Quality Of Care In Health Facilities Research Articles

Effect of COVID-19 Pandemic on Complications and Mortality in the Early Postoperative Period After Heart Transplantation

IntroductionThe coronavirus disease 2019 (COVID-19) outbreak directly impacted heart transplantation (HT) surgery activity. Reallocating resources and converting surgical intensive care units to COVID‐19 facilities led to reduced accessibility and quality of health care facilities to heart recipient patients. AimTo study the effect of the COVID-19 pandemic on heart transplantation activity and outcomes in the early postoperative period. MethodsRetrospective data analysis of patients undergoing orthotopic heart transplantation in our institution from March 2018 to February 2022. The patient population (N = 281) included 223 (79.4%) men and 58 (20.6%) women. The perioperative data of the prepandemic group, March 2018 to February 2020 (N = 130), and the pandemic group, March 2020 to February 2022 (N = 151), were compared. ResultsWe found differences in preoperative inotropic support between the groups (N = 43 (33.1%) vs N = 72 (47.7%), P < .05), respectively). The number of urgent HTs increased during the COVID-19 pandemic (N = 51 (39.2%), vs N = 72 (47.7%), P = .155). Analyzed groups did not differ according to renal, pulmonary, or neurology complications. Intensive care unit (ICU) standing time was longer in the pandemic group (6 days [3-12] vs 11 days [5-12], P < .001). ConclusionWe found that during the COVID-19 pandemic, the number of end-stage heart failure recipients requiring cardiac support increased. Extended time of ICU standing in the pandemic group may be related to the COVID-19 pandemic. Although some efforts have been made to reduce the impact of the pandemic, more research is required.

Empowering Cadres In Preparing The Community To Face The New Normal Era In Jabungan Banyumanik Village, Semarang City

Special attention to health issues is still the main focus of the government in Indonesia. Some health aspects that are of concern include health degrees, cross-sectoral cooperation, health development policies, health development financing systems, quality of health facilities, health workers, and health supplies (Suparyanto, 2010). These health problems can affect the general public as well as certain groups such as infants, toddlers, pregnant women, the elderly, and workers. The purpose of this study is to run the Tri Darma of higher education by implementing community service activities, especially in the form of preparing health cadres to face the New Normal Era in Jabungan Banyumanik Village, Semarang City. The implementation method includes a preparatory stage that involves coordinating with health cadres, identifying participants, compiling materials, and carrying out activities using lectures, demonstrations, and discussion methods. Evaluation is carried out through pretest and posttest to measure the increase in cadre knowledge. Findings from the study showed that there was an increase in cadre knowledge by 15%. The impact of this research is improving the quality of health cadres, public understanding of the New Normal Era, and strengthening cooperation between universities and the community. Therefore, increasing the knowledge and skills of cadres, as well as community understanding, is expected to have a positive impact on health services and preparation for new situations.

Mother and Child Health Services in North Central Timor District Through the Mother and Child Love Movement Program (Border Area Studies Republik Indonesia-Republica Democratica De Timor Leste)

The maternal, infant and toddler mortality rates in North Central Timor Regency as the Indonesia-Timor Leste border area have fluctuated in the last 5 years (2013-2017). The Mother and Child Love Movement program has not been able to reduce the maternal, infant and toddler mortality rates so that the level of health mothers and children at TTU do not yet comply with national health standards. The elements analyzed include elements of structure/input, environment, process and output. specialists, general practitioners, nurse midwives and other health workers, the quality and quantity of health facilities and equipment, limited health budgets and the culture of the TTU community which is contrary to medical regulations. So that maternal and child health services in TTU Regency through the Mother and Child Love Movement program can be To reduce the mortality rate of mothers, babies and toddlers, the efforts that must be made by the government are the addition of specialist doctors at the Kefamenanu Regional Hospital, there must be a permanent doctor at every community health center in TTU, the addition of permanent midwives at the Regional Hospital and Community Health Centers, increasing the number and quality of health facilities and equipment such as community health centers, pustu, polindes, laboratories and pharmacies, health budget allocation according to community needs, improving the quality of antenatal, delivery and neonatal/postpartum care, slowly eliminating the culture/tradition of se'i, tattoos and slow decision making in referring patients to community health centers and hospital. The recommended model for maternal and child health services at TTU is the model of empowering women through safe motherhood (family planning, antenatal care, clean delivery and obstetrical services) and empowering posyandu, poskesdes, posbindu and standby villages as community-based health efforts by community health centers

