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乌干达基层医疗服务提供者对建立社区老年支持的看法。

Primary care provider notions on instituting community-based geriatric support in Uganda.

机构信息

Division of Infectious Diseases and Geriatric Health, Center for Innovations in Health Africa, Kampala, Uganda.

Health Care Programmes, VIVES University of Applied Sciences, Kortrijk, Belgium.

出版信息

BMC Geriatr. 2022 Mar 29;22(1):258. doi: 10.1186/s12877-022-02897-9.

DOI:10.1186/s12877-022-02897-9
PMID:35351013
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8962536/
Abstract

BACKGROUND

Understanding of the most economical and sustainable models of providing geriatric care to Africa's rising ageing population is critical. In Uganda, the number of old adults (60 years and above) continues to rise against absence of policies and guidelines, and models for providing care to this critical population. Our study explored public primary health care provider views on how best community-based geriatric support (CBGS) could be instituted as an adaptable model for delivering geriatric care in Uganda's resource-limited primary public health care settings.

METHODS

We interviewed 20 key informants from four districts of Bukomansimbi, Kalungu, Rakai, and Lwengo in Southern Central Uganda. Respondents were leads (in-charges) of public primary health units that had spent at least 6 months at the fore said facilities. All interviews were audio-recorded, transcribed verbatim, and analysed based on Hsieh and Shannon's approach to conventional manifest content analysis.

RESULTS

During analysis, four themes emerged: 1) Structures to leverage for CBGS, 2) How to promote CBGS, 3) Who should be involved in CBGS, and 4) What activities need to be leveraged to advance CBGS? The majority of the respondents viewed using the existing village health team and local leadership structures as key to the successful institutionalization of CBGS; leveraging community education and sensitization using radio, television, and engaging health workers, family relatives, and neighbors. Health outreach activities were mentioned as one of the avenues that could be leveraged to provide CBGS.

CONCLUSION

Provider notions pointed to CBGS as a viable model for instituting geriatric care in Uganda's public primary healthcare system. However, this requires policymakers to leverage existing village health team and local governance structures, conduct community education and sensitization about CBGS, and bring onboard health workers, family relatives, and neighbors.

摘要

背景

了解向非洲不断增长的老年人口提供老年护理的最经济和可持续模式至关重要。在乌干达,老年人口(60 岁及以上)的数量不断增加,但缺乏政策和指导方针,也没有为这一关键人群提供护理的模式。我们的研究探讨了公共初级卫生保健提供者的观点,即如何最好地将基于社区的老年支持(CBGS)作为一种适应性模式,在乌干达资源有限的初级公共卫生保健环境中提供老年护理。

方法

我们采访了来自乌干达中南部布卡曼西比、卡伦古、拉凯和卢韦诺四个区的 20 名关键信息提供者。受访者是在上述设施担任领导(主管)的公共初级卫生单位的负责人。所有访谈均进行了录音,并逐字记录,然后根据 Hsieh 和 Shannon 的传统显式内容分析方法进行分析。

结果

在分析过程中,出现了四个主题:1)可以利用的 CBGS 结构,2)如何促进 CBGS,3)谁应该参与 CBGS,4)需要利用哪些活动来推进 CBGS?大多数受访者认为利用现有的乡村卫生工作队和地方领导结构是成功实施 CBGS 的关键;利用广播、电视和动员卫生工作者、家庭亲属和邻居进行社区教育和宣传。健康外展活动被认为是可以利用的途径之一,可以提供 CBGS。

结论

提供者的观点表明,CBGS 是在乌干达公共初级卫生保健系统中实施老年护理的可行模式。然而,这需要政策制定者利用现有的乡村卫生工作队和地方治理结构,开展有关 CBGS 的社区教育和宣传,并让卫生工作者、家庭亲属和邻居参与进来。

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The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review.低收入和中等收入国家初级保健中整合心理健康服务的有效性和成本效益:系统评价
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