Quality Of Health Service Delivery Research Articles

Factors Affecting Quality of Health Care Services in Government Facilities in Kakindo Health Centre IV in Kakumiro District

This study aimed to examine the factors that affect quality of health services in Kakindo Health Center IV in Kakumiro District. The study used a cross-sectional design using a quantitative approach on the population which was under study. Data was collected using questionnaires, processed in excel, and word using SSP software for correlation purposes. The study found a high significant relationship between health-related factors, health worker related factors and quality of health service delivery. Patient related factors had a low significance. The study concluded that the quality of health services depends on the level to which the management of the facility provides the employees with a conducive work environment. appropriate knowledge and skills, and positive attitude of health workers towards patients was emphasized. health workers were argued to carry out daily patient education in order to change their traditional beliefs. Grading the facility to a level of Hospital this would help to build more infrastructure for both patients and staffs, for security of both patients and staff, the facility needs tapped water so that staff can access clean water inwards, especially the paediatric ward, theatre, general ward, outpatient department, A R T Clinic Cold chain unit and a few staff quarters. A proper fence must be put constructed at the facility. Keywords: Health service, Health workers, Patients, Delivery, Staff.

Quality of health service in the local government authorities in Tanzania: a perspective of the healthcare seekers from Dodoma City and Bahi District councils.

Improvement and access to quality healthcare are a global agenda. Sustainable Development Goal (SDG-3) is committed to ensuring good health and well-being of the people by 2030. However, this commitment heavily depends on joint efforts by local authorities and the immediate service providers to communities. This paper is set to inform the status of health service provision in local authorities in Tanzania using the determinants for quality health services in Dodoma City and Bahi District. A cross-sectional research design was employed to collect data from 400 households in the Local Government Authorities. The five-service quality (SERVQUAL) dimensions of Parasuraman were adopted to gauge the quality of service in public healthcare facilities. Descriptive statistics were used to compute the frequency and mean of the demographic information and the quality of health services, respectively. A binary logistic regression model was used to establish the influence of the demographic dimensions on the quality of health services. The findings revealed that quality health services have not been realised for healthcare seekers. Further, the area of residence, education, and occupation are significantly associated with the perceived quality of health service delivery in the Local Government Authorities. The healthcare facilities under the LGAs offer services whose quality is below the healthcare seekers' expectations. The study recommends that the Local Government Authorities in Tanzania strengthen the monitoring and evaluation of health service delivery in public healthcare facilities.

Acceptability and use of the electronic community health information system and its determinants among health extension workers in Ethiopia: a retrospective cross-sectional observational study

BackgroundThe electronic community health information system has been increasingly developed and deployed to quantify and support quality health service delivery by community health workers in Ethiopia. However, the success and failure of the electronic community health information system depend on the acceptability and use by its users. This study assessed the acceptability and use of the electronic community health information system and its determinants among health extension workers in Ethiopia.MethodsA retrospective cross-sectional observational study was conducted among 587 randomly selected health extension workers from six regions of Ethiopia. The Revised Technology Acceptance Model was used as a theoretical framework for the study. Descriptive statistics, structural equation modeling, and principal component analysis techniques were used to analyze the data. For all significance tests, multiple comparison adjustments were made using the Bonferroni Correction Method.ResultsThere was near universal acceptance of the electronic community health information system, ranging from 94.4 to 97.4% among health extension workers. However, actual use of the system was considerably lower, at 50%. Perceived usefulness of the electronic community health information system had a direct and positive effect on acceptability (β3 = 0.415, p < 0.001). Perceived ease of use had both direct and indirect positive effects on electronic community health information system acceptability (β2 = 0.340, p < 0.001 and β1*β3 = 0.289, p < 0.001, respectively), while acceptability had a direct and positive effect on the use of the electronic community health information system (β3 = 0.297, p < 0.001).ConclusionsDespite the very high acceptability of the electronic community health information system among health extension workers, actual use of the system is considerably lower. Hence, an integrated and coordinated approach is required to close the acceptance-use gap.

