Public Primary Health Care Research Articles

ANTENATAL INTERACTIONS: IMPERATIVES OF CLEAR INFORMATION EXCHANGE BETWEEN CAREGIVERS AND EXPECTANT MOTHERS

This study investigated Antenatal Interactions: Imperatives of Clear Information Exchange between Caregivers and Expectant Mothers. There were two sets of population in this study. The first population comprised the Public Primary Health Centers (PHCs) in the five states of South-East Nigeria which was (2,110) and the second population comprised the total number of women in the five states of the South-East who are between the ages of 18 and 45 (7,159,548). The sample size for the first population was 32 which represented 30% of the total number PHCs in the five L.G.A’s sampled from the five states in the South-East Nigeria and the second sample size for the second population was 384 calculated with online sample size calculator at survey system.com. The study adopted survey research design with questionnaire as instrument for data collection. Finally, the data were descriptively analysed and thematically explained. The results from the study revealed that healthcare givers clearly exchanged information to expectant mothers in South-East Nigeria during antenatal interactions. It was therefore concluded that adequate, appropriate and timely information exchange during antenatal interactions guaranteed satisfaction of expectant mothers. Expectant mothers are easily irritated. Therefore, it is recommended that healthcare givers must always ensure that politeness and caring are their watchword during antenatal and other healthcare delivery interactions. This attitude would ensure that every healthcare seeker would not engage in self-care for the fear of engaging in infuriating information exchanges during healthcare interactions.

Common maternal health problems and their correlates in early post-partum mothers.

Mothers experience a wide range of maternal health problems after childbirth, which in turn, affect their well-being and ability to care for their newborn. These problems may be influenced by factors such as mode of delivery or socio-economic status. This study aims to investigate the prevalence of common maternal health problems and their correlates in a public primary healthcare institution in Singapore. This was a cross-sectional study, based on a self-administered questionnaire. A total of 373 mothers (mean age 31.9 years) who accompanied their infants for their 4- to 8-week development assessments at a public primary care clinic in Singapore completed a self-administered questionnaire from June 2021 to December 2021. The questionnaire assessed demographic factors, mode of delivery, number of children, number of individuals providing significant help, and the frequency of common physical and mental maternal health problems using a 5-point Likert-type scale. The five most common maternal health problems were fatigue (77.7%), lower back pain (59.3%), Caesarean wound pain (54.3%), upper back pain (53.0%) and vaginal pain (41.2%). The prevalence of depression and anxiety was 22.0% and 11.3%, respectively. With respect to the symptoms' correlates, pain on passing urine was more frequent after assisted vaginal deliveries than all other forms of deliveries (all pairwise p < 0.01), and pain on passing motion was more frequent in vaginal deliveries than in Caesarean deliveries (all pairwise p < 0.05). Mothers having a larger number of children more frequently experienced headaches (β = 0.17, SE = 0.05, p = 0.002) and less frequently experienced breastfeeding difficulties (β = -0.28, SE = 0.08, p < 0.001). Mothers experienced a high prevalence of maternal health problems in multiple domains during the first 8 weeks after childbirth. Mode of delivery and number of children were associated with increased prevalence of certain problems. Mothers' physical and mental well-being should be investigated early after delivery and addressed with adequate treatments and resources.

Patients’ perspectives and experiences with the national e-prescribing service and transfer of pharmaceutical services to community pharmacies in Saudi Arabia

