Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015

Malaz Elbashir Ahmed; Khalid Fadl Alla Khalid; Talal Elfadil Mahi; Nada Jafar Osman; Ibrahim Ismail Mohammed Abu; Nada Mohamed Ali Alnair; Rania Hassan Abdelgfour

doi:doi:10.11648/j.sjph.20190702.15

Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015

Malaz Elbashir Ahmed, Khalid Fadl Alla Khalid, Talal Elfadil Mahi, Nada Jafar Osman, Ibrahim Ismail Mohammed Abu, Nada Mohamed Ali Alnair, Rania Hassan Abdelgfour

Published in Science Journal of Public Health (Volume 7, Issue 2)

Received: 24 September 2018 Accepted: 8 April 2019 Published: 27 May 2019

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Sudan public sectors’ has three levels of services delivery: primary, secondary and tertiary care. Primary level intended for health facilities that provide the basic package of health services and supposed to be the first contact for seeking medical help, advices and referral to high specialized services. Therefore, coordination between these three levels is important. As well as bypassing primary care level results in overburdening of referral facilities, increasing cost for the patients and depreciating health care system in terms of manpower, equipment and resources. Information about the health services utilizations’ and it’s the associated factors will be useful for improving service delivery to achieve universal health coverage. This paper intended to explore the experiences of caretakers seeking care for their under-five children related in public PHC facilities in Sharg-Alneel Locality, 2015. The study was descriptive cross-sectional applied qualitative research methods. Focus group discussions were conducted with caretakers who had experience with PHC services. Qualitative data was manually analyzed using thematic content analysis. This paper revealed that the main reasons that force the respondents to bypass the primary health facilities and seek care directly from the hospitals were related to the quality of the provided services. Accessibility issues, affordability issues, lack of knowledge of existing services, inadequacy of drugs, health staff competency and proper referrals system which is crucial to a functioning PHC, also reported to be lacking. Also, in this paper the respondents recommend the expansion of health insurance services coverage, provision of ambulances to all PHC facilities. Therefore, this paper recommends to educate and sensitize the individuals, families and community on PHC services role as the first line of health services to increase their knowledge and create awareness of services provided at the PHC facilities. This will increase demand for and improve access to PHC services. Also, to strengthen the implementation and facilitate the monitoring and evaluation by the authorities at the different levels. To enhance role of health insurance fund as purchaser rather than services provider and breach of free health care policy jeopardized affordability of PHC services need urgent actions, and continuous professional development for the PHC healthcare providers which will contribute in improving performance and providing quality PHC, and building their capacity on management of the under-5 common illness and by strengthen the supportive supervision and monitoring.

Published in	Science Journal of Public Health (Volume 7, Issue 2)
DOI	10.11648/j.sjph.20190702.15
Page(s)	59-65
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Primary Health Care, Service Delivery Levels, Factors Associated with Bypassing Behaviour, Caretakers Experience, Adequacy of Services, Referral System, Quality Primary Health Care Services