Assessment of patients satisfaction with mobile medical clinics in the two districts of north Bengal, India

Background: Patient satisfaction is an important indicator to measure the quality of healthcare services and plays a crucial role in enhancing the quality of health service delivery. The aim of the study was to assess the patient’s satisfaction level with the quality of health care delivered at the mobile medical clinics (MMC) in two districts of north Bengal, India. Methods: A cross-sectional survey was done using a purposive sampling method, and total of 294 samples were recruited. A questionnaire (PSQ-18) was used to assess the patient satisfaction level. Chi-square tests were used for categorical variables. F-test and t-test were used for mean differences between the variables. Linear regression analysis was done to examine the linear effect of social factors on patient satisfaction. Results: The present study shows that overall satisfaction was 74.04%, with a mean value of 3.702. In the Jalpaiguri district, 27.5% of patients are highly satisfied, whereas 17.0% are in Alipurduar. Alipurduar district has a higher low satisfaction rating (39.7%) than Jalpaiguri district (19.7%), and a district-wise significant association was found (p&lt;0.001). Overall satisfaction level effects by occupation (p&lt;0.001), population and socio economic status (p&lt;0.05). Conclusions: Policymakers may consider that MMCs could be an effective strategy to improve primary health care in remote, underserved areas where there are no public health care facilities.

THE INFLUENCE OF HEALTH WORKERS’ DISTRIBUTION ON THE QUALITY OF HEALTH SERVICE DELIVERY IN PUBLIC HOSPITALS IN MANDERA COUNTY, KENYA

Background: Quality health care access remains a primary agenda on SDGs at global level. Locally, on personnel, the number of medical professionals per capita within the local governmental entities is frequently used to indicate the unequal distribution of healthcare personnel. Variances in increased mortality trends, the necessity for healthcare services per capita, and hence the human required resources per capita, may differ among units. Mandera County faces similar challenges. The main objective of this study was to determine how health workers’ distribution influences the quality of service delivery of health services at government hospitals in Mandera County. Methods: Using a descriptive research design, health personnel from Mandera County Referral Hospital, Laffey, Rhamu and Banisa Sub County Hospitals formed the unit of analysis. The study conducted December 2022 used a random sample of 189 respondents from a population of 357 using proportional and simple systematic sampling procedures. A questionnaire method that was self-administered and 10 KII (patients) was used to gather data. Results: The study found and concluded that at the significance level of 95%, skills mix, Individual Factors, Institutional Environment and socio-cultural factors were significant and positively correlated factors in influencing quality of health service delivery in public hospitals in Mandera County with significance values of 0.001, .005, .003 and .002 respectively. Conclusion: All the studied variables only affect quality of healthcare service at 53.2%, implying 46.8% needs to be explored further. KEY WORDS: Quality Healthcare, Health Workers’ Distribution, Skill Mix, Service Delivery, Individual Factors, Institutional Environment, Socio-Cultural Factors

Funding primary health care service delivery in the West Nile sub-region, Uganda

The provision of primary health care services is a global concern and quality health service delivery is based on a number of factors, including motivated health workers, good-quality infrastructure, consistent supply of medicines and technologies, adequate funding, sound health plans, and evidence-based policies. This study investigated the funding of primary health care service delivery in three local government districts in Uganda’s West Nile sub-region, and identified deficiencies in the allocation, disbursement and timeliness of health funding which have a negative impact on service delivery. Inadequate funding affects the quality of services, limits essential supplies and causes excessive reliance on private financing, which is not sustainable in poor rural economies. In view of these findings, the study recommended deliberate action by both central government and district councils to increase the percentage of funding allocated in their annual budgets to the health sector, in line with the 2001 Abuja Declaration. The government of Uganda should consider prioritising an increase in total national budget allocations to local governments; primary health care disbursements from central government should be paid on time directly to health facilities by use of the ‘straight-through processing system’ for all types of funding; the government should introduce, support and encourage additional community financing initiatives such as Community Health Insurance Schemes; and district and local community leaders should be sensitised on the benefits of this approach.

