Customers health literacy on health check-up services and primary health care providers attitudes Dulamsuren Samdan, MD,MPH,PhD President, “New Public Health” (NPHA) Khishgee Majigzav, MD.MPH Ministry of Health, Mongolia

Outline Brief introduction of health services in Mongolia Background Significance of the study Goal/objectives Study Methodology Study location Main findings of the study Conclusion

Brief introduction of health services in Mongolia Primary health care is delivered by family health centres, soum health centres and intersoum hospitals. Secondary health care is provided by district and aimag general hospitals, rural general hospitals and private clinics. Tertiary health care is delivered by multispecialty central hospitals and specialized centres in Ulaanbaatar.

Patient pathways

Legal environment Health law 2011 State Policy on Public Health Health sector Master Plan

Background Primary health care aide, service coverage, prevention, early detection events were held based on the community active involvement. However due to the customers’ low health literacy on illness prevent and the primary health care providers’ negative attitudes toward early detection examination visiting primary health care are still not sufficient.

Significance of the study In Mongolia, there are not many studies which identify the health check-up service seeking active customer behavior. Studying the relationship between community members behavior that do not visit primary health care centers and primary health care providers’ attitude Identifying a methodology to improve the community voluntary visit for the health check- up and service providers’ attitude.

Goal To determine the customers health literacy on health seeking behavior and the primary health care provider’s attitude

Objectives Identify the community knowledge, attitude and practices toward health seeking behavior Primary health care providers’ attitude Identify the methodology to establish practices for health check-up service.

Study methodology Cross sectional study Quantitative and qualitative research methods Specifically developed questionnaire was used to collected information from customers; Specifically designed interview questions were used in meetings with the primary health care providing doctors and clinic specialists. The data analysis was done using SPSS

Study location ☆ ☆ ☆ 11 ☆ ☆

Main findings of the study The total of 846 customers and 112 health care providers were involved in this study

Community knowledge, attitudes and practices toward Health check-up services 727 participants or 85.9% knew about acquiring voluntary health check-up service

Community’ understanding of the right time to get health check-up examination, survey participants by volume

Is FHC visit voluntary? (by participants responses in percentage)

When do you visit the FHC? (by percentage)

The reason for FHC visit within the last year, (by respondents response in percentage)

Primary health care providers’ attitude

Why the community do not get health check up services? (the doctors and the clinics staff responses by reoccurrence) –Lack of Health education ( %) –No health check-up examination participation behavior +++ (60-69%) –Unaware of the health check-up examination significance ++++ ( 70-79%)

Continued There aren’t scheduled time table for check up examination. FHC health check-up examinations are conducted for the kindergartens, school students, and the elderly and disabled people. Lack of funding, insufficient supply of appropriate equipments and supplies, lack of human resource are the obstacles in conducting health check-up examination. Lack of health education, poor awareness on significance of health check-up examination and busy schedule of the working age people are the main reasons for the community for not participating in health examination

Health check-up examination organization and reason of not covered in health check up

The clinic sides factors that influence on none participation in health check-up examination, (responses by percentage)

When you receive health check-up examination voluntarily do the doctors an specialists greet you with smile? (by percentage)

Conclusion People who go to the family health centers /FHC/ only when they have illness (70%) The study findings demonstrated that doctors and FHC’s staff have unsatisfactory attitude toward their clients There is a further need to address the health seeking behavior of people, change their negative attitude toward health check ups and increase their awareness for importance to pay attention on their health

Thank you for your attention.