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Ação educativa na Atenção Básica à Saúde de pessoas com diabetes mellitus e hipertensão arterial: avaliação e qualificação de estratégias com ênfase na educação nutricional; Educational action in basic health care of people with diabetes mellitus and hypertension: evaluation and qualification of strategies emphasizing nutrition education

Rezende, Ana Maria Bartels
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 01/06/2011 PT
Relevância na Pesquisa
66.05%
Introdução: As ações educativas são práticas inerentes ao projeto assistencial de saúde em todos os níveis de atenção, na perspectiva de empoderamento e emancipação das pessoas para atuar nos aspectos fundamentais de sua vida, como a alimentação. O diabetes mellitus e a hipertensão arterial estão entre os fatores de risco modificáveis para as doenças cardiovasculares, cujo controle associado a mudanças de estilo de vida pode ser estimulado no âmbito da Atenção Básica à Saúde, minimizando a morbimortalidade por essas doenças e o seu impacto na saúde pública. Objetivo: Analisar o processo educativo com ênfase na educação alimentar e nutricional para pessoas com diabetes mellitus e hipertensão arterial no âmbito da Atenção Básica à Saúde. Métodos: Estudo analítico-descritivo de natureza qualitativa, realizado entre profissionais de saúde e pessoas com diabetes mellitus e/ou hipertensão arterial acompanhadas em Unidade de Estratégia de Saúde da Família do município de Vitória- ES. Procedeu-se a coleta de depoimentos por meio de entrevistas semiestruturadas. Aplicou-se a técnica do Discurso do Sujeito Coletivo para a análise das percepções sobre os espaços, os sujeitos, os resultados e os desafios das ações educativas na promoção de práticas de vida e alimentares adequadas. As ideias centrais destacadas no material discursivo foram utilizadas como substrato para a qualificação dessas ações...

A Grounded Theory of Advance Directives and Guardianship Planning by People with HIV and AIDS

Sellers, Craig Robert ; Norton, Sally Ann
Fonte: Universidade de Rochester Publicador: Universidade de Rochester
Tipo: Tese de Doutorado
ENG
Relevância na Pesquisa
66.12%
Thesis (Ph.D.)--University of Rochester. School of Nursing. Dept. of Nursing, 2008.; Purpose To develop a grounded theory of how people with HIV and AIDS make plans for future health care. Background Although many people believe HIV/AIDS to be a chronic illness, most people with HIV/AIDS have not executed advance directives (ADs). ADs include living wills, health care proxies, and do-not-resuscitate orders. More people have considered ADs than have actually documented their wishes. Previous theory generation about how people with HIV/AIDS make AD decisions was limited to people who had already received an educational intervention to increase advance care planning. Methods In this qualitative study, HIV+ people 18 years or older with or without AIDS were sampled theoretically from among community-dwelling adults in western New York State. Verbatim transcriptions of audiotape-recorded in-depth individual interviews were analyzed using a grounded theory approach and the constant comparative method. Results A grounded theory of Advance Directives and Guardianship Planning by People with HIV and AIDS was constructed. A number of conditions affected an HIV+ person’s likelihood of making plans for the future: having already completed pre-existing plans...

Improving Primary Health Care Delivery in Nigeria : Evidence from Four States

World Bank
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
66.12%
This study aims mainly at understanding the performance of primary health care (PHC) providers in four Nigerian states and the variables driving this performance. The study is primarily based on quantitative surveys at the level of primary health care facilities, health care personnel, and households in their vicinity. These surveys were implemented in four states: Bauchi, Cross River, Kaduna, and Lagos. This study represents the second phase of the Nigeria Health, Nutrition, and Population Country Status Report (CSR). The first phase aimed at analyzing the health situation of the poor and how the health system was performing in terms of meeting their needs. This first phase identified PHC as the weakest chain in the entire health sector and the level of care the poor use the most. This second phase of the CSR is therefore focused on the analysis of the delivery of PHC services. In contrast to the first phase, this study is mainly based on primary data, data collected through facility, health personnel...