References

[1]	FMOH: National Health Sector Strategic Plan 2012-2016. Khartoum: Policy and Planning Unit 2011.
[2]	FMOH: Primary Health Care Revitalization Strategy. Khartoum: Directorate General for PHC and Preventive Medicine 2009.
[3]	FMOH: National Human Resources for Health Strategic Plan for Sudan. Khartoum: Directorate General of Human Resources for Health Development 2011.
[4]	FMOH: Specifications and standards for the health system in Sudan, Part II: Document of Characterization of services and health units. Khartoum: Policy and Planning Unit 2010.
[5]	FMOH: Promoting access to high quality primary health care services in Sudan (policy brief). Khartoum: Policy and Planning Unit 2011.
[6]	FMOH: Knowledge, Attitudes and Practices (KAP) in the Sudanese communities for their health seeking behavior: Policy and Planning Unit 2011.
[7]	WHO: Referral Systems - a summary of key processes to guide health services managers. Geneva: World Health Organization no date.
[8]	Robin Gauld et al: The World Health Report 2008–Primary Healthcare: How Wide Is the Gap between Its Agenda and Implementation in 12 High-Income Health Systems?, HEALTHCARE POLICY 2012, 7 (3).
[9]	Coulter A, Bradlow J: Effect ofNHSreforms on general practitioners' referral patterns. British Medical Journal 1993; 306:433.
[10]	Grol R M, Faber G, Voerman J, Burgers and S. Leatherman: “Primary Care in the 21st Century: What Can Be Learned from the Netherlands?” Paper under review 2010.
[11]	KSMOH: referral system, Khartoum state experience. Khartoum: Directorate General for curative Medicine 2014.
[12]	WHO: Reduction of child mortality in the Eastern Mediterranean Region. Geneva: World Health Organization 2012.
[13]	Deogaonkar M: Socio-economic inequality and its effect on health care delivery in India: Inequality and health care. Electronic Journal of Sociology 2004.
[14]	Herman E, Black RE, Wahba S, Khallaf N: Developing strategies to encourage appropriate care-seeking for children with acute respiratory infections: an example from Egypt. Int J Health Plann Manage 1994, 9: 235–243.
[15]	Thind A: Analysis of health services use for respiratory illness in Indonesian children: implications for policy. J BiosocSci2005, 37: 129–142.
[16]	FMOH: National Maternal and Child Health Strategic Plan 2012-2016. Khartoum: Directorate General for PHC and Preventive Medicine 2011.
[17]	Kahabuka et al.: Why caretakers bypass Primary Health Care facilities for child care - a case from rural Tanzania. BMC Health Services Research 2011, 11:315.
[18]	Kahabuka et al.: Unfulfilled expectations to services offered at primary health care facilities: Experiences of caretakers of under-five children in rural Tanzania. BMC Health Services Research 2012, 12:158.
[19]	Wu D, Lam TP. Underuse of Primary Care in China: The Scale, Causes, and Solutions. JABFM 2016, Vol. 29 No.
[20]	Audo MO, Ferguson A, Njoroge PK: Quality of health care and its effects in the utilization of maternal and child health services in Kenya. East Afr Med J 2006, 82(11).
[21]	Dong et al: Focus on vulnerable populations andpromoting equity in health service utilization ––an analysis of visitorcharacteristics and service utilization of the Chinese community healthservice. BMC Public Health 2014, 14:503.
[22]	Tsukahara T., The Choice of Healthcare Providers for Febrile Children after Introducing Non-professional Health Workers in a Malaria Endemic Area in Papua New Guinea. 2015; 3:275.
[23]	Wolkite Olani Abdi, Waju Beyene Salgedo, Gebeyehu Tsega Nebeb. Magnitude and Determinants of Self-Referral of Patients at a General Hospital, Western Ethiopia. Science Journal of Clinical Medicine 2015; 4:5, 86-92.
[24]	FMOH: Free healthcare policy for under-fives and pregnant women in northern Sudan: findings of a review. Khartoum: directorate general of planning and international health 2011.
[25]	Mæstad O, Mwisongo A, Institute CM: Informal payments and the quality of health care in Tanzania: results from qualitative research. Chr. Michelsen institute (CMI) 2007.
[26]	Peters D H, Garg A, Bloom G, Walker DG, BriegerWR, Rahman M. H: Poverty and access to health care in developing countries. Annals Of The New York Academy Of Sciences 2008; 1136:8, 161-171.
[27]	Khalid. F. K, Samia. Y. I. H, Nada. J. O, Malaz. E. A, Rania. H. A Factors Affecting Patient’s Satisfaction with Provided Sexually Transmitted Infections Primary Health Care Service in El-Damazin Locality at Blue Nile State, Sudan 2015 - 2016, World Journal of Public Health. Vol. 3, No. 3, 2018, pp. 93-98. doi: 10.11648/j.wjph.20180303.14
[28]	WHO: Referral Systems - a summary of key processes to guide health services managers. Geneva: World Health Organization no date.
[29]	Peter Berman, Fatma El Zanaty, Healthcare Utilization and expenditure in the ARE. Harved University for decision making project.
[30]	Sadok. J. M. Marketing Patients the best marketing spokespeople. Hosp Mater Manage Q, Nov. 1990; 13 (2):pp. 18-21.
[31]	Peters D H, Garg A, Bloom G, WalkerDG, Brieger WR, Rahman M. H: Poverty and access to health care in developing countries. Annals Of The New York Academy Of Sciences 2008; 1136:8, 161-171.