Understanding the factors influencing health workers’ choice of workplace locations: a qualitative description of primary healthcare workers’ perspectives in Nigeria

Background Universal access to a qualified, skilled, motivated and equitably distributed health workforce is pertinent for the delivery of quality health services needed to achieve national health sector goals and sustainable development goals. However, there remains a shortage of health workers attributed to health workers’ choices of not taking up postings due to the characteristics of workplace locations, amongst other factors. This study sought to understand the factors influencing primary healthcare workers’ choice of workplace locations in Nigeria. Methods This study applied a qualitative research design. We interviewed 41 primary healthcare workers, including nurses, midwives, and community health practitioners, in Bauchi and Cross River States in Nigeria. The interviews elicited responses on the important issues that health workers consider when thinking of taking up or staying in a work location. Results We found that the working conditions, living environment and human resources for health (HRH) management practices influence the choice of work location amongst health workers. For working conditions, the quality of facilities, workload concerns, the scope of practice and community support were suggested as important factors. The living environment, specifically the availability of quality housing or an allowance to pay for quality accommodation, availability of transport facilities, and quality schools for children’s education were suggested as important factors. Lastly, the HRH management practices linked to supportive management, remunerations, career advancement and continuing education were highlighted as central factors. Conclusions Our study highlights the importance of work location to health workers. In practice, there is a need for policymakers and health planners to gain and apply contextual evidence on factors influencing health workers’ choice of workplace locations in health and HRH planning and management. This is pertinent in designing and implementing tailored interventions for ensuring the equitable distribution of health workers.

Practices of health citizenship in South Africa: a case study of the Treatment Action Campaign (TAC) in Khayelitsha, Cape Town

This article examines the Treatment Action Campaign’s (TAC) evolution and attrition as a social movement organisation to discern its implications for practices of health citizenship at the grassroots level. A qualitative approach to case study research was used to collect and analyse data. Practices of health citizenship were framed around the integration of biomedical knowledge and people’s experiences of grassroots activism. By exploring how the TAC’s brand of activism filtered down to the community level, the findings reveal the importance of diverse forms of activist-led collective action in promoting health-seeking behaviour. These comprise activist-led branch meetings, community workshops, health promotion talks at clinics and community radio stations, as well as protest action at community clinics. Findings indicate that participation in TAC-led activism in Khayelitsha is not a passive form of responsible HIV citizenship. Rather, it is an active process through which TAC members integrate their lived experiences with biomedical knowledge to construct meanings and articulate grievances to enhance the quality of health service delivery in their community. Also, although the TAC’s practices of health citizenship have not changed significantly over time, its campaigns have evolved based on contextual factors. These practices have entrenched ways of being, doing and knowing that have become an important resource for activist-led health promotion. Key stakeholders in government and civil society can harness these practices to strengthen health systems.

Impact of electronic dealing on the quality of health service delivery

The current study aimed to determine the extent to which electronic transactions affect the quality of healthcare services. To achieve the study's goal, a descriptive and analytical approach was adopted to evaluate healthcare services, and a questionnaire was distributed to administrative staff in Saudi hospitals. The data was processed, classified, hypotheses tested, and results analyzed, and conclusions and appropriate recommendations were drawn. A total of 120 questionnaires were distributed, and it was found that all were valid for statistical analysis. The research found that the level of electronic transactions in all its requirements (administrative, human, financial, technical, and security) in Saudi hospitals is high, and there is a high level of quality in the provision of healthcare services in Saudi hospitals. There is a direct effect of electronic transactions in all their requirements (administrative, human, financial, technical, and security) on the quality of healthcare services in Saudi hospitals. 

Anestezi Ekibinin İkinci Mağdur Fenomeni Deneyimi: Odak Grup Çalışması

Objective: As a result of the negative events experienced, the patient becomes the first victim, while the healthcare provider becomes the second victim. This situation is frequently experienced in the operating room (OR) and intensive care unit (ICU). Our aim is to reveal the problems and experiences of the anesthesia personnel working in OR / ICU regarding the second victim phenomenon (SVP) and to propose solutions. Methods: The research was conducted with the qualitative research method. Focus group interviews were conducted with six volunteer healthcare personnel working in OR / ICU. The data was written down and thematic content analysis was done through MAXQDA 22. Results: 5 main themes and 21 subthemes were reached. These main themes can be counted as the frequency of experiencing SVP, the main problems, emotions/feelings, coping methods, and suggestions/requests. The anesthesia team encountered the SVP frequently and this could be due to medical, violent, or technical reasons. In this situation, they felt worthlessness, helplessness, injustice, anger, and aggression. In order to cope with the SVP, they use methods such as self-suggestion, taking a break, calming down, and sharing with colleagues. As suggestions, they demanded psychological, legal, technical, managerial, physiotherapy, peer, and academic support as well as free time, elimination of patient complaints, and increased hospital security. Conclusion: The operating room and intensive care units are the busiest departments, and the frequency of adverse events is very high. Some of the situations that cause to feel SVP are preventable problems. Being aware of what you feel and how to overcome it will increase the quality of health service delivery and reduce the burnout status of health workers. Keywords: Patient safety, anesthesia, critical care