The Comparative Nature of Faith-Inspired Health Care Provision in Sub-Saharan Africa : Strengthening the Evidence for Faith-inspired Health Engagement in Africa, Volume 2

Olivier, Jill; Wodon, Quentin
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
66.05%
This role of faith-inspired health care providers in sub-saharan Africa and public-private partnerships is comprised of a three volume series on strengthening the evidence for faith inspired engagement in health in sub-Saharan Africa. An increasing level of interest in the role of faith in development has generated much debate and dialogue at the international and national levels over the last decade. Despite difficulties in communication and differences in cultures within such debates, there has been a continued reaffirmation of the potential benefits that faith-inspired communities can bring towards efforts to achieve the millennium development goals (MDGs), especially in the areas of health. This series focuses on assessing the role and market share of faith-inspired providers and on assessing the extent to which they are involved in and benefit from public-private partnerships. The purpose of this series of three HNP discussion papers is to round up various analytical perspectives and emerging research on faith engagement in health in Africa from a range of researchers and practitioners from the north as well as the south. The series is structured into three volumes: a first volume on the role and market share of faith-inspired providers and public-private partnerships...

The Role of Faith-inspired Health Care Providers in Sub-Saharan Africa and Public-Private Partnerships : Strengthening the Evidence for Faith-inspired Health Engagement in Africa, Volume 1

Olivier, Jill; Wodon, Quentin
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
66.07%
This role of faith-inspired health care providers in sub-saharan Africa and public-private partnerships is comprised of a three volume series on strengthening the evidence for faith inspired engagement in health in sub-Saharan Africa. An increasing level of interest in the role of faith in development has generated much debate and dialogue at the international and national levels over the last decade. Despite difficulties in communication and differences in cultures within such debates, there has been a continued reaffirmation of the potential benefits that faith-inspired communities can bring towards efforts to achieve the millennium development goals (MDGs), especially in the areas of health. This series focuses on assessing the role and market share of faith-inspired providers and on assessing the extent to which they are involved in and benefit from public-private partnerships. The purpose of this series of three HNP discussion papers is to round up various analytical perspectives and emerging research on faith engagement in health in Africa from a range of researchers and practitioners from the north as well as the south. The series is structured into three volumes: a first volume on the role and market share of faith-inspired providers and public-private partnerships...

Equity, Access to Health Care Services and Expenditures on Health in Nicaragua

Angel-Urdinola, Diego; Cortez, Rafael; Tanabe, Kimie
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
66.12%
Nicaragua has embarked on an ambitious health sector program, which has contributed to significant progress in the health sector over the past decade. Health indicators show gradual but steady improvements: access to basic services such as clean water and sanitation facilities has improved, as have other related performance indicators such as life expectancy, infant/child mortality, immunization rates, and child nutrition among others. Despite these achievements, there are still large inequities in access and quality of health services across socioeconomic groups and regions. Poor individuals living in rural areas (especially in the Central and Atlantic regions), the indigenous population, and individuals living in households engaged in agriculture have average access to health care services and preventive care. The lack of risk mitigation mechanisms such as insurance and social security is causing users in Nicaragua to spend, out-of-pocket, a significant share of their income on health care, especially to buy medications and other non-consultation items such as medical tests. Long distances...

Contracting for Reproductive Health Care : A Guide

Rosen, James E.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
66.06%
Government contracting of private organizations is an increasingly common tool to meet the growing demand for quality reproductive health care in developing nations. This guide brings together information about such contracting experiences in a way to serve the practical needs of World Bank staff and their government counterparts in developing countries interested in trying contracting. Contracting is not a cure-all for ailing health systems, and there exists relatively little systematic evaluation of the contracting experience in developing countries. Still, many in the field recognize the potential of contracting as a powerful tool to improve reproductive health care. This guide touches on some of the reasons why governments go the contracting route. The guide is meant to be used during the development of new projects or during the supervision phase, and assumes that the reader: has identified population and reproductive health as an issue for the health sector in a particular country or region; already has decided to include a reproductive health component in the loan and wants to involve the private sector actively in the project; is considering opportunities for contracting out of reproductive health care; or is looking for ideas and models for contracting.

