Health Centers In Rural Areas Research Articles

Survey and analysis on the resource situation of primary health care institutions in rural China.

China's rural population is immense, and to ensure the well-being of rural residents through healthcare services, it is essential to analyze the resources of rural grassroots healthcare institutions in China. The objective is to examine the discrepancies and deficiencies in resources between rural grassroots healthcare institutions and the national average, providing a basis for future improvements and supplementation of rural healthcare resources. The study analyzed data from 2020 to 2022 on the number of healthcare establishments, the capacity of hospital beds, the number of healthcare professionals, and the number of physicians in both rural and national settings. Additionally, it examined the medical service conditions and ratios of township health centers in rural areas to assess the resource gap between rural areas and the national average. Healthcare establishments: On average, there were 2.2 fewer healthcare institutions per 10,000 persons in rural areas compared to the national average over three years. Hospital beds: On average, there were approximately 36 fewer hospital beds per 10,000 persons in rural areas compared to the national average over three years. Healthcare professionals and physicians: On average, there were about 48 fewer healthcare technical personnel and 10 fewer practicing (including assistant) physicians per 10,000 persons in rural areas compared to the national average over three years. Compared to the national average, there are significant discrepancies and deficiencies in grassroots healthcare resources in rural China. This underscores the necessity of increasing funding to progressively enhance the number of healthcare institutions in rural areas, expand the number of healthcare personnel, and elevate medical standards to better align with national benchmarks. Improving rural healthcare resources will strategically equip these institutions to cater to rural communities and effectively handle public health emergencies. Ensuring that the rural population in China has equal access to healthcare services as the rest of the country is crucial for promoting the well-being of rural residents and achieving health equity.

AT: Asynchronous Teleconsultation for Health Centers in Rural Areas of Peru

AT: Asynchronous Teleconsultation for Health Centers in Rural Areas of Peru

Trends in output of hypertension management and associated factors in primary care facilities: a latent trajectory analysis in China from 2009 to 2017

BackgroundThe prevalence of hypertension is high (25.2% in 2012) and there were a large number of patients with hypertension (more than 200 million) in China. Township health centres in rural areas and community health centres in urban areas are responsible for hypertension management. This study aims to identify trends in hypertension management output and related facility-level, geographical and economic factors in primary care facilities and to assess the effect of the national project of basic public health services in China from 2009 to 2017.MethodsA cross-sectional survey (2018) was combined with retrospective data collection (2009–2017) from 685 primary care facilities in six provinces in China. The hypertension management output was indicated by the number of patients with hypertension under management per 10,000 population. Latent class growth analysis and group-based trajectory models were applied to classify trajectories and determine associations with facility-level, geographic and economic characteristics.ResultsThe trend in the output increased rapidly from 2009 to 2012 with an average growth rate of 54.58% and slowed down from 2012 to 2017 (growth rate of 5.94%). Five trajectories of the output were identified and labelled according to baseline status and increase rates: low-gradually increasing (16.9%), middle-slightly increasing (16.2%), low-sharply increasing (7.9%), middle-sharply increasing (34.2%) and persistently high (24.9%). The time-stable characteristics, including region (eastern, central or western), district (urban or rural), landform, were associated with hypertension management output of the facilities. Number of public health physicians was a significant time-dependent characteristic influencing management output.ConclusionsFive latent trajectories of hypertension management output were identified. The output was still at a low level compared with the prevalence of hypertension. Hypertension screening in young people need to be emphasized. Facilities are recommended to establish good relationships with residents for better hypertension management outcomes especially in urban areas.

Adherence model to cervical cancer treatment in the Covid-19 era

Cervical Uterine Cancer is a disease that explains the vulnerability in which women are in terms of reproductive health with an impact on occupational health and public health, even when in Mexico the prevalence rate is lower than the other member countries of the OECD, its impact on Human Development and Local Development shows the importance that the disease have in communities more than in cities where prevention policies through check-ups and medical examinations seem to curb the trend, but show the lack of opportunities and capacities of health centers in rural areas. To establish the reliability, validity, and correlations between the variables reported in the literature with respect to their weighting in a public hospital. A non-experimental, cross-sectional and exploratory study was carried out with a non-probabilistic selection of 104 patients from a public hospital in the State of Mexico. The Scale of Psychosocial Variables Determinants of Adherence to Treatment of Cervical Uterine Cancer was constructed. From a structural model, it was demonstrated the adjustment of the trajectories of determining relationships in which knowledge influenced the behavior of adherence to treatment. The limits of the design, sampling and analysis of the study are noted and it is recommended to include organizational and psychological variables supported by theories of organizations and theories of personality.