Cite This Article

Plain Text BibTeX RIS

APA Style

Malaz Elbashir Ahmed, Khalid Fadl Alla Khalid, Talal Elfadil Mahi, Nada Jafar Osman, Ibrahim Ismail Mohammed Abu, et al. (2019). Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015. Science Journal of Public Health, 7(2), 59-65. https://doi.org/10.11648/j.sjph.20190702.15

Copy | Download

ACS Style

Malaz Elbashir Ahmed; Khalid Fadl Alla Khalid; Talal Elfadil Mahi; Nada Jafar Osman; Ibrahim Ismail Mohammed Abu, et al. Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015. Sci. J. Public Health 2019, 7(2), 59-65. doi: 10.11648/j.sjph.20190702.15

Copy | Download

AMA Style

Malaz Elbashir Ahmed, Khalid Fadl Alla Khalid, Talal Elfadil Mahi, Nada Jafar Osman, Ibrahim Ismail Mohammed Abu, et al. Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015. Sci J Public Health. 2019;7(2):59-65. doi: 10.11648/j.sjph.20190702.15

Copy | Download

@article{10.11648/j.sjph.20190702.15,
  author = {Malaz Elbashir Ahmed and Khalid Fadl Alla Khalid and Talal Elfadil Mahi and Nada Jafar Osman and Ibrahim Ismail Mohammed Abu and Nada Mohamed Ali Alnair and Rania Hassan Abdelgfour},
  title = {Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015},
  journal = {Science Journal of Public Health},
  volume = {7},
  number = {2},
  pages = {59-65},
  doi = {10.11648/j.sjph.20190702.15},
  url = {https://doi.org/10.11648/j.sjph.20190702.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20190702.15},
  abstract = {Sudan public sectors’ has three levels of services delivery: primary, secondary and tertiary care. Primary level intended for health facilities that provide the basic package of health services and supposed to be the first contact for seeking medical help, advices and referral to high specialized services. Therefore, coordination between these three levels is important. As well as bypassing primary care level results in overburdening of referral facilities, increasing cost for the patients and depreciating health care system in terms of manpower, equipment and resources. Information about the health services utilizations’ and it’s the associated factors will be useful for improving service delivery to achieve universal health coverage. This paper intended to explore the experiences of caretakers seeking care for their under-five children related in public PHC facilities in Sharg-Alneel Locality, 2015. The study was descriptive cross-sectional applied qualitative research methods. Focus group discussions were conducted with caretakers who had experience with PHC services. Qualitative data was manually analyzed using thematic content analysis. This paper revealed that the main reasons that force the respondents to bypass the primary health facilities and seek care directly from the hospitals were related to the quality of the provided services. Accessibility issues, affordability issues, lack of knowledge of existing services, inadequacy of drugs, health staff competency and proper referrals system which is crucial to a functioning PHC, also reported to be lacking. Also, in this paper the respondents recommend the expansion of health insurance services coverage, provision of ambulances to all PHC facilities. Therefore, this paper recommends to educate and sensitize the individuals, families and community on PHC services role as the first line of health services to increase their knowledge and create awareness of services provided at the PHC facilities. This will increase demand for and improve access to PHC services. Also, to strengthen the implementation and facilitate the monitoring and evaluation by the authorities at the different levels. To enhance role of health insurance fund as purchaser rather than services provider and breach of free health care policy jeopardized affordability of PHC services need urgent actions, and continuous professional development for the PHC healthcare providers which will contribute in improving performance and providing quality PHC, and building their capacity on management of the under-5 common illness and by strengthen the supportive supervision and monitoring.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015
AU  - Malaz Elbashir Ahmed
AU  - Khalid Fadl Alla Khalid
AU  - Talal Elfadil Mahi
AU  - Nada Jafar Osman
AU  - Ibrahim Ismail Mohammed Abu
AU  - Nada Mohamed Ali Alnair
AU  - Rania Hassan Abdelgfour
Y1  - 2019/05/27
PY  - 2019
N1  - https://doi.org/10.11648/j.sjph.20190702.15
DO  - 10.11648/j.sjph.20190702.15
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 59
EP  - 65
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20190702.15
AB  - Sudan public sectors’ has three levels of services delivery: primary, secondary and tertiary care. Primary level intended for health facilities that provide the basic package of health services and supposed to be the first contact for seeking medical help, advices and referral to high specialized services. Therefore, coordination between these three levels is important. As well as bypassing primary care level results in overburdening of referral facilities, increasing cost for the patients and depreciating health care system in terms of manpower, equipment and resources. Information about the health services utilizations’ and it’s the associated factors will be useful for improving service delivery to achieve universal health coverage. This paper intended to explore the experiences of caretakers seeking care for their under-five children related in public PHC facilities in Sharg-Alneel Locality, 2015. The study was descriptive cross-sectional applied qualitative research methods. Focus group discussions were conducted with caretakers who had experience with PHC services. Qualitative data was manually analyzed using thematic content analysis. This paper revealed that the main reasons that force the respondents to bypass the primary health facilities and seek care directly from the hospitals were related to the quality of the provided services. Accessibility issues, affordability issues, lack of knowledge of existing services, inadequacy of drugs, health staff competency and proper referrals system which is crucial to a functioning PHC, also reported to be lacking. Also, in this paper the respondents recommend the expansion of health insurance services coverage, provision of ambulances to all PHC facilities. Therefore, this paper recommends to educate and sensitize the individuals, families and community on PHC services role as the first line of health services to increase their knowledge and create awareness of services provided at the PHC facilities. This will increase demand for and improve access to PHC services. Also, to strengthen the implementation and facilitate the monitoring and evaluation by the authorities at the different levels. To enhance role of health insurance fund as purchaser rather than services provider and breach of free health care policy jeopardized affordability of PHC services need urgent actions, and continuous professional development for the PHC healthcare providers which will contribute in improving performance and providing quality PHC, and building their capacity on management of the under-5 common illness and by strengthen the supportive supervision and monitoring.
VL  - 7
IS  - 2
ER  -