Design and Prototype of SIMAKLIK: Web-based Information System to Support Document Management and Self-Assessment of Primary Care Clinics Accreditation

The preparation of primary care clinic accreditation in Indonesia still uses a manual system, causing unpreparedness and slowing down the performance of officers in preparing for accreditation. Other inhibiting factors are workload and adjustments to the latest accreditation standards. Accreditation is an important point in maintaining the quality of health care facilities. The fact that clinic accreditation in Indonesia is still quite low, only 1.7% of private clinics have been accredited out of 10,380. Driven by technological developments, it is necessary to develop a system that helps facilitate the documentation management and self-assessment. The research aims to design a system from problem analysis, system architecture to functionality. This research method using design thinking involves potential users at the Permata Keluarga Clinic and the design refers to the Clinic accreditation standards by the Ministry of Indonesian through H.K.01.07/MENKES/1983/2022. SIMAKLIK can be used by leaders and quality team members, accreditation assistance officers and surveyors. Features of this system prototype include: systematic documentation in accordance with the accreditation standard, self-assessment report features, dashboard, notes and recommendations features. This prototype has been successfully tested to users with SUS Score results of 81.78. The SUS Score results are categorized as grade B or very good, which indicates that the system's acceptability and usability are good. SIMAKLIK has contributed to the development of a document management system as an innovative product in health care facilities, especially clinics. In the future, that prototype can be followed up through development by the engineer team.

Understanding multilevel barriers to childhood vaccination uptake among Internally Displaced Populations (IDPs) in Mogadishu, Somalia: a qualitative study

BackgroundDisparities in vaccination coverage exist in Somalia with Internally Displaced Persons (IDPs) being among the groups with the lowest coverage. We implemented an adapted Participatory Learning and Action (PLA) intervention, which focused on routine vaccinations among displaced populations living in Mogadishu IDP camps. The intervention was successful in improving maternal knowledge and vaccination coverage but unsuccessful in improving timely vaccination. We conducted a qualitative study to understand this result and analyze the multi-level barriers to routine childhood immunization uptake.MethodIn this qualitative study we used observation data from 40 PLA group discussions with female caregivers and purposively sampled nine vaccination service providers and six policy makers for interview. We also reviewed national-level vaccine policy documents and assessed the quality of health facilities in the study area. We used the socioecological framework to structure our analysis and analyzed the data in NVivo.ResultsThe barriers to childhood vaccination among IDPs at the individual level were fear due to lack of knowledge, mistrust of vaccines, concerns about side effects and misinformation; opportunity costs; and costs of transportation. At the interpersonal level, family members played an important role as did the extent of decision-making autonomy. Community factors such as cultural practices, gender roles, and household evictions influenced vaccination. Organizational issues at health facilities such as waiting times, vaccine stock-outs, distance to the facility, language differences, and hesitancy of health workers to open multi-dose vials affected vaccination. At the policy level, confusion about the eligible age for routine vaccination and age restrictions for catch-up vaccination and certain antigens such as BCG were important barriers.ConclusionComplex and interrelated factors affect childhood vaccination uptake among IDPs in Somalia. Interventions that address multiple barriers simultaneously will have the greatest impact given the complex nature of vulnerabilities in this population. There is a need to strengthen the health system and connect it with existing community structures to increase demand for services. Our research highlights the importance of formative research before implementing interventions. Further research on the integration of health service strengthening with PLA to improve childhood vaccination among IDPs is recommended.Trial registration numberISRCTN-83,172,390. Date of registration: 03/08/2021.

