Primary health care research & development最新文献

{"title":"Effect of primary health care on hospitalizations: health services analysis based on Estonian data.","authors":"Kaija Kasekamp, Andres Võrk, Ruth Kalda","doi":"10.1017/S1463423625000222","DOIUrl":"10.1017/S1463423625000222","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to assess the effect of primary health care (PHC) service provision continuity on inpatient admissions for people with chronic diseases in Estonia.</p><p><strong>Background: </strong>Non-communicable diseases (NCDs) were collectively responsible for more than 7 out of 10 deaths worldwide in 2019. As the burden of NCDs increases, PHC has an increased role of coordinating care management. High-performing PHC can reduce unnecessary hospitalizations. Estonia has a strong PHC system focusing on multidisciplinary care. Yet it has not been evaluated for its effect on hospitalizations. Therefore, it is imperative to evaluate PHC continuity to improve care for NCD patients.</p><p><strong>Methods: </strong>This study used routinely collected electronic medical billing data of the Estonian population aged 15 years or older from 2005 to 2020 identifying patients with seven ambulatory care sensitive chronic (ACSC) conditions. We developed an indicator to describe the continuity of PHC. Charlson Comorbidity Index (CCI) was used to assess the impact of comorbidities and we controlled the patient's age, gender, county of residency and socio-economic status. We estimated multilevel logistic regression models with family doctor patient list random effects to assess how the odds of hospitalization depend on continuity of care, allowing for confounders.</p><p><strong>Findings: </strong>We identified that 45% of the adult Estonian population had at least one of the target diagnoses. Among the target population, 96% had contact with their PHC providers. We found that there is a non-linear relationship between PHC continuity and patient outcomes. Any contact with PHC provider during the past 5 years decreases odds for hospitalization, but hospitalization risk is higher for people who are elderly and have higher CCI score. We found that after accounting for patient characteristics, differences among patient lists minimally impact outcomes. Further research should explore policies to better support family doctors in reducing hospitalizations for chronic patients.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e29"},"PeriodicalIF":0.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary health care in Austria: qualitative analysis of requirements and challenges in interprofessional collaboration from the perspective of health care and social professionals.","authors":"Ana Atalaia, Clemens J Schnegg, Johanna Bodenhofer, Babette Grabner, Melanie Roth","doi":"10.1017/S1463423625000234","DOIUrl":"10.1017/S1463423625000234","url":null,"abstract":"<p><strong>Background: </strong>Primary health care (PHC) delivered in Austria's newly established primary health care units (PHCU) is based on interprofessional collaboration (IPC) between health care and social professionals.</p><p><strong>Aim: </strong>This study aims to explore the requirements and challenges in IPC in Austrian PHCUs from the perspective of health care and social professionals.</p><p><strong>Methods: </strong>15 semi-standardized, online, mono-professional focus group interviews were conducted with a total of 58 professionals with the following backgrounds: biomedical sciences, dietetics, medical training therapy, medicine, midwifery, nursing, occupational therapy, office assistance, orthoptics, pharmacy, physiotherapy, psychotherapy, radiography, social work, and speech therapy. The participants were representatives from PHC practice (especially PHCUs), respective educational institutions, and professional organizations. The data were inductively analysed using qualitative content analysis according to Mayring.</p><p><strong>Findings: </strong>The analysis displayed two main fields discussed by the participants, the setting for IPC and the professional relationships. The content analysis revealed three and four topics, respectively, within the main discussion fields. Within the setting for IPC, these topics were elaborated on (1) the operational area where IPC takes place in PHC, (2) the structural and organizational premises for this cooperation in PHCUs, and (3) the observed benefits of PHCUs for patients. Regarding the professional relationships, these topics were discoursed: (1) successful IPC, (2) challenges in IPC, (3) competencies required for IPC, and (4) previous and present corresponding training content.</p><p><strong>Conclusion: </strong>Austrian health care and social professionals aim to get more involved in PHC in general and PHCUs specifically. They see opportunities and also challenges for their professional groups. Specific training is desired focusing on the unique requirements of Austrian PHCUs and equipping the workforce for the intensive, necessary, and beneficial collaboration between multiple professional groups in the increasingly important setting.