Https://journals.scholarpublishing.org/index.php/ASSRJ/article/view/14030

The study examined the effect of corruption on service delivery in local governments, a case study of health service delivery in Magwi County-Eastern Equatoria State of South Sudan. Specifically, study examined the level of corruption in health service delivery Magwi County-Eastern Equatoria State of South Sudan; assessed the quality of health service delivery in Magwi County-Eastern Equatoria State of South Sudan; and established the effect of corruption on health service delivery in Magwi County-Eastern Equatoria State of South Sudan. The study used descriptive research design. The study population was 75 where a sample of 63 respondents was selected using simple random and purposive sampling techniques. The study used both self-administered questionnaire and interview guide. Findings revealed that, it is a common practice in public facilities to first cash in individual healthcare providers to receive treatment, money intended for healthcare services is embezzled, there is high rates of favoritism where family members, relatives and friends receive the treatment first before others, people pay bribes to receive treatment in public health facilities, and healthcare providers sell public drugs to individual drug shops. It is concluded that corruption is the reason why public investment in health coupled with high rates of private spending has not translated into good health outcomes. The study recommends an establishment of an independent system to supervise delivery of services as this will help reduce corrupt tendencies. Furthermore, GoSS should develop a political will to fight and reduce corruption in Local government and all sphere of public institutions.

Estimating the base rate by using unit cost analysis approach to design capitation payment method at primary health care level: A case study of Minh Hoa district, Quang Binh province

Strengthening and innovating the healthcare provider payment is being an important solution to improve operational and financial efficiency and the quality of health service delivery at the primary health care (PHC) level. This study applied cost analysis to measure the unit cost in the determination of base rate for the capitation payment method by combining the top - down and bottom - up calculations along with step-by-step cost allocation. All costs include full components as prescribed by the government. Results showed that the base rate of health facilities was higher than the average cost of current health insurance paid by fee-for-services method. In addition, the district hospital illustrated the highest difference when comparing the capitation fund to outpatient visits cost based on cost analysis with a reduction of 79.9%. Most of the Commune Health Centers (CHCs) received the capitation fund that was higher than outpatient visits cost in 2018, exception for CHC at Quy Hoa. The research provides scientific evidence to help policy makers design and develop the system of capitation payment method at the PHC level based on the cost analysis approach.

Is the Triage System Welcomed in the Tertiary Hospital of the Limpopo Province? A Qualitative Study on Patient's Perceptions.

A triage system in the emergency department is necessary to prioritize and allocate scarce health resources to the medical needs of the patients to facilitate quality health service delivery. This paper aimed to ascertain if the triage system is welcomed in the tertiary hospital of Limpopo Province by exploring patients' perceptions in the emergency department in South Africa. A qualitative research approach was used in this study with descriptive, explorative, and contextual research design to reach the research objective. Purposive sampling was used to select the patients who participated in semi-structured one-on-one interviews, which lasted between 30 and 45 min. The sample size was determined by data saturation after 14 participants were interviewed. A narrative qualitative analysis method was used to interpret and categorize the patients' perceptions into seven domains of Benner's theory. The six relevant domains illustrated mixed patients' perceptions regarding the triage system in the emergency departments. The domain-helping role of the triage system was overweighed by the dissatisfaction of the needy patients who waited for an extended period to receive emergency services. We conclude that the triage system at the selected tertiary hospital is not welcomed due to its disorganization and patient-related factors in the emergency departments. The findings of this paper are a point of reference for reinforcing the triage practice and improved quality service delivery by the emergency department healthcare professionals and the department of health policymakers. Furthermore, the authors propose that the seven domains of Benner's theory can serve as a foundation for research and improving triage practice within emergency departments.