Decentralization of Health Care in Brazil : A Case Study of Bahia

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
75.97%
This report is a case study analyzing key issues--coverage, equity, sustainability--faced by the Brazilian health system in the state of Bahia, in the context of national reforms geared to the decentralization of health care. Thus, the report examines the instruments and the incentives in the system to: 1) improve the coverage of the key health interventions that influence the basic health outcomes of the population; 2) reduce the inequality in the distribution of publicly financed health care; and 3)) improve the fianncial sustainability of the health sector through greater efficiency and through improved mechanisms for cost control. Special attention is paid to implementation in Bahia of the latest and most ambitious of the national reforms based on those objectives: the Operational Regulations for Health Care, issued in early 2001 and referred to in this report by its Brazilian acronym, NOAS. NOAS is expected to have a significant impact on the organization of public health care over the next several years. Its main features are described in the Introduction. The structure of the report is as follows: the report has four chapters dealing...

Economic Analysis of Health Care Utilization and Perceived Illness : Ethnicity and Other Factors

Paqueo, Vicente B.; Gonzalez, Christian Y.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
76.07%
Paqueo and Gonzalez look at the determinants of health-seeking behavior of the Mexican population and within this context focus on the effect of ethnicity. They address the following questions: To what extent are the indigenous people at a disadvantage health care-wise and in what particular health services are they disadvantaged? Is the health care gap due to indigenous cultures by itself as opposed to the impact of socioeconomic differences? What policy instruments can be used to reduce the gap? The authors find that contrary to expectations, the indigenous people in Mexico tend to have a positive behavior toward modern preventive care compared with the nonindigenous population, holding socioeconomic factors constant. Apparently, there is no cultural barrier in regard to these services. But ethnicity remains negatively associated with the use of inpatient hospital care and medical and dental consultations. Insurance has a significant and positive effect on health care use. Therefore, it appears to be an effective instrument for addressing the health care disadvantages faced by the indigenous population in regard to inpatient care and the use of outpatient services of doctors...

Navy Health Care Strategic Planning Process: a draft functional description

Thompson, Helen V.; STRATEGY, HEALTH CARE FACILITIES, REQUIREMENTS, DEPARTMENT OF DEFENSE, INFORMATION SYSTEMS, HEALTH, DEPTH, PLANNING, EXECUTIVES, WARTIME, STANDARDS, MILITARY MEDICINE, MEDICINE, THESES, NAVAL PERSONNEL, PEACETIME, AUTOMATION
Fonte: Monterey, California. Naval Postgraduate School Publicador: Monterey, California. Naval Postgraduate School
Tipo: Tese de Doutorado
EN_US
Relevância na Pesquisa
76.13%
This thesis explores the Navy Health Care Strategic Planning Process (NHCSPP) and attempts to apply the Department of Defense Automated Information Systems (AIS) Documentation Standard (DOD-STD-7935A) to develop a draft a functional description for the automation of the NHCSPP as module of the Navy Medical Executive Information System. The thesis begins with a discussion of Wartime and Peacetime Health Care Planning. This is followed by an in depth evaluation of the Navy Health Care Strategic Planning Process. The Navy Medical Executive Information System is then discussed, followed by the Functional Description Overview. The research indicates that Navy Health Care Strategic Planning is an extremely complex and intricate process and as such, traditional methodologies that emphasize capturing and representing users requirements upfront, i.e. DOD-STD-7935A, are not appropriate for automating the planning process. Additionally, the health care planning process needs to be standardized across all branches of the armed services. It is further ended that Navy Medicine create a workgroup of end-users and functional experts to develop a more detail functional description

