A qualitative study on the implementation of family health team: the perspectives of providers and patients.


Journal

BMC family practice
ISSN: 1471-2296
Titre abrégé: BMC Fam Pract
Pays: England
ID NLM: 100967792

Informations de publication

Date de publication:
09 08 2020
Historique:
received: 30 03 2020
accepted: 10 07 2020
entrez: 11 8 2020
pubmed: 11 8 2020
medline: 25 9 2021
Statut: epublish

Résumé

Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention. In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually. Data were analysed using a thematic analysis, with codes being organised into larger themes. Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings. The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability. The study is registered with the National Medical Research Register, Ministry of Health Malaysia ( NMRR-17-295-34711 ).

Sections du résumé

BACKGROUND
Malaysia has committed to the global call to achieve universal health coverage, and with the adoption of Sustainable Development Goals, is further strengthening the health system through the primary health care services, particularly the family doctor concept. The Enhanced Primary Health Care (EnPHC) initiative was implemented to address the worrying upward trend of non-communicable disease prevalence, and incorporates the Family Health Team (FHT) concept. The aim of this paper is to describe the implementation of the FHT as part of the EnPHC intervention.
METHODS
In-depth interviews and focus group discussions were conducted with the intervention design team, healthcare providers and patients in two rounds during the implementation period. A total of 121 individuals in the two rounds, split into different groups, where some of the participants of the FGD were also interviewed individually. Data were analysed using a thematic analysis, with codes being organised into larger themes.
RESULTS
Themes that emerged from the data were around the process of FHT implementation and the advantages of the FHT, which included continuity of health care and improved quality of care. Patients and health care providers were receptive to the FHT concept, and took the effort to adapt the concept in the local settings.
CONCLUSIONS
The FHT concept implemented at 20 public primary health clinics has benefits appreciated by health care providers and patients. Addressing the viable shortcomings would better prepare the current primary healthcare system to scale up the FHT concept nationwide and enhance its feasibility and sustainability.
TRIAL REGISTRATION
The study is registered with the National Medical Research Register, Ministry of Health Malaysia ( NMRR-17-295-34711 ).

Identifiants

pubmed: 32772931
doi: 10.1186/s12875-020-01217-7
pii: 10.1186/s12875-020-01217-7
pmc: PMC7416414
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

162

Subventions

Organisme : National Institutes of Health (MY)
ID : NMRR-17-295-34771
Pays : International

Références

J Family Med Prim Care. 2014 Jul;3(3):180-2
pubmed: 25374848
BMJ. 2001 Oct 6;323(7316):784-7
pubmed: 11588082
Ann Fam Med. 2011 Mar-Apr;9(2):165-71
pubmed: 21403144
JAMA. 2004 Mar 10;291(10):1246-51
pubmed: 15010447
Fam Pract. 2001 Feb;18(1):21-6
pubmed: 11145623
Hong Kong Med J. 2010 Apr;16(2):106-15
pubmed: 20354244
BMC Public Health. 2014;14 Suppl 2:S4
pubmed: 25080846
Lancet. 2016 Apr 30;387(10030):1811
pubmed: 27203497
BMJ. 2000 Feb 26;320(7234):569-72
pubmed: 10688568

Auteurs

Ainul Nadziha Mohd Hanafiah (AN)

Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia. ainulnadziha.mh@moh.gov.my.

Mohammad Zabri Johari (MZ)

Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.

Syafinas Azam (S)

Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.

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