Nursing education reform in South Africa: Implications for postgraduate nursing programmes

Training of Specialist Nurses is of critical importance for the continued delivery of quality health services globally and in South Africa. In accordance with international trends, nursing education in South Africa has undergone significant educational reforms in the past few years. The aim of this paper is to critically reflect on current nursing education reform in South Africa and the implications for the postgraduate diploma in nursing programmes. The paper highlights some of the challenges encountered with the development, accreditation and implementation of the new nursing postgraduate diploma programmes. Successful nursing education reform requires collaborative and proactive conversations between all stakeholders before changes are made to existing nursing categories and skills mix, during the development of new programme frameworks, during programme development and after implementation of the reform strategies.

Assessment of health system readiness for routine maternal and newborn health services in Nepal: Analysis of a nationally representative health facility survey, 2015.

Access to and utilisation of routine maternal and newborn health (MNH) services, such as antenatal care (ANC), and perinatal services, has increased over the last two decades in Nepal. The availability, delivery, and utilisation of quality health services during routine MNH visits can significantly impact the survival of mothers and newborns. Capacity of health facility is critical for the delivery of quality health services. However, little is known about health system readiness (structural quality) of health facilities for routine MNH services and associated determinants in Nepal. Data were derived from the Nepal Health Facility Survey (NHFS) 2015. Total of 901 health facilities were assessed for structural quality of ANC services, and 454 health facilities were assessed for perinatal services. Adapting the World Health Organization's Service Availability and Readiness Assessment manual, we estimated structural quality scores of health facilities for MNH services based on the availability and readiness of related subdomain-specific items. Several health facility-level characteristics were considered as independent variables. Logistic regression analyses were conducted, and the odds ratio (OR) was reported with 95% confidence intervals (CIs). The significance level was set at p-value of <0.05. The mean score of the structural quality of health facilities for ANC, and perinatal services was 0.62, and 0.67, respectively. The average score for the availability of staff (e.g., training) and guidelines-related items in health facilities was the lowest (0.37) compared to other four subdomains. The odds of optimal structural quality of health facilities for ANC services were higher in private health facilities (adjusted odds ratio (aOR) = 2.65, 95% CI: 1.48, 4.74), and health facilities supervised by higher authority (aOR = 1.96; CI: 1.22, 3.13) while peripheral health facilities had lower odds (aOR = 0.13; CI: 0.09, 0.18) compared to their reference groups. Private facilities were more likely (aOR = 1.69; CI:1.25, 3.40) to have optimal structural quality for perinatal services. Health facilities of Karnali (aOR = 0.29; CI: 0.09, 0.99) and peripheral areas had less likelihood (aOR = 0.16; CI: 0.10, 0.27) to have optimal structural quality for perinatal services. Provincial and local governments should focus on improving the health system readiness in peripheral and public facilities to deliver quality MNH services. Provision of trained staff and guidelines, and supply of laboratory equipment in health facilities could potentially equip facilities for optimal quality health services delivery. In addition, supervision of health staff and facilities and onsite coaching at peripheral areas from higher-level authorities could improve the health management functions and technical capacity for delivering quality MNH services. Local governments can prioritise inputs, including providing a trained workforce, supplying equipment for laboratory services, and essential medicine to improve the quality of MNH services in their catchment.

Factors that Affect the Quality of Health Care Services in the North-West Province

The study was conducted to assess and evaluate the quality of health service delivery in the North-West Province of South Africa. Data was gathered by administering a questionnaire to 488 health professionals (public health administrators, medical doctors, pharmacists and professional nurses) working in various public health care facilities in the North-West Province. Results obtained from structural equations modelling (SEM) showed that the quality of health care services in designated health facilities in the North-West Province was influenced by 3 factors. These were the availability of enough number of suitably qualified health professionals at all designated health facilities, the ability to provide primary health care services to all people who need the services at all designated health facilities, and the availability of essential medicines and drugs at all times at all designated health facilities.