Copy | Download

Author Information

Malaz Elbashir Ahmed

Free Lance Community Medicine Consultant, Khartoum, Sudan
Khalid Fadl Alla Khalid

HIV Prevention Program, United Nations Population Fund, Khartoum, Sudan
Talal Elfadil Mahi

Community Medicine, National Health Insurance Fund, Khartoum, Sudan
Nada Jafar Osman

Community Medicine, Primary Health Care Directorate, Federal Ministry of Health, Khartoum, Sudan
Ibrahim Ismail Mohammed Abu

Community Medicine Department, Faculty of Medicine, Al-Fashir University, Al-Fashir, Sudan; Community Medicine Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Nada Mohamed Ali Alnair

Continuous Professional Development Directorate, Federal Ministry of Health, Khartoum, Sudan
Rania Hassan Abdelgfour

HIV Prevention Program, United Nations Population Fund, Khartoum, Sudan

Download PDF

Sections

Plain Text BibTeX RIS

APA Style

Malaz Elbashir Ahmed, Khalid Fadl Alla Khalid, Talal Elfadil Mahi, Nada Jafar Osman, Ibrahim Ismail Mohammed Abu, et al. (2019). Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015. Science Journal of Public Health, 7(2), 59-65. https://doi.org/10.11648/j.sjph.20190702.15

Copy | Download

ACS Style

Malaz Elbashir Ahmed; Khalid Fadl Alla Khalid; Talal Elfadil Mahi; Nada Jafar Osman; Ibrahim Ismail Mohammed Abu, et al. Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015. Sci. J. Public Health 2019, 7(2), 59-65. doi: 10.11648/j.sjph.20190702.15

Copy | Download

AMA Style

Malaz Elbashir Ahmed, Khalid Fadl Alla Khalid, Talal Elfadil Mahi, Nada Jafar Osman, Ibrahim Ismail Mohammed Abu, et al. Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015. Sci J Public Health. 2019;7(2):59-65. doi: 10.11648/j.sjph.20190702.15

