Utilization Of Health Facilities Research Articles

Perinatal mortality audit in a rural referral hospital in Tanzania to inform future interventions: A descriptive study.

BackgroundClear evidence exists that perinatal audit and feedback can lead to important improvements in practice. The death audit can lead to the identification of existing potential delays which are the decision to seek medical care, reaching an appropriate facility, and receiving timely adequate care at the facility. Such an audit potentially initiates a positive discussion, which may foster the implementation of changes that aims at saving more lives.ObjectiveTo review the perinatal deaths case notes and identify potential gaps in care provision and health-seeking behavior to foster best practice.MethodsThe stillbirths and neonatal death case notes that occurred between January 2019 and May 2020 at the hospital were reviewed using an adapted WHO checklist. The completed review case notes were entered into an electronic system and a quality control check-up was done. Data were analysed descriptively, and findings were presented in tables.ResultsThere were 4,898 births, and 1,175 neonatal admissions, out of these there were 135 recorded stillbirths (2.8%) and 201(4.1% of the total hospital births) early neonatal deaths. Out of the 1,175 neonates, 635 (54%) were born within the hospital and 540 (46%) were admitted from other facilities and home deliveries. In total 86 stillbirths and 140 early neonatal deaths case notes were retrieved and audited. Out of 86 stillbirths’ case notes audited, 30 (34.9%) seemed to have died during labor, and of these 5 had audible fetal heart rate during admission. Apgar scores less than 7 at 5 minutes, prematurity, and meconium aspiration were the top three recorded causes of neonatal deaths. Inadequate/late antenatal care visits and home delivery were the maternal factors likely to have contributed to perinatal deaths. Inadequate labor monitoring (12%) and documentation (62%) were among the providers’ factors likely to have contributed to perinatal deaths.ConclusionThis audit shows that there are high rates of preventable intrapartum stillbirths and early neonatal deaths. Both women and providers’ factors were found to have contributed to the stillbirths and neonatal deaths. There is a need to encourage women to adequately attend antenatal care, utilize health facilities during birth, and improve maternity and neonatal care at the health facilities.

Tale of 22 cities: utilisation patterns and content of maternal care in large African cities.

IntroductionGlobally, the majority of births happen in urban areas. Ensuring that women and their newborns benefit from a complete package of high-quality care during pregnancy, childbirth and the postnatal period present specific challenges in large cities. We examine health service utilisation and content of care along the maternal continuum of care (CoC) in 22 large African cities.MethodsWe analysed data from the most recent Demographic and Health Survey (DHS) since 2013 in any African country with at least one city of ≥1 million inhabitants in 2015. Women with live births from survey clusters in the most populous city per country were identified. We analysed 17 indicators capturing utilisation, sector and level of health facilities and content of three maternal care services: antenatal care (ANC), childbirth care and postnatal care (PNC), and a composite indicator capturing completion of the maternal CoC. We developed a categorisation of cities according to performance on utilisation and content within maternal CoC.ResultsThe study sample included 25 326 live births reported by 19 217 women. Heterogeneity in the performance in the three services was observed across cities and across the three services within cities. ANC utilisation was high (>85%); facility-based childbirth and PNC ranged widely, 77%–99% and 29%–94%, respectively. Most cities showed inconsistent levels of utilisation and content across the maternal CoC, Cotonou and Accra showed relatively best and Nairobi and Ndjamena worst performance.ConclusionThis exploratory analysis showed that many DHS can be analysed on the level of large African cities to provide actionable information about the utilisation and content of the three maternal health services. Our comparative analysis of 22 cities and proposed typology of best and worst-performing cities can provide a starting point for extracting lessons learnt and addressing critical gaps in maternal health in rapidly urbanising contexts.