Challenges and Ethical Implications in Rural Community Mental Health: The Role of Mental Health Providers.

This manuscript reviews the unique challenges, barriers, and ethical implications of providing mental health services in rural and underserved areas. Community mental health centers in rural areas are often underserved due to shortages of mental health providers and limited resources. Individuals living in rural areas are at increased risk of developing mental health condition with limited access to mental health clinicians and healthcare facilities. These access to care issues are often exacerbated by geographical barriers as well as social, cultural, and economic challenges. A rural mental health professional may encounter several barriers to providing adequate care to individuals living in rural areas. For example, limited services and resources, geographic barriers, conflict between professional guidelines and community values, managing dual relationships, and challenges pertaining to confidentiality and privacy are several barriers to providing adequate care in rural areas. We will briefly summarize the primary ethical domains that are especially influenced by rural culture and the complex responsibilities of mental health providers in rural areas including barriers to care, crisis intervention, confidentiality, multiple relationships/dual roles, limits of competency, and rural mental healthcare practice implications.

Eliciting primary healthcare physicians’ preferences for job characteristics in rural China: a discrete choice experiment

IntroductionThe outflow and scarcity of physicians in rural areas can adversely affect universal health coverage and population health outcomes, which are critical concerns in China. This study explored primary healthcare...

Correlates of level of satisfaction among primary health care workers in Albania

Aim: The aim of this study was to explore the level of satisfaction of primary health care staff in Albania and the factors associated with it. Methods: A cross-sectional study was conducted in Tirana city, the Albanian capital, from 11 November 2020 until 25 November 2020. Among all health centers (HCs) and health centers of specialties (HCSs) of Tirana Municipality, there were selected randomly a HC in rural areas, a HC in urban areas and one HCS. All the staff (doctors and nurses) being present at the time of data collection was interviewed, using an international standardized tool (the Dartmouth-Hitchcock Medical Center instrument) assessing the satisfaction with various elements of the work in PHC, validated in Albanian. A total of 102 PHC staff were included in the study. Binary logistic regression was used to assess the association of staff satisfaction with independent factors. Results: The aspects of work most appreciated by PHC staff (% satisfied or very satisfied) were: respectful treatment by colleagues (78.2%), staff morale and their positive attitude towards work (73.2%). The most disliked aspects of work by PHC staff (% dissatisfied or very dissatisfied) were: current salary (60.8%), stress at work (38.3%), physical and medical infrastructure in the institution (27%). Staff in rural HCs, older staff, females and nurses and family doctors are more likely to be satisfied compared to their respective colleagues. Conclusion: Our findings suggest various factors associated with the satisfaction of PHC staff in Albania. These findings could be guiding future efforts aiming to improve the work conditions of the professionals working in primary health care in Albania.

The preparedness of disaster among nurses in community health centers in rural areas during the COVID-19 pandemic in Malang City.

Positive COVID-19 cases in Malang City, Indonesia continue to increase. Until 04 August 2021, the COVID-19 update shows 3301 positive cases with 7754 cured and 832 deaths. This study aims to identify nurses preparedness in rural area community health centers during the COVID-19 pandemic in Malang for self-control to implement health protocol. This study intends to provide insights on controlling COVID-19 spread in Malang, Indonesia.This research is a quantitative study with correlative analytic observational design and a cross-sectional approach involving 120 nurses from 16 primary health centers. The results of the bivariate analysis using gamma correlation test are: knowledge factors (p = 0.005; r = 0.35), attitude (p = 0.000; r = 0.46), means of infrastructure (p = 0.000; r = 0.54), and self-control (p = 0.000; r = 0.52) for the quarantined COVID-19 patients. Knowledge, attitude, infrastructure, and safe house factors can influence self-control for COVID-19. In rural areas, health education—as education and empowerment for patient self-control—is an effort to encourage them to obey health protocol during the pandemic.Nurse readiness and preparedness during the pandemic is crucial for strengthening the assertive behavior commitment through self-control. This ensures the community's awareness of the importance of complying with health protocols for the common good. Mental nursing intervention needs to be added as a part of psychosocial therapy for the community's social problems, primarily in reducing the pressure due to the social distancing enforcement to control and prevent COVID-19 spread.

