Selected Community Health Centres Research Articles

Assess the level of health problem perceived by postmenopausal women in selected community health Centre, Verka, Amritsar

Assess the level of health problem perceived by postmenopausal women in selected community health Centre, Verka, Amritsar

Assessing the Effectiveness of an E-Coaching Intervention in Improving Family Support for Individuals with Mental Disorders: A Quasi-Experimental Approach.

The increasing number of mental disorders (MDs) requires government, social, and family attention. The purpose of this study was to determine the effectiveness of an e-coaching empowerment application in improving families' abilities to care for individuals with mental disorders (MDs). A quasi-experimental design was used for this study. Totaling 122 individuals selected through purposive sampling from families with (MDs) in six selected community health centers that divided into two groups, intervention and regular mental healthcare. The data collected were analyzed using multiple linear regression. The independent variable was the provision of intervention using the e-coaching application with GROW (Goal, Reality, Option, Will) model, while the dependent variables were the family's ability to recognize problems, make decisions, take care of people with MDs, modify the environment, and utilize health facilities. Further, multivariate tests were used to evaluate the effect of e-coaching empowerment on families' ability to care for MDs. The results demonstrated a significant impact of e-coaching on the family's ability to care for individuals with MDs (p<0.01). Education also partially affected the family's ability to care for individuals with MDs (p<0.01). Additionally, age, gender, occupation, relationship with the individual MDs, and duration of care simultaneously did not significantly affect the family's ability to care for individuals with MDs (p<0.01). However, educationally background was significantly affect family ability in taking care for MD patients. Overall, e-coaching significantly improved the family's ability to recognize problems, make decisions, care for patients with MDs, modify the environment, and utilize health facilities. The e-coaching empowerment application for families can assist healthcare workers in enhancing the family's ability to provide assistance for individuals with MDs at home. This application can improve mental health services in the broader location accessible via the internet and can be developed for other health fields. The application can be expanded into a simple game so that families can view their scores for their proficiency in each session to make it more entertaining.

QUALITATIVE STUDY TO EXPLORE CHILDBIRTH EXPERIENCES AMONG PRIMIPAROUS MOTHERS IN SELECTED COMMUNITY HEALTHCENTRE, UTTAR PRADESH

Aim:This study aimed to explore the childbirth experiences of primipara mothers in selected community health centre of Noida, Uttar Pradesh. Design: Qualitative exploratory study. Methods: The study was conducted among 10 primiparous women using semi structured interviews on 3rd day of delivery. Results: Data analysis led into two themes and seven sub- themes. The themes include low self-esteem and unrealistic childbirth expectations. Low self esteem theme consisted of self-blame, poor self-confidence, ambivalent feelings, novel experience and the theme of unrealistic childbirth expectations the subtheme are unfamiliar environment, pain, medical intervention. Womens low childbirth self-efficacy can be the result of negative childbirth experience. Therefore, it seems that providing positive childbirth experience plays an important role in improving womens self-efficacy and self-esteem, which requires cooperation and effort at the level of the individual, family, education system and health care system.

Effect of structured teaching programme on knowledge regarding modified partograph among auxiliary nurse midwives in selected community health centers

Maternal mortality remains one of the major problems in developing countries. In India the incidence of women dying while giving birth is among the highest in the world. The partograph has been considered as one of the valuable tool in the improvement of maternity services.Partogram serves an “early warning system” and assist in early decision on transfer, augmentation and termination of labour. It also increases the quality and regularity of all observations on the fetus and the mother in labour, and aids early recognition of problems with either. Partograph prevents prolonged labour effectively and thus reduces the risk of postpartum hemorrhage, sepsis uterine rupture, operative interventions and improving neonatal outcomes and reducing fetal mortality and morbidity. A pre-experimental one group pre-test, post-test design was used to observe the effect of structured teaching programe among Auxiliary Nurse Midwives regarding modified partograph. Reliability of the tool was tested by Karl Pearson (Correlation Coefficient) formula and it was found reliable r = 0.803. 60 samples were selected for the main study by non-probability convenient sampling technique. Highest percentage of Auxiliary Nurse Midwives (38.3%) were in the age group &amp;#62;35 years and (88.3%) were married. Highest percentage of Auxiliary Nurse Midwives (66.6%) were having high school basic qualification and (85%) were from 18 months revised auxiliary nurse midwives MPHW (F). Highest percentage of Auxiliary Nurse Midwives (58.3%) had 9 years and above total clinical experience, (41.6%) had 7 and above years of experience in labour room and (33.3%) Auxiliary Nurse Midwives had seldom used partograph in labour room. Highest percentage of Auxiliary Nurse Midwives (86.6%) had previous source of information during training. Highest percentage of Auxiliary Nurse Midwives (46.6%) agreed that partograph sheet is been supplied by the concerning department, (75%) agreed that use of partograph is allowed by medical officers / gynaecologists where (63.3%) are confident in using partograph.