The Mediating Effect of Healthcare Utilization on Livelihood Empowerment against Poverty (LEAP) and Health Security of Older Adults in Ghana: A Case Study on the Ga-West Municipality in Accra, Ghana

The concept of health security has aroused several interpretations because of theoretical technique indifferences or academic methodology. The focus has been on human security, old age health security (OAHS), whereas there remain issues of low healthcare utilization by older people from rural Ghana while there are social assistance programs. The study aimed at investigating the mediating effect of healthcare utilization on Livelihood Empowerment against Poverty (LEAP) and old age health security OAHS. With purposive sampling technique, participants were selected to participate in the study with standardized quantitative questionnaire to measure the variables involved in the study and a regression technique to analyze the data. The result of the mediation analysis showed a partial mediation between LEAP and Healthcare Utilization (HU) was found to have bridged the gap between the LEAP and OAHS. The LEAP policy also caused an increase in Health Utilization and, subsequently, an increase in old age health security (OAHS). The study is essential to help the National Health Insurance Authority NHIA in restructuring health care premiums to incite utilization of health facilities by the aged.

Sustainability of the Effects and Impacts of Using Digital Technology to Extend Maternal Health Services to Rural and Hard-to-Reach Populations: Experience From Southwest Nigeria.

BackgroundNigeria has one of the worst health and development profiles globally. A weak health system, poor infrastructure, and varied socio-cultural factors are cited as inhibitors to optimal health system performance and improved maternal and child health status. eHealth has become a major solution to closing these gaps in health care delivery in low- and middle-income countries (LMICs). This research reports the use of satellite communication (SatCom) technology and the existing 3G mobile network for providing video training (VTR) for health workers and improving the digitization of healthcare data.ObjectiveTo evaluate whether the expected project outcomes that were achieved at the end-line evaluation of 2019 were sustained 12 months after the project ended.MethodsFrom March 2017 to March 2019, digital innovations including VTR and data digitization interventions were delivered in 62 healthcare facilities in Ondo State, southwest Nigeria, most of which lacked access to a 3G mobile network. Data collection for the evaluation combined documents' review with quantitative data extracted from health facility registers, and 24 of the most significant change stories to assess the longevity of the outcomes and impacts of digital innovation in the four domains of healthcare: use of eHealth technology for data management, utilization of health facilities by patients, the standard of care, and staff attitude. Stories of the most significant changes were audio-recorded, transcribed for analysis, and categorized by the above domains to identify the most significant changes 12 months after the project closedown.ResultsFindings showed that four project outcomes which were achieved at end-line evaluation were sustained 12 months after project closedown namely: staff motivation and satisfaction; increased staff confidence to perform healthcare roles; improved standard of healthcare delivery; and increased adoption of eHealth innovations beyond the health sector. Conversely, an outcome that was reversed following the discontinuation of SatCom from health facilities is the availability of accurate and reliable data for decision-making.ConclusionDigital technology can have lasting impacts on health workers, patients, and the health system, through improving data management for decision-making, the standard of maternity service delivery, boosting attendance at health facilities, and utilization of services. Locally driven investment is essential for ensuring the long-term survival of eHealth projects to achieve sustainable development goals (SDGs) in LMICs.

Adolescents' Sexual and Reproductive Healthcare-Seeking Behaviour and Service Utilisation in Plateau State, Nigeria.

The high rate of sexual and reproductive health (SRH) challenges among adolescents in Nigeria has been linked with the poor access to and utilisation of health facilities. This study explores the factors that influence the actual use and willingness to use SRH services among adolescents. Survey questionnaires were administered to 428 adolescents aged 18 to 19 years in six local government areas (LGAs) in Plateau State. The results showed that more than one-third of the participating adolescents were currently sexually active, slightly more than three-quarters (76.6%) had never visited health facilities for SRH issues, and more than half (56.0%) were not willing to visit a health facility if they ever had any SRH issues. The most frequent reason for the non-use of health care facilities for SRH issues by adolescents was a perceived lack of privacy and confidentiality (66.1%), followed by the perceived negative attitude of health care providers (68.2%). However, being sexually active was the only independent covariate of seeking SRH care from health facility (AOR = 005; CI = 0.01–0.49; p = 0.011), while awareness of HIV was a significant covariate of willingness to seek SRH care in a health facility in the future (AOR = 3.17, 95% CI = 1.50–6.70; p = 0.002). We concluded that the utilisation of SRH services and willingness to do so in the future was fairly limited among adolescents in this study. Therefore, there is a need to address the challenges of privacy and confidentiality and commencement of the health promotion of SRH for adolescents ahead of sexual initiation to alleviate the SRH challenges adolescents encounter when sexually active.