Herbs as Antidote for Snake Bite Treatment- Traditional Practices and Its Future Prospects- A Review

Snake bite is a life-threatening neglected tropical infection reporting high mortality across the world including India. Out of the available yearly statistics of this occupational hazard caused 4.5-5.4 million people and nearly 1,38,000 fatalities were reported globally. Several factors such as the low availability of antivenom, inadequate health centres in rural areas, poor transportation facilities affected the higher number of morbidity and mortality cases of snake bite. The prognostic and diagnostic approach towards the snake bite infection is difficult due to its complexity in venom. The conventional therapy is polyvalent antivenom derived from horses or sheep, with its limitations. The traditional physicians use plants and other herbs as its sustainable remedy for snake bite treatment. Nearly, 523 plant species from 122 families reported their neutralizing property against toxic venom. The secondary metabolites extracted from plants, are capable of reducing the toxic effects of the venom. Many research works has been reported the inhibitory potential of the plant compounds against the snake venom enzymes. Therefore, there is a necessity for increasing therapeutic studies on plant metabolites and the development of an antidote for the better treatment of snakebite. This review article discusses various herbal plant used for snake bite in India.

Strategies of Health Workers in Tackling Stunting in Rural Areas during the Covid-19 Pandemic

The current Covid-19 vaccination has reached most people throughout Indonesia. The main focus of this spectrum is on handling the Covid-19 pandemic through the provision of vaccines in Indonesia. The pandemic's impact is indisputably clear, especially in the Stunting Management Programs, which are likely not optimal and require a viable strategy in handling it. Objective: This study aims to identify the strategy of health workers in tackling stunting in rural areas during the Covid-19 Pandemic. Method: This study employs a quantitative descriptive design where the population involved are health workers holding nutrition programs from health centres in rural areas in the province of Bali. The sampling technique in this study utilizes a non-probability sampling technique, namely purposive sampling of 34 respondents. Afterwards, data collection was done online, with the inclusion criteria for health workers working as nutrition program holders and community health centres in rural areas. This study indicates that 55.90% of health workers are not well-performing at dealing with stunting during the pandemic, while 44.10% of them show positive performance. Therefore, prevention of stunting by health workers during a pandemic is one of the indicators of whether stunting is in a high or low incidence.

Towards a Blockchain-based Medical Test Results Management System: A Case Study in Vietnam

The role of the testing process cannot be denied in the diagnosis and treatment of patients’ diseases in medical facilities today. The results from this process help doctors and nurses in medical centers make a preliminary and detailed assessment of symptoms and provide a specific course of treat-ment for their patients. In addition, these results are stored as a patient’s medical record that serves as a reference for subsequent therapies. However, the storage of this information (i.e., paper-based, electronic-based) faces some difficulties for both approaches. Especially for developing countries (i.e., Vietnam), this process encounters some major obstacles at health centers in rural areas. Many centralized/decentralized storage methods have been proposed to solve the above problem. Besides, the current popular method is patient-centered (all information shared is decided by the patient) can solve the above problems and be applied by many research directions. However, these methods require the user (i.e., patient) to have a background in security and privacy as well as the cutting-edge technologies installed on their phones. This is extremely difficult to apply in rural areas in developing countries where people are not yet conscious of protecting their personal information. This paper proposes a mechanism for storing and managing test results of patients at medical centers based on blockchain technology - applicable to developing countries. We build a proof-of-concept based on the Hyperledger Fabric platform and exploit the Hyperledger Caliper to evaluate a variety of scenarios related to system performance (i.e., create, query, and update).

Factors influencing the retention of secondary midwives at health centres in rural areas in Cambodia: the role of gender\u2014a qualitative study

BackgroundRetention of skilled midwives is crucial to reducing maternal mortality in rural areas; hence, Cambodia has been trying to retain at least one secondary midwife who can provide basic emergency obstetric care at every health centre even in rural areas. The factors influencing the retention of midwives, but not solely secondary midwives, have been identified; however, the security issues that affected female health workers during the conflict and the post-conflict years and gender issues have been unexplored. This study explores these and other potential factors influencing secondary midwife retention and their significance.MethodsSequential two-stage qualitative interviews explored influential factors and their significance. The first stage comprised semi-structured interviews with 19 key informants concerned with secondary midwife retention and in-depth interviews with eight women who had deliveries at rural health centres. Based on these interview results, in-depth interviews with six secondary midwives who were deployed to a rural health centre were conducted in the second stage. These midwives ranked the factors using a participatory rural appraisal tool. These interviews were coded with the framework approach.ResultsLiving with one’s parents or husband, accommodation and security issues were identified as more significant influential factors for secondary midwife retention than current salary and the physical condition of the health centre. Gender norms were entrenched in these highly influential factors. The deployed secondary midwives who were living apart from one’s parents or spouse requested transfer (end of retention) to health centres closer to home, as other midwives had done. They feared gender-based violence, although violence against them and the women around them was not reported. The health workers surrounding the midwives endorsed the gender norms and the midwives’ responses. The ranking of factors showed similarities to the interview results.ConclusionsThis study suggests that gender norms increased the significance of issues with deployments to rural areas and security issues as negative factors on female health workforce retention in rural areas in Cambodia. This finding implies that further incorporating gendered perspectives into research and developing and implementing gender-responsive policies are necessary to retain the female health workforce, thereby achieving SDGs 3 and 5.

