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Impact of health systems strengthening on coverage of maternal health services in Rwanda, 2000–2010: a systematic review
Maurice Bucagu, Jean M. Kagubare, Paulin Basinga, Fidèle Ngabo, Barbara K Timmons & Angela C Lee
Reproductive Health Matters
(2012)
CC
From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public heal
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th system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the literature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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The Department of Health is committed to providing the best quality care to patients and users o
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f health services, in order to meet their expectations and needs, and to improve service delivery.
The main purpose of the National Core Standards is to:
• Develop a common definition of quality of care, which should be found in all health establishments in South Africa as a guide to the public and to managers and staff at all levels;
• Establish a benchmark against which health establishments can be assessed, gaps identified, strengths appraised; and
• Provide a national framework to certify health establishments as compliant with standards
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High prices, hard-to-access human insulin, few insulin producers, and weak health systems are just some of the barriers that people with diabetes f
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ace a century after insulin was discovered, WHO notes in a new report
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Delivering quality health services: A global imperative for universal health coverage
Kieny, Marie-Paule; Evans, Timothy Grant; Scarpetta, Stefano; Kelley, Edward T.; Klazinga, Niek; Forde, Ian; Veillard, Jeremy Henri Maurice; Leatherman, Sheila; Syed, Shamsuzzoha; Kim, Sun Mean; Nejad, Sepideh Bagheri; Donaldson, Liam
World Health Organization (WHO), Organisation for Economic Co-operation and Development (OECD), and The World Bank
(2018)
C_WHO
Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, med ... ication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
Today, inaccurate diagnosis, med ... ication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training and expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries. more
Conclusion: To ensure that people with disabilities can successfully access the necessary health services, the barriers on the demand side (the ind
...
ividuals requiring healthcare) as well as the barriers that are part of the healthcare system, should be attended to.
more
Save the Children in collaboration with the Pune Municipal Corporation (PMC) and the state National Health Mission (NHM) undertook this study in the urban slums of Pune City to generate learnings fo
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r designing a city-specific public health approach to improve MNH services for the urban poor.
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state
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that efficiency measurement can be a substantial contribution to saving lives. Therefore we analyse the performance of health centres in rural Burkina Faso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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This paper explores access to water, sanitation, and health in pastoral communities in northern Tanzania. It argues that the concept of gender, use
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d on its own, is not enough to understand the complexities of sanitation, hygiene, water, and health. It explores pastoralists’ views and perspectives on what is ‘clean’, ‘safe’, and ‘healthy’, and their need to access water and create sanitary arrangements that work for them, given the absence of state provision of modern water, sanitation, and hygiene (WASH) infrastructure. Although Tanzania is committed to enhancing its citizens’ access to WASH services, pastoral sanitation and hygiene tend to be overlooked and little attention is paid to complex ways in which access to ‘clean’ water and ‘adequate sanitation’ is structured in these communities. This paper offers an intersectional analysis of water and sanitation needs, showing how structural discrimination in the form of a lack of appropriate infrastructure, a range of sociocultural norms and values, and individual stratifiers interact to influence the sanitation and health needs of pastoralist men, women, boys, and girls.
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Namibia has a two-tier health system: public health under the Ministry of Health and Social Services (MoHSS) and the private
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health service. MoHSS‘ vision is to be the leading provider of quality health care and social services according to international set standards. Since Namibia’s independence, the government adopted Primary Health Care (PHC) as the approach to providing health service and as a key strategy in attaining the goal of health. Good health is also strengthened by the Sustainable Development Goals (SDGs). The SDGs provide a road map for human development and, among others, systematically address the social determinants of health. Notable is Goal 3, which focuses on good health and well-being.
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Security Survey for Health Facilities
recommended
The purpose of the survey is to identify the level of preparedness required by a health-care facility t
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o be able to continue operating during, or following a conflict-related security event.
The survey method provides a measure of the security and preparedness of a given health facility in its specific context. Such a measure offers evidence-based guidance to assess whether urgent action needs to be taken and, if so, in what form.
Decision-makers can prioritize the most effective actions to mitigate specific risks and, eventually, will be able to rank the importance of needs faced by multiple facilities.