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e31"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Take home messages from the implementation of the primary health care measurement and improvement (PHCMI) initiative in the WHO Eastern Mediterranean Region (EMR).","authors":"Karen Kinder, Hassan Salah, Hagar Azab, Hamid Ravaghi, Henry Doctor, Roberta Tosques, Arash Rashidian, Awad Mataria","doi":"10.1017/S1463423625000179","DOIUrl":"10.1017/S1463423625000179","url":null,"abstract":"<p><strong>Aim: </strong>To summarize the findings from the PHC Measurement and Improvement (PHCMI) initiative in the World Health Organization WHO Eastern Mediterranean Region (EMR) and highlight key lessons to build PHC-oriented health systems.</p><p><strong>Background: </strong>To support countries in enhancing their commitment to the primary health care (PHC) approach, the WHO Regional Office for the Eastern Mediterranean (EMRO) established the PHCMI initiative in 2019 to evaluate PHC performance and identify priorities for improvement.</p><p><strong>Methods: </strong>Building on the experience of the global PHC Performance Initiative (PHCPI), PHCMI updated the master indicator list through iterative processes and reflecting country priorities. Progress in five domains: system/structure, inputs, processes, outcomes, and impact was assessed. Existing policy documents, data sources, and key informant interviews were used in the assessment.</p><p><strong>Findings: </strong>Of the 21 countries and one territory, 14 participated in the assessment including Afghanistan, Bahrain, Egypt, I.R. of Iran, Iraq, Jordan, Lebanon, Libya, Morocco, Oman, Pakistan, occupied Palestinian territory, Qatar, and Yemen. Despite the observed heterogeneity in PHC implementation, most countries reported that public primary care services were acceptable, accessible, and affordable. Strong leadership, the existence of PHC-related national health policies, and the engagement of stakeholders were key success factors.Areas for additional attention include the need to increase investment in PHC, increase the PHC workforce, enhance equitable distribution of the workforce, expand training of primary care clinicians, improve health information systems, and inform the population on the benefits of preventive care. Health systems should be more tailored to the PHC approach and encouraged towards a more holistic view of the PHC approach.The PHCMI initiative provides a foundation for an open discourse for advancing universal health coverage (UHC) and health security in EMR and re-orienting health systems towards the PHC approach.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e30"},"PeriodicalIF":0.0,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Turnover intentions among rural-oriented medical students in Western China: a constructivist grounded theory study.","authors":"Pinghua Zhu, Xinyi Xu, Chun Zhai, Chen He, Yulu Su, Haitao Yuan, Zukang Gong, Zhong Tang","doi":"10.1017/S1463423625000039","DOIUrl":"10.1017/S1463423625000039","url":null,"abstract":"<p><strong>Objective: </strong>The rural-oriented tuition-waived medical education program in China, started in 2010, provides free medical education to students committed to serving in rural areas to address medical staff shortages. Despite its success in training and deploying graduates, retaining them post-obligation remains challenging. This study explores the mechanisms behind the turnover intentions of rural-oriented medical students in Western China, offering insights for their retention.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 47 rural-oriented medical students and 30 health clinic directors in Nanning City. Interview data were analysed using grounded theory, and open, axial and selective coding was applied.</p><p><strong>Results: </strong>Through three levels of coding analysis, 34 tree nodes, 13 sub-categories and 3 main categories were identified from the interviews with rural-oriented medical students and health clinic directors. 3 main categories were Subjective Norms, Behavioural Attitudes, and Perceived Behavioural Control.</p><p><strong>Conclusion: </strong>A model of turnover intention among rural-oriented medical students was developed. This model can serve as a valuable reference for future policy optimization concerning China's rural order-directed medical students.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e28"},"PeriodicalIF":0.