Impacts of performance-based financing on health system performance: evidence from the Democratic Republic of Congo

BackgroundHealth systems’ weakness remains one of the primary obstacles towards achieving universal access to quality healthcare in low-income settings. Performance-based financing (PBF) programs have been increasingly used to increase access to quality care in LMICs. However, evidence on the impacts of these programs remains fragmented and inconclusive. We analyze the health system impacts of the PBF program in the Democratic Republic of the Congo (DRC), one of the largest such programs introduced in LMICs to date.MethodsWe used a health systems perspective to analyze the benefits of PBF relative to unconditional financing of health facilities. Fifty-eight health zones in six provinces were randomly assigned to either a control group (28 zones) in which facilities received unconditional transfers or to a PBF program (30 zones) that started at the end of 2016. Follow-up data collection took place in 2021–2022 and included health facility assessments, health worker interviews, direct observations of consultations and deliveries, patient exit interviews, and household surveys. Using multivariate regression models, we estimated the impact of the program on 55 outcomes in seven health system domains: structural quality, technical process quality, non-technical process quality, service fees, facility management, providers’ satisfaction, and service coverage. We used random-effects meta-analysis to generate pooled average estimates within each domain.ResultsThe PBF program improved the structural quality of health facilities by 4 percentage points (ppts) (95% CI 0.01–0.08), technical process quality by 5 ppts (0.03–0.07), and non-technical process by 2 ppts (0–0.04). PBF also increased coverage of priority health services by 3 ppts (0.02–0.04). Improvements were also observed for facility management (9 ppts, 0.04–0.15), service fee policies, and users’ satisfaction with service affordability (14 ppts, 0.07–0.20). Service fees and health workers’ satisfaction were not affected by the program.ConclusionsThe results suggest that well-designed PBF programs can lead to improvements in most health systems domains relative to comparable unconditional financing. However, the large persisting gaps suggest that additional changes, such as allocating more resources to the health system and reforming the human resources for health management, will be necessary in DRC to achieve the ambitious global universal health coverage and mortality goals.Trial registrationAmerican Economics Association Trial registry AEARCTR-0002880.

Improving the quality of maternal and newborn healthcare at the district level: Addressing newborn deaths in Nepal.

Maternal and newborn care quality can be measured in three dimensions (Dimensions 1: care provision, 2: care experience, and 3: human and physical resources); however, little is known about which dimensions are associated with newborn and perinatal deaths. We examined the association between care quality and newborn and perinatal deaths in Nepal. This study incorporated secondary data from Nepal Service Provision Assessments (NSPA) 2015 (623 delivery facilities, facility inventory survey; 1,509 women, ANC clients interviews; 1,544 women, ANC observation) and Nepal Demographic and Health Surveys (NDHS) 2016 (5,038 women who reported having given birth in the five years preceding data collection). The outcome variables were newborn and perinatal deaths derived from the NDHS. The exposure variables were district-level maternal and newborn care quality scores calculated from the NSPA data. Covariates were women's sociodemographic, health, and obstetric characteristics. We applied the administrative boundary method to link these two surveys. We conducted binary logistic regression analyses to examine the association between care quality and newborn/perinatal deaths. In Dimension 1, higher mean and maximum quality scores at the district level were associated with a lower number of newborn deaths (mean: odds ratio [OR] = 0.04, 95% confidence interval [CI]: 0.00-0.76; max: OR = 0.09, 95% CI: 0.01-0.58), but not with perinatal deaths. In Dimensions 2 and 3, the quality score was not significantly associated with newborn deaths and perinatal. Enhancing the quality of care provision at its average and highest levels in each district may contribute to the reduction of newborn deaths, but not perinatal death. Health administrators should assess the quality of care at the administrative division level and focus on enhancing both average and maximum care quality of health facilities in each region in the care provision dimension.

Data quality and associated factors of routine health information system among health centers of West Gojjam Zone, northwest Ethiopia, 2021.

Data quality is a multidimensional term that includes accuracy, precision, completeness, timeliness, integrity, and confidentiality. The quality of data generated by a routine health information system (RHIS) is still very poor in low- and middle-income countries. There is a paucity of studies as to what determines data quality in health facilities in the study area. Therefore, the aim of the present study was to assess the magnitude of the quality of routine health information system data and its determinants among health centers. A facility-based quantitative study design triangulated by the qualitative method was conducted. A total of 314 health professionals from 32 health centers were selected using a simple random sampling procedure. Data were gathered using a standardized checklist, interviewer-administered questionnaires, and key informant interview guidelines. Descriptive statistics were used to describe variables and binary logistic regression was used to identify factors associated with data quality using STATA version 14. Variables with p-value <0.25 in the bivariate analysis were entered to a multivariable logistic regression analysis. P-values <0.05 at 95% confidence intervals (CI) were taken to be statistically significant. A manual analysis was conducted for the qualitative data collected from purposively selected key informants. The study found that the overall data quality at the health centers of West Gojjam Zone was 74% (95% CI 68-78). The complexity of the routine health information system format [adjusted odds ratio (AOR) 3.8; 95% CI 1.7-8.5], problem-solving skills for RHIS tasks (AOR 2.8; 95% CI 1.2-6.4), and knowing duties, roles, and responsibilities were significantly associated with data quality (AOR 12; 95% CI 5.6-25.8), and lack of human resources, poor feedback mechanisms, delay in completing data records, lack of data use, and inadequate training on health information systems were barriers affecting data quality. The level of data quality among public health centers in the Amhara region was lower than expected at the national level.