Sustaining Health Care Practice Change: The Experience of Best Practice Spotlight Organizations Implementing and Sustaining RNAO Best Practice Guidelines

Schenck, Tracey
Fonte: Brock University Publicador: Brock University
Tipo: Electronic Thesis or Dissertation
ENG
Relevância na Pesquisa
75.91%
Sustainability of change for improvement initiatives has been widely reported as a global challenge both within and outside health care settings. The purpose of this study was to examine the extent to which factors related to staff training and involvement, staff behaviour, and clinical leaders’ and senior leaders’ engagement and support impact the long term sustainability of practice changes for BPSO health care organizations who have implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines. Semi structured interviews with eleven organizational leaders’ from ten health care organizations were conducted to explore the unique experiences, views and perspectives on factors related to staff, clinical leaders and senior leaders and their involvement and impact on the long term sustainability of clinical practice changes within organizations who had implemented Registered Nursing Association of Ontario’s (RNAO) Best Practice Guidelines (BPGs). The interviews were coded and analyzed using thematic content analysis. Further analysis identified patterns and themes in relation to: 1. The National Health Service (NHS) Sustainability Model which was used as the theoretical framework for this research; and 2. Organizations found to have sustained practice changes longer term verses organizations that did not. Six organizations were found to have sustained practice changes while the remaining four were found to have been unsuccessful in their efforts to sustain the changes. Five major findings in relation to sustainability emerged from this study. First is the importance of early and sustained engagement and frontline staff...

Planning primary health-care services for South Australian young offenders: A preliminary study

Wilson, A.
Fonte: Blackwell Science Asia Pty Ltd Publicador: Blackwell Science Asia Pty Ltd
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
66.11%
Although many young offenders receive health care during periods of detention, addressing their health needs after release from secure care is a key strategy for successful rehabilitation and reintegration into the community. The purpose of this preliminary study was to examine current discharge planning practices for young offenders in Youth Training Centres in South Australia with a view to improving offenders' connection with primary health-care services on discharge. To determine the strengths and weaknesses of current discharge planning practices, this exploratory study involved in-depth review of literature and a semistructured focus group of stakeholders. Findings were discussed with an expert advisory group before final recommendations were made. This study identified a service model approach to discharge planning that recommended a nurse located within the Divisions of General Practice as the coordinator. The study found that trusted staff in detention centres, with an awareness of services available in the location of release, influence young offenders' decision-making in relation to health-care services. Awareness and recognition of young offenders' health beyond periods of juvenile detention and into their adult lives is valuable in that it has the potential to establish lifelong healthy behaviours. Bonding with young offenders and gaining their trust increases their likelihood of attending primary health-care services.; The definitive version of this article can be found at www.blackwell-synergy.com

Croatia : Health Finance Study

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Other Health Study; Economic & Sector Work
ENGLISH; EN_US
Relevância na Pesquisa
66.15%
The health system in Croatia developed relatively well among the countries in the region: the system has a well-trained health workforce, a well-established system of public health and health delivery programs, and good health outcomes in relation to countries at comparable income levels. However, these results have been achieved at a high cost, and the growing deficits in the social health insurance fund is a major concern. Croatia's challenge is to channel its already substantial public spending on health care, towards cost-effective services, targeting public subsidies to protect the most vulnerable groups. The Government is currently engaged in a new round of reforms, aimed at improving the performance of the health system. The report reviews the 2000-2002 health reform initiatives, examines the high cost of care (attributed to its aging population), and focuses on the 2002 health insurance law and the reforms in the revenue base for health insurance. Legislation established the principals of central and local government responsibilities for subsidizing the premium and co-payments for special categories of population...