Health service utilization in Manicaland Province, Zimbabwe during the COVID-19 pandemic: results from a cross-sectional household survey

Background The coronavirus disease 2019 (COVID-19) pandemic has impacted utilization of health care, especially in low-resource settings in Sub-Saharan Africa. Here, the current state of health care utilization in Manicaland Province, Zimbabwe during the COVID-19 pandemic was assessed. Methods Cross-sectional surveys were administered to randomly selected households in three districts in Manicaland Province, Zimbabwe from August to September 2020. Data on socio-demographic characteristics, utilization and perceptions of health facilities, and COVID-19 risk perceptions and impact were collected using a structured questionnaire administered to heads of households. Factors associated with health care utilization in the 4 weeks prior to the survey were identified using logistic regression. Findings Among the 542 respondents enrolled in the study, most were married or co-habiting, were employed, had attended secondary school or higher, and headed households with more than 4 members. About half (53.3%) of households reported visiting a health facility in the previous 4 weeks. The most cited barriers of service at health facilities were the unavailability of medicines, cost of services and waiting time see a provider. The multivariate logistic regression analysis indicated that the likelihood of health care utilization in the previous 4 weeks was higher among households with a respondent who was 55 years or older, had attended secondary school or higher, and was unemployed; and among households with a child under 5 years or a pregnant woman and located in Makoni or Mutare rural districts. Conclusions These findings indicate the need to improve quality of care by increasing the availability of essential medicines, removing financial barriers to health services, and reducing waiting times. Key factors such as age and education level of the head of household and the presence of vulnerable populations such as children and pregnant women in households should be considered when targeting health awareness and education to improve health service utilization during the pandemic.

The Behavior Of Adolescent Reproductive Health Facility Utilization

Background: Adolescence is the starting point of the human life cycle in preparing for a healthy reproductive process. Guidance and information that is not true at this time can oftaffectect the future of adolescents. Most adolescents don’t use Adolescent Reproductive Health (ARH) services (57%), quite a lot of adolescents (46.3%) use internet technology in accessing the information on ARH (Sampulawa & Mubarokah, 2015). Based on the above background, the researcher wants to explore the behavior of using ARH facilities in the city of Malang. 
 Methods: Descriptive research method with cross-sectional approach, with population, are all teenagers in the city of Malang. The research sample was taken using the purposive sampling technique, obtained a suitable sample of 200 adolescents from April to June 2021. The inclusion criteria of this study were unmarried and willing to be research respondents. Collecting data using a questionnaire via a google form. Descriptive analysis technique, presented in the frequency distribution.
 Results: The majority of respondents have never received correct knowledge about reproductive health (89.6%), with the majority of information sources obtained from schools (80%) and mass media (45.5%). Respondents used mass media to access information on reproductive health from the internet (87.5%) and books (51.5%). In using gadgets, respondents use them for 5-10 hours a day (53.5%), but only occasionally use them to find information about reproductive health (50.5%). Respondents stated that the use of mass media as a source of information about reproductive health can help in maintaining health (96.5%).
 Conclusion: Internet-based health education about adolescent reproductive health is needed because it is easy and simple, and the content is interesting to read. It can be used as an alternative media for reproductive health learning.

Association between PM2.5 and daily pharmacy visit tendency in China: A time series analysis using mobile phone cellular signaling data