Numerical investigation of indoor air quality in health care facilities: A case study of an intensive care unit

The risk of healthcare-associated infections (HAIs) is higher in patients admitted to intensive care units (ICU) and high dependency units (HDU). Currently, most ventilation studies focus on specialized areas, mainly isolation rooms and operating rooms. This paper focuses on the ventilation of multiple-bed hospital wards in developing countries. This study uses computational fluid dynamics (CFD) simulation to model and investigate airflow and the spread of pollutants. The study aims to investigate ICUs with various ventilation system designs. These predicted behaviors and characteristics were compared numerically to determine compliance with the requirements of airflow patterns, airborne contaminant distribution, and current international standards. The case study simulations were carried out using ANSYS Fluent simulation software as a solution tool. Three different ventilation systems, Vertical Laminar Airflow Ventilation (VLAF), Horizontal Laminar Airflow Ventilation (HLAF), and Temperature-Controlled Airflow Ventilation (TcAF), were modeled within five different designs to determine the most effective possible distribution of air inside the patient's room, based on different categories, primarily temperature distribution, CO2 concentration, and airflow distribution. The authors applied the TcAF technique in an ICU room, comparing the results of the proposed technique with those of other common techniques (HLAF and VLAF). It was found that TcAF showed the most effective airflow distribution around patients, isolating each patient from the others. However, the temperature distribution was excluded from the ASHRAE standard. HLAF with two exhausts is the most suitable option, with a lower CO2 concentration than the alternatives and a temperature that meets ASHRAE standards.

Bibliometric review of credentialing and quality in healthcare field

Health service credentials are important because they can improve the quality and profitability of health care facilities. Performance improvement through structured credentialing needs to be carried out continuously to support the quality of health care facilities, both in terms of skills, knowledge, and behavior in the work environment. Evidence-based implementation of credentials to support the quality of health services needs to be reviewed further because science and technology are increasingly developing. A series of selection went through 1705 publications and 639 publications meet the desired criteria in Scopus Database (Publications from 2011-2021 using keywords: ‘credentialing’ AND ‘quality’, and within medicine-related field of study). The data then being analyzed using VOSViewer to form whole 4 clusters. The majority of studies was held in America. Most citated publications are about standardization of medical processes. Throughout cluster themes assessed, the main topic of the publications was described as such: Standardization actions, and credentialing team programs. Future reviews with similar approach are needed to further expand new ideas to improve healthcare service quality.

Co-epidemics: implications of COVID-19 outbreak associated with human immune-deficiency virus, tuberculosis and Lassa fever in a low resource economy-a call for proactive measures

As the global struggle to combat the quadruple burden of COVID-19, human immunodeficiency virus, tuberculosis and Lassa fever continues to increase, Sub-Saharan Africa has been the most affected region, especially Nigeria. There is a close interaction between these four diseases and a clear understanding of each of these diseases is very crucial. People living with chronic medical conditions such as HIV, TB and Lassa fever are more likely to experience poor outcomes from COVID-19 even though there are still some unknown facts as regards the burden of COVID-19 on patients with TB, Lassa fever and HIV in our low-middle–income nation. This study was conducted to review different researches on COVID-19 associated with HIV, TB and Lassa fever co-infections, to understand the interactions between them and its implications on clinical investigations and health management in high burden countries of COVID-19, especially Nigeria. The research was designed to accommodate research and reports from different geopolitical zones of Nigeria where the diseases has been reported and centering on Ondo State reports. This was done using search engines, with reference to valid studies from academic sources like ResearchGate, PubMed and Google Scholar. We also evaluated various related titles, abstracts and full reports for eligibility. Ondo state was the centre of study as it is one of the states with high prevalence of Lassa fever, TB, HIV and COVID-19 co-infections in Nigeria. Structured diagnostic algorithms and clinical management are suggested to improve COVID-19/HIV/TB/Lassa fever or COVID-19/Lassa fever co-infection outcomes. With low quality of health care facilities for laboratory diagnosis of COVID-19 and Lassa fever, reliance on clinical acumen and high index of suspicion may be the only process that health professionals may rely upon to make early diagnosis.