Background and purposeThe Wasfaty (My e-prescription) service, introduced recently and continuously expanding, is a national service for e-prescribing and dispensing medicines in Saudi Arabia. This service introduced e-prescriptions and transferred the dispensing of medicines and pharmacy services from public primary healthcare facilities to community pharmacies. This study aimed to assess patients’ perspectives on and experiences with the service. MethodsThis nationwide, cross-sectional study used a web-based survey. The study population comprised the general public of Saudi Arabia aged ≥18 years. The invitation to participate in the study and link to the survey were distributed electronically through several electronic platforms. ResultsA total of 718 individuals participated in the study (66.30 % women). Most participants were satisfied with the e-prescriptions and Wasfaty services (n = 571; 79.53 %), preferred e-prescriptions over traditional paper prescriptions (n = 576; 80.22%), and found it easier to renew their e-prescriptions and refill their medicines using the community pharmacy's Wasfaty services, which saved time on re-appointments with physicians (n = 568; 79.11 %). Moreover, most participants indicated that there were sufficient community pharmacies to provide Wasfaty services near their area of residence (n = 558; 77.72 %) and agreed that community pharmacists provided adequate medication counseling (n = 560; 77.99 %) and advice on disease monitoring at home (n = 468; 65.18 %). However, only 355 (49.44 %) participants indicated that community pharmacies had suitable areas for private medication counseling. Furthermore, only 40.11 % (n = 288) of the participants mentioned that they never or rarely visited more than one pharmacy to obtain all their prescribed medicines using the e-prescription service. Finally, 634 (88.30 %) participants suggested adding more medicines and therapeutic options to service coverage and ensuring the availability of medicines in pharmacies. ConclusionMost participants had positive views regarding e-prescriptions and the accessibility of the community pharmacies providing this service. However, further improvements must be made to pharmacy facilities (particularly patient care areas), advanced pharmacy services, and the availability of all medicines in the community pharmacies participating in e-prescription services.

Availability of Natriuretic Peptide Testing in Primary Public Health Care in Brazil

Availability of Natriuretic Peptide Testing in Primary Public Health Care in Brazil

JOB SATISFACTION AND TURNOVER INTENTION OF BLUD WORKERS AT TROSOBO PUBLIC PRIMARY HEALTH CARE

Job satisfaction is defined as a person's attitude or emotional response toward their job duties. Poor job satisfaction leads to turnover. Trosobo public primary health care staffing data showed a high turnover intention of BLUD workers. This study aims to determine the job satisfaction and turnover intention of BLUD worker at the Trosobo public primary health care. This study was quantitative study with a cross-sectional design. The research was conducted in November 2023 at Trosobo public primary care. Eleven BLUD workers were obtained using total sampling calculations. Data analyzed descriptively. The instruments used in this study were MSQ and TIS-6. The lowest average satisfaction score was recognition (43.64) and the highest were authority and achievement (80,00). Job satisfaction of BLUD workers was in the moderate category (score 26-74) and the turnover intention was in the high category (score &gt;15). Trosobo public primary health care BLUD workers had a moderate category of job satisfaction and high turnover intention. Providing services based on workload and length of service, as well as opportunities for career development to BLUD workers, can be carried out by the Trosobo public primary health care as an effort to reduce the turnover problem

Seasonal Malaria Chemo-Prevention Strategy: A Cross-Sectional Study of Healthcare Workers in Public Primary Healthcare Facilities in Edo State, Nigeria

Malaria infection is one of the most significant public health problems and the leading cause of global morbidity and mortality. Pregnant women and under-five (U5) children are particularly at risk in areas where malaria is endemic. The U5 children account for about 80% of all malaria-related deaths. This study aims to assess the adherence to the national guidelines for administering seasonal malaria chemoprevention (SMC) in U5 children by healthcare workers (HCWs) working in public Primary Health Care (PHC) facilities in Edo State, Nigeria. A cross-sectional study design was employed to assess the sociodemographic characteristics, awareness, and prescription of chemo-preventive therapy for the U5 by 200 HCWs in public PHC facilities in Edo State, with the aid of the researcher-designed pretested, self-administered, semi-structured questionnaire. Descriptive and inferential data analyses were carried out using the IBM SPSS version 20 software. All p-values had two tails and were deemed statistically significant if &lt; 0.05. The majority of HCWs (71.5%) did not adhere to the national guideline for using chemo-preventive treatment for malaria in children, and there was a statistically significant relationship between many sociodemographic factors and compliance. The length of the HCW’s work (in years) was a critical indicator of compliance with the recommendation. In conclusion, the use of malaria chemo-preventive treatment in accordance with the Nigerian malaria diagnosis and treatment guidelines is being practiced ineffectively by HCWs in public PHCs in Edo State. A longer period of employment (in years) predicts a better practice. Keywords: Implementation, Nigeria, Primary healthcare (PHC), Seasonal malaria chemoprevention (SMC), Under-five children.