A Framework for Purchasing Health Care Labor

Zurn, Pascal; Adams, Orvill
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Working Paper; Publications & Research
ENGLISH; EN_US
Relevância na Pesquisa
75.98%
Health care labor is central to managing and delivering health services. Because recruitment and retention policies are key issues for purchasers, gaining insights into labor-purchasing mechanisms may permit them to be addressed more effectively. This paper is intended to provide a brief introduction to health care labor purchasing and the mechanisms through which it can have an impact on the delivery of health services and on health system performance. A framework is developed to foster understanding of health labor purchasing mechanisms. This framework examines the different types and characteristics of the purchasers and providers. It also examines the terms of labor purchasing, that is, working conditions (career development, contract duration, working time and shift work, work autonomy and separation), remuneration and benefits. These elements determine, to a large extent, workers' behavioral responses such as willingness to apply for and accept employment and job satisfaction. In turn, these behavioral responses are likely to affect performance. Finally...

Nigeria—Improving Primary Health Care Delivery : Evidence from Four States

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Other Health Study; Economic & Sector Work
ENGLISH; EN_US
Relevância na Pesquisa
66.13%
The delivery of quality primary health care (PHC) services can have a large impact on the health of Nigerians. This study aims mainly at understanding the performance of primary health care providers and the variables driving this performance. The study is primarily based on quantitative surveys at the level of primary health care facilities, health care personnel, and households in their vicinity. These surveys were implemented in four states: Bauchi, Cross River, Kaduna, and Lagos. The purpose of this study is three fold: (i) to contribute to the evidence base of the Federal Government's health system reform efforts; (ii) to inform the Bank's and Canadian International Development Agency (CIDA) sector policy dialogue with the Government; and (iii) to inform the current and eventual health support programs of both donors at state level. This study represents the second phase of the Nigeria Health, Nutrition, and Population Country Status Report (CSR). The first phase aimed at analyzing the health situation of the poor and how the health system was performing in terms of meeting their needs. This first phase identified primary health care as the weakest chain in the entire health sector and the level of care the poor use the most. This second phase of the CSR is therefore focused on the analysis of the delivery of PHC services. In contrast to the first phase...

Improving Access to Health Care Services through the Expansion of Coverage Program : The Case of Guatemala

Lao Pena, Christine
Fonte: World Bank, Washington DC Publicador: World Bank, Washington DC
Tipo: Publications & Research :: Working Paper
EN_US
Relevância na Pesquisa
66.12%
Since the signing of the 1996 Peace Accords, Guatemala has made efforts to establish economic and political stability, and to improve its social indicators. The country's Constitution states that access to health care is a basic right of all Guatemalans. In practice, however, it has been challenging for the Government of Guatemala to guarantee this right using public facilities. As a result, it has been trying to improve access to health services using both Ministry of Public Health and Social Assistance (MOH) facilities and staff, and alternative health service providers, particularly nongovernmental organizations (NGOs). This case study reviews the experience implementing the Expansion of Coverage Program (Programa de Extension de Cobertura, PEC) that was established by the Government of Guatemala in 1997 to improve coverage of health and nutrition services to poor, rural, and largely indigenous areas by contracting NGOs. It describes its origins; its package of services; contracting, financing, monitoring, and supervision mechanisms; and its contributions to improving access and strengthening primary health care services in Guatemala. It also discusses opportunities and challenges that need to be addressed to continue to improve health services coverage in the country.

Improving Universal Primary Health Care by Kenya : A Case Study of the Health Sector Services Fund

Ramana, Gandham NV; Chepkoech, Rose; Walelign, Netsanet
Fonte: World Bank, Washington DC Publicador: World Bank, Washington DC
Tipo: Publications & Research :: Working Paper; Publications & Research
EN_US
Relevância na Pesquisa
66.07%
This case study describes the Government of Kenya's initiative to expand the supply of health care and strengthen primary health care through implementation of the Health Sector Services Fund (HSSF), which provides direct cash transfers to primary health facilities. This initiative, launched in 2010, is a direct response to challenges identified by the Public Expenditure Tracking Surveys in making funds for operation and maintenance available to the health facilities, and builds on lessons from initiatives supported by the Danish International Development Agency (DANIDA) in the Coastal Region.