Analysis on vaccine hesitation and its associated factors among parents of preschool children in Songgang Street, Shenzhen.

China has the largest number of vaccinated population around the world. However, there has been few research on the prevalence and associated factors of vaccine hesitation among parents of preschool children. Therefore, we conducted this study to evaluate the status of vaccine hesitation and its associated factors among children’s parents. A cluster random sampling method was adopted to select six community health service centers in Shenzhen, and parents of preschool children who were immunized in the vaccination outpatient department of the selected community health centers were surveyed using a structured self-administered questionnaire. Vaccine hesitation was assessed by the Parent Attitudes about Childhood Vaccines (PACV) scale. A multiple linear regression analysis was used to assess the associated factors for vaccine hesitance among children's parents. A total of 1025 parents (response rate, 93.18%) filled out the questionnaires. The average score of vaccine hesitancy was 43.37 (SD = 10.34) points. 23.61% of parents wanted children to get all the recommended shots, 53.76% of them did not believe that many of the illnesses shots prevent were severe, and 75.41% of them could not guarantee the information they receive about shots. The results of multiple linear regression showed that the number of children in the family (β = −0.93, 95% CI: −1.31 to 0.54), health status of the child (β = 0.47, 95% CI: 0.07 to 0.87), education level of the parents (Father: β = −0.84, 95%CI: −1.37 to 0.31; Mother: = −1.59, 95%CI:−2.13 to −1.05), and annual family income (β = 1.64, 95%CI: 1.13–2.16) were significantly associated with vaccine hesitation. The average score of parents' vaccine hesitation in Shenzhen was 43.37. The results showed that the number of children in the family, health status of the children, education level of the parents and annual family income were important factors associated with the parents' vaccine hesitation.

Analysis of the Electronic Implementation of A Malaria Surveillance Information System (E-SISMAL) in the Lahat District

Background: The requirement for malaria elimination to be recognized is to prove API lower than 1 per 1000 in the population, together with no indigenous case. Lahat Regency is an area of low-endemicity for malaria, where the target for elimination is projected for 2024. Since 2019, Lahat Regency has received socialization about E-SISMAL, which was developed as a web-based basis to speed up the reporting process. However, there are still delays in reporting malaria on E-SISMAL.&#x0D; Methods: Descriptive research with a qualitative approach was designed. The study subjects were the malaria person in charge, the head of seven selected community health centers (Puskesmas) and the Lahat District Health Office. Primary data came from observation, focus group discussion (FGD) and in-depth interviews with eighteen informants selected by the purposive sampling method.&#x0D; Results: The available inputs are inadequate, such as the human resource education was not up to standard, the internet network was not smooth, and there were no guidelines on E-SISMAL in the health centers. Malaria person in charge does not understand how to use E-SISMAL. In the process, there was the involvement of cross-sectoral and networked establishments. The output shows that the report indicators on E-SISMAL are not up to standard with less than 80%.&#x0D; Conclusions: The use of E-SISMAL in the Lahat district has not been maximized. It has an impact on delays in reporting. It is recommended that training and practice of E-SISMAL occur to improve officers' ability through socialization and that the Lahat Health Office establishes partnerships with telecommunications companies to ensure the smooth running of the network. Developing specific guidelines on E-SISMAL and a mobile phone-based malaria surveillance information system to speed up the malaria reporting process in the Lahat district is also advisable.