Adaptability of Integrated Community Care models in Moldova to overcome compounded crisis, including supporting refugees.&amp;nbsp;

Introduction: The Healthy Life Project in Moldova works and collaborates with local authorities across all sectors, including civil society organisations, community members and NCD patients to promote integrated, person-centered care. The aim is to ensure vulnerable people, including refugees, have access to health and social care. Overall, Moldova has received nearly 698,000 Ukrainian refugees, of which 96,646 currently remain in the country.&#x0D; Methods: Through intersectoral capacity building community teams developed local integrated care work plans, including joint assessments of people with NCDs and coordinated individual care across different sectors and community resources. The plans also involved a focus on responding to the needs of Ukrainian refugees. Within this continued implementation support, the project included questions of access to health and social care along the migratory cycle to maintain management of chronic conditions. Around 97% of refugees are residing in the host community, most of them require particular support in accessing their rights in practice, being women (59%), children (48%) and the elderly (21%).&#x0D; Results: Request for health care services from refugees (28,30%) is one of the forms of assistance expected in addition to cash handouts (76,84%) and in-kind support (35,79%). Therefore, in addition to building capacities for monitoring and management of NCDs, and the application of integrated care, the project considered specific actions for refugees. Training on managing NCDs within the refugee crisis was provided to Primary Health Care (PHC), hospital, Public Health, and emergency care management teams in 20 districts. To support and ensure mobility of PHC practitioners in responding to increased community needs due to hosted refugees, 835 medical kits were purchased and distributed, alongside protective equipment and disinfectants for both the health and social workers. A guide for community social workers on supporting refugees was developed in partnership with the National Social Assistance Agency and has since been embedded in the curricula of the social assistance faculty within the State Pedagogical University. &#x0D; During 2022, 20 integrated community care centers have reached 8,464 persons with NCDs, with 77% having their wellbeing jointly assessed by a community nurse and social worker. As a result, most of them were included in preventive measures and supported to manage NCDs (7851 persons). The most vulnerable were identified and assisted, including 15% of NCD patients (675 persons) and supported to gain access to social benefits, while people with complex needs (663 persons) received access to home health and social care. Considerable progress has been made to promote integrated working locally, between health and social care. As everywhere, collaboration is reliant on personal motivation and local relationship building, and some teams take longer than others.&#x0D; Conclusions: Such community approaches are playing an important role in coordination of efforts to support the most vulnerable, as Moldova continues to face a refugee crisis. This continuous support to build capacity and ensure implementation of common approaches, facilitated by a jointly held normative framework supports a more integrated approach to service provision at community level, coordinated by local authorities thus making more efficient use of scarce resources.&#x0D;

Exploring Factors Shaping Primary Health Care Readiness to Respond to Family Violence: Findings from a Rapid Evidence Assessment

