Improving Access to Malarial Healthcare by Eliminating Bureaucracy in Healthcare

Introduction

Prompt access to ideal malaria treatment is the central to make successful malaria control globally. However, minimal fevers are effectively treated with anti-malaria within 24 hours of system onset (Anaemene, 2016). Over the last decades, there has been an upsurge of plans to enhance effective malaria treatment across the world. Health care professionals are complaining of too much bureaucracy that hinders effective malaria treatment access. Eliminating bureaucracy in healthcare systems improves access to malaria healthcare because of effective malaria treatment where the patients get proper medication and support.

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Reduction of User Fee

Ensuring that, all malaria patients’ access effective malaria treatment promptly remains a challenge to health systems, which are resource constrained. Policy actions to address the diverse barriers to access the malaria health care should be designed around access dimensions and diversified interventions for the revitalisation of public health care systems. Failure to direct more efforts on addressing access barriers among the marginalised and poor society members, malaria will remain a major cause of mortality and morbidity. Fedeli, Leonida & Santoni (2018) deems user fees as an available regressive form of healthcare financing, as they highly contribute to imposition of unaffordable cost burdens on poor households, thus, representing a social exclusion facet subjected to poor households (Onyiah et al., 2018). The author further argues that, attacking healthcare's calcified bureaucracy is an ideal solution to skyrocketing healthcare costs. This can be achieved through increasing price transparency, reducing physician paperwork and eliminating soviet style regulations such as Certificates of Need.

Hopkins & Cunningham (2019) argue that, the high cost of treatment is a barrier to access to malarial health care. The high costs prevent people from seeking effective malaria treatment despite of the knowledge that should be appropriate for anti-malarial to treat malaria. Marginalised and poor members of the society seek for alternative cheap treatments, though ineffective. Hopkins & Cunningham (2019) suggest that, user fee should be removed for primary health care and a policy change should be enacted to ensure that all people have access to malaria treatment.

Paperless Health Care Provision

The NHS has experienced numerous attempts to free health practitioners from the shackles of unnecessary paperwork allowing more time for patient care. The process cuts back bureaucracy in the healthcare system. The bureaucracy and regulation review is necessary for the public, mid staffs and political desire for the growth of external assurance. According to Oliver (2017), the NHS is under pressure to restore public confidence, improve patients care quality and promote accountability and openness a smarter system of information use and a digital NHS is important for the growth of external assurance. According to Lalloo et al. (2016), the regulators lack real-time data while the data gets distributed across the inspectors and regulators.

A single-payer reform cuts Health costs for access to malaria effective treatment. This can be achieved by eliminating insurance middlemen and radically simplifying payments to hospitals and doctors. Misinformed insurance companies reject tests frustrating the physicians. This causes ineffective access to malarial treatments (Gauri et al., 2018). Lalloo et al. (2016) argue that, economic and financial factors affect the type of the provider to be visited, care-seeking timelines and decisions to seek care for suspected malaria. The decision to seek care is highly influenced by treatment affordability. Self-medication is prioritised especially by poor households. The travelling costs to healthcare facilities and the time spent travelling opportunity costs and the waiting periods at the facility are also crucial factors. Poor socioeconomic households seek care at informal or lower-level providers. According to Chen et al. (2016), strengthened capacity and role for community health workers are effective for high-quality care.

Slowing Down Frontline Staff Administrative Burdens

Establishing an agreed set of information, collected and held from one place, considering both local and national requirements of what is needed to deliver effective care ensures that, relevant information is recorded at minimal costs. This is because, the information is collected at once and is subsequently used for multiple purposes. According to Oliver (2017), the NHS tolerates far more information being demanded as opposed to the necessary information to serve its purpose. To this end, the staff, supervising and regulatory bodies are frustrated as they struggle to use the considerable data effectively. NHS managers, clinicians and board members and others bust bureaucracy claiming that they spend between one and three hours of their working day collecting and recording information personally. Additionally, about three-quarters of the information collected for national or regulators requirement is normally irrelevant (Michael et al., 2019).