The Impact of Hospital Demographic Factors on Total Quality Management Implementation: A Case Study of UAE Hospitals

Aim: Maintaining service quality and value using quality and management tools is crucial in any organization. In essence, improving service quality boosts both efficiency of organizations and consumer pleasure. The deployment of quality development programs such as Total Quality Management (TQM) is one technique that businesses may employ to deliver exceptional customer service. The health sector, in particular, is one of the industries that require TQM adoption due to its complexity and the need for constant service improvement. TQM helps to improve service quality in health facilities through advanced clinical and administrative procedures. This research comprehensively assesses TQM levels and the impact of hospital demographics on its implementation process in hospitals in the United Arab Emirates (UAE).&#x0D; &#x0D; Methods: The study used a quantitative research strategy based on a survey study design. Questionnaires were used to gather primary data from respondents deployed a self-administered technique. 1850 questionnaires were delivered to the hospital's senior staff based on their number in each hospital. Of the 1850 questionnaires distributed, 1238 usable questionnaires were analyzed, yielding a response rate of 66.9%. The study used a binary logistic regression model to determine if hospital demographics affected TQM implementation. The study data were examined and analysed using version 25.0 of the SPSS software.&#x0D; &#x0D; Results: The results show that most of the health facilities with an overall TQM between 4.12 and 4.82 were utilized, governmental, accredited and utilized and large hospitals, while the hospitals with a mean between 2.91 and 3.45 were small, unaccredited private, and non-specialised. Thus, large hospitals have a higher TQM utilization rate than small hospitals. In addition, the findings of the t-test revealed that a high TQM is represented by means of 4.68, 4.67, 4.43, and 4.12 for accredited, utilized, governmental and large hospitals. The binary regression analysis also reveals similar results: large, governmental, utilized and accredited hospitals have greater chances of TQM adoption than other categories of hospitals (Exp (B): 1.2; 95%CI: 1.001 – 1.421, P&lt; .05); (Exp (B): 1.3; 95%CI: 1.012 – 1.721, P&lt; .05); (Exp (B): 1.5; 95%CI: 1.127 – 2.051, P&lt; .01); and (Exp&#x0D; &#x0D; (B): 1.5; 95%CI: 1.102 – 2.012, P&lt; .05); correspondingly. Another observation from the results is that hospitals that implemented technological tools had a greater chance of successfully executing the TQM program than hospitals that did not utilize advanced technologies due to the limited availability of resources (Exp (B): 1.7; 95%CI: 1.332 – 2.187, P&lt; .01).&#x0D; Conclusion: Even though health facilities need to adopt TQM, its implementation depends on the hospital size and demographics that significantly influence the adoption of TQM programs. However, this study will help bridge the current gap on the usage of TQM in the health context by examine the influence of demographic factors on adopting TQM in hospitals. Hence, provide adequate information to help the UAE hospital administrators appropriately execute the TQM program in the hospitals and enhance the efficacy of their operations.&#x0D;

The Influence of Doctor Service and Facilities on Healthcare Service Quality

To support the basic human rights provision, The Indonesian government issued several policies. One of these policies is the Health Insurance program issuance in 2014. With the issuance of the program, doctors and healthcare facilities must follow certain procedures, while also providing enhanced services to optimize healthcare service quality. This research is a quantitative study using descriptive and inferential statistics, conducted on 94 people as the sample in this research. Based on the results of this research, it was revealed that doctor service and healthcare facilities simultaneously affect service quality insignificant ways. Based on a further detailed test, both doctor service and healthcare facilities are also proven to partially provide a significant effect on the quality of service. Based on these results, it can be concluded that by improving the quality of doctor services and healthcare facilities, service quality in healthcare facilities will improve significantly and will lead to optimized patient satisfaction.

