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This report explores community-focused change initiatives in the financing, organization, and delivery of mental health services in Peru from 2013
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to 2016. It examines the national dimension of reforms but focuses above all on implementation and results in the economically fragile district of Carabayllo, in northern Lima.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out
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of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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The interventions summarized in this guide are intended to lower the risk of delivery and post-partum complications for both the mother and the newborn, particularly the risk
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of postpartum haemorrhage and infections, and improve the immediate care of premature babies. The recommendations are also intended to minimize the exposure of health care providersto blood and bodily fluids that could transmit Ebola
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Monitoring is a crucial element in any successful programme. It is important to
know if health care facilities – and ultimately countries – are meeting the agreed
goals and objectives for prev
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enting and managing cardiovascular diseases (CVD).
Monitoring is the on-going collection, management and use of information to
assess whether an activity or programme is proceeding according to plan and/
or achieving defined targets. Not all outcomes of interest can be monitored. Clear
outcomes must be identified that relate to the most important changes expected to result from the project and to what is realistic and measurable within the timescale of the project. Once these outcomes have been articulated, indicators can be chosen that best measure whether the desired outcomes are being met.
To allow progress to be monitored, this module provides a set of indicators on
CVD management. Agreeing on a set of indicators allows countries to compare
progress in CVD management and treatment across different districts or
subnational jurisdictions, as well as at a facility level, identify where performance
can be improved, and track trends in implementation over time. Monitoring
these indicators also helps identify problems that may be encountered so that
implementation efforts can be redirected.
This module starts from the collection of data at facility level, which is then
“transferred up” the system: facility-level data are aggregated at subnational level
to produce reports that allow tracking of facility and subnational performance over time and allow for comparison among facilities. National-level data are obtained through population-based surveys.
Implementing a monitoring system requires action at many levels. At national and
subnational levels, staff can determine how best to integrate data elements into
existing data collection systems – such as the routine service-delivery data that are collected through facility-level Health Management Information Systems (HMIS).
In the facility setting, personnel must be aware of what data are needed. Sample
data-collection tools are included, recognizing that countries use different datamanagement systems for HMIS, so the CVD monitoring tools will be adapted to work with the HMIS system being used by the country, such that the indicators can be collected with minimal disruption/work to existing systems and tools
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption
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of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multiple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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Primary care can play a significant role in the COVID-19 response by differentiating patients with respiratory symptoms from those with COVID-19, making an early diagnosis, helping vulnerable people cope with their anxiety about the virus, and reduc
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ing the demand for hospital services. This document provides national and subnational health managers, as well as staff at primary care facilities, with interim guidance on timely, effective and safe supportive management of patients with suspected and confirmed COVID-19 at the primary care level; and delivery of essential health services at the primary care level during the COVID-19 outbreak
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Consumables associated with oxygen delivery are generally intended as single use devices. They should be treated as infectious1 material and disposed of accordingly. Disposal
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of patient interface, tubing, water bag and water chamber, for example, should be done as per facility standard operating procedures for infectious/biohazardous waste management.
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The objective of this brief is to consolidate WHO guidance to support the implementation of high-quality HIV services through approaches to policy, strategy and service
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delivery, to suggest considerations for selecting measures of high-quality services and to provide case examples of quality management in HIV services in low- and middle- income countries.
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During ventilation and between patients
Always read and follow the instructions and recommendations of the manufacturer`s manual
Consumables associated with oxygen delivery are generally intended
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as single use devices, and should be treated as infectious material and disposed of accordingly. Dispose of patient interface and filters, for example, as per facility standard operating procedures for infectious/ biohazardous waste management.
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During non-invasive ventilation and between patients
Always read and follow the instructions and recommendations of the manufacturer`s manual
Consumables associated with oxygen delivery are genera
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lly intended as single use devices, should be treated as infectious material and disposed of accordingly. Dispose of patient interface and filters, for example, as per facility standard operating procedures for infectious/biohazardous waste management.
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Bilevel or two-level Positive Airway Pressure (BiPAP).
Continuous Positive Airway Pressure (CPAP)
During non-invasive ventilation and between patients
Always read and follow the instructions and recommendations of the manufacturer`s manual
Con
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sumables associated with oxygen delivery are generally intended as single use devices, should be treated as infectious material and disposed of accordingly. Dispose of patient interface and filters, for example, as per facility standard operating procedures for infectious/biohazardous waste management
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These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis
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C infection and the 2017 WHO Guidelines on hepatitis B and C testing. These priority areas are:
direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
simplified HCV service delivery (decentralization, integration and task sharing)
HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing.
These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.
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Comprehensive Abortion Care Training
Ministry of Health & Family Welfare Government of India
Ministry of Health & Family Welfare Government of India
(2010)
C1
Training and Service Delivery Guidelines
DHS Further Analysis Reports No. 111
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in ... Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delivery, and timely postnatal care (PNC).
This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12 regions. We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use. We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery. more
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in ... Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delivery, and timely postnatal care (PNC).
This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12 regions. We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use. We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery. more
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predispos
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ing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delivery, and timely postnatal care (PNC).This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12regions.We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use.We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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(You need free registration to download the book)
Disasters and public health emergencies can stress health care systems to the breaking point and
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disrupt delivery of vital medical services. During such crises, hospitals and long-term care facilities may be without power; trained staff, ambulances, medical supplies and beds could be in short supply; and alternate care facilities may need to be used. Planning for these situations is necessary to provide the best possible health care during a crisis and, if needed, equitably allocate scarce resources
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The Ministry of Health together with its partners realizes that efficient and effective
delivery of
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clinical care is highly dependent on the availability of appropriately
upgraded environment, which is in well facilitated space. Such facilities and utilities
should always be properly designed, built, and maintained, so as to ensure efficient
treatment in clean and safe from infection.
The main challenges in achieving this include the lack of, appropriate holistic and
futuristic management plans, human resource for facility/utility management and
maintenance, adequate budget funds for renovation/maintenance activities at all
levels which means daily and long-term of facility maintenance plans and executions.
It is hoped that the guidelines will help to standardise
design of medical facilities and utilities country wide and result in efficient and
effective establishment of these life-saving function
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Continuum of HIV services refers to a comprehensive package of HIV prevention, diagnostic, treatment, care and support services provided for people
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at risk of infection or living with HIV and their families. This revised edition of the guidelines for use of ARV and opportunistic infection
(OI) drugs in adults, adolescents and children is based on recent national and
global evidences and experiences. The Federal Ministry of Health believes that
these guidelines, along with other national guidelines and training manuals, will be
instrumental in maintaining the standard of care and ensuring quality of HIV service
delivery.
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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery
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of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-limited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. P4P can affect health
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care by providing incentives for providers to put more effort into specific activities, and by increasing the amount of resources available to finance the delivery of services. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. Treatment facilities were enrolled in the P4P scheme in 2006 and comparison facilities were enrolled two years later. The incentive effect is isolated from the resource effect by increasing comparison facilities’ input-based budgets by the average P4P payments to the treatment facilities. The data were collected from 166 facilities and a random sample of 2158 households. P4P had a large and significant positive impact on institutional deliveries and preventive care visits by young children, and improved quality of prenatal care. The authors find no effect on the number of prenatal care visits or on immunization rates. P4P had the greatest effect on those services that had the highest payment rates and needed the lowest provider effort. P4P financial performance incentives can improve both the use of and the quality of health services. Because the analysis isolates the incentive effect from the resource effect in P4P, the results indicate that an equal amount of financial resources without the incentives would not have achieved the same gain in outcomes.
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