Abstract:
CONTEXT:The Nepalese primary healthcare system at sub-district level consists of three different levels of health facility to serve the mostly rural population. The Ministry of Health and Population decentralised health services by handing over 1433 health facilities in 28 districts to Health Facility Operation and Management Committees (HFOMCs), which were formed following a public meeting, and consist of 9 to 13 members, representing the health facility in-charge, elected members of the village development committee, dalit (disadvantaged caste) and women members. The purpose was to make this local committee responsible for managing all affairs of the health facility. However, the handing over of the health facilities to HFOMCs was not matched by an equivalent increase in the managerial capacity of the members, which potentially makes this initiative ineffective. ISSUE:The Health Facility Management Strengthening Program was implemented in 13 districts to foster good governance in the health facilities by increasing the capacity of HFOMCs. This effort focuses on capacity building of HFOMCs as a continuous process rather than a one-off event. Training, follow-up and promotional activities were conducted. This article focuses on how good governance at the peripheral public health facilities in Nepal can be fostered through the active engagement and capacity building of HFOMCs. This article used baseline and monitoring data collected during technical support visits to HFOMCs and their members between July 2008 and October 2011. LESSONS LEARNED:The results show that the Health Facility Management Strengthening Program was quite successful in strengthening local health governance in the health facilities. The level of community engagement in governance improved, that is, the number of effective HFOMC meetings increased, the inclusion of dalit/women members in the decision-making process expanded, resource mobilization was facilitated, and community accountability, as measured by health facility opening days, increased. Furthermore, availability of technical staff, supervision and monitoring, and display of the citizen charter increased, and health services became more inclusive. Several lessons emerged. Functioning of HFOMCs is largely dependent on the process of selecting members, the staff and community's support of the HFOMC, and a sense of volunteerism and team spirit among the members. Similarly, to ensure the effective participation of dalit/woman members, the educational and livelihood empowerment of the members is deemed necessary. Furthermore, capacity building of and giving authority to HFOMCs should go hand-in-hand. CONCLUSION:Local governance of health facilities was fostered through the local people's active engagement in HFOMCs and capacity building of the HFOMC members.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Gurung G,Tuladhar Ssubject
Has Abstractpub_date
2013-04-01 00:00:00pages
2042issue
2issn
1445-6354pii
2042journal_volume
13pub_type
杂志文章abstract:INTRODUCTION:Breastfeeding provides health benefits to infants and mothers, yet many women decide against breastfeeding. This study examined differences in the prevalence of breastfeeding among national, urban, rural, and Appalachian regions of the USA. METHODS:Secondary data analysis of the US 2007 National Survey of...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2011-01-01 00:00:00
abstract:CONTEXT:For those residing in rural and isolated parts of Canada, obtaining quality mental health services is often an unfulfilled wish. Rural and isolated communities share the problems of health status and access to care. Health deteriorates the greater the distance from urban areas in the following dimensions: lower...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2010-07-01 00:00:00
abstract:INTRODUCTION:The next influenza pandemic is predicted to disproportionately impact marginalized populations, such as those living in geographically remote Aboriginal communities, and there remains a paucity of scientific literature regarding effective and feasible community mitigation strategies. In Canada, current pan...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2013-10-01 00:00:00
abstract:INTRODUCTION:Chronic conditions are a growing healthcare concern. People living in rural regions are particularly affected because many barriers exist to accessing services and supports. Peer support for chronic condition self-management, where people living with chronic conditions learn about how to care for themselve...
journal_title:Rural and remote health
pub_type: 杂志文章,评审
doi:
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Thailand has recognised and sought to remedy rural medical workforce shortages. The Collaborative Project to Increase Production of Rural Doctors (CPIRD) has improved rural workforce recruitment through publicly funding medical school places for students with rural backgrounds. However, challenges in rural...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4709
更新日期:2018-11-01 00:00:00
abstract:INTRODUCTION:In Italy the course to become a general practitioner (GP) lasts 3 years and includes both theoretical and practical study. Different from the theoretical part, until recently the practical activity has not been assessed at all. The Emilia Romagna Regional Health Authority has developed a special program ca...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-07-01 00:00:00
abstract:CONTEXT:This article describes the development and evaluation of a tool to prioritize physiotherapy referrals in a remote, under-serviced region in Canada's eastern Arctic. The Baffin Region of Nunavut is home to approximately 16 000 people dispersed across 12 communities accessible only by air. Physiotherapists are ba...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract:INTRODUCTION:Health sciences programs are being designed to attract students who are likely to stay and practice in rural and northern Canada. Consequently, student recruitment and screening are increasingly including assessment of suitability for rural practice. Although retention factors among rural physicians and nu...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2009-10-01 00:00:00
abstract::Traditionally dental plaque, calculus and stains have been removed by scaling and polishing manually with hand instruments such as curettes, chisels, hoes and scalers. However, ultrasonic scaling is becoming the preferred method of initial periodontal treatment and maintenance, due to improved patient and operator com...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-10-01 00:00:00
abstract:INTRODUCTION:Rates of mental health issues are increasing, coupled with insufficient resources to provide appropriate support. This is a particular challenge for rural areas in Australia that face significant social inequities including a scarcity of health resources. E-health initiatives are often proposed to maximise...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH5103
更新日期:2019-08-01 00:00:00
abstract:CONTEXT:Hypothyroidism is a significant cause of pericardial effusion. However, large pericardial effusions due to hypothyroidism are extremely rare. Hormone replacement therapy is the cornerstone of treatment for hypothyroidism and regular follow-up of patients after initiation of the therapy is indicated. Herein, the...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4384