THE EFFECT OF WALK THROUGHT AUDIT (WTA) ON IMPROVING THE QUALITY OF HEALTH SERVICES IN THE FIRST LEVEL OF HEALTH FACILITIES

This study aims to analyze how influential the Walk Through Audit (WTA) is on improving the quality of health services at the First Level Health Facility at the Johan Pahlawan Health Center, Meulaboh, Aceh Barat by using the direct interview method to participants of the National Health Insurance - Healthy Indonesia Card (JKN-KIS). ) which was assisted by a survey of JKN-KIS participants' satisfaction with the implementation of public services at the Johan Pahlawan Health Center, Meulaboh. This method focuses on theories and phenomena directly at the research site. The data used in this study is primary data. Primary data is data obtained by direct interaction with respondents. This aims to analyze the satisfaction of participants as users of health services at one of the first level health facilities (FKTP) in Meulaboh where through this WTA participants are directly involved in the function of supervising the fulfillment of the obligations of health facilities, and the results of the WTA will be one of the evaluation materials for services. first-level health facilities (FKTP) in order to improve the quality of health service delivery for JKN-KIS participants. The results of the research analysis show that the Walk Through Audit (WTA) has a positive and significant effect on improving the quality of health services at the First Level Health Facility at the Johan Pahlawan Health Center, Meulaboh City.

Influence of Leadership Styles on Quality Health Service Delivery at Mnazi Mmoja Hospital Zanzibar

The aim of the study was to assess the influence of transformational, transactional and democratic leadership styles on quality health service delivery at Mnazi Mmoja Hospital, Zanzibar. Bearing the importance of quality health service there is no doubt that leadership style could be integral in offering quality health service. Despite the efforts done to improve health service delivery, Zanzibar has not optimally achieved quality health service delivery. The study used transformational, transactional and democratic leadership styles to assess their influence on quality health service delivery. Cross-sectional research design which involved quantitative research approach was used. The quantitative analysis included mean, standard deviation and multiple linear regressions. A sample size of 317 was determined using stratified Sampling method. Multifactor Leadership Questionnaire, (MLQ) was used to collect data. The results found that transformational, transactional and democratic leadership styles impacted quality of health service delivery with 37.3%, 25.7% and 21.8% respectively. The study recommended the management of Mnazi Mmoja to put effort in practicing all aspects of transformational, transactional and democratic leadership styles in order to enhance delivery of quality health services.

Multi-Stakeholder Partnerships (MSPs) for Health Service Delivery in Ethiopia

The past few decades have witnessed the integration of non-state actors in public service delivery. Partnerships as a form of governance involves state and non-state actors in public policy formulation and implementation. The widespread poverty and severe health problems in Ethiopia demand for an increasing role of a wide range of actors outside of the state. In the past few years, the Ethiopian government has been actively seeking collaborative arrangements for health service delivery that are aimed at ensuring access to basic and quality health service delivery. The paper will focus on studying MSPs for health service delivery as a form of governance, hence we focus on the internal dynamics of the MSPs for health service delivery and provide an understanding of state and non-state interaction in these governance networks. The case analysis is based on a specific MSP for helath service delivery at local level.

Are we there yet? Unbundling the potential adoption and integration of telemedicine to improve virtual healthcare services in African health systems

Since the outbreak of COVID-19, the attention has now shifted towards universal vaccination to gracefully lift strict COVID-19 restrictions previously imposed to contain the spread of the disease. Sub-Saharan Africa is experiencing an exponential increase of infections and deaths coupled with vaccines shortages, personal protective equipment, weak health systems and COVID-19 emerging variants. Some developed countries integrated telemedicine to reduce the impacts of the shortage of healthcare professionals and potentially reduce the risk of exposure, ensuring easy delivery of quality health services while limiting regular physical contact and direct hospitalization. However, the adoption of telemedicine and telehealth is still nascent in many sub-Saharan Africa countries. Therefore, this study reflects on progress made towards the use of telemedicine, virtual health care services, challenges encountered, and proffers ways to address them. We conducted a systematic literature review to synthesise literature on telemedicine in sub-Saharan Africa. The study revealed that telemedicine provides unprecedented benefits such as improving efficiency, effective utilization of healthcare resources, forward triaging, prevention of medical personnel infection, aiding medical students' clinical observation and participation, and assurance of social support for patients. However, the absence of policy on virtual care and political will, cost of sustenance of virtual health care services, inadequate funding, technological and infrastructural barriers, patient and healthcare personnel bias on virtual care and cultural barriers are identified as limiting factors to the adoption of virtual health care in many African health systems. To alleviate some of these barriers, we recommend the development of robust policies and frameworks for virtual health care, the inclusion of virtual care in the medical school curriculum, supporting virtual care research and development, increasing health funding, removing monopolisation of telecommunication services, developing of virtual health solutions that address eccentricities of African health systems.