Analysis of the Electronic Implementation of A Malaria Surveillance Information System (E-SISMAL) in the Lahat District

Background: The requirement for malaria elimination to be recognized is to prove API lower than 1 per 1000 in the population, together with no indigenous case. Lahat Regency is an area of low-endemicity for malaria, where the target for elimination is projected for 2024. Since 2019, Lahat Regency has received socialization about E-SISMAL, which was developed as a web-based basis to speed up the reporting process. However, there are still delays in reporting malaria on E-SISMAL.&#x0D; Methods: Descriptive research with a qualitative approach was designed. The study subjects were the malaria person in charge, the head of seven selected community health centers (Puskesmas) and the Lahat District Health Office. Primary data came from observation, focus group discussion (FGD) and in-depth interviews with eighteen informants selected by the purposive sampling method.&#x0D; Results: The available inputs are inadequate, such as the human resource education was not up to standard, the internet network was not smooth, and there were no guidelines on E-SISMAL in the health centers. Malaria person in charge does not understand how to use E-SISMAL. In the process, there was the involvement of cross-sectoral and networked establishments. The output shows that the report indicators on E-SISMAL are not up to standard with less than 80%.&#x0D; Conclusions: The use of E-SISMAL in the Lahat district has not been maximized. It has an impact on delays in reporting. It is recommended that training and practice of E-SISMAL occur to improve officers' ability through socialization and that the Lahat Health Office establishes partnerships with telecommunications companies to ensure the smooth running of the network. Developing specific guidelines on E-SISMAL and a mobile phone-based malaria surveillance information system to speed up the malaria reporting process in the Lahat district is also advisable.

Do Chinese Parents Deny to Vaccinate Their Children? An Analysis of Vaccine Hesitation and Influencing Factors

Background: China has the largest number of vaccinated population around the world. However, there has been little research on the prevalence and associated factors of vaccine hesitation among Chinese parents of preschool child, and further research is urgently needed. Therefore, we carried out a survey to evaluate the status of vaccine hesitation and its associated factors among children’s parents and provided an reference for relevant research and policy-making. Methods: A cluster random sampling method was adopted to select 6 community health service centers of Shenzhen, and parents of preschool children who were immunized in the vaccination outpatient department in the selected community health centers were recruited and surveyed using a structured questionnaire. Vaccine hesitation was assessed by the Parent Attitudes about Childhood Vaccines (PACV) scale. A multi-variable analysis assessed the relationship between demographics characteristics and scores of hesitance scale. Results: A total of 1,025 parents filled out the questionnaires with effective recovery rate of 93.18%. The average score of vaccine hesitancy was 43.37 (43.37±10.34) points, with 58.50% of parents have delayed having their child get a shot, and 74.73% of parents concerned that their child might have a serious side effect from a shot. The results of multiple linear regression showed the number of children in the family (β=-0.93, 95%CI: -1.31 – -0.54), the health status of the child (β=0.47, 95%CI: 0.07 – 0.87), the education level of the parents (Father:β=-0.84, 95%CI: -1.37 – -0.31; Mother: = -1.59, 95%CI: -2.13 – -1.05), and the annual family income (β=1.64, 95%CI: 1.13 – 2.16) were significant associated with vaccine hesitation. Conclusions: The average score of parents' vaccine hesitation in Shenzhen was 43.37. The results showed that the number of children in the family, the health status of the children, the educational level of the parents and the annual family income were important factors influencing the parents' vaccine hesitation. Funding Information: This study was supported by the National Social Science Foundation of China (18ZDA085) and Science and Technology Innovation Commission of Shenzhen. Declaration of Interests: We declare that we have no conflict of interests. Ethics Approval Statement: This study was approved by the Research Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China and performed in accordance with the principles of the Declaration of Helsinki. Respondents were informed that their participation was voluntary, and consent was implied on the completion of the questionnaire.

Perceptions, attitudes and understanding of health professionals of interprofessional practice at a selected community health centre.