While much is known about the effects of PM2.5 pollution on severe health outcomes, less is known about the heterogeneous impacts of air pollution on less severe health effects experienced by large numbers of people, such as those resulting in pharmacy visits. Based on anonymized daily pharmacy visits extracted from about 136,000 mobile phone station macrocells and 28,170 pharmacy locations, we used the generalized additive model and meta-analysis to investigate the effects of PM2.5 exposure on pharmacy visit tendencies (PVTs), as a proxy variable of health facility utilization, across regions, groups and social contexts. Overall, PVTs increased by 0.338% (95% CI: 0.335%–0.342%) for per 10 μg/m3 increases in PM2.5. The exposure-response curve was nonlinear, having a sharp slope below 60 μg/m3 and then flattening. Sensitivity analyses showed that results were robust to modeling choices and existence of noise in captured PVT data. At pharmacy level, higher percentage increases in PVTs were observed in near-residency pharmacies (0.474%), designated medical insurance pharmacies (0.360%), and pharmacies in urban areas (0.457%) than their counterparts (0.156%, 0.321%, 0.180%). This indicates that social contexts, including inconvenient access to the pharmacy and limited social medical insurance coverage, inhibited residents from utilizing health facilities for the health care needed. Interactions of social contexts led to strong heterogeneity among cities, between rural and urban regions as well as across communities, which call for differentiated health resources allocations to ensure health equity.

Impact evaluation of subsidized health insurance programs on utilization of healthcare facilities: evidence from Indonesia.

Despite subsidized health insurance has long been proclaimed by many countries including Indonesia, the variety of evaluation results showing that the optimization of benefits obtained by recipients is still questionable. The objective of this study is to analyze the impact of subsidized health insurance programs (ASKESKIN and JAMKESMAS) on the utilization of healthcare facilities in Indonesia. Data from two waves longitudinal data, the Indonesian Family Life Survey (IFLS), were analyzed using the propensity score matching method. This study found that in general, ASKESKIN and JAMKESMAS had very small impacts on the utility of healthcare facilities measured by outpatient and inpatient visits by program's beneficiaries. It implies that being subsidized health insurance holders does not necessarily encourage them to visit formal healthcare facilities. In addition, the comparison of average treatment effect on the treated (ATT) between ASKESKIN and JAMKESMAS also did not show any significant improvement even though the program had tried to be improved. The results of this study provide the basis for advising policy makers that there needs to revisit the effectiveness of subsidized health insurance program implementation.

Role of cystatin C and calprotectin as potential early prognostic biomarkers in COVID-19 patients admitted to a dedicated COVID care facility.

The COVID-19 pandemic has claimed millions of lives. A tool for early prediction of severity and mortality risk is desirable for better utilization of health care facilities. Several biomarkers like D-dimer, lactate dehydrogenase (LDH), C-reactive protein (CRP) and some recently explored biomarkers like serum cystatin C and serum calprotectin have been proposed as prognostic markers of COVID-19, but their role as prognostic markers is so far undefined. The present work attempted to investigate the possible role of serum cystatin C and serum calprotectin as prognostic tools to predict severity and outcome ahead of time. This observational cohort study was carried out on 95 COVID-19 patients admitted to a dedicated COVID care facility from mid-October 2020 to January 2021. Serial estimations of serum cystatin C and serum calprotectin levels were done and assessed for significant difference between severe (NEWS 2 score ≥5) and non-severe (NEWS 2 score <5) groups, survivors and deceased and on the basis of comorbidities at each time points. Survival analysis was done based on the optimal thresholds for severity and mortality, calculated from the receiver operating characteristic (ROC). The results showed that median cystatin C levels were significantly higher on the first day in the severe group (P < 0.001) and in patients with cardiovascular disease (P < 0.05), chronic lung disease (P = 0.009) and among patients who died (P < 0.05). It remained raised on day 3 in severe (P < 0.05) and deceased (P < 0.05) group. Serum calprotectin levels were significantly higher in patients with chronic lung disease (P = 0.008) and in those who died (P < 0.05). Serum cystatin C could be used as a tool for early prognosis and therapeutic decision-making for COVID-19 patients. Serum calprotectin seems to be a better marker of critical illness.

Burden of non-communicable diseases and its associated economic costs in India

Non communicable diseases (NCD) are a rising problem worldwide and is a cause of public health concern in India too. These diseases result in high health care demand and are expensive especially in low resource settings. We studied the NCD burden estimates for India and its major states and the associated cost in 2017. The disease burden was estimated using DALYs (Disability Adjusted life years), the Years of Life lost (YLL) and Years lived in disability (YLD). Health expenditure data from National Sample Survey was used to calculate out of pocket expenditure (OOPE) and catastrophic health expenditure (CHE). NCDs account for 16939 DALYs per 100 000 in India. About 50–70% of patients took treatment in private facilities. There is huge variation in the utilization of health facilities, disease burden and cost of treatment across the states. Karnataka had highest DALY rate of 25790 DALYs per 100 000 but Chandigarh showed highest mean OOPE of INR 63952 and Arunachal Pradesh showed the highest CHE of 47.7 percent. The economic burden of NCDs is notably high both in terms of OOPE and CHE and indicate variation across states in both disease burden and economic burden. The findings highlight the need for improvement of NCD management programmes in socioeconomically lower states of India.