Abstract Purpose Family violence (FV) is defined as any situation where an individual employs abusive behaviour to control and/or harm a former or current spouse, non-marital partner, or a member of their family. The health consequences of FV are vast, including a wide range of physical and mental health conditions for individuals experiencing violence or survivors, perpetrators, and their children. Primary health care (PHC) is recognized as a setting uniquely positioned to identify the risk and protective factors for FV, being an entry point into the health care system and a first, or only, point of contact for families with professionals who can facilitate access to specialist care and support. Methods A rapid evidence assessment of empirical studies on FV interventions in PHC was conducted to examine outcomes of effective FV interventions that promote identification, assessment, and care delivery within diverse PHC settings, factors shaping PHC provider and system readiness, and key intervention components that are important for sustaining PHC responses to FV. After completing data extraction, quality appraisal, and a hand search, a total of 49 articles were included in data synthesis and analysis. Results Several FV interventions that include multiple components such as, screening and identification of FV, training of PHC providers, advocacy, and referrals to supports, have been rigorously tested and evaluated in diverse PHC settings in rural and urban areas including primary care/family medicine practice clinics and community PHC centers. These interventions have demonstrated to be effective in identifying and responding to violence primarily experienced by women. There is a dearth of FV interventions or programs from empirical studies focused on men, children, and perpetrators. Additionally, provider and system readiness measurement tools and models have been implemented and evaluated in PHC specifically to assess physician or the health care team’s readiness to manage FV in terms of knowledge and awareness of FV. The findings highlight that there is no clear or standardized definition of provider or system “readiness” in the literature related to FV responses in PHC. Further, the findings revealed four key intervention components to facilitate PHC provider and organization readiness to address FV: (1) multidisciplinary teamwork and collaboration, (2) improving provider knowledge on the social and cultural determinants impacting FV, and (3) embedding system-level supports within PHC. Conclusions FV is a serious public health concern and PHC providers have a vital role in early detection of FV and the poor health outcomes associated with violence A focus on comprehensive or multi-component FV interventions are more likely to change provider behavior, and would allow for safe, confident, and professional identification and assessment of FV within PHC.

Targeted Dementia Screening Performance, Its Barriers and Associated Factors Among Primary Care Doctors at Public Primary Healthcare Clinics in Malaysia

Introduction: Targeted dementia screening is recommended for early recognition of dementia. However, many persons with dementia were not identified and managed in timely manner. This study aimed to determine the proportion of performing targeted dementia screening, its barriers and associated factors among primary care doctors in public primary healthcare clinics. Methods: A cross sectional study was conducted at 4 public healthcare clinics, Putrajaya from December 2018 – February 2019. All primary care doctors who fulfilled the eligibility criteria were recruited. We collected data using a pre-tested self-administrated questionnaire comprised socio-demographic, medical information, healthcare experience and training, knowledge on dementia, awareness of dementia screening tool availability and barriers to dementia screening. The outcome was the performance of targeted dementia screening. Descriptive, Chi-square and independent t-test analyses were performed. Results: A total of 106 primary care doctors participated in this study. The proportion of primary care doctors who performed targeted dementia screening was 11.3%. Most participants were family medicine trainee (42.9%), with duration of service between 5 and 10 years (15.0%), had professional caring experience of dementia patients (21.4%), and had undergone dementia training (36.2%). Many of the participants perceived barriers to perform targeted dementia screening that included lack of time (72.6%) and lack of knowledge (59. 4%). Conclusion: The prevalence of performing targeted dementia screening was low with modifiable barriers. Strategies to improve the performance of targeted screening such as creating awareness among primary care doctors could be done for a start.

Evaluating financial management competency in primary healthcare managers of Kondoa, Iramba, and Sumbawanga District Councils, Tanzania