BackgroundDespite being identified as a solution to the challenges related to healthcare service delivery, the incorporation of interprofessional practice (IPP) into clinical practice has been limited. To implement an interprofessional model of healthcare, successfully, health professionals need to have an understanding of IPP and its related content.AimThe aim of this study was to explore and describe the health professionals’ perceptions, attitudes and understanding of IPP at a selected community health centre.SettingThis study was conducted at a primary healthcare facility in the Western Cape, South Africa.MethodsEthical clearance and permission to conduct the study was obtained from all relevant stakeholders. Four focus group discussions were conducted with health professionals at the facility. Themes, codes and categories were highlighted from the transcripts of the audiotape-recorded data.FindingsThe findings suggest that health professionals do not have an understanding of IPP, and are thus unable to apply it practically. The health professionals perceived certain healthcare processes in the facility as barriers to the integration of practices. In addition, the health professionals expressed the need for interprofessional relationships, creation of opportunities for IPP, and communication to transform the current practice.ConclusionTo implement IPP into this facility, effectively, the authors of this study recommend that facility management implement campaigns for and training on, the transition to IPP, staff induction programmes and regular meetings.

Postnatal Depression Screening among Postpartum Women Attending Postnatal Care at Selected Community Health Centres Situated in the Nkangala District of South Africa

Background: The postnatal period represents a time of risk for the emergence of Postnatal Depression (PND), a common maternal mental health problem affecting the well-being of the mother, the newborn and the entire family. Previously, it was postulated that African women were not affected by PND, due to traditional rituals and other cultural factors. However, the assumption has been refuted because of the existence of empirical evidence of PND in Africa and beyond, particularly among women living in socio-economic disadvantaged regions. Despite the growing magnitude of PND reported in South Africa, the country continues to focus more on reducing maternal and infant mortality and promoting infant physical health with limited efforts made to address PND among postpartum women. Objective: To screen for PND and determine the associated risk factors among postpartum women in selected community health centres situated in the Nkangala District, South Africa. Methods: The study was cross-sectional in design and applied a quantitative approach. Random sampling was used to select the three community health centres in the Nkangala District. A sample of 228 women who had delivered a live infant within 12 weeks of the time of data collection was selected using purposive sampling from the three community health centres. Trained research assistants administered a questionnaire to obtain information on demography and obstetric history, while the Edinburgh Postnatal Depression Scale (EDPS) was used to screen for postnatal depression. An EDPS score of 13+ confirmed the probability of PND. Data was analysed using STATA 14. Results: The mean age of women was 28±7 years. The majority of women were single (61%), living in large households (77%), and living in households with a monthly income of less than $291.10 (63%). Most women had normal (i.e., vaginal) delivery (83%) and reported unplanned pregnancies (65%). The probability of developing PND among women was 22%. The odds of developing PND were 3.17 times more likely in women with babies aged six weeks and above (AOR=3.17, CI; 1.39 - 7.23) and 4.50 times more likely in women living in households with an income of less than $115.55 (AOR=4.50, CI; 1.03 - 19.74). Partner/husband violence increased the odds of developing PND (AOR = 6.89, CI; 1.49 - 31.93), as well as a stressful life event (AOR= 3.73, CI: 1.52 - 9.17). Having partner/husband support (AOR=0.10, CI: 0.03 - 0.37) and receiving social support (AOR=0.28, CI: 0.09 - 0.93) reduced the risk of developing PND. A chi-square test showed significant associations between the EDPS scores and partner/husband support, partner/husband having another sexual partner, receiving social support, having a person who offers social support, partner/husband violence, and stressful life events. Conclusion: The probability of PND was high among postpartum women in the Nkangala District of the Mpumalanga Province, South Africa. The key determinants for the probability of PND were the age of a baby, household income, partner/husband violence, partner/husband support and receiving social support. Routine screening to identify women who are at risk of PND should be integrated into postnatal care settings for immediate intervention to protect the mother and her baby from different forms of morbidity.

A Medicaid Alternative Payment Model Program In Oregon Led To Reduced Volume Of Imaging Services.