The institutions that generate information requests focus on the impacts of frontline support. Most of the organisations justify their need for data from a legitimate perspective. However, this information is rarely shared between the sectors, organisations and departments. Although all these bodies have malaria patients in common, it is necessary to have repetitive and separate requests for similar information. Bassat et al. (2016) argued that, there is a need to streamline the available data ensuring that it is shared with the public and patients as well as cutting across diverse relevant institutions.

Any new request for information should be subject to is policed patient proof, thus the benefit outweighs the staff time and the cost to collect and provide quality care valuable intelligence. Oliver (2017) argued that, there is a need for NHS to catch up with some other sectors and exploit all the technology on offer so that staff can have more time to care for the patients. The paperless technology would impact greatly on creating more time for medical practitioners for taking care of malaria patients. For instance, the use of barcodes on medications and letters, use of smart devices that take readings and feed them into databases directly and voice recognition software applied in various parts of NHS to slow down frontline staff administrative burdens. Worth noting the NHS has a variety of the switches that would create up to 50% reductions in the time staffs spend on data input, though patchy creating a need to be systematically availed across the entire service (Ukoha et al., 2016).

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Providers’ Supplies

Provider supplies such as availability of drugs, award, and laboratory, equipment such as microscopes, good infrastructures and injecting drips attract patients at public health facilities. Additionally, the desire for specialist services inclusive of transfusions, investigations, admissions and surgery at higher-level facilities attract patients to public health care providers (Ejike, Ohaeri & Amaechi, 2017). On the other hand, first aid at lower-level providers such as community health workers and drug shops attract patients. Bassat et al. (2016) claimed that, accurate and rapid diagnosis of malaria is integral to the ideal treatment of affected individuals and in the prevention of the further spread of the infection in the community. CDC provides technical and diagnostic assistance on the diagnosis of malaria as a national reference centre for malaria. Notably, CDC provides specialised tests such as PCR, serology and drug resistance testing and microscopic diagnosis. Additionally, training and telediagnosis are provided for malaria through DPDx (Kosack, Page, & Klatser, 2017). CDC provides 24-hour basis consultations for clinicians in need of diagnosis, access to anti-malarial medication, management of malarial cases or urgent issues linked with adverse anti-malarial drug reactions. According to Kosack, Page & Klatser (2017), patients are attracted to medical health providers that they believe the medicines or treatment would cure their illness. For instance, patients attend biomedical health facilities as they strongly believe they have appropriate and adequate treatment to cure their illness.

Health Care Provider’s Positivity

Kosack, Page & Klatser (2017) claims that, a positive attitude by the health service provider includes polite, friendly, empathy and consolation which enhances the access to appropriate malarial treatments. The author highlights that, the health seekers desire provision of health services with respect, dignity and humility. Health seekers are more attracted to medical practitioners who offer both consolation and guidance.

Proximity to Healthcare

Easy access or proximity to health care providers is a key factor reflecting preferences for the medical service providers located where transport is easy to afford and secure (Brunette, 2017). Patients frequent where medical provider timeliness of services includes short waiting times and convenient opening hours. This helps malaria patients to access timely treatment due to short waiting hours and accessibility of the clinic's conveniences.

Higher-Level Providers

Specific attractions to higher-level medical providers are linked with qualifications of staff and perceived to provide better quality health services, therefore patients are recommended by other medical providers to seek these services. A higher-level of medical facilities is attractive to malaria patients as they are linked with a higher level of medical providers experience and formal training. According to patients perceive these providers as competent, with great expertise and ideal to treat symptoms linked with uncomplicated malaria. Patients visit public and private health facilities for their better quality services which include qualified personnel, availability of drugs and laboratory services. In essence, this incorporates prompt diagnosis of malaria, ideal treatment and good follow up advice (Oleribe & Taylor-Robinson, 2016).

