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The case study focused on: (1) Expansion of mobile clinic services and visit schedule; (2) Clinical monitoring and evaluation system; and (3) Recognition, documentation and brief psychosocial support for symptoms suggestive of anxiety, depression and PTSD.
The revised mobile health strategy, implemented in 6 villages of Walungu Territory over the course of one year (July 2010 June 201111), had three primary components: (1) Expansion of mobile clinic services and visit schedule; (2) Clinical monitoring and evaluation system; and (3) Recognition, documentation and brief psychosocial support for symptoms suggestive of anxiety, depression and PTSD.
FORAL's mobile clinic services are located at the PHC, typically within 30 – 90 minutes walking distance from the targeted villages.
Also, the government has taken several innovative actions, such as authorizing community health workers to provide Sayana Press, creating new mobile clinic services for isolated communities, and integrating family planning in the school health curriculum.
Health: UNICEF will procure and distribute essential emergency drugs and equipment to 50 health centres to provide basic maternal and child health services; facilitate mobile clinic services; rehabilitate and reconstruct health facilities; and train 150 health staff in maternal and child health clinic activities.
Depending on space, FORAL mobile clinic services were provided within a dedicated space in the PHC or in a tent located just outside the PHC; this ensured that visits to the mobile clinic were seen as part of normal health services, not services only for raped women.
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In 2006, in response to the conflict and the resultant significant civilian displacement to temporary relief camps Médecins Sans Frontières (MSF) started a primary health care mobile clinic service in the border area between the states of Chhattisgarh and Andhra Pradesh.
The proportion of clients, 31 to 50 years and older than 50 years, were significantly more likely to access mobile than clinic services.
Participants emphasized the importance of regular and published visit schedules and inclusion of community members in planning mobile health clinic services.
No significant difference was found for socio-economic variables between participants who accessed mobile and clinic services (Table 3) with the exception of access to own piped water, defined as piped water in their house or yard.
Future research should determine the drivers and barriers to HCT at either mobile or clinic services through community surveys to assess those who have never tested previously and may be at high risk.
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