Primary Health Care Project Research Articles

Linking Health and Mental Health Services in Rural Areas

As part of growing effort in the United States to increase coordination between primary health care and health care, federal officials initiated program to link community health centers (CMHCs) with primary health care projects (PHCPs). The Bureau of Community Health Services (BCHS)has supported about 850 primary health care projects in medically underserved areas of the country. In fiscal 1978, in conjunction with the National Institute of Mental Health, BCHS officials allocated $1.5 million to fund linkage initiative to coordinate its PHCPs with the CMHCs in their respective catchment areas. Initial grants of as much as $30,000 were awarded to 57 PHCPs to hire mental health professional to provide triage, referral, and health consultation services at each PHCP. In terms of organizational impact, this clinical service was expected to assure a continuing relationship between the PHCP and the CMHC.1 From the beginning, this special initiative has included commitment to evaluating the effects of the linkage program, and the initial findings have been reported elsewhere [ 1, 2] . This paper will focus on differentiating the characteristics of linkage programs in rural areas from those in urban

Federal primary health care projects in Texas.

The rural health strategy of the Bureau of Community Health Services has focused on the integrative mechanism of the Rural Health Initiative (RHI) to combine resources in the best manner to meet local community health needs. An essential component is the National Health Service Corps which provides physicians and other health service personnel both to the RHIs and to free-standing sites.

Future Directions in Primary Care/Mental Health Research

a major policy emphasis on increasing the availability of providers of primary health care while limiting the supply of medical specialists (P.L. 94-484). The development of a comprehensive public mental health delivery system has failed to occur as rapidly as anticipated, as reflected in a slightly less than 50% accomplishment of the 1963 goal of establishing 1,500 community mental health centers by 1983. Further, a holistic approach within medicine has been emphasized recently (Eisenberg, 1979; Lazerson, 1978). Related to these concerns, the Presidents Commission on Mental Health (1978) recommended that greater attention be paid to the relationship between health and mental health. Limited new initiatives have been undertaken to increase the mental health training of primarycare practitioners (PCPs) and to coordinate health and mental health services through linking government-funded primary health care projects with community mental health centers. Nonetheless, there are major gaps in knowledge with respect to mental health needs

Implementing Skilled Midwifery Services in Dhaka City Urban Area: Experience from Community Based Safe Motherhood Project, Bangladesh

In Bangladesh majority of deliveries are attended by unskilled traditional birth attendants and maternal mortality is still quite high. Global evidence suggests that most critical intervention for reduction of maternal mortality is to ensure skilled attendance at birth. The objective of this study was to explore the effect of strengthening obstetric care services through implementation of skilled Midwives at selected urban centres in terms of utilization of antenatal and delivery care in the community. A quasi experimental community trial was conducted during January 2000 to June 2003. Ten health centers were selected from the maternity care centers of urban primary health care project in Dhaka city, matched into comparable pair and assigned randomly as intervention and control centers. The intervention consisted of deployment of 10 skilled midwives in pair to provide obstetric care services in five intervention centre and the community. Essential drugs and logistics were supplied to both intervention and control centers for optimizing the function. A total of 6077 mothers having less than one year child were interviewed. There was significant improvement from baseline in the utilization of antenatal care services (6.1 vs. 2.1%, p<0.001), availing antenatal visits 5 times or more (13.4% vs. 8.1%, p<0.001), consultation with skilled health care providers for pregnancy complication (9.3% vs. 5.7 %, p<0.001), institutional delivery (7.3% vs. 4.1%, p<0.001) and delivery by skilled birth attendant (9.4% vs. 5.8%, p<0.001) between intervention and control area respectively. The intervention of deployment of skilled midwives improved utilization of ANC, increased institutional delivery and delivery by skilled birth attendants. The program can be scaled up to see its impact on maternal health. Key words: skilled midwife; emergency obstetric care; urban health care; antenatal care DOI: 10.3329/jbsp.v29i1.7165J Bangladesh Coll Phys Surg 2011; 29:10-15

ST AGNES: A STUDY OF A HEALTH CENTRE IN EVOLUTION

The growth of St Agnes Health Centre is described, with its transition from simple group practice to a comprehensive health centre over a five-year period. Its position in a rapidly growing suburb is analysed and illustrated by usage and referral patterns. The sucessful integration of general practice, sessional specialists and allied health workers under one roof makes it unique as a primary health care project in Australia.