ABSTRACT
IntroductionProvide evidence necessary for effective implementation of the National Programme on Prevention and Control of NCDs by studying the services delivered by family health centers for prevention, screening and reduction of risk factors of cardiovascular diseases, cancer and diabetes, problems encountered and professional support.GoalStudy the role of family health centers in prevention, screening and reduction of risk factors of cardiovascular diseases, cancer and diabetes and the methodological and professional support they are receiving.Materials and MethodsThe study covered 30.7% of family health centres of UB city and 18.9% of family health centres in rural areas, which are together 19.7% of all family health centres.Results and conclusions18 family health centres from Central, Dornogobi, Orkhon aimags and 25 family health centres from Bayanzurkh, Sukhbaatar, Nalaikh districts of Ulaanbaatar city as well 258 doctors and 18 managers who provide with qualified methodology were involved in the survey. Informal training activities such as lecture, discussions, memo printed on the reverse side of the check-up numbers, e-mails, SMS messages and advice during visits need to be used to promote healthy behaviour and healthy lifestyle. There are no incentives for promoting health, and preventing non-contagious diseases, the budget for these activities is really minimal around 60,000-200,000 tugrugs per annum. Cooperation with international organizations can be enhanced in order to receive financial support for these activities. The staffs of family health centres consists in average of 11-15 personnel, they are overloaded with the treatment of patients and less time is available for them to work for prevention, screening, and addressing risk factors. The instructing and counselling skills of medical staff are low.
ABSTRACT
Aim and objectivesTo assess the community health seeking behavior, knowledge, attitude, practice and the attitude ofprimary health care providers and to determine methodologies for developing of voluntary attendanceof preventive screening services. This included:• Assessment of community knowledge, attitude and practice related with preventive healthservices and health seeking behavior;• Assessment of the attitude of primary health care providers on preventive healthservices;• Identify methodologies to establish a practice of voluntary attendance of preventivescreening services;Materials and MethodsIn this survey both quantitative and qualitative research methods were used. 846 individuals wereinvolved in the quantitative survey and 112 family doctors, nurses, social workers of the selectedaimags and districts participated in the qualitative surveys.ResultsThough the participants demonstrate knowledge that the primary health care facilities should beapproached on the initiative of the patients themselves (85%), while healthy (50%) and for earlydetection of a disease (70%), this knowledge on preventive care is not evolving into actual practiceas most of them visit the primary care facilities only as they become sick (70%). The communityparticipants demonstrate incorrect attitude that preventive services do not require personal initiativesand engagement of patients (42%), primary care facilities are visited in order to obtain a referral tothe next level of care (46%), primary care facilities should be visited only when there are symptoms ofdiseases (32%) and only when the patient has free time. The participants of the survey also noted theinsufficient attitude and communication manners of the doctors and health professionals (31%), thatpatients are not received with smile when they visit for preventive screening (60%), dissatisfaction withthe services of primary care facilities (28%).ConclusionsThe majority of the respondents know that visit to primary health care clinic for health check-up isrequired. Although most of the participants demonstrate knowledge that primary health care unitsshould be visited voluntarily for preventive screening services, most do not practice this knowledge.The attitude of most of the participants was that the benefit of visiting a primary care facility is obtaininga referral to the specialist doctor. One out of three of the survey participants had an incorrect attitude asthey perceive that health check-up is only necessary if a patient is sick with one or more conditions.
ABSTRACT
Goal: To outline possible approaches in improving clinical hospital management upon reviewing of its current setting Materials and Methods: The study was conducted by qualitative method and data was collected through applying discussions and participatory approaches. In total, 155 participants were enrolled in the study, from which 72 were covered by the Focus Group Discussions, and the remained 83 were studied for Organizational Diagnostic Analysis. Conclusions: 1. Advantages and Disadvantages of the Clinical hospital management levels, although they vary, management aspects are reasonably unsatisfactory. If to view in a isolation by each key role and direction of the management functions, organization, planning, quality assurance, monitoring and evaluation management encompass comparatively predominant advantages whereas human resources, information, finance, motivation, and decision making management enclose prevailing disadvantages. In terms of marketing management, it is extremely poor. 2. Healthcare Organizations’ strategic planning is advantageous focusing on essential skills and tools needed to enhance quality and accessibility of health care as new models of care delivery. Nevertheless, it is weak in operational processes resembling of introduction of technology initiatives and improving of health care targeted to vulnerable groups of the population. 3. Human resources management surrounds in a large amount of disadvantages, particularly, career development of personnel, workforce selection and research capability are inadequate. 4. Although management decisions made are usually accepted by working groups and are enforced their implementations, issues associated with any decisions to involve representaitives of community, regular dialogue of managers with staaf and clients and provision of supervision are fairly poor. 5. By and large, leading skills of managers are quite pleasing and the orders given by managers are executed on a timely manner. Conversely, awarding, incentives and motivation of personnel is highly problematic. 6. The following actions were in good shape, e.g monitoring and evaluation is performed according to the given guidelines, and performance evaluation is recognized by employees followed by inclusion of the findings in planning design. Notably, issues linked with cooperation with other agencies, ensuring quality assurances at the all levels and transparency to inform the cases for not being accountable and for poor performamce of the commands are in low morale. 7. Application of internal information network and provision of transparency and responsiveness has considerably been improved, while predominant mono communicative management, availability of electronic health security data, proper information utilization and time management is deficient. 8. Marketing and its management for High-Performance Healthcare Organizations are underprivileged and absolutely disadvantegious. 9. Even though financial management aspect has gained an introduction of software applications compatable with the Internationally Accepted Standards and Requirements and the projected resources have well mobilized, the necessary investment required for introduction of new technology, the budget for hospital expansion, the insufficient resources for risk management, mobilization of additional assets are limited. 10. International cooperation and collaboration is subject to the legal environment, economic, financial factors, inflation and other technical dynamics. Moreover, partnership with other sectors, private entities, civil society, and the public is scarce, and even, there is no adequate mechanism to gain supports of diverse aspects and to work effectively together.