Background : Examining the financial managerial competency of primary healthcare facility managers is very important. Despite its importance, empirical investigation is limited in this area. To contribute mpirical evidence on this subject this study looked at Tanzania's public primary healthcare facility managers. Materials and Methods : The study was conducted in Kondoa, Iramba and Sumbawanga District Councils in Tanzania. This research adopted a cross-sectional research design. A census sampling strategy was employed to obtain primary data from 102 public primary healthcare facility managers. The Statistical Product and Service Solution (SPSS) Version 25 was used to analyse the data. Results : Findings reveal that slightly more than half (57.85%) of managers were competent whereas (42.15%) of them were less competent in acting on the financial statements. In monitoring financial performance (47.53%) were less competent and (52.47%) were competent. Also, in developing budgets following organisational objectives, (50.97%) were less competent and (49.03%) were competent. Additionally, in managing budgets by organisational objectives, (45.09%) were less competent and (54.91%) were competent. Furthermore, in establishing and maintaining the organisation's insurance contracts and financial relationships, (53.92%) were less competent and (46.08%) were competent. Conclusions : Nearly half of the facility managers in selected Tanzanian District Councils demonstrated competence in financial statement analysis, performance monitoring, budget development, and managing insurance contracts and financial relationships. Recommendations : This study recommends improving the financial managerial competency of facility managers in all areas of financial management roles as a key area of investment in efforts to improve the management of primary healthcare facilities.

Prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in Tlaxcala, Mexico.

Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widely recognised as two prevalent sexually transmitted infections that can have detrimental effects on women's reproductive health. Previous research has concentrated on studying high-risk populations, resulting in limited epidemiological data regarding the general population. Therefore, the objective of this study was to estimate the prevalence of CT and NG among women attending public primary health care in Tlaxcala, Mexico. The study sample included 2,396 women already participating in the cervical cancer screening programme, from July to November 2014. After obtaining informed consent, the CT and NG tests were conducted on cervical samples, using a nucleic acid amplification test. We estimate the prevalence with 95% confidence intervals (CIs). Women who tested positive were promptly notified and provided with appropriate treatment. In our study population, CT and NG prevalences were 3.2 (95% CI: 2.6-4.0) and 0.01 (95% CI: 0.01-0.03), respectively. CT prevalence was higher in younger women (age<40), although the results indicate a low prevalence; due to the potentially significant impact of CT and NG on women's health, we require adequate surveillance, and guaranteeing rapid referral to the correct treatment is a priority for the control of these diseases.

Assessment of Primary Health care Facilities on readiness for Antenatal Care and Childhood Immunization Services in Zamfara State, Nigeria

Effective maternal and child healthcare delivery centers on availability of essential medical equipment, drugs and trained medical personnel in health facilities. Poor funding, inadequate supply of physicians, essential equipment and drugs as well as mismanagement characterized healthcare delivery system in Nigeria. This study assessed public primary health care facilities on readiness of Antenatal Care (ANC) and childhood immunization services in Zamfara State, Nigeria. Based on theoretical orientation of Political Economy of Health Care, quantitative and qualitative data were used for the study. Descriptive statistic was used for quantitative data analysis using Statistical Package for Social Sciences (SPSS), while ATLASti8 software was used for qualitative data. The study found most of the visited health facilities offered various components of ANC and childhood immunisation services but did not comply with the current eight (8) ANC visits as recommended by WHO. Other essential services including hepatitis B tests, breast examination, Fansida for malaria prevention, free folic acid and iron supplements, insecticide treated nets, weight scale, ROTA vaccine and midwives were grossly inadequate in most health facilities. The study also found urban bias in terms of distribution of healthcare staff in Zamfara State. This study recommends that Zamfara State government, non-governmental organisations and donor agencies should urgently channel their efforts to PHC centers and address the challenges confronting primary health care centers in Zamfara State.

Prevalence and sociodemographic predictors of high-risk vaginal human papillomavirus infection: findings from a public cervical cancer screening registry