Impoverishing effects of out-of-pocket healthcare expenditures in India.

Out of the 1.324 billion people in India (2016), around 12.4% of the population is below the poverty line. In India, out-of-pocket health expenditure (OOP) expenses account for about 62.6% of total health expenditure - one of the highest in the world. High OOP health expenditures push many households into poverty. This study aims to identify the impoverishing effects of OOP health expenditures in India. Data from the recent national survey by the National Sample Survey Organization - Social Consumption in Health 2014 are used to investigate the effect of OOP health expenditure on household poverty. Poverty headcounts and poverty gaps were estimated at the household level before and after making OOP healthcare payments. A logistic regression model is for predicting the effect of various factors on the incidence of impoverishment due to OOP health expenditures. There were 65,932 households in the sample. The total poverty headcount in the population before making OOP payments was 16.44% and it increased to 19.05% after making OOP payments. This 2.61% increase in the poverty headcount corresponds to 6.47 million households. Logistic regression results showed that medium and large households, household members with increased duration of stay in the hospital, utilization of private health facility and the presence of chronic illness increased odds of impoverishment due to OOP health expenditures. Health insurance programmes must be expanded to cover outpatient and preventive health services, include people above the poverty line, cover the whole household irrespective of the number of members living in the household and the coverage threshold limits must be increased. Urban poor must be enrolled in health insurance programmes without any delay.

Factors influencing health facility delivery among women of reproductive age in Lilongwe district; Malawi: a cross-section study

utilization of health facility for delivery could save pregnant women from avoidable maternal deaths. However, use of health facility in deliveries remains inconsistent. The main study objective was to identify factors influencing health facility delivery among women of reproductive age in Lilongwe District. a cross-sectional study using structured questionnaires administered to 210 women of reproductive age was used. Chi-square (or Fischer Exact Test), where appropriate was used to analyze data. the findings of the study revealed that the level of health facility delivery in Lilongwe District is 73.8%. It revealed that 97.1% of the respondents are aware of health facility delivery and most (89.5%) prefer health worker as the best person to assist pregnant women during delivery. There is a significant association between level of knowledge (p = 0.000), the level of education (p=0.000), employment (94.7%) and religious teachings (p=0.000) with delivery in a health facility. The study further shows that more Muslim´s women (91.7%) delivered at health facility compared to their counterparts from others religions and African traditionalists (20%). in conclusion, the level of knowledge, age, level of education and marital status, Occupation, monthly income, and the amount spent during the past delivery, and the religious teachings influence health facility delivery. We recommend the sharing of the findings with different stakeholders in order to find the solutions and the need for dialogue with traditional chiefs and religious leaders on advocating for health facility delivery.

Public Private Health Care Facility Utilization among Diabetic People in an Urban Area: A Descriptive Study

INTRODUCTION: Diabetes was considered the disease of affluent and imposes a significant burden on the health services. The modalities of diabetes therapies are different in different parts of the world. However, studies regarding public or private healthcare utilization are lacking in Nepal. Therefore, this study was designed to assess public private health care facility utilization among diabetic people in an urban area of Ithari, Nepal. MATERIALS AND METHODS: A community based cross-sectional study was conducted in Itahari, Submetropolitan of Sunsari district in the Koshi zone of Nepal from September 2017 - September 2018. The study population included 221 participants of age 25 years and above, diagnosed with type 2 Diabetes. Multi-stage proportionate random sampling method was adopted to select the participants. Chi square test was applied to find out the association and p&lt;0.05 is considered significant. RESULTS: Out of the total (221) participants, 55.7% were aged 45-64 years with male of 50.2%. Higher proportion of participants above poverty line (79.7%) were used private healthcare facilities. Among the participants those reported less or equal to two hours waiting time, majority (90.8%) had gone to private healthcare facilities, whereas those reported more than two hours waiting time, majority (70.8%) had gone to public healthcare facilities for the treatment which was found statistically significant (p=0.0002). CONCLUSIONS: Maximum participants prefer private health care services as compared to government health services for their treatment. Therefore, additional community based studies are needed to include larger study populations in order to help healthcare providers develop proper health care programs for these patients.

