“Health for All” in a Least-Developed Country: HEALTH SERVICE AREA CONCEPT AND REFERRAL SYSTEM

It is generally considered that access to health­care is a global concern, especially in developing countries. In the least-developed and developing nations, problems with access relate to fundamental issues, such as infrastructure, physical facilities, availability of equipment and trained personnel. Infrastructural issues include lack of transportation to healthcare facilities and lack of means to commu­nicate with healthcare providers. Furthermore, the availability of high-quality healthcare for a nation is related to its overall economic activities.

In Lesotho, for ease of administration and provi­sion of health services, the health service areas (HSAs) are geographical divisions of 38,000- 40,000 people served by an HSA hospital (district hospital). generic singulair

Each HSA hospital, a secondary level facility, super­vises all the health centers and clinics under it, pro­vides basic hospital services and implements primary healthcare as well as all other government policies.

Lesotho has 19 HSAs, 10 of which are super­vised by government hospitals and nine by mission hospitals. The Lesotho Flying Doctors Service (LFDS) unit serves the very remote clinics in the mountainous areas, which are normally inaccessible by road. The LFDS uses the Queen Elizabeth II as its referral center. They operate using single-engine six-seater planes and helicopters for transportation. Thus, no area of the Mountain Kingdom is left uncared for in the provision of healthcare, and the referral system in Lesotho is organized to provide services of increasing complexity to the people. buy lexapro

At the primary level, the health centers/clinics, each serving between 6,000-10,000 people, are locat­ed so that they are accessible to the people within 1-2 hours’ walk. Staffed by nurse clinicians and nurse assistants, they provide community and primary healthcare services to the people. There are also the traditional birth attendants (TBA), whose services have been effectively integrated into the healthcare system at the primary level and have been instrumen­tal to successes recorded in health education, improved sanitation and the expanded immunization programs. Difficult cases at this level are referred to the next level of health facilities, the district hospitals.

Each district hospital, acting as a secondary level facility, has 100-250 beds. It is equipped with labo­ratory and radiological facilities to offer basic hospi­tal services to function as a full-fledged hospital. There is also an integrated mental observation and treatment unit. Regular visits by consultants from the national referral hospital are provided, and cases needing further specialist care are sent to the appro­priate referral center. Each district hospital has ambulance services for prompt patient evacuation to the specialist hospitals.
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To enhance communication between the health center/clinics and the hospitals, a one-way radio communication facility (referred to as “Roger-Roger”), is provided in places where telephone services are not available. Secondary level healthcare is provided by medical officers, registered nurses/mid-wives and nurse assistants as well as visiting consultants of various specializations.

Radiographers and laboratory technicians offer additional basic radiological and laboratory services. Pharmacy technicians provide pharmaceutical services. The secondary level of care caters to family health needs, including intermediate surgical procedures; cases beyond the limits of the facilities at this level are referred to the tertiary center. female viagra uk

The national referral hospital has facilities for computerized axial tomography (CAT) scan, echocardiography, endoscopies, operative laparascopy and basic radiological contrast studies. At this tertiary level of care, the health team consists of specialist consultants in the major discipline of pediatrics, obstetrics and gynecology, medicine, psychiatry, surgery and the laboratory sciences. There are also specialty trained nurses, nurse assistants and laboratory scientists. Services at this level are mainly curative and rehabilitative. Furthermore, patients requiring more exhaustive and highly specialized interventional management are referred to the Universitas Academic Hospital, Bloemfontein, Orange Free State in the neighboring Republic of South Africa. The commitment of the Lesotho government to the good health of its citizens is underscored by this latter part of the referral chain. The total cost of treatment at the Universitas is borne by the government through the Ministry of Health and Social Welfare. This latter service is provided for every citizen, when needed, irrespective of socioeconomic status. generic viagra uk

Category: Health

Tags: developing countries, healthcare delivery, healthcare financing, Lesotho

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