IntroductionHigh-risk human papillomavirus (HPV) screening is vital for early cervical cancer detection and treatment. With the introduction of the national cervical cancer screening programme and screening registry in Malaysia, there is a need to monitor population-based HPV screening uptake and high-risk HPV prevalence as part of cervical cancer surveillance.ObjectiveTo determine the prevalence and sociodemographic factors predicting high-risk HPV infection in Malaysia based on a public, community-based cervical cancer screening registry targeting women at risk of getting HPV infection.MethodsThe study used data from the Malaysian cervical cancer screening registry established by the Family Health Development Division from 2019 to 2021. The registry recorded sociodemographic data, HPV test details and results of eligible women who underwent HPV screening at public primary healthcare facilities. A vaginal sample (via self-sampling or assisted by a healthcare provider) was used for DNA extraction for HPV detection and genotyping. Registry data were extracted and analysed to determine prevalence estimates of high-risk HPV infection. Multifactorial logistic regression analysis was conducted to determine predictors of high-risk HPV infection. All analyses were performed using Stata version 14.ResultsThe programme screened a total of 36,738 women during the study period. Women who attended the screening programme were mainly from urban areas, aged 30–39 years, and of Malay ethnicity. The prevalence of high-risk HPV infection was 4.53% among women screened, with the yearly prevalence ranging from 4.27 to 4.80%. A higher prevalence was observed among urban settling women, those aged 30–49 years, those of Indian ethnicity, and those without children. The results from logistic regression showed that women from urban areas, lower age groups, of Indian or Chinese ethnicity, and who are self-employed were more likely to be infected with high-risk HPV.ConclusionTargeted and robust strategies to reach identified high-risk groups are needed in Malaysia. In addition, the registry has the potential to be expanded for an improved cervical cancer elimination plan.Trial registrationTrial registration number: NMRR ID-22-00187-DJU.

Opportunities and challenges in delivering maternal and child nutrition services through public primary health care facilities in urban Bangladesh: a qualitative inquiry

BackgroundPublic primary health facilities are an important source of nutrition services for the urban areas in Bangladesh. We aimed to understand the challenges and facilitators of delivering maternal and child nutrition services through public sector from the perspectives of the users and service providers.MethodThe study was conducted in selected public primary health care facilities and their catchment area in Dhaka city from April-July 2019. We carried out 15 free listing exercises and 43 semi-structured interviews (SSI) with pregnant women and mothers of 0–24 months old children; 6 key informant interviews (KII) with facility managers and healthcare providers; and observed service delivery in 8 health facilities.ResultsFindings reveal that public primary health facilities address some economic and cultural barriers to access such as cost and provision of female service providers for maternal and child health services but challenges such as distance, waiting time, and cleanliness remained. In terms of service provision, there were gaps in provision of anthropometric measurement and counseling, and healthcare providers had inadequate training and therefore, knowledge of nutrition. The low priority given to nutrition services during program design hampered the delivery of nutrition services provided through urban public sector health facilities.ConclusionsThere were important gaps in terms of service provision and capacity of healthcare providers, and therefore, the quality of nutrition service provided through public primary health care facilities. To maximize the coverage of quality nutrition services in the urban areas, it is important to think through the design of nutrition service delivery and allocate adequate resources to fill the material and capacity gaps.

Effectiveness of behavioural change interventions on physical activity, diet and body mass index of public primary healthcare users in Kosovo: the KOSCO cohort

BackgroundPrevalent physical inactivity and poor nutrition contribute to high non-communicable disease (NCD) morbidity and mortality in Kosovo. To improve health services for patients with NCD the Accessible Quality Healthcare project...

Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya.

