Scaling up integration of health services

Ferenchick, Erin; Rasanathan, Kumanan; Polanco, Núria Toro; Bornemisza, Olga; Kelley, Edward; Mangiaterra, Viviana

doi:10.1016/s0140-6736(18)30020-5

Cited by 7 publications

(6 citation statements)

References 7 publications

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“…1,2 In this way, several studies have been done to document evidence about the relevance of Alma Ata Declaration in the context of developing countries. [3][4][5][6][7][8][9][10][11][12] Primary health care (PHC) are essential services based on practical, evidence-based, socially and religiously acceptable, and scientifically approved processes, made accessible uniformly to populations at an affordable cost. 13 Furthermore, PHC is the initial level of contact for individuals and community by bringing health care services as near as possible to places where people live and work and develops the first component of the continuous and preventive health care process.…”

Section: Introductionmentioning

confidence: 99%

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Challenges and Patterns of Seeking Primary Health Care in Slums of Karachi: A Disaster Lurking in Urban Shadows

Aleemi

Khaliqui

Faisal

2018

Asia Pac J Public Health

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This study aimed to evaluate the challenges and patterns of seeking primary health care services in slums of Karachi, where about 60% of the population lives in various informal settlements. We surveyed 8 largest slums of the metropolitan, and analyzed the data both descriptively and inferentially to evaluate the factors associated with health care seeking behavior. Significantly positive association of quality health care seeking behavior and various socioeconomic indicators were found. In addition, substantial insights about the conditions of slum dwellers and health challenges of the population, such as low immunization and low vaccinations, among others, were reported. Thus, the role of policymakers is emphasized to strategize for the inclusion of these people in national health plans and to develop health infrastructure near these communities. Furthermore, there is a strong need to increase awareness of the population about hygiene practices, importance of immunization, and importance of utilizing appropriate health care services.

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Section: Introductionmentioning

confidence: 99%

“…1,2 In this way, several studies have been done to document evidence about the relevance of Alma Ata Declaration in the context of developing countries. 3-12…”

Section: Introductionmentioning

confidence: 99%

Challenges and Patterns of Seeking Primary Health Care in Slums of Karachi: A Disaster Lurking in Urban Shadows

Aleemi

Khaliqui

Faisal

2018

Asia Pac J Public Health

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“…The first component focused on what has been the main policy and implementation space for primary health care since Alma-Ata: primary care, ideally delivered as close as possible to where people live through a people-centred approach. 3 , 25 The Astana Declaration also highlighted the need for essential public health functions to be seen as an integral part of primary health care. These functions include health promotion and surveillance, and preparedness and response for health emergencies including outbreaks.…”

Section: Primary Health Care At Astanamentioning

confidence: 99%

“…2 None of these principles have lost their relevance over time. 3 The Alma-Ata Declaration’s influence and canonical status in public health are unmatched by almost any other text, and certainly in comparison with the many declarations, statements and resolutions issued each year by the global health community.…”

Section: Introductionmentioning

confidence: 99%

Primary health care, the Declaration of Astana and COVID-19

Rasanathan¹

2020

Bull. World Health Organ.

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Four decades after the Declaration of Alma-Ata, its vision of health for all and strategy of primary health care are still an inspiration to many people. In this article we evaluate the current status of primary health care in the era of the Declaration of Astana, the sustainable development goals, universal health coverage and the coronavirus disease 2019 pandemic. We consider how best to guide greater application of the primary health care strategy, reflecting on tensions that remain between the political vision of primary health care and its implementation in countries. We also consider what is required to support countries to realize the aspirations of primary health care, arguing that national needs and action must dominate over global preoccupations. Changing contexts and realities need to be accommodated. A clear distinction is needed between primary health care as an inspirational vision and set of values for health development, and primary health care as policy and implementation space. To achieve this vision, political action is required. Stakeholders beyond the health sector will often need to lead, which is challenging because the concept of primary health care is poorly understood by other sectors. Efforts on primary health care as policy and implementation space might focus explicitly on primary care and the frontline of service delivery with clear links and support to complementary work on social determinants and building healthy societies. Such efforts can be partial but important implementation solutions to contribute to the much bigger political vision of primary health care.

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“…The concept of integrated care is not new but has been reinvigorated in the global push towards Universal Health Coverage and the Sustainable Development Goals 9 12. These global goals have stimulated dialogue about new approaches to healthcare delivery, including how to decrease fragmentation and increase efficiency via integration 13 14. These discussions about shifting from disease-specific programmes towards integrated services also have particular salience given the growing burden of NCDs, which may require more complex and often lifelong care 3 15…”

Section: Introductionmentioning

confidence: 99%

Integrated care experiences and out-of-pocket expenditures: a cross-sectional survey of adults receiving treatment for HIV and hypertension in Malawi

Moucheraud

Hing

Seleman³

et al. 2020

BMJ Open

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ObjectivesAs HIV-positive individuals’ life expectancy extends, there is an urgent need to manage other chronic conditions during HIV care. We assessed the care-seeking experiences and costs of adults receiving treatment for both HIV and hypertension in Malawi.Design, setting and participantsA cross-sectional survey was conducted with HIV-positive adults with hypertension at a health facility in Lilongwe that offers free HIV care and free hypertension screening, with antihypertensives available for purchase (n=199). Questions included locations and costs of all medication refills and preferences for these refill locations. Respondents were classified as using ‘integrated care’ if they refilled HIV and antihypertensive medications simultaneously. Data were collected between June and December 2017.ResultsOnly half of respondents reported using the integrated care offered at the study site. Among individuals using different locations for antihypertensive medication refills, the most frequent locations were drug stores and public sector health facilities which were commonly selected due to greater convenience and lower medication costs. Although the number of antihypertensive medications was equivalent between the integrated and non-integrated care groups, the annual total cost of care differed substantially (approximately US$21 in integrated care vs US$90 for non-integrated care)—mainly attributable to differences in other visit costs for non-integrated care (transportation, lost wages, childcare). One-third of those in the non-integrated care group reported no expenditure for antihypertensive medication, and six people in each group reported no annual hypertension care-seeking costs at all.ConclusionsIndividuals using integrated care saw efficiencies because, although they were more likely to pay for antihypertensive medications, they did not incur additional costs. These results suggest that preferences and experiences must be better understood to design effective policies and programmes for integrated care among adults on antiretroviral therapy.

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Scaling up integration of health services

Cited by 7 publications

References 7 publications

Challenges and Patterns of Seeking Primary Health Care in Slums of Karachi: A Disaster Lurking in Urban Shadows

Challenges and Patterns of Seeking Primary Health Care in Slums of Karachi: A Disaster Lurking in Urban Shadows

Primary health care, the Declaration of Astana and COVID-19

Integrated care experiences and out-of-pocket expenditures: a cross-sectional survey of adults receiving treatment for HIV and hypertension in Malawi

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