Facilitators and barriers of service utilization: Perspectives of stakeholders in a family health center of central Kerala - A qualitative study

Vijayan, Sajna Mathumkunnath; Puliyakkadi, Safa; Chalil, Swathi

doi:10.4103/ijph.ijph_995_20

Cited by 9 publications

(7 citation statements)

References 1 publication

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Section: Discussionsupporting

confidence: 78%

“…Unlike other Indian states where maternal and child health services delivered through CHWs are a priority, Kerala with its achievements in improved maternal and child health outcomes can focus the job role of CHWs more towards NCD and palliative care services. The primary care reforms in Kerala recognised this role of CHWs, and their work in the forefront of the public health system appears to have improved the quality of health services and community uptake of government health services, which is reported in our study and similar studies conducted in Kerala post the PHC reforms (45,46). The dedicated work done by CHWs of Kerala during the COVID-19 pandemic in delivering essential health services, surveillance of cases, and psychosocial support to the community as narrated by our study participants is consistent with news reports and studies that describe the role of CHWs during the COVID-19 pandemic in detail (47-50).…”

Section: Discussionsupporting

confidence: 75%

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The role(s) of community health workers in primary health care reform in Kerala, before and during the COVID 19 pandemic: a qualitative study

Sankar D,

Joseph,

Benny

et al. 2024

Front. Health Serv.

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BackgroundAccredited Social Health Activists (ASHA) are Community Health Workers (CHWs) employed by the National Health Mission of the Government of India to link the population to health facilities and improve maternal and child health outcomes in the country. The government of Kerala launched primary health reform measures in 2016 whereby Primary Health Centres (PHCs) were upgraded to Family Health Centres (FHCs). The COVID-19 pandemic in 2020 impacted essential health service delivery, including primary care services. The CHWs network of Kerala played a crucial role in implementing the primary care reforms and COVID-19 management efforts that followed. We carried out a study to understand the perspectives of the CHWs in Kerala about their role in the recent primary healthcare reforms and during the COVID-19 pandemic management efforts.MethodsWe conducted in-depth interviews (IDI) with 16 ASHAs from 8 primary care facilities in Kerala from July to October 2021. We further conducted Focus Group Discussions (FGDs) (N = 34) with population subgroups in these eight facility catchment areas and asked their opinion about the ASHAs working in their community. We obtained written informed consent from all the participants, and interview transcripts were thematically analysed by a team of four researchers using ATLAS.ti 9 software.ResultsOur study participants were women aged about 45 years with over 10 years of work experience as CHWs. Their job responsibilities as a frontline health worker helped them build trust in the community and local self-governments. CHWs were assigned roles of outpatient crowd management, and registration duties in FHCs. The COVID-19 pandemic increased their job roles manifold. Community members positively mentioned the home visits, delivery of medicines, and emotional support offered by the CHWs during the pandemic. The CHWs noted that the honorarium of INR 6,000 (US$73) was inconsistent and very low for the volume of work done.ConclusionThe CHWs in Kerala play a crucial role in primary care reforms and COVID-19 management. Despite their strong work ethic and close relationship with local self-governments, low and irregular wages remain the biggest challenge.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 75%

The role(s) of community health workers in primary health care reform in Kerala, before and during the COVID 19 pandemic: a qualitative study

Sankar D,

Joseph,

Benny

et al. 2024

Front. Health Serv.

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“…8 Similarly, a study conducted in Kerala reported that good behaviour of healthcare workers, improved infrastructure and clean premises and subsidised laboratory services were quoted as facilitators to using services provided at a family healthcare centre. 16 In another study, conducted in Mumbai, trust over providers (31.5%), proximity to home (20%), staff availability (12.7%), good-quality treatment (10.2%) and time-efficient services (8%) were cited as reasons for the utilisation of services from an urban healthcare centre. 17 …”

Section: Discussionmentioning

confidence: 99%

Utilisation of services provided at an outreach healthcare facility and its associated factors among residents in a coastal taluk of southern Karnataka: A cross-sectional study

