under polyhouse conditions were higher in lower altitudes (temperate regions), which may provide a production centre for seedlings to interested farmers in other regions.

STUDY ON IMMUNIZATION STATUS OF CHILDREN AGED 12 TO 23 MONTHS IN SLUM AREAS

Background: Immunization forms a critical component of primary health care and ensures nations health security. Immunization is one of the most important public health interventions and cost effective strategy to reduce both morbidity and mortality associated infectious diseases. Our national immunization programme is aimed at 100% coverage. Recent WHO estimates suggest that globally 23 million children are not completely immunized with, almost 98% of them residing in developing countries.Recently GOI introduced many new vaccines like Rotavirus, PCV in a phased manner. There is no enough data regarding immunization coverage in slum areas available. Hence this study addresses this issue and also studies the inuence of epidemiological and socio demographic factors in immunization coverage. Methodology: This study was a community based cross sectional study. The study involved interviewing the mothers having a child in the age group 12 months to 23 months. It was carried out from January 2018 to September 2019. Results: 683 study subjects were included in our study in which majority of mothers belonged to 15 to 25 age groups. Both rural and urban slum covered and equal representation is given for both. Fully immunized-were 409(59.9%). partially immunized-207(30.3%), not immunized-67 (9.8%). Individual vaccine wise-BCG=618(90.5%), PV3&amp;OPV3=578 (84.6%), MR=443(64.4%), RV=573(83.9%), More drop out for MR- 240(35 6%). Conclusion: In present study it is showed that majority of study population were immunized but it is not up to mark. The study showed that there is strong association between the mother Literacy and Immunization coverage.

The ISSUES, CHALLENGES AND MANAGEMENT OF URBAN HOUSEHOLD WATER SUPPLY: AN OVERVIEW IN CASE OF DURAME CITY, KAMBATA TEMBARO ZONE, SNNP REGION, ETHIOPIA JANUARY, 2019

The provision of urban infrastructure like water service has become a major concern in many developed and developing countries. Access to safe water and sanitary means of waste disposal is universal needs and indeed basic human rights. Besides, they are essential elements of human development and poverty alleviation and constitute an obligatory component of primary health care. The main objective of this study is to assess issues, challenges and management of urban household water supply: in case of Durame city, Kambata Tembaro Zone, SNNP Region. The study is descriptive in its nature and both qualitative and quantitative research Approach with a sample size of 120 which selected through systematic random sampling method used. Interview questionnaires were employed for data collection. Lastly the data were analyzed using descriptive statistical tools like frequency and percentage. The study findings revealed that factors like, shortage of water at the sources; rapid population growth, electric power failure, and rapid urbanization were classified to be main causes of water supply shortage to the city communities. The gap between demand and output is increasing from year to year as a result of the aforementioned primary factors. Water source for the city entirely relying only on groundwater is not enough. The study therefore recommends that the groundwater source has to be enlarged by surface water through water conservation techniques. Therefore, as a long- run solution to water supply shortage in the city great attention should be given for surface water development. Furthermore, surface water might serve as a recharging source for groundwater sources in the surrounding area. Through water conservation techniques around the water potential areas (boreholes sites) groundwater have to be recharged so as to balance the recharging and discharging rates. On the other hand, bottom-up community engagement should be promoted, and existing women's groups such as religious, trade, and professional associations should be involved in order to debate how to utilize water responsibly.

Factors influencing utilization of physiotherapy services by patients and people living with disability at Busia County Referral Hospital in Kenya

BackgroundPhysiotherapy, a component of primary health care, could be a remedy for physical challenges permeating widely in the world community due to non-communicable diseases trauma and infections.ObjectivesTo establish the level of knowledge about physiotherapy and the association between level of knowledge and demographic profile among people living with disabilities and physiotherapy patients and how it influences utilization of physiotherapy services in Busia, Kenya.MethodThis was a descriptive cross-sectional quantitative study. One hundred fifty-eight participants were involved. Physiotherapy patients and people living with disabilities male and female above 18 years were purposively selected, and they completed self-administered questionnaires between August and November 2019. Data was cleaned, organized, and scientifically analyzed.ResultsMost of patients and PWD (67%) attended treatment sessions once a week only as there is inadequacy to meet their needs of treatment and it is difficult for them (87.42%) to recommend physiotherapy to others for they had lower level of knowledge of the importance of physiotherapy. The main challenge for patients and PWD to attend physiotherapy was lack of money (55.71%) and distance to hospital (63.3%).ConclusionLower utilization of physiotherapy services in Busia County could be due to inadequate knowledge about physiotherapy, lack of finances to pay for physiotherapy, attitude of the health care providers towards physiotherapy, and inadequate infrastructure. There is a need to create awareness about physiotherapy and integrate physiotherapy service at all levels of practice of the components of primary health care in order for Busia community to benefit.

Availability of Key Essential Medicines in Public Health Facilities of South Indian Union Territory: One of the Crucial Components of Universal Health Coverage.

IntroductionThe supply of essential medicines is one of the vital components of primary health care. One of the important objectives of Indian health policy is to provide all the essential medicines at an affordable cost for the public. The performance of healthcare facilities is directly affected by the supply of essential medicines. This study was conducted to check the availability of key essential medicines in selected public healthcare facilities of the South Indian Union Territory.MethodsA snapshot survey was conducted between March 2019 and February 2020 in 10 selected public health facilities to assess the availability of 50 key essential medicines. Percentage availability for all surveyed medicines for the individual facility as well as percentage availability of individual medicines in all surveyed health facilities was calculated.ResultsPercentage availability of 50 key essential medicines in 10 surveyed public health facilities was found in a range of 66 to 80%. Out of 50 medicines, 26 (52%) medicines were available in more than 80% of health facilities while six (12%) medicines were available in less than 30% of surveyed facilities.ConclusionThis study reported the high availability of essential medicines in public health facilities as compared to similar studies done in other parts of India but the availability of some essential medicines was found sub-optimal and needs to be improved.