The Impact of Price Subsidies on Child Health Care Use : Evaluation of the Indonesian Healthcard

Somanathan, Aparnaa
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH
Relevância na Pesquisa
66.13%
Financial barriers to seeking care are frequently cited as one of the main causes of underutilization of child health care services. This paper estimates the impact of Indonesia's healthcard on health care use by children. Evaluation of the healthcard effect is complicated by the fact that card allocation was non-random. The analysis uses propensity score matching to control for systematic differences between treatment and control groups. A second potential source of bias is related to contemporaneous, exogenous influences on health care use unrelated to the healthcard itself. Using panel data collected prior to and after the introduction of the healthcard, a difference-in-differences estimator is constructed to eliminate the effects of exogenous changes over time. The author finds that although health care use declined for all children during the crisis years of 1997-2000, use of public sector outpatient services declined much less for children with healthcards. The protective effect of the healthcard on public sector use was concentrated among children aged 0-5 years. The healthcard had no significant impact on use of private sector services. The results highlight the need to provide adequate protection against the financial burden of health care costs...

Contribuições ao planejamento da força de trabalho em saúde para a atenção básica; Contribution to workforce planning at primary health care

Manoela de Carvalho
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 26/04/2012 PT
Relevância na Pesquisa
66.13%
Esta pesquisa teve por objeto de investigação o processo de planejamento da força de trabalho em saúde do SUS, especialmente voltado à Atenção Básica. O objetivo geral foi analisar as condições determinantes e as consequências da ausência de práticas institucionalizadas de planejamento da força de trabalho em saúde no Brasil, ao longo do período de implementação do SUS. Para tanto, utilizou-se dos recursos da pesquisa bibliográfica e documental cujas fontes foram artigos e textos científicos publicados e disponíveis, na sua maioria, em bases de dados virtuais; bibliografia sobre o tema do planejamento em saúde, planejamento da força de trabalho, gestão do trabalho e modelos assistenciais em saúde, políticas sociais e de saúde que guardavam relação com o objeto estudado. Também foram utilizados documentos oficiais emitidos pela Organização Pan- Americana de Saúde e pelo Ministério da Saúde, principalmente no período posterior à criação do SUS, portarias, normas e decretos relacionados à gestão e planejamento da força de trabalho em saúde e a Política Nacional de Atenção Básica. Para definir o percurso do estudo, foram considerados os pressupostos de que o planejamento da força de trabalho em saúde é determinado pelas políticas sociais vigentes e...

Improving equity in the provision of primary health care: lessons from decentralized planning and management in Namibia

Bell,Ruth; Ithindi,Taathi; Low,Anne
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/08/2002 EN
Relevância na Pesquisa
76.02%
This paper draws lessons from a review of primary health care services in Windhoek, the capital of Namibia, undertaken by a regional health management team. The review was carried out because of perceived increases in workload and inadequate staffing levels, arising from the rapid expansion of the city associated with inward migration. A survey of the utilization of government clinics was used to develop a more equitable allocation of primary health care services between localities. The survey revealed disparities between patterns of utilization of the services and the allocation of staff: the poorer localities were relatively underprovided. Decisions made centrally on resource allocation had reinforced the inequities. On the basis of the results of the review, the regional health management team redistributed nursing and medical staff and argued for a shift in the allocation of capital expenditure towards the poorer communities. The review demonstrates the potential for regional and provincial health management teams to make effective assessments of the needs of their populations and to promote the equitable delivery of primary health care services. In order to achieve this they need not only to become effective managers, but also to develop population-based planning skills and the confidence and authority to influence the allocation of resources between and within their regions and provinces.