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing loss characteristics and cerumen management efficacy in low-income South African communities: a cross-sectional study.","authors":"Sello Marven Manganye, Caitlin Frisby, Tarryn Marisca Reddy, Tersia de Kock, De Wet Swanepoel","doi":"10.1017/S1463423625000246","DOIUrl":"10.1017/S1463423625000246","url":null,"abstract":"<p><strong>Aim: </strong>To describe the prevalence and characteristics of hearing loss in a self-referred adult cohort in low-income South African communities and to evaluate the effectiveness of a cerumen management protocol within a community-based service setting.</p><p><strong>Background: </strong>Hearing loss affects 1.5 billion people globally, with a disproportionate impact on individuals in low- and middle-income countries (LMICs) and the elderly, often attributed to age-related factors and cerumen impaction. Despite the high prevalence, access to ear and hearing care remains challenging, particularly in LMICs, such as Africa.</p><p><strong>Methods: </strong>A total of 227 participants aged 43-102 were recruited from two community centres in low-income South African communities for hearing evaluation and cerumen management for those with cerumen impaction. A cross-sectional, predominantly quantitative approach was used.</p><p><strong>Findings: </strong>Video otoscopy of 448 ears revealed normal findings in 57.9%, cerumen impaction in 29.1%, and other abnormalities in 1.3%. The prevalence of confirmed hearing loss was 97.8%, primarily mild (45.8%), and sensorineural hearing loss (SNHL) was the most common (55.3%). Cerumen impaction accompanied hearing loss in 28.4% of cases. Post-treatment, 50.9% of participants with cerumen impaction showed normal otoscopy results, with mean hearing improvements of 16.2 dB (±17.9 SD) in the left ears and 15.8 dB (±17.2 SD) in the right ears, though overall significance was limited.</p><p><strong>Conclusion: </strong>The high prevalence of hearing loss and cerumen impaction in low-income communities emphasizes the importance of ear care in primary healthcare (PHC) settings, especially for the elderly. Effective community-based cerumen management highlights the potential of integrating community resources and task-shifting strategies for cost-effective ear care in resource-limited settings.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11955542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of the population with chronic kidney disease in Spain in the context of the COVID-19 pandemic: a longitudinal retrospective study.","authors":"Liliana Bilbie-Lupchian, Bárbara Oliván-Blázquez, Beatriz González-Álvarez, Priscila Matovelle-Ochoa, Verónica Casado-Vicente, María Antonia Sánchez-Calavera","doi":"10.1017/S1463423625000155","DOIUrl":"10.1017/S1463423625000155","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the sociodemographic characteristics and trends in clinical and analytical parameters among individuals with chronic kidney disease (CKD) in Aragon (Spain), who remain uninfected with COVID-19 during the first year of pandemic. The secondary objectives were to identify the associated comorbidities and their evolution throughout the pandemic, as well as to determine the cases that got worse and their possible relationship with the control of the main risk factors.</p><p><strong>Background: </strong>CKD is a major public health problem worldwide. Studies encompassing national, European, and global contexts, show a rise in the prevalence of CKD, with a significant decrease in life quality, high morbidity and mortality, and increased healthcare costs. In this scenario, primary care is a cornerstone for the early detection of CKD and for the management of progression factors. To date, there are few publications regarding the evolution of the CKD population throughout the pandemic that are not related to hospitalizations or complications due to COVID-19.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal study with real-world data from the population over 16 years of age registered in Aragon (Spain), collecting data from electronic health records. The variables included were sociodemographic, analytical and clinical (glomerular filtration rate, cholesterol, triglycerides, glycated haemoglobin, and blood pressure) and comorbidities (hypertension, dyslipidemia, obesity, diabetes, and smoking). The data were archived and processed using the SPSS v22.0 software package.</p><p><strong>Results: </strong>During the first six months of COVID-19 pandemic, the clinical parameters of people with CKD were poorly controlled, although there was a later improvement which could be related to the progressive recovery of health services. The glycated haemoglobin value found was low, which makes us suspect possible overtreatment. There is a high prevalence of high blood pressure, diabetes, dyslipidemia, obesity and smoking. Interventions targeting these factors could help reduce the burden of CKD.