Need to investigate COVID-19 beliefs for tailor-made sensitisation campaigns

ObjectivesThe main objective of this study was to investigate the COVID-19 beliefs of a random sample of Mauritian social media users. Study designCross-sectional study. MethodsThis quantitative research was undertaken by means of an online survey instrument, with questions on participants’ behaviour towards COVID-19 and their beliefswith respect to susceptibility, barriers, benefits, cues to actions and self-efficacy. ResultsIn total, 405 participants completed the survey. Participants had a low mean COVID-19 perceived susceptibility and perceived severity. Significant differences in susceptibility were observed among different age groups, places of residence and educational levels. A significant difference in self-efficacy was found between people living in urban and rural areas. Participants aged <39 years showed a significantly lower perceived benefit of staying at home to avoid COVID-19 infection compared with those aged 39–54 years. Multiple linear regression modelling revealed that participants aged 39–65 years and those who were single were the most concerned about the risk of COVID-19 infection. ConclusionsThe findings of this study provide the basis for evidence-based health education programmes that are tailor-made for specific targeted audience. Sensitisation campaigns on the benefits of staying home should be aimed at younger social media users (aged <39 years). Community health centres in rural areas need to be involved in providing educational videos to empowering people towards self-efficacy.

Examining the Effect of the Training Program by Using the Health Belief Model in Performing Self-Care Behaviors of Rural Patients Having High Blood Pressure

High blood pressure effects on patients' life. One of the problems in controlling blood pressure is lack of self-care. As a primary form of care, self-care is under patients' control and the patient's belief plays an important role in self-care behaviors. Using the Health Belief Model, this study aimed to determine the effect of educational program on self-care behaviors of rural patients afflicted with hypertension in Toyserkan city. This study was a quasi-experimental research. It studied 100 hypertensive patients in four health centers in rural areas in Toyserkan city in 2019. The samples were simple random sampling among those people referred to the four health centers. Participants in the intervention group attended three training sessions, but the control group did not take part in any training program. The assessment was conducted in both groups before and after the intervention through personal interviews with patients. The questionnaire including the Health Belief Model and self-care behavior constructs was administered. Perceived susceptibility, perceived severity, self-efficacy and self-care behavior constructs did not have significant statistical differences in terms of mean scores before intervention between the two groups, but after intervention, there were statistically significant differences between the two groups. Examining the model factor in predicting self-care in the intervention group showed that the perceived severity and self-efficacy constructs had the highest predictive power. The results showed that planning and intervention based on HBM, as the models that were used in education and health promotion could be effective in achieving better performance and attitude of patients suffering from hypertension and their self-care. Also, special mention is needed to health care providers to improve self-care training in patients with high blood pressure.

Improving continuity of HIV/AIDS care through electronic health records in resource-limited settings: A Botswana perspective

ObjectiveTo investigate barriers to the effective use of electronic health records (EHR) to improve health outcomes for HIV/AIDS care treatment in health centres in rural areas of Botswana. MethodsIn a qualitative study interviews were held with 57 staff members at 32 health centres in rural and remote areas of the country. Closed and open-ended questions were used to gain insights into the implementation and use of the EHR system. Transcripts were analysed and evaluated using thematic coding and structured around themes through NVivo 11 data analysis software. Themes covered were: changes in nursing practice; EHR system support; non-use of EHR; lack of leadership commitment to EHR use; and risks of using EHR. ResultsA large majority of staff were confident users of the EHR, despite limited training. Many nursing staff reported changes in administrative duties as documentation with EHR was different from that used in paper-based records and reports to management. Lack of appropriate support led to challenges in consistent operation and management of the EHR system. There were risks of data corruption through equipment failures and security vulnerabilities. The EHR system could not communicate with outside healthcare providers or facilities, leading to loss of patient follow up and delays in obtaining results of laboratory tests. ConclusionProgress has been made with a national EHR system to support HIV management in Botswana within small local facilities. However, nurses’ perspectives indicate limitations in staff training, insufficient support for health centres, and lost communication between facilities. Such barriers led to continued delays in treatment and fragmentation of health records. These areas should be addressed in further development.