Factors influencing choice of healthcare facilities utilisation by rural households in Ogun State, Nigeria

Abstract Understanding the choice of healthcare facility utilisation is essential to the provision of need-based healthcare services to the population. This study was carried out to estimate factors influencing the choice of healthcare facilities utilised by rural households. A multistage sampling procedure was used to select 240 rural households comprising 1440 persons. Data were collected with the use of a structured questionnaire and analysed with descriptive techniques and a multivariate probit (MVP) model. The MVP result showed that households supplement public healthcare facilities with private clinics, support traditional medical treatment with self-medication, and replace self-medication with public healthcare facilities and private clinics. Similarly, age, gender, household size, cost of drugs, distance to public healthcare facilities, travelling cost, contact with community health workers, total income, awareness of public health facilities, quality of health facilities, and terrain of health facilities influence the choice of healthcare facilities utilised. The study concluded that increased total income, contact with community health extension workers, awareness of health facilities, and perceived quality of services rendered positively influence the choice of healthcare facilities sorted after while the increase in the cost of drugs, distance to health facilities, travelling cost and difficult terrain of health facilities negatively impact the choice of healthcare facilities utilised. The study recommended that public healthcare facilities should be located within the reach of the people and equipped with essential drugs at a reduced cost. Households should also engage in activities that will increase their income so that they can use better healthcare facilities.

A Systematic Review of Factors Associated with Under-Five Child Mortality.

Preventing the life of the newborn and reducing the entrenched disparity of childhood mortality across different levels is one of the crucial public health problems, especially in underdeveloped and developing countries in the world. Sustainable development goals (SDGs)-3.2 is aimed at terminating all preventable under-five child mortality and shrinking it to 25 per 1000 live births or lower than this by 2030. Several factors have been shown to be linked with childhood mortality. This review is aimed at pointing out the significant determinants related to under-five child mortality by a systematic review of the literature. EMBASE, PubMed, Scopus database, and Google Scholar search engine were used for the systematic search of the literature. Special keywords and Boolean operators were used to point out the relevant studies for the review. Original research articles and peer-reviewed papers published in the English language till August 10, 2022, were included in the analysis and synthesis of the results. As per the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, out of 299 studies identified from different sources, only 22 articles were ascertained for this study. Eligible articles were appraised in detail, and relevant information was extracted and then integrated into the systematic review. Mother's education, size of child at birth, age of mother at childbirth, place of residence, birth interval, sex of child, type of birth (single or multiple), and birth order, along with other socioeconomic, maternal, child, health facility utilization, and community level variables, were observed as important covariates of under-five mortality. Women's education and easy access to quality healthcare facilities should be the apex priority to lessen childhood mortality.

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.

Service quality and accessibility of healthcare facilities: digital healthcare potential in Ho Chi Minh City

BackgroundEffective delivery of health services requires adequate quality in healthcare facilities and easy accessibility to health services physically or virtually. The purpose of this study was to reveal how the quality of healthcare facilities varies across the different parts of Ho Chi Minh City and how well residents (N = 9 million) can reach healthcare facilities. By demarcating the deficiently served areas of low accessibility, the study shows where urban planning and digital healthcare could improve accessibility to health services and the quality of services efficiently.MethodsThe analysis utilised geocoded information on hospitals, clinics, roads and population and the data of the quality scores of healthcare facilities. Quality scores were analysed by hot spot analysis and inverse distance weighting. Accessibility and formation of travel time-based service areas by travel time distances were calculated using road network, driving speed and population data.ResultsThe results unveiled a centripetal spatial pattern of healthcare facilities and a similar pattern in their quality. Outside the travel time of 30 min for hospitals and 15 min for clinics, the deficiently served areas have a population of 1.1 to 1.2 million. Based on the results and the evidence of digital healthcare, this paper highlights how to develop and plan spatially effective service provision. Especially, it gives grounds to discuss how cost-effective digital healthcare could be applied to improve the accessibility and quality of health services in an urban structure of extensively varying accessibility to health services.ConclusionsThe results bring up the need and the means for improving the quality of health services and their cost-efficient availability by location optimisation, road improvements and implementing digital healthcare provided by hospitals and clinics in the city. At the same, this study provides a multidisciplinary approach for planning more equal and efficient health service provision geographically.