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peer-led digital health lifestyle intervention for a low-income community at risk for cardiovascular diseases (MYCardio-PEER): a quasi-experimental study protocol.","authors":"Geok Pei Lim, Jamuna Rani Appalasamy, Badariah Ahmad, Kia Fatt Quek, Shazwani Shaharuddin, Amutha Ramadas","doi":"10.1017/S1463423625000192","DOIUrl":"10.1017/S1463423625000192","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) poses a substantial global health burden, necessitating effective and scalable interventions for primary prevention. Despite the increasing recognition of peer-based interventions in managing chronic diseases, their application in CVD prevention still needs to be explored.</p><p><strong>Aims: </strong>We describe the protocol of a quasi-experiment to evaluate the effectiveness of a peer-led digital health lifestyle intervention, MYCardio-PEER, for a low-income community at risk for CVD. This study aims to assess the effectiveness of MYCardio-PEER in improving the participants' knowledge, lifestyle behaviours and biomarkers related to CVD. Secondarily, we aim to assess the adherence and satisfaction of participants towards MYCardio-PEER.</p><p><strong>Methods: </strong>A minimum total sample of 68 low-income community members at risk for CVD will be recruited and allocated either to the control group or the intervention group. Participants in the control group will receive standard lifestyle advice and printed materials for CVD prevention, while the intervention group will participate in the 8-week MYCardio-PEER intervention program. The participants will be assessed at Week 0 (baseline), Week 8 (post-intervention) and Week 20 (post-follow-up).</p><p><strong>Discussion: </strong>We anticipate a net improvement in CVD risk score, besides investigating the effectiveness of the intervention program on CVD-related knowledge, biomarkers, and diet and lifestyle behaviours. The successful outcome of this study is essential for various healthcare professionals and stakeholders to implement population-based, cost-effective, and accessible interventions in reducing CVD prevalence in the country.<b>Trial registration</b>: ClinicalTrials.gov (NCT06408493).</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e20"},"PeriodicalIF":0.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experience of an innovative interdisciplinary model of primary care delivery in changing organizational dynamics: a grounded theory study.","authors":"Elisabetta Mezzalira, Jessica Longhini, Elisa Ambrosi, Giulia Marini, Luisa Saiani, Achille Di Falco, Chiara Leardini, Federica Canzan","doi":"10.1017/S1463423625000210","DOIUrl":"10.1017/S1463423625000210","url":null,"abstract":"<p><strong>Introduction: </strong>Changing dynamics are pushing institutions to focus on care delivery innovation. To address the shortage of general practitioners (GPs), an Italian health district recently introduced a new primary care model called Primary Health Point (PHP) to provide primary integrated care to its population.</p><p><strong>Aim: </strong>To investigate the healthcare professionals' (HCPs) experience regarding the introduction of the PHP and to describe its process of care delivery.</p><p><strong>Methods: </strong>Qualitative study design with a grounded theory approach and convenience sampling. Interviews were conducted using a semi structured guide to explore the experience of HCPs working at the PHP. The development of open coding was followed by the creation of categories. The analysis was conducted utilizing NVivo software.</p><p><strong>Results: </strong>Twelve HCPs working at the PHP were interviewed and highlighted the model structure. The themes were <i>the context and the antecedents</i> that identified the most common health complaints and the patients with more needs and reflected on the traditional GP model; <i>the process,</i> which highlighted the complexity of interdisciplinary teamwork and the role of the Family and Community Nurse (FCN) in the new model; <i>the outcome</i> identified the factors mediating satisfaction with the care delivered by the PHP.</p><p><strong>Conclusions: </strong>The PHP has been considered a possible alternative to the GP model by its end users. It addresses disease pathway coordination, referrals, and medication management, focusing on chronic and older adult populations. It features interdisciplinary workflows with rotating physicians and consistent family nurse support. Proactive monitoring and a focus on disease education benefit fragile patients.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators influencing midwives' implementation of South Africa's maternal care guidelines in postnatal health: a scoping review.","authors":"Ngozichika Okeke, Roinah Ngunyulu","doi":"10.1017/S1463423625000015","DOIUrl":"10.1017/S1463423625000015","url":null,"abstract":"<p><strong>Introduction: </strong>The implementation of South Africa's maternal care guidelines is still subpar, especially during the postnatal periods, despite midwives playing a key part in postnatal care for women and their newborns. This article aimed to pinpoint the obstacles to and enablers of midwives' roles in putting South Africa's maternal care recommendations for postnatal health into practice.