Modelling Adherence to the Treatment of Cervical Cancer

Background. Cancer Cerval Uterine is a disease That Explains the vulnerability in Which women are in reproductive health With an impact on occupational health and public health, even When In Mexico the prevalence rate is lower than the other Member Countries OECD, ITS impact on Human Development and Local Development shows the Importance That the disease has on Communities rather than in cities Where policies of prevention through screening and medical examination seemed to slow the trend but show a lack Opportunities and capabilities of health centers in rural areas. Objective. Establish the reliability, validity and correlations Between variables Reported in the literature Regarding ITS weighting in a public hospital. Method. A non-experimental, cross-sectional and exploratory study with a nonrandom selection of 104 Patients from a public hospital in the State of Mexico was held. Scale Variables psychosocial determinants of treatment adherence Uterine Cervical Cancer built. Results. From a structural model [χ² = 490.330 (28 gl) p = 0.000; GFI = 0.927; CFI = 0.970; RMSEA = 0,003]se Showed relationships in adjustment paths Determining Which Had an impact on knowledge treatment adherence behavior (β = 0.50). Conclusion. the boundaries of design, sampling and analysis of the study are noted and recommended to include organizational and psychological variables supported in theories of Organizations and theories of personality.

Telehealth Practice Among Health Centers During the COVID-19 Pandemic - United States, July 11-17, 2020.

Early in the coronavirus disease 2019 (COVID-19) pandemic, in-person ambulatory health care visits declined by 60% across the United States, while telehealth* visits increased, accounting for up to 30% of total care provided in some locations (1,2). In March 2020, the Centers for Medicare & Medicaid Services (CMS) released updated regulations and guidance changing telehealth provisions during the COVID-19 Public Health Emergency, including the elimination of geographic barriers and enhanced reimbursement for telehealth services† (3-6). The Health Resources and Services Administration (HRSA) administers a voluntary weekly Health Center COVID-19 Survey§ to track health centers' COVID-19 testing capacity and the impact of COVID-19 on operations, patients, and staff. CDC and HRSA analyzed data from the weekly COVID-19 survey completed by 1,009 HRSA-funded health centers (health centers¶) for the week of July 11-17, 2020, to describe telehealth service use in the United States by U.S. Census region,** urbanicity,†† staffing capacity, change in visit volume, and personal protective equipment (PPE) supply. Among the 1,009 health center respondents, 963 (95.4%) reported providing telehealth services. Health centers in urban areas were more likely to provide >30% of health care visits virtually (i.e., via telehealth) than were health centers in rural areas. Telehealth is a promising approach to promoting access to care and can facilitate public health mitigation strategies and help prevent transmission of SARS-CoV-2 and other respiratory illnesses, while supporting continuity of care. Although CMS's change of its telehealth provisions enabled health centers to expand telehealth by aligning guidance and leveraging federal resources, sustaining expanded use of telehealth services might require additional policies and resources.

Impact of Health Level on Agricultural Productivity in Cameroon

The objective of this study is to assess the effect of health on agricultural productivity in Cameroon. To achieve this objective, we use the techniques of Propensity Score Matching on data from the fourth Cameroonian household survey (ECAM 4). The results of the analysis show that healthy farmers produce on average than farmers in fragile health. Indeed, healthy farmers produce an average of FCFA 583,601 per hectare. This effect is statistically significant at the 5% threshold. Due to the fact that the level of health improves agricultural yields, we recommend to the public authorities, to facilitate farmers' access to health care through a reduction in health care costs, but also through a multiplication of health centers in rural areas.

Essential Workflow and Performance Measures for Optimizing Acute Ischemic Stroke Treatment in India.

Essential Workflow and Performance Measures for Optimizing Acute Ischemic Stroke Treatment in India.

Benefits for Older People from Government Subsidies for Healthcare in China: Is the Distribution Equitable?

Population aging poses an unprecedented challenge in China. Barriers such as health insurance schemes, socio-economic status, social support, and family structure hinder access to healthcare and have led to an inequitable distribution of government health subsidies for older people. However, the extent of equity of government subsidies for China’s older people’s care services has never been evaluated. Benefit incidence analysis was used to examine the distribution of government health subsidies for older people by income quintile. The concentration index was calculated in both urban and rural areas in 2008 and 2013. The equity of distribution of government health subsidies for older people improved over the period 2008–2013 after expansion of health insurance schemes in both urban and rural areas. All types of older people’s care services were inequitable in 2008, but only urban inpatient care remained inequitable in 2013. The situation was better for rural than urban areas, and outpatient than inpatient care. This is probably the result of expansion of health insurance schemes in urban areas and increased government funding for township health centers in rural areas. Underfunding and inappropriate reimbursement policies by health insurance schemes have resulted in inequitable inpatient subsidies in urban areas.