The patient-centered medical home model aspires to fundamentally restructure care processes, but a volume-based payment system may hinder such transformations. In 2013 Oregon's Medicaid program changed its reimbursement of traditional primary care services for selected community health centers (CHCs) from a per visit to a per patient rate. Using Oregon claims data, we analyzed the price-weighted volume of care for five service areas: traditional primary care services, including imaging, tests, and procedures; other services provided by CHCs that were carved out from the payment reform; emergency department visits; inpatient services; and other services of non-CHC providers. We further subdivided traditional primary care services using Berenson-Eggers Type of Service categories of care. We compared participating and nonparticipating CHCs in Oregon before and after the payment model was implemented. The payment reform was associated with a 42.4percent relative reduction in price-weighted traditional primary care services, driven fully by decreased use of imaging services. Other outcomes remained unaffected. Oregon's initiative could provide lessons for other states interested in using payment reform to advance the patient-centered medical home model for the Medicaid population.

Recommendations to Improve Antenatal Care Uptake through Community Participation and Local Accountability

Antenatal care, an integral component of primary health care, is offered as a free health service for pregnant women at public health facilities. However, the death of women during pregnancy, during childbirth, or after delivery continues to be a major challenge in health care systems due to poor antenatal care uptake. The main aim of this study was to explore and describe recommendations from local stakeholders and health governance structures to promote the uptake of Basic Antenatal Care (BANC) services in the areas surrounding local clinics. The study used a qualitative, descriptive design, with purposively selected participants sharing detailed information in their own words on the subject. Twenty individual in-depth interviews were conducted at three selected community health centres (CHCs) in the Bushbuckridge sub-district, Mpumalanga province. The results revealed the following needs: clinic committees must participate in promoting BANC awareness through health education, use of existing community-based structures must be strengthened, men’s support for their pregnant partners must be harnessed, and the roles and responsibilities of clinic committees must be amplified. The study showed that community leaders and clinic committees are willing to work in collaboration with health care providers in promoting antenatal care uptake in the community by expanding BANC awareness. Clinic committees’ previous involvement in health awareness campaigns is a strength that could contribute to making antenatal care awareness programmes successful. Vital recommendations include formalising reporting mechanisms for clinic committees so that they can be accountable to the community in promoting BANC services, strengthening stakeholder collaboration, and resourcing.

Perceptions of Nurses Regarding Barriers to Implement Maternal and Newborn Care at Rural Community Health Centers of Madhya Pradesh, India: A Phenomenology Study

Introduction: Nurses are vital to providing high-quality rural maternity care throughout the continuum of adolescence, pregnancy, birth and postpartum period. Objectives: The objective of this study is to examine the barriers perceived by nurses in maternal and newborn care at community health centers in rural areas of India. Material and Method: A qualitative study was conducted to identify barriers at two selected community health centers of Madhya Pradesh. Participants were interviewed and data were analyzed using Atlas.ti software. Results: Major themes that surfaced during data analysis were related to manpower, facilities, nurses, culture and rural area. Conclusion: It is very crucial to address these reported barriers in order to provide better &amp; evidence based maternal and newborn care in rural areas.

A Study to assess the effectiveness of Planned Teaching programmed in term of Knowledge and situation-based practice regarding partograph among midwives of selected community Health centre of Bhavnagar District

A Study to assess the effectiveness of Planned Teaching programmed in term of Knowledge and situation-based practice regarding partograph among midwives of selected community Health centre of Bhavnagar District

Knowledge of Asha worker regarding reproductive and child health package in selected community health centres district Jodhpur, Rajasthan with a view to develop a brochure

Accredited Social Health Activist (ASHA) acts as interface between community and public health system through implementation of Reproductive and child health package. Objective 1) to assess the knowledge of ASHA worker regarding RCH package. 2) To establish the relationship between knowledge of ASHA workers with selected socio demographic variables. 3) To develop a Brochure. A Non experimental co relational design was used with 100 sample size. R was 0.78. Maximum 59% of ASHA workers had Average, 38% had Good and 3% had poor knowledge. ASHA had adequate knowledge regarding Essential New Born Care, Safe motherhood & inadequate regarding Family Planning, Oral rehydration therapy, Prevention & control of Vitamin A deficiency in children, Immunization, Prevention & management of RTI/STD. Relationship with Academic qualification, Duration of Experience & Training for Module- 6 or above was statically significant at p value 0.05. Regular up gradation of training module is recommended.

