Use Of Primary Health Care Services Research Articles

Primary Health Care Service Use Among Women Who Have Recently Left an Abusive Partner: Income and Racialization, Unmet Need, Fits of Services, and Health

Primary health care (PHC) can improve the health of women who have experienced intimate partner violence; yet, access to and fit of PHC services may be shaped by income and racialization. We examined whether income and racialization were associated with differences in PHC service use, unmet needs, fit with needs, and mental and physical health in a sample of 286 women who had separated from an abusive partner. Mothers, unemployed women, and those with lower incomes used more PHC services and reported a poorer fit of services. Poorer fit of services was related to poorer mental and physical health.

The long walk to universal health coverage: patterns of inequities in the use of primary healthcare services in Enugu, Southeast Nigeria

BackgroundKnowledge and understanding of health service usage are necessary for health resource allocation, planning and monitoring the achievement of universal coverage (UHC). There is limited information on patterns of utilization among adult users of primary health care (PHC) services. Lack of understanding of current and past utilization patterns of health services often hinders the improvement of future Primary Health Care (PHC) delivery in the remote areas of developing countries. This paper presents new knowledge on the patterns of utilization of PHC services among adults in Enugu metropolis southeast Nigeria.MethodsA cross-sectional study was conducted in 15 PHC facilities of Enugu North Local Government Area (LGA) from June to July 2012. A total of 360 consenting adult users aged 18 years and above were consecutively recruited as they attended the health facilities. An interviewer-administered questionnaire was used to collect data from the respondents. A modified Likert scale questionnaire was used to analyze data on patterns of utilization. Utilization of PHC services was compared by gender, socio-economic status (SES) and level of education.ResultsOut of the 360 respondents, (46.9%) utilized PHC services regularly. The components of PHC mostly utilized by respondents were immunization with a mean score of 3.05, treatment of common ailments (2.99) and maternal and child health (2.64). The least poor SES group utilized PHC services the most while the very poor and poor SES groups used PHC services least. There were statistically significant relationships between utilization of PHC services and gender (p = 0.0084), level of education (p = 0.0366) and income (p = 0.0001).ConclusionsMost adult users in this study did not utilize the health facilities regularly and there were gender, educational and SES inequities in the use of PHC services. These inequities will negate the achievement of universal health coverage with PHC services and should be remedied using appropriate interventions.

ANALYTICAL PROBLEMS AND APPROACHES TOWARDS IMPROVING THE UTILIZATION OF PRIMARY HEALTH CARE SERVICES BY THE RURAL COMMUNITIES IN NIGERIA

Utilization of healthcare services for the most vulnerable and underprivileged populations have been recommended by the World Health Organization as a basic primary healthcare concept. It has been suggested that healthcare should be universally accessible without barriers based on affordability, physical accessibility, or acceptability of services Access to quality health is a basic civic right of all Nigerian citizens. While Primary Health Care (PHC) centers are relatively uniformly distributed throughout Local Government Areas (LGAs) in Nigeria, the rural people tend to underutilize the basic health services. Therefore, this paper assesses some analytical problems and approaches towards improving the utilization of primary health care services by the rural communities in Nigeria. This article examines some cross cutting issues in PHC and outlines approaches to improve the use of health services by rural people. An extensive search of the Pub Med database, Medline and Google Scholar was done to retrieve literature on PHC services and approaches for improving the use in rural community. Furthermore, Pub Med, Medline and Google Scholar searches were conducted using the research title and the related articles link for key publications and additional papers were also identified from the respective reference lists. Non-indexed literature and reports from international organizations were also accessed using Google and organizational websites. Due to the variability in quality of information and the broad range of values reported in published literature and reports, this paper did not attempt to provide any quantitative summary of effects of programs. Instead a review of information is being presented with analysis of overall trends and knowledge gaps. The responsibility for perpetuating the existing low use of PHC services should be held by PHC policy makers and LGA. Responsible health personnel can build a new social order, based on greater equity and human dignity, in which health for all including that of rural populations will no more be a dream but a reality. Capacity building and empowerment of communities through orientation, mobilization and community organization as regards training, information sharing and continuous dialogue, could further enhance the utilization of PHC services by rural communities.