更新日期:2018-05-01 00:00:00
abstract:INTRODUCTION:The Indian Ocean Territories (IOT) comprising Christmas and Cocos (Keeling) Islands are situated over 2500 km from Perth, Australia, and are accessible by commercial aircraft only twice a week. The IOT Health Service (IOTHS) is administered from the Department of Transport and Regional Services in Canberra...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:CONTEXT:This article explores the relevance of the body of military psychology knowledge to the management and support of those living and working in rural/remote industries and locations, particularly within Australia. ISSUES:For those who live and work in rural/remote settings, there are social, occupational, health...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00
abstract:CONTEXT:Providing health care in remote and very remote areas has long been a major concern in Indonesia. In order to improve access to quality health care for residents in these areas, various policies on recruitment and deployment of health workers have been implemented, among them compulsory service, contracted staf...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:Farmers and farm workers have higher than expected rates of suicide and undetermined deaths in UK studies, and some rural areas of Scotland have higher than average male suicide rates. Firearm access seems to be an influencing factor in England and Wales. Type of farming, and farming social networks may al...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION:The chronic diseases associated with overweight and obesity are major contributors to the excess disease burden of Aboriginal Australians. Surveillance of overweight and obesity is required to monitor these conditions, and to develop and evaluate interventions to improve health and wellbeing. Remote Aborig...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00
abstract:INTRODUCTION:This study aimed to assess the impact of live interactive telenephrology on diagnosis and disease management, patients' quality of life, and time- and cost savings. METHODS:A pre-test-post-test one-group design was used to evaluate the process and outcomes of the teleconsultations among all consecutive pa...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:For many women, and particularly rural women, birthing locally and within their own community is important for personal, social and/or cultural reasons. If concerns about the woman or her baby mean transfer to a secondary or tertiary facility is necessary, this can be disruptive and stressful, especially i...
journal_title:Rural and remote health
pub_type: 杂志文章,多中心研究
doi:
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTON:The key parameter for rural clinical schools (RCSs) is to provide at least 1 year of clinical training in rural areas for 25% of Australian Commonwealth supported medical students with the intent to influence future rural medical workforce outcomes. The objective of this study was to describe the associatio...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Iran has a major land mine injury problem in its border areas. Mine injuries have a high mortality and morbidity, and the injuries generally occur in remote areas. Iran has a well developed system of rural health workers and clinics, covering most border areas. These have mainly had prevention, immunizatio...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-10-01 00:00:00
abstract:INTRODUCTION:Health promotion is a key component of comprehensive primary health care. Health promotion approaches complement healthcare management by enabling individuals to increase control over their health. Many primary healthcare staff have a role to play in health promotion practice, but their ability to integrat...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH4413
更新日期:2018-05-01 00:00:00
abstract::FPA Health (Family Planning NSW) has conducted two integrated clinical and health promotion projects with Aboriginal communities in western NSW, Australia. The first was in Coonamble, a small rural community which had been selected as a pilot site for the Royal Australian College of General Practitioners Women's Abori...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2006-04-01 00:00:00
abstract:INTRODUCTION:This paper will discuss health issues among Filipinas (women born in the Philippines) living in remote and rural environments in Queensland in comparison to Filipinas living in other parts of the state. The sample was recruited as part of the University of Queensland component of the Australian Longitudina...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:CONTEXT:Diabetes is a chronic long-term disease with an increasing incidence. There is a need to increase access to effective care and to ensure such care is delivered as locally as possible. The geographical spread of NHS Highland Scotland presents additional challenges to ensuring a skilled workforce given education ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2013-01-01 00:00:00
abstract:INTRODUCTION:Reacting to demand and supply pressures, European healthcare systems are undergoing significant structural changes to the organisation and delivery of out of hours care. Such pressures are of particular concern to rural practice. Although patient satisfaction with out of hours care has been extensively stu...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
abstract::Many rural Australian communities continue to endure a prolonged drought. The mental health effects of short-term natural disaster are well known; those of a long-term and chronic natural disaster such as drought are less well understood. However, in addition to immediate distress there are likely to be feelings of lo...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2008-07-01 00:00:00
abstract:INTRODUCTION:Skin infections including scabies and impetigo have a high burden and cause significant morbidity in remote Aboriginal communities in Australia. Nevertheless, there is limited knowledge about community, healthcare practitioner and service provider perspectives on skin infections and treatment preferences. ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:10.22605/RRH5227
更新日期:2019-09-01 00:00:00
abstract:INTRODUCTION:Australia is the sixth largest country (in area) in the world with a total area of over 7.5 million km² (3 million miles²). To date much of the research and policy activity in the dental workforce has been based on simple statistical analysis including practitioner-to-population ratios; however, risks are ...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2013-10-01 00:00:00
abstract::Iodine deficiency disorder (IDD) is an important health problem in Thailand. Due to the geographical limitation of marine salt distribution, the Northern and Northeastern regions of Thailand are endemic areas of this disorder. In this study, a cross-sectional survey on the domestic use of iodine-enriched salt by the p...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:This study was undertaken to assess the prevalence and predominant causes of low back pain (LBP) among peasant farmers in Ebubu community in South-south Nigeria. METHODS:This was a community based cross-sectional study of 310 consenting, adult, full-time farmers, recruited using a two-stage cluster sampli...
journal_title:Rural and remote health
pub_type: 杂志文章
doi:
更新日期:2012-01-01 00:00:00