Quality Evaluation of Health Services at Community Health Centers: through Accreditation Surveys in Indonesia

Introduction: Community health centers as primary health care centers are required to be able to provide quality assurance services to the community. The current problems of the Community Health Centre are the low quality of services, the lack of standardized infrastructure, and the low number of quality human resources, and high constant of patients’ complaints. The aim of this study is to evaluate the quality of health services at community health centers. Material and Method: The research method is an observational study by taking data in 13 provinces in Indonesia for 3 years (2016‑2018). A total of 45 randomly selected community health centers were evaluated for 3 days per health community center using an accreditation instrument that had been prepared and established by the Indonesian Ministry of Health consisting of 9 chapters, 42 standards, 168 criteria, and 776 assessment elements. Finding and Discussion: The results showed that there were 2.2% of the community health centers which are not accredited, while the other 97.8% are accredited. The basic accreditation status was 45.5%. The status of intermediate accreditation was 40.9%. The main accreditation status was 13.6%. There was no plenary status of accreditation. Conclusion: The conclusion of the study was that there are more community health centers with basic accreditation status so management supervision, human resources, facilities and infrastructure, and innovation of the community health center still needs to be improved.

A Study on the Pattern of Self-reported Tobacco Addiction in Hypertensive Patients in Gujarat, India.

BackgroundBoth hypertension (HTN) and tobacco addiction pose a threat to the health, environment, and socioeconomic status (SES) of the people. When tobacco use disorder exists in people with HTN, it hastens the disease progress and causes early complications. The present study aimed to study the knowledge and practice of tobacco addiction in patients with HTN and find out the correlates of knowledge and practice of tobacco addiction.MethodsA cross-sectional study was conducted for a period of one year in the Jamnagar District of Western Gujarat, India. Out of total 400 samples, 50% were collected from the five selected Community Health Centers (CHCs) by random sampling and the rest from non-communicable disease (NCD) clinics at the tertiary care hospital of the district.FindingsMost of the patients were in their fifties or above (67.0%), women (57.0%), and married (86.5%). Only 12.0% had awareness about the hazards of tobacco addiction and the prevalence of tobacco addiction was 11%. It was found that use of smokeless tobacco (SLT) among samples was the highest (72.7%) followed by dual consumption, i.e., SLT and smoking (20.5%). The frequency of consumption was ≥ 5 times/day in 54.5%, 70.4% were addicted for > 10 years, and only 15.9% had ever tried to quit tobacco while only 11.4% had successfully quit it. It was seen that those who were aged < 50 years, men, literates, employed, and those belonging to higher SES and urban residence had better knowledge of the health hazards. This was found to have significant statistical association.ConclusionThe results provide valuable insight into the tobacco addiction in patients with HTN on which non-pharmacological treatment of HTN can be based.

Knowledge on Management of Diabetes Mellitus among Patients with type II Diabetes Mellitus in a Selected Community Health Centre of Dadra and Nagar Haveli Area

Knowledge on Management of Diabetes Mellitus among Patients with type II Diabetes Mellitus in a Selected Community Health Centre of Dadra and Nagar Haveli Area

Effectiveness of Structured Teaching Programme on Fasting Blood Sugar among Patients with Type II Diabetes Mellitus in a selected Community Health Centre of Dadra and Nagar Haveli area

Effectiveness of Structured Teaching Programme on Fasting Blood Sugar among Patients with Type II Diabetes Mellitus in a selected Community Health Centre of Dadra and Nagar Haveli area

A Study to Assess the Effectiveness of the Early Skin to Skin Contact and Initiation of Breastfeeding in Terms of Duration of Third Stage of Labor among Mothers Admitted in Selected Community Health Centers of Gujarat State

A Study to Assess the Effectiveness of the Early Skin to Skin Contact and Initiation of Breastfeeding in Terms of Duration of Third Stage of Labor among Mothers Admitted in Selected Community Health Centers of Gujarat State