Maternal and child health data quality in health care facilities at the Cape Coast Metropolis, Ghana

BackgroundThe demand for quality maternal and child health (MCH) data is critical for tracking progress towards attainment of the Sustainable Development Goal 3. However, MCH cannot be adequately monitored where health data are inaccurate, incomplete, untimely, or inconsistent. Thus, this study assessed the level of MCH data quality.MethodA facility-based cross-sectional study design was adopted, including a review of MCH service records. It was a stand-alone study involving 13 healthcare facilities of different levels that provided MCH services in the Cape Coast Metropolis. Data quality was assessed using the dimensions of accuracy, timeliness, completeness, and consistency. Health facilities registers were counted, collated, and compared with data on aggregate monthly forms, and a web-based data collation and reporting system, District Health Information System (DHIS2). The aggregate monthly forms were also compared with data in the DHIS2. Eight MCH variables were selected to assess data accuracy and consistency and two monthly reports were used to assess completeness and timeliness. Percentages and verification factor were estimated in the SPSS version 22 package.ResultsData accuracy were recorded between the data sources: Registers and Forms, 102.1% (95% CI = 97.5%—106.7%); Registers and DHIS2, 102.4% (95% CI = 94.4%—110.4%); and Forms and DHIS2, 100.1% (95% CI = 96.4%—103.9%). Across the eight MCH variables, data were 93.2% (95% CI = 82.9%—103.5%) complete in Registers, 91.0% (95% CI = 79.5%—102.5%) in the Forms, and 94.9% (95% CI = 89.9%—99.9%) in DHIS2 database. On the average, 87.2% (95% CI = 80.5%—93.9%) of the facilities submitted their Monthly Midwife’s Returns reports on time, and Monthly Vaccination Report was 94% (95% CI = 89.3%—97.3%). The overall average data consistency was 93% (95% CI = 84%—102%).ConclusionGiven the WHO standard for data quality, the level of MCH data quality in the health care facilities at the Cape Coast Metropolis, available through the DHIS2 is complete, reported on timely manner, consistent, and reflect accurately what exist in facility’s source document. Although there is evidence that data quality is good, there is still room for improvement in the quality of the data.

Patient Centered Care and Centeredness Perspective

Background: Patient-centred care (PCC) helps multidisciplinary health teams to follow informed decision-making practices, and improved healthcare treatments are ensured for patients. The need for significant changes in the healthcare system can be identified with the help of centred patient care, and new healthcare systems are designed and revolve around patient needs. The purpose of the review was to evaluate patient-centred care and the concept of centeredness. Review results: PCC assists in meeting the targets of healthcare settings for patients. This aids the health team to ensure that patient nutrition, cleanliness, emotional, physical comfort, and psychological needs are fulfilled. PCC contributes to reducing the length of patient stay at the hospital, and chances of future admission to the hospital are also lowered. The review may assist to develop better insight into patient-centred care, its dimensions, possible benefits of PCC and perspectives of centeredness. Conclusion: patient-centred care aids to meet the objectives of improved patient care outcomes, lower treatment costs, and increased satisfaction with the quality of health care facilities cared for in the health sector. Healthcare organizations have begun to focus on individualised-oriented care, and they no longer follow traditional procedures to meet the needs of patients. The patient-centred care model showed that health care providers could be dedicated to their work and ready to meet the health expectations set for patients. PCC reduces patients' length of stay in the hospital, and the chances of recovery from chronic illness also increase. This review contributes to the field of health by highlighting important aspects of patient-centred care that would create cost-effective care, improve hospital services, emphasise communication and promote aspects of patient caring skills.

Challenges on tuberculosis care in health care facilities during COVID-19 pandemic: Indonesian perspective.

Indonesia is among the top three countries globally with the highest tuberculosis burden. During the past decades, Indonesian health authorities have struggled to improve tuberculosis care quality in health care facilities by optimizing the regulation and strengthening the private sector contributions. The coronavirus disease 2019 (COVID-19) pandemic has hardly affected the Indonesian health care system, including the National Tuberculosis Control Program. While the end of the COVID-19 pandemic in Indonesia is uncertain, the measure to control tuberculosis must not be weakened. Early identification and measurement of the problem size are essential to decide the most appropriate approach to maintain the sustainability of National Tuberculosis Control Program, particularly in health care facilities during the COVID-19 pandemic. This article points out the possible threats to the sustainability of TB care in Indonesia during the COVID-19 pandemic, including some approaches to overcome those problems.