Conclusion

From the literature and the theory above, access to malarial health services in the developed countries focuses on patients and their community's characteristics. This paper has reviewed access to malarial healthcare improvement by bureaucracy elimination in the healthcare systems. It has also reviewed the medical provider's aspect that attracts patients to seek health care services. Diverse characteristics that attract patients to providers such as proximity to patients, lower cost of services, positive manner of providers, and timeliness of services and availability of medicines. The paper highlights that access to services necessitates attention the highlighted aspects that attract patients and recommends that bureaucracy to be eliminated for the patients to receive prompt and quality health care.

References

Anaemene, B. U. (2016). The Dilemma of Bureaucratic Rationalisation: The Role of the World Health Organisation during the Nigerian Civil War and its Aftermath, 1967-1975. Lagos Historical Review, 16(1).

Bassat, Q., Tanner, M., Guerin, P. J., Stricker, K., &Hamed, K. (2016).Combating poor-quality anti-malarial medicines: a call to action. Malaria journal, 15(1), 302.

Brunette, G. W. (2017). CDC Yellow Book 2018: health information for international travel. Oxford University Press.

Chen, I., Clarke, S. E., Gosling, R., Hamainza, B., Killeen, G., Magill, A., ...& Riley, E. M. (2016). “Asymptomatic” malaria: a chronic and debilitating infection that should be treated. PLoS medicine, 13(1), e1001942.

Ejike, B. U., Ohaeri, C. C., & Amaechi, E. C. (2017). Home management practices and its impact on malaria prevalence amongst pregnant women in South-Eastern Nigeria. Asian Pacific Journal of Tropical Disease, 7(2), 68-70.

Fedeli, S., Leonida, L., &Santoni, M. (2018). Bureaucratic institutional design: the case of the Italian NHS. Public Choice, 177(3-4), 265-285.

Gauri, V., Jamison, J. C., Mazar, N., Ozier, O., Raha, S., & Saleh, K. (2018). Motivating bureaucrats through social recognition: evidence from simultaneous field experiments. The World Bank.

Hopkins, H., & Cunningham, J. (2019). Point‐of‐Care and Near‐Point‐of‐Care Diagnostic Tests for Malaria: Light Microscopy, Rapid Antigen‐Detecting Tests and Nucleic Acid Amplification Assays. Revolutionizing Tropical Medicine: Point‐of‐Care Tests, New Imaging Technologies and Digital Health, 137-158.

Kosack, C. S., Page, A. L., &Klatser, P. R. (2017). Better health for everyone». Bulletin of the World Health Organization, 95, 639-645.

Kosack, C. S., Page, A. L., &Klatser, P. R. (2017).A guide to aid the selection of diagnostic tests. Bulletin of the World Health Organization, 95(9), 639.

Lalloo, D. G., Shingadia, D., Bell, D. J., Beeching, N. J., Whitty, C. J., &Chiodini, P. L. (2016). UK malaria treatment guidelines 2016. Journal of Infection, 72(6), 635-649.

Michael, G. C., Aliyu, I., Idris, U., Ibrahim, H., Olalere, O. S., Grema, B. A., ... & Abah, S. (2019). Investigation of malaria by microscopy among febrile outpatients of a semi-rural nigerian medical center: What happened to malaria control programs?. The Nigerian Journal of General Practice, 17(1), 23.

Oleribe, O. O., & Taylor-Robinson, S. D. (2016). Before sustainable development goals (SDG): why Nigeria failed to achieve the millennium development goals (MDGs). The Pan African medical journal, 24.

Oliver, D. (2017). David Oliver: Let’s streamline NHS bureaucracy and then leave it well alone. Bmj, 357, j2426.

Onyiah, P., Adamu, A. M. Y., Afolabi, R. F., Ajumobi, O., Ughasoro, M. D., Odeyinka, O., ... & Ajayi, I. O. (2018). Bottlenecks, concerns and needs in malaria operational research: the perspectives of key stakeholders in Nigeria. BMC research notes, 11(1), 272.

Ukoha, N. K., Ohiri, K., Chima, C. C., Ogundeji, Y. K., Rone, A., Nwangwu, C. W., ... & Reich, M. R. (2016). Influence of organizational structure and administrative processes on the performance of state-level malaria programs in Nigeria. Health Systems & Reform, 2(4), 331-356.

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