Predictors of Healthcare-Seeking Behaviour, Health Services Access and Utilization in Ajebo Community, South-West, Nigeria

Background: Health is a fundamental requirement for living a socially and economically productive life. Poor health inflicts great hardships on households, including debilitation, substantial monetary expenditures, loss of productivity and sometimes, death.&#x0D; Objectives: To describe healthcare-seeking behaviour, access to health services and utilisation, and their predictors in a southwestern Nigerian community.&#x0D; Methods: A descriptive, cross-sectional study was conducted in Ajebo community, Obafemi/Owode Local Government Area in Ogun State. A total of 420 respondents were studied using an interviewer-administered questionnaire to collect quantitative data. &#x0D; Results: More than half (54.0%) of the respondents had access to public health facilities, 41.7% had access to private health facilities, while patent medicine stores were accessed by 4.3% of the respondents. Out of the 249 (59.3%) who were ill in the preceding three months, 92.4% of them sought healthcare. More males utilized government-owned health services s than females (χ² = 3.878, p = 0.049). More than half (56.4%) travelled &gt;10 minutes to access healthcare services. Lack of formal education was not a hindrance to seeking healthcare (OR = 31.392, p = 0.003, CI = 3.323-2.347). Income earning &lt;30,000 Naira was the strongest predictor of healthcare utilization (OR = 3.304, p =0.001, 95% CI = 2.007-5.441). Education with OR = 31.392 (p = 0.003, 95% CI = 3.323-96.570) was the strongest predictor of healthcare-seeking behaviour.&#x0D; Conclusion: Healthcare-seeking behaviour was not limited by lack of formal education. The utilisation of public health facilities was high among the respondents. State of employment and income were strong predictors of healthcare utilisation in Ajebo community.

Covid-19 Decision Making Intelligence during Disasters Management

As the coronavirus (COVID-19) spreads from China to neighbouring areas and beyond, increased national and international efforts are underway to contain the epidemic. Humanity is increasingly confronted with a diverse array of man-made and natural disasters. While emergency circumstances cannot be avoided, they may be managed more efficiently. Effective emergency management requires thorough planning, informed reaction, and well-coordinated actions throughout the emergency management life cycle. According to the literature, data-driven emergency management information systems that are well-integrated help in disaster management operations. Recent advances in molecular and computational techniques, as well as in information and communication technologies (ICTs), artificial intelligence (AI), and Big Data, can assist in managing the massive, unprecedented amount of data generated by public health surveillance, real-time epidemic outbreak monitoring, trend nowcasting/forecasting, routine situation briefing and updating from governmental institutions and organisms, and health facility utilisation. This study could be tailored to assist organisations in adapting to their new normal.

Predictors and Utilization of Health Institution Services for Childbirth among Mothers in a Southern Nigerian City.

Background Poor maternal health indices, including high maternal mortality, are among Nigeria's major public health problems. Most of these deaths can be prevented by timely access and utilization of maternity healthcare services by women. Aim/Objective. This study seeks to identify factors affecting the utilization of health facilities for the delivery of babies among mothers in Calabar, Cross River State, Nigeria. Methodology. The study was a community-based cross-sectional study. A structured questionnaire was administered to 422 women of reproductive age residents in the study area who had given birth at least once within the last five years prior to the survey using a multistage random sampling technique. Data generated were entered, coded, and analyzed using Statistical Packages for Social Sciences (SPSS version 22.0), and results were presented in tables and charts. Chi-squared tests and multiple logistic regression were used for the identification of variables associated with health facility-based delivery. Result The mean age of respondents was 27.3 years (SD = 8.4). Fifty-two percent of the respondents utilized the health facility for delivery, 89.6% attended at least one antenatal clinic (ANC), and 18.9% completed at least 3 ANC sessions. There was a statistically significant association between health facility delivery and marital status (P=0.007), education (P=0.042), and family size (P=0.002). Older women (OR = 0.7, CI = 0.169–3.714), Christians (OR = 1.9, CI = 0.093–41.1), divorcees (OR = 3.7, CI = 0.00–0.00), and respondents who registered early (first trimester) for ANC (OR = 4.9, CI = 0.78–31.48) were found to be higher users of delivery services at the health facility. Conclusion Community health intervention focusing on improving the knowledge and awareness of the significance of utilizing available delivery services at the healthcare facility should be developed and implemented.