Diabetes and hypertension pose a significant socio-economic burden in developing countries such as Kenya, where financial risk-protection mechanisms remain inadequate. This proves to be a great barrier towards achieving universal health care in such settings unless mechanisms are put in place to ensure greater access and affordability to non-communicable disease (NCD) management services. This article aims to examine outpatient management services costs for patients with diabetes and hypertension attending public primary healthcare facilities. The study was conducted in Busia and Trans-Nzoia counties in Western Kenya in facilities supported by the PIC4C project, between August 2020 and December 2020. This cross-sectional survey included 719 adult participants. Structured interviewer-administered questionnaires were used to collect information on healthcare-seeking behaviour and associated costs. The annual direct and indirect costs borne by patients were computed by disease type and level of healthcare facility visited. Patients with both diabetes and hypertension incurred higher annual costs (KES 13 149) compared to those with either diabetes (KES 8408) or hypertension (KES 7458). Patients attending dispensaries and other public healthcare facilities incurred less direct costs compared to those who visited private clinics. Furthermore, a higher proportionate catastrophic healthcare expenditure of 41.83% was noted among uninsured patients. Despite this study being conducted in facilities that had an ongoing NCDs care project that increased access to subsidised medication, we still reported a substantially high cost of managing diabetes and hypertension among patients attending primary healthcare facilities in Western Kenya, with a greater burden among those with comorbidities.Contribution: Evidenced by the results that there is enormous financial burden borne by patients with chronic diseases such as hypertension and diabetes; we recommend that universal healthcare coverage that offers comprehensive care for NCDs be urgently rolled out alongside strengthening of lower-level public healthcare systems.

Levels and predictors of nurses’ knowledge about diabetes care and management: disparity between perceived and actual knowledge

BackgroundNurses have a crucial role in managing, educating, and caring for diabetic patients. However, their knowledge should be regularly assessed to avoid preventable complications and reduce costs. Therefore, the present study assessed the perceived and actual knowledge about diabetes among nurses in Hail province of Saudi Arabia and investigated predictors of such knowledge.MethodsA cross-sectional study was conducted among 325 conveniently sampled nurses from all public hospitals and primary healthcare centres in Hail province from September to December 2022. A pre-designed questionnaire was used to collect demographic and practice-related characteristics of the nurses. In addition, data on nurses’ perceived and actual knowledge about diabetes were collected using the Diabetes Self-Report Tool (DSRT) and Diabetes Basic Knowledge Tool (DBKT) self-report questionnaires, respectively. The mean knowledge scores for demographic and practice-related variables were compared using the independent-samples t-test and one-way analysis of variance. Multiple linear regression was used to identify significant predictors of perceived and actual knowledge. The correlation between perceived and actual knowledge was investigated using Pearson’s correlation coefficient. A P-value ˂0.05 was considered statistically significant.ResultsBased on a highest maximum score of 60 using the DSRT, the mean score of perceived knowledge was 38.4 ± 12.0, corresponding to a percentage mean score of 64%. On the other hand, based on a highest maximum score of 49 using the DBKT, the mean score of actual knowledge was 23.2 ± 9.6, corresponding to a percentage mean score of 47.3% of correct responses. Being Indian, having a diploma or a bachelor’s degree, and having a poor or fair self-perception of competence in diabetes care were predictors of lower perceived knowledge scores, whereas having no access to diabetes guidelines was a predictor of higher scores. However, being non-Saudi and having experience of at least 16 years were predictors of higher actual knowledge scores. The correlation between actual and perceived knowledge about diabetes was negligible and statistically non-significant (r = 0.011, P = 0.055).ConclusionNurses affiliated with public health facilities in Hail province lack adequate knowledge about diabetes, with no correlation between what is perceived to be known and what is actually known. Indian citizenship, having a diploma or bachelor’s degree, not having access to diabetes guidelines, not attending courses/workshops, and having a poor or fair self-perception of competence in diabetes care can significantly predict nurses’ perceived knowledge. However, being non-Saudi (Filipino or Indian) and having at least 16 years of experience can significantly predict their actual knowledge of diabetes.