Barriers to use of primary health care in a low-income setting in Nigeria: a cross-sectional descriptive study

BackgroundPrimary health care aims to provide essential health services and commodities to individuals and communities using available, acceptable, and sustainable resources. However, the demand for and use of primary care has fallen despite government investment. We sought to identify the main barriers affecting use of primary health-care services in Batsari (Katsina, Nigeria). MethodsWe did a cross-sectional descriptive study. The study population consisted of heads of households within the catchment area of the 21 primary health centres in Batsari. A sample size of 630 was drawn using cluster and random sampling techniques (using a random number table for all houses clustered within 30 min walking distance from primary health centre). We asked participants about predominant health problems and major determinants of access and use of primary health-care services. We analysed the results with SPSS (version 17.0). Findings337 of 630 participants (53%) preferred to seek care from local pharmacies run by community health workers or artisans compared with only 49 (8%) who used primary health-care services. The most common reasons for not using these services were a lack of essential drugs (n=276; 44%), high cost of services (n=149; 24%), and inadequate infrastructure in primary health-care facilities (n=42; 7%). InterpretationOur findings show the underutilisation of primary health-care services, and so will guide policy makers in improving health-care delivery, especially where the need is greatest—at the level of local governance —in line with the national health policy and national health strategic development plan of Nigeria. FundingNone.

Primary health care services in Nigeria: Critical issues and strategies for enhancing the use by the rural communities

Quality health is a fundamental right of all Nigerian citizens. While primary health care (PHC) centres are relatively uniformly distributed throughout local government areas (LGAs) in Nigeria, the rural people tend to underuse the basic health services. This article examines some cross cutting issues in PHC and outlines strategies to enhance the utilization of health services by rural people. The responsibility for perpetuating the existing low use of PHC services should be held by PHC policy makers and LGA. Responsible health personnel can build a new social order, based on greater equity and human dignity, in which health for all by the year 2015, including that of rural populations, will no more be a dream but a reality. Capacity building and empowerment of communities through orientation, mobilization and community organization as regards training, information sharing and continuous dialogue, could further enhance the utilization of PHC services by rural populations. Key words: Healthcare, services, strategies, use, rural.

Utilização e acesso de idosos a serviços de atenção básica em Porto Alegre (RS, Brasil)

A cross-sectional study was carried out in the second semester of 2004 by means of a household survey with 292 elderly people in a Southern Brazilian city, selected by probabilistic sampling. The objectives were: to describe the use and geographic access of the elderly to primary healthcare (PHC) in Porto Alegre (RS), and to analyze the association between variables of interest to the study and access to PHC. Descriptive and bivariate analysis was used. The primary health care services were used by 49.7% of the respondents, motivated by their location, quality and "free service." The factors negatively associated with the use of PHC services were "level of education" and "perception of good health" and the variable related positively was "self-diagnosed chronic condition". The elderly exposed to frailty related with economic and health conditions were more likely to use PHC, showing signs of equity in the health system. On the other hand, it is necessary to broaden the coverage to the elderly that do not have access, as well as implement healthcare strategies to meet the heterogenous demands of this age group.

A study of health services for the Chinese minority in Manchester.

This article describes a small-scale study which examined the views of both users and providers of primary healthcare services for the Chinese minority in Manchester. Thirty Chinese mothers of pre-school children were selected from immunization records and interviewed face-to-face at their homes using structured questionnaires and unstructured discussions. Thirty-eight GPs who had the largest number of Chinese patients (n = 10) registered with them, and 26 health visitors who worked with these GPs were also interviewed, using semi-structured questionnaires. The findings indicate that a discrepancy exists between the views of GPs, health visitors and Chinese mothers on the use of primary healthcare services. The health professionals' awareness of the effects of socio-economic characteristics, demographic profile and indigenous health beliefs and attitudes on the quality of primary healthcare services for Chinese families in Manchester is discussed.

The client's perspective in primary health care.

The criteria that define primary health care (PHC) dictate that PHC programs be instituted in response to both the clients perspective and needs. However the clients perspective and role in PHC has been supported in theory but not in reality. The purpose of this volume is to emphasize the importance of this perspective to the success of PHC programs by exploring a series of cases in different settings. The papers are limited to 2 areas Latin America and India where PHC has a longer history. Most PHC programs suffer from failure to accomodate 3 basic facts: 1) clients perceived needs may vary widely from planners epidemiologic definition of needs; 2) PHC is inextricably interwoven with socioeconomic and political processes; and 3) the effectiveness of PHC programs depends in large part on prospective clients perception and use of PHC services in combination with other Western and traditional health care services. This series is aimed at the health planner who might perceive through these anthropological case studies how client-oriented research and services could contribute to more successful PHC programs.