Patients’ choice of healthcare providers and predictors of modern healthcare utilisation in Bangladesh: Household Income and Expenditure Survey (HIES) 2016–2017 (BBS)

ObjectivesThe number of modern healthcare providers in Bangladesh has increased and they are well equipped with modern medical instruments and infrastructures. Despite this development, patients seeking treatment from alternative healthcare...

Kajian Pustaka: Gambaran Pengetahuan dan Perilaku Masyarakat untuk Mencari Fasilitas Kesehatan dalam Penanganan Penyakit Tuberkulosis

Introduction: The knowledge and behavior of the community in seeking health facilities for the treatment of tuberculosis were studied separately by previous researchers, so it is necessary to do a literature review to get a complete picture of this phenomenon. This study aims to obtain an overview of knowledge about tuberculosis and the behavior of people seeking health facilities in the treatment of tuberculosis in various previous studies.Methods: The study was a literature review. The sample of this study was eight articles, with inclusion criteria i.e. published in journals in the last 10 years, descriptive research, and full text. The articles were obtained through the search engines Science Direct, Scopus and Ebsco Host. The literature analysis was carried out by means of a narrative review and presented in a table.Results: The level of public knowledge about the causes of tuberculosis, signs and symptoms of the disease, modes of transmission, ways to prevent transmission, as well as knowledge that tuberculosis can be cured varied from low to high levels of knowledge. People take advantage of government and private health services, buy drugs at pharmacies, and go to traditional healers/traditional healers to get treatment for tuberculosis.Conclusion: There are still public misunderstandings about tuberculosis and obstacles in utilizing health facilities for the treatment of tuberculosis. Therefore, health education and counseling need to be improved so that public knowledge related to tuberculosis is getting better and has a positive impact on the behavior of seeking health facilities in the treatment of tuberculosis. It is necessary to conduct further studies on the factors that underlie people's behavior in seeking health facilities in the treatment of tuberculosis.

PERAN KELUARGA UNTUK MENCEGAH PENULARAN TB PARU DALAM KELUARGA DI WILAYAH KERJA PUSKESMAS GAJAH DEMAK

According to the health profile of Demak, the number of TB in Gajah health center ranks 6th out of 20 places. Total cases is 924 sufferes, with the number of BTA+ patients as a whole as many as 516 patients. In doing disease prevention efforts not only be done by the client itself or health workers alone but also play a role, so it takes the role of family to prevent the occurrence of transmission of pulmonary TB disease in the working area of Gajah Health Center Demak District. This research uses qualitative method with case study approach. The purpose of this research is to knowing deeply the five roles of family in knowing, deciding, taking care, modifying environment and utilizing health facility to prevent transmission of pulmonary TB disease in working area of Gajah Health Center of Demak Regency. From the results of this study, most of the informants did not know about the understanding of TB disease but, in general the role of the family to prevent transmission of pulmonary TB was good enough, although it was still not optimal because, there were still a number of efforts to prevent TB transmission that were not done by the family. For example, families do not understand the duties and functions of PMO, do not separate the use of eating utensils with patients pulmonary TB, and do not pay attention to the importance of reminding people with pulmonary TB when coughing. Suggestion of this research result for Puskesmas Gajah of Demak Regency in order to add and modify program of Lung TB prevention. In addition to regular monitoring or regular home visits to monitor the treatment and prevention of TB transmission done by the family at home.