Decline in varicella cases contacting primary health care after introduction of varicella vaccination in Finland – A population-based register study

A two-dose varicella vaccination programme at the age of 18 months and 6 years started in September 2017 in Finland with catch-up vaccinations, based on earlier modelling results, for children <12 years (born in 2006 or later) with no history of varicella. Nationwide population-based register data were used to assess the age-specific vaccination coverage and the annual incidence rates of varicella cases contacting public primary health care in 2014–2020. Age-specific incidence rates after (2022) and before (2014–2016) the implementation of the vaccination programme was compared by incidence rate ratios (IRR) with 95 % confidence interval.In 2019–2022, the first-dose coverage of varicella vaccination among children following the routine vaccination programme ranged from 85 to 87 % (children born in 2016 or later). The second-dose coverage was 58 % for the children born in 2016. The coverage of the catch-up vaccinations ranged from 18 % (children born in 2006) to 82 % (children born in 2015) for the first dose and from 10 % to 64 % for the second dose in the respective birth cohorts.In 2022, compared to the pre-vaccination period (2014–2016) the annual incidence rate of varicella cases contacting public primary health care declined in all age groups. The reduction ranged from 92 % to 98 % among the children eligible for the vaccinations (born 2006 or later). The 87 % reduction in the incidence rate among the unvaccinated children < 1 year suggests the indirect effect of the vaccinations.Introducing varicella vaccinations with catch-up was associated with rapid reduction in the varicella cases contacting primary health care in all ages. However, the coverage of the routine programme needs to be improved further as presently susceptibles accumulate and enable thus further outbreaks in coming decades.

MEDIATING ROLE OF TRUST IN LINKING TRANSFORMATIONAL LEADERSHIP STYLE AND NURSES’ PERFORMANCE

This study aimed at investigating indirect effect of trust between leadership style and nurses performance. Population of this study was nurses working in the Qassim province in public and private sector hospitals and primary health care centers. Non-probability convenience sampling technique was used to select sample. Total 100 completed questionnaires were received and used in statistical analysis. Reliability analysis found that questionnaires used in the study were found reliable. Moreover, trust partially mediated between idealized influence behavior attribute of the leadership while fully mediated between other attributes of the transformational leadership and nurses’ performance. It is concluded that leadership in hospitals &amp; primary health care centers should create strong bond with nurses and win their trust to boost nurses’ performance. It is imperious for hospital management to develop better relationship to brings better outcomes. Therefore health practitioners take benefits from this study finding. The trusted leaders’ have high leadership effectiveness and they retain the productive workforce. It is recommended for the future studies to use other leadership styles as the predicting variable such as servant leadership, distributed and Ihsan based leadership styles.

Healthcare seeking behavior among patients visiting public primary and secondary healthcare facilities in an urban Indian district: A cross-sectional quantitative analysis.

In this work, we examined healthcare seeking behavior (HSB) of patients visiting public healthcare facilities in an urban context. We conducted a cross-sectional survey across twenty-two primary and secondary public healthcare facilities in the South-west Delhi district in India. The quantitative survey was designed to ascertain from patients at these facilities their HSB-i.e., on what basis patients decide the type of healthcare facility to visit, or which type of medical practitioner to consult. Based on responses from four hundred and forty-nine participants, we observed that factors such as wait time, prior experience with care providers, distance from the facility, and also socioeconomic and demographic factors such as annual income, educational qualification, and gender significantly influenced preferences of patients in choosing healthcare facilities. We used binomial and multinomial logistic regression to determine associations between HSB and socioeconomic and demographic attributes of patients at a 0.05 level of significance. Our statistical analyses revealed that patients in the lower income group preferred to seek treatment from public healthcare facilities (OR = 3.51, 95% CI = (1.65, 7.46)) irrespective of the perceived severity of their illness, while patients in the higher income group favored directly consulting specialized doctors (OR = 2.71, 95% CI = (1.34, 5.51)). Other factors such as having more than two children increased the probability of seeking care from public facilities. This work contributes to the literature by: (a) providing quantitative evidence regarding overall patient HSB, especially at primary and secondary public healthcare facilities, regardless of their presenting illness, (b) eliciting information regarding the pathways followed by patients visiting these facilities while seeking care, and (c) providing operational information regarding the surveyed facilities to facilitate characterizing their utilization. This work can inform policy designed to improve the utilization and quality of care at public primary and secondary healthcare facilities in India.