The policies for restructuring health systems in Latin America during the 1990s have included an emphasis on changing in the model of health care delivery to one that incorporates prevention and promotion activities. At the same time, health systems have been decentralized in their management, allowing room for greater variation in local interpretation and implementation of policy directives. D...

AIM The aim of this analysis was to compare the level of self-perceived competencies of primary health care physicians in Kosovo with patients' viewpoint, as well as the necessary (required) level of such competencies from decision-makers' standpoint. METHODS Three cross-sectional studies were carried out in Kosovo in 2013 including: i) a representative sample of 1340 primary health care user...

Primary health care (PHC) is the best approach to achieve health goals in a country. As medical students are a prominent part of future health care providers, it is important to assess their knowledge regarding basic concepts and functions of PHC. Total 400 medical students, 200 (50%) each from public and private medical universities responded in this study. Mean score was 15.21 ± 2.43 and 14.9...

Cultural values and beliefs about the primary care physician bolster the myth of the lone physician: a competent professional who is esteemed by colleagues and patients for his or her willingness to sacrifice self, accept complete responsibility for care, maintain continuity and accessibility, and assume the role of lone decision maker in clinical care. Yet the reality of current primary care m...

AIM To explore the factor structure, reliability, and potential usefulness of a patient safety climate questionnaire in UK health care. SETTING Four acute hospital trusts and nine primary care trusts in England. METHODS The questionnaire used was the 27 item Teamwork and Safety Climate Survey. Thirty three healthcare staff commented on the wording and relevance. The questionnaire was then s...

In 1987 UNICEF launched the so-called Bamako Initiative, which has as its main objective to improve the sustainability of primary health care in Africa by making people pay for it. The question is raised whether paying for health care is culturally acceptable in African communities. The author argues that 'money' is not a new phenomenon in Africa and that paying for goods and services does not ...

Despite an early interest in pediatrics among psychologists and a natural partnership between psychology and pediatrics, psychologists’ impact on services for children in primary care settings could be much greater than it is. The purpose of this article is to describe the special contributions of pediatric psychologists and pediatricians in the development of comprehensive, integrated systems ...

BACKGROUND New forms of leadership are required to bring about the fundamental health system changes demanded by primary health care (PHC). Using theory about complex adaptive systems and policy implementation, this paper considers how actors' sensemaking and the exercise of discretionary power currently combine to challenge PHC re-orientation in the South African health system; and provides ex...