Sudhakaran,

Mallya,

Pandey

et al. 2024

Malays Fam Physician

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Introduction: Understanding the patterns of utilisation of primary health services can help to improve service delivery and utilisation, thereby reducing common morbidities in the community. The study aimed to assess the patterns of utilisation of services provided at an outreach healthcare centre. Methods: A community-based survey was conducted among families residing in the field practice area of an outreach centre for more than a year. Data were collected using a questionnaire administered to adults aged ≥18 years. Collected data were entered into and analysed using the Statistical Package for the Social Sciences version 16.0. Results: Approximately 65.1% of the respondents were aged 31–59 years, and 67.4% were women. Among 126 surveyed households, 50.7% had utilised services from the outreach centre. The facilitators of utilisation among 64 households included proximity to their area of residence (90.6%) and availability of good-quality services (40.6%). The most common barriers included a lack of awareness (30.9%) and inconvenient timings (18.2%) of the healthcare centre. The respondents aged <18 years (odds ratio [OR]=7.64; 95% confidence interval [CI]=4.37–13.37) and >45 years (OR=2.65; 95% CI=1.57–4.47) had higher odds of utilising services than those aged 18–45 years. The female respondents (OR=2.89; 95% CI=1.86–4.51) were more likely to utilise services than the male respondents. Conclusion: Creating awareness regarding the outreach healthcare centre and designing services based on the observed needs of the community can further improve the utilisation of services provided at the healthcare centre.

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“…Informasi lain yang juga didapat yaitu berupa pendapat petugas kesehatan mengenai insentif petugas kesehatan. Sebagian petugas kesehatan dalam menjalankan tugas merasa tidak memperoleh uang transport (31). Oleh sebab itu sudah sewajarnya petugas kesehatan memperoleh insentif sesuai kebutuhan mereka di dalam kerja di luar kantor.…”

Section: Pengaruh Insentif Tenaga Kesehatan Terhadap Akreditasi Puske...unclassified

Determinan Kinerja Tenaga Kesehatan terhadap Akreditasi Puskesmas Sosopan Kecamatan Sosopan Kabupaten Padang Lawas

Ikrima Daulay,

Haslinah Ahmad,

Owildan Wisudawan B

et al. 2024

Media Publ. Promosi Kesehat. Indones

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Latar belakang: Akreditasi Puskesmas merupakan suatu proses penting yang menilai dan menjamin mutu layanan kesehatan yang disediakan oleh Puskesmas. Kinerja tenaga kesehatan di Puskesmas menjadi faktor kunci dalam mencapai standar yang diperlukan untuk memperoleh akreditasi. Tujuan: Penelitian ini bertujuan untuk menganalisis determinan kinerja tenaga kesehatan terhadap akreditasi Puskesmas Sosopan Kecamatan Sosopan Kabupaten Padang Lawas. Metode: Jenis penelitian observasional dengan desain cross sectional study. Penelitian dilakukan di Puskesmas Sosopan Kecamatan Sosopan Kabupaten Padang Lawas selama Desember 2023 sampai dengan Januari 2024. Populasi dan sampel adalah seluruh tenaga kesehatan yang bekerja di Puskesmas Sosopan sebanyak 65 orang dan pengambilan sampel secara total sampel (exhaustic sampling). Pengumpulan data dengan menggunakan instrument penelitian berupa kuesioner penelitian yang diberikan kepada sampel serta pengolahan dan analisis data menggunakan analisis deskriptif, uji chi-square dan regresi logistik. Hasil: Penelitian diperoleh bahwa motivasi (p=0,001), insentif (p=0,001), pelatihan (p=0,001), penghargaan (p=0,008), masa kerja (p=0,002), sarana dan prasarana (p=0,006) berpengaruh terhadap akreditasi Puskesmas Sosopan. Sedangkan variabel yang paling berpengaruh adalah insentif dengan nilai Exp (B)= 7,033. Kesimpulan: Akreditasi puskesmas dipengaruhi oleh faktor motivasi, insentif, pelatihan, penghargaan, masa kerja dan sarana prasarana sehingga diperlukan dinas kesehatan memfasilitasi pegawai puskesmas untuk mengikuti pelatihan untuk akreditasi.

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Facilitators and barriers of service utilization: Perspectives of stakeholders in a family health center of central Kerala - A qualitative study

Cited by 9 publications

References 1 publication

The role(s) of community health workers in primary health care reform in Kerala, before and during the COVID 19 pandemic: a qualitative study

The role(s) of community health workers in primary health care reform in Kerala, before and during the COVID 19 pandemic: a qualitative study

Utilisation of services provided at an outreach healthcare facility and its associated factors among residents in a coastal taluk of southern Karnataka: A cross-sectional study

Determinan Kinerja Tenaga Kesehatan terhadap Akreditasi Puskesmas Sosopan Kecamatan Sosopan Kabupaten Padang Lawas

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