</p><p><strong>Method: </strong>A scoping review was conducted following Arksey and O'Malley method. Systematic searches were conducted using the PsycINFO, Nursing and Allied Health (CINAHL), PubMed, EBSCOhost web, and Google Scholar. The screening was guided by the inclusion and exclusion criteria. Data were analyzed using the Braun and Clarke method for thematic content analysis and included 22 articles. The quality of included studies was determined by Mixed Method Appraisal Tool and these were reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analysis for Scoping Review.</p><p><strong>Results: </strong>There is a gap between inadequate postnatal care services provision and suboptimal implementation of maternal recommendations. Owing to a lack of basic knowledge about the guidelines, an absence of midwives in the maternity units, inadequate facilities and resources, a lack of drive and support, inadequate training of midwives in critical competencies, and poor information sharing and communication. Maintaining qualified midwives in the maternity units and providing them with training to increase their capacity, knowledge, and competencies on the guidelines' critical information for managing postnatal complications and providing high-quality care to women and their babies is necessary to effectively implement the recommendations.</p><p><strong>Conclusion: </strong>The relative success in implementing maternal care guidelines in South Africa lies in the contextual consideration of these factors for the development of intersectoral healthcare packages, strengthening health system collaborations, and stakeholder partnerships to ameliorate maternal and newborn morbidity and mortality.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e16"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity effect of a community-based primary healthcare program on the incidence of childhood morbidity in rural Northern Ghana.","authors":"Edmund Wedam Kanmiki, Abdullah A Mamun, James F Phillips, Martin O'Flaherty","doi":"10.1017/S1463423625000106","DOIUrl":"10.1017/S1463423625000106","url":null,"abstract":"<p><strong>Background: </strong>Childhood morbidity is a precursor and contributor to under-five child mortality. Community-based primary healthcare programs are culturally responsive and low-cost strategies for delivering maternal and child health services in rural communities.</p><p><strong>Aim: </strong>To evaluate the equity effect of the Ghana Essential Health Intervention Program (GEHIP) - a five-year community-based primary healthcare program - on childhood morbidity.</p><p><strong>Methods: </strong>GEHIP was implemented in the Upper East region of Northern Ghana. Household baseline and end line surveys conducted in 2010/2011 and 2014/2015, respectively, from both intervention and comparison districts were used to assess three childhood morbidity conditions: maternal recall of neonatal illness, the incidence of diarrhoea, and fever. Difference-in-differences analysis, mean comparison test, and multivariate logistic regressions are used to assess the effect of GEHIP exposure on these three childhood morbidity conditions.</p><p><strong>Results: </strong>Baseline sample data of 2,911 women and end line sample of 2,829 women were included in this analysis. There was generally more reduction in all three childhood morbidity conditions in intervention communities relative to comparison communities. Diarrhoea and fever had a statistically significant treatment effect (AOR = 0.95, p-value<0.01 and AOR = 0.94, p-value<0.001). Results of equity analysis indicate significant mean reductions for both the poor and non-poor for neonatal illness and diarrhea, while only the intervention group had a significant reduction for both poor and non-poor for fever. Regression analysis shows no significant equity/inequity effects of GEHIP on the incidence of diarrhoea and fever. Neonatal illness, however, shows significant effects of wealth within the intervention group.</p><p><strong>Conclusion: </strong>This study shows that GEHIP contributed significantly to childhood morbidity reduction. This implies that community-based strategies have the potential to improve child health and contribute to the attainment of the United Nations sustainable development goal related to child health. Specific targeted measures are recommended to ensure both the poor and relatively better-off benefit from interventions.</p>","PeriodicalId":74493,"journal":{"name":"Primary health care research & development","volume":"26 ","pages":"e23"},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11883786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}