Copy | Download

@article{10.11648/j.sjph.20190702.15,
  author = {Malaz Elbashir Ahmed and Khalid Fadl Alla Khalid and Talal Elfadil Mahi and Nada Jafar Osman and Ibrahim Ismail Mohammed Abu and Nada Mohamed Ali Alnair and Rania Hassan Abdelgfour},
  title = {Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015},
  journal = {Science Journal of Public Health},
  volume = {7},
  number = {2},
  pages = {59-65},
  doi = {10.11648/j.sjph.20190702.15},
  url = {https://doi.org/10.11648/j.sjph.20190702.15},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.sjph.20190702.15},
  abstract = {Sudan public sectors’ has three levels of services delivery: primary, secondary and tertiary care. Primary level intended for health facilities that provide the basic package of health services and supposed to be the first contact for seeking medical help, advices and referral to high specialized services. Therefore, coordination between these three levels is important. As well as bypassing primary care level results in overburdening of referral facilities, increasing cost for the patients and depreciating health care system in terms of manpower, equipment and resources. Information about the health services utilizations’ and it’s the associated factors will be useful for improving service delivery to achieve universal health coverage. This paper intended to explore the experiences of caretakers seeking care for their under-five children related in public PHC facilities in Sharg-Alneel Locality, 2015. The study was descriptive cross-sectional applied qualitative research methods. Focus group discussions were conducted with caretakers who had experience with PHC services. Qualitative data was manually analyzed using thematic content analysis. This paper revealed that the main reasons that force the respondents to bypass the primary health facilities and seek care directly from the hospitals were related to the quality of the provided services. Accessibility issues, affordability issues, lack of knowledge of existing services, inadequacy of drugs, health staff competency and proper referrals system which is crucial to a functioning PHC, also reported to be lacking. Also, in this paper the respondents recommend the expansion of health insurance services coverage, provision of ambulances to all PHC facilities. Therefore, this paper recommends to educate and sensitize the individuals, families and community on PHC services role as the first line of health services to increase their knowledge and create awareness of services provided at the PHC facilities. This will increase demand for and improve access to PHC services. Also, to strengthen the implementation and facilitate the monitoring and evaluation by the authorities at the different levels. To enhance role of health insurance fund as purchaser rather than services provider and breach of free health care policy jeopardized affordability of PHC services need urgent actions, and continuous professional development for the PHC healthcare providers which will contribute in improving performance and providing quality PHC, and building their capacity on management of the under-5 common illness and by strengthen the supportive supervision and monitoring.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Experiences of Caretakers Seeking Care for Their Under-five Children Related to Public Primary Health Care in Sharg-Alneel Locality, 2015
AU  - Malaz Elbashir Ahmed
AU  - Khalid Fadl Alla Khalid
AU  - Talal Elfadil Mahi
AU  - Nada Jafar Osman
AU  - Ibrahim Ismail Mohammed Abu
AU  - Nada Mohamed Ali Alnair
AU  - Rania Hassan Abdelgfour
Y1  - 2019/05/27
PY  - 2019
N1  - https://doi.org/10.11648/j.sjph.20190702.15
DO  - 10.11648/j.sjph.20190702.15
T2  - Science Journal of Public Health
JF  - Science Journal of Public Health
JO  - Science Journal of Public Health
SP  - 59
EP  - 65
PB  - Science Publishing Group
SN  - 2328-7950
UR  - https://doi.org/10.11648/j.sjph.20190702.15
AB  - Sudan public sectors’ has three levels of services delivery: primary, secondary and tertiary care. Primary level intended for health facilities that provide the basic package of health services and supposed to be the first contact for seeking medical help, advices and referral to high specialized services. Therefore, coordination between these three levels is important. As well as bypassing primary care level results in overburdening of referral facilities, increasing cost for the patients and depreciating health care system in terms of manpower, equipment and resources. Information about the health services utilizations’ and it’s the associated factors will be useful for improving service delivery to achieve universal health coverage. This paper intended to explore the experiences of caretakers seeking care for their under-five children related in public PHC facilities in Sharg-Alneel Locality, 2015. The study was descriptive cross-sectional applied qualitative research methods. Focus group discussions were conducted with caretakers who had experience with PHC services. Qualitative data was manually analyzed using thematic content analysis. This paper revealed that the main reasons that force the respondents to bypass the primary health facilities and seek care directly from the hospitals were related to the quality of the provided services. Accessibility issues, affordability issues, lack of knowledge of existing services, inadequacy of drugs, health staff competency and proper referrals system which is crucial to a functioning PHC, also reported to be lacking. Also, in this paper the respondents recommend the expansion of health insurance services coverage, provision of ambulances to all PHC facilities. Therefore, this paper recommends to educate and sensitize the individuals, families and community on PHC services role as the first line of health services to increase their knowledge and create awareness of services provided at the PHC facilities. This will increase demand for and improve access to PHC services. Also, to strengthen the implementation and facilitate the monitoring and evaluation by the authorities at the different levels. To enhance role of health insurance fund as purchaser rather than services provider and breach of free health care policy jeopardized affordability of PHC services need urgent actions, and continuous professional development for the PHC healthcare providers which will contribute in improving performance and providing quality PHC, and building their capacity on management of the under-5 common illness and by strengthen the supportive supervision and monitoring.
VL  - 7
IS  - 2
ER  -

Copy | Download