Capitalizing on specialists' services in rural family health unit: Interventional study

Abstract

For achieving universal health coverage in Egypt, Ministry of Health aims to improve the accessibility to quality specialized health care. Objectives: The objectives of the study were to explore legal and regulatory environment for the policy of specialists' visits to unit and assess the impact of gynecology specialist's visits on utilization pattern of gynecological services and clients' satisfaction. Methods: Settings. The study settings were Ministry of Health/Headquarters, Giza Health Directorate, El-Badrashin Health District and Hospital, and Met-Rahinah Unit. Study design. The study includes qualitative research (in-depth interviews with policymakers at all Ministry of Health levels and focus group discussions with service providers) and quantitative research (interventional operation research using separate sample pretest (n = 210) and posttest (n = 209) and family-planning service statistics). Results: Analysis of specialist outreach services indicated integration absence between preventive and curative sectors. Capitalizing on the policy of specialists' outreach visits to the unit could support clients' access quality services and reduce referral to get specialist services in hospitals. There is a 6-month intervention of scheduled visits of a female gynecologist to a rural health unit. The intervention led to 12% increase in efficiency and utilization of services compared with the previous 6 months. Clients' satisfaction increased from 27% to 73% after the intervention (.001, OR = 7.5, CI = 4.9-11.6). Conclusion: Scheduled specialists' visits increase services' efficiency and clients' satisfaction.