The survey covers three modules: the hazards affecting the facility, the current management procedures in place and the state of the physical infrastructure. Each of these modules is further divided into categories, and each category contains the questions – or indicators ‒ that cover the actual issues addressed in the survey. A detailed description of each indicator is provided in this manual. more
The survey method provides a measure of the security and preparedness of a given health facility in its specific context. Such a measure offers evidence-based guidance to assess whether urgent action needs to be taken and, if so, in what form.
Decision-makers can prioritize the most effective actions to mitigate specific risks and, eventually, will be able to rank the importance of needs faced by multiple facilities.
The survey covers three modules: the hazards affecting the facility, the current management procedures in place and the state of the physical infrastructure. Each of these modules is further divided into categories, and each category contains the questions – or indicators ‒ that cover the actual issues addressed in the survey. A detailed description of each indicator is provided in this manual. more
UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services
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, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills & vocational training opportunities. The WFHS also facilitates referral to other services including Psychosocial Counseling Centers (PSCCs).
The aim of this guidance note is to provide an overview of approaches on how to successfully integrate adolescent and youth (A&Y) programming into the WFHSs. UNFPA activities for women’s and girl’s protection in health facilities aim to protect women and girls including child marriage. Given that vulnerable women and girls in Afghanistan continue to access health facilities, particularly for reproductive health and maternal health services, it is crucial to provide support for survivors in the same location to improve access to essential psychosocial and protection support for women and girls. To support the integration of A&Y in the WFHS programming each WFHS will be supported by two full time Youth Educators. A female Youth Educator who will be working within the WFHS and a male Youth Educator who will be working in the community. The role of the Youth educators is to increase A&Y awareness and knowledge on living healthy lifestyles and ensuring a referral system to services in existing facilities.
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In sum, the goal is to understand the need to increase fiscal space for health as a prerequisite, but within the framework of efforts
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to transform the health system. These changes should foster equitable and efficient expenditures and create or strengthen comprehensive integrated health systems with a first level of care capable of solving health problems and coordinating networks, based on a primary health care approach that offers not only curative care but also health promotion and disease prevention services.
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More time or more money to improve nutrition in Benin Republic?
M. C. D. N. Vodouhe, L. Fakambi
Institut National des Recherches Agricoles du Bénin (INRAB)
(2015)
C2
Children malnutrition eradication in developing countries is a real challenge, especially among
vulnerable population. There are so many effort towards women (who are the main care providers)
socio-economic situation in order
...
to improve their children nutrition. This article aims to identify the
impact of mothers’ activities on child nutrition and care. Interviews were used to collect data from
mothers of children less than 5 years old. Pearson correlation test and regression models were
performed to highlight relation and to identify the main factors that affect child nutrition and care. The
nutritional statuses of children show a high prevalence of underweight (38.46%), emaciation (25.17%)
and stunting (23.77%). Statistic results show that a child whose mother has food processing as main
activity has 2,322 more times to not suffer from emaciation malnutrition compared to a child whose
mother has trade as main activity. A child whose mother has high revenue has 1.463 more times to
not be suffering from stunting malnutrition compared to a child whose mother has lower revenue. A
child whose father has fishing as main activity has 8,4 more chance to not be suffering from stunting
malnutrition compared to a child whose father has another activity as main activity. A child whose
father is present in the household has 8.11 more chance to not suffer from stunting malnutrition
compared to a child whose father is absent. A child from mother who has food processing as main
activity is 2,464 more times preserved from fever compared to a child from mother whose main activity
is trade. Moreover child position, child feeding with porridge, child nursing are correlated with mother
activity. This situation is justified by the fact that mother need money to improve child nutrition and
health but they are also confronted to the fact that those activity that provide significant money are
sometime time consuming and not permit to take care of children in term of feeding practices, hygiene
control etc. Therefore it is important that intervention towards women take in consideration those
factors (money and time) but also the family in the whole.
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This document aims to assist policy‑makers, health care providers and researchers to understan
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d key concepts in health ethics and to identify basic ethical questions surrounding health and health care. It illustrates the challenges of applying ethical principles to global public health and outlines practical strategies for dealing with those challenges.
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This Toolkit aims to support the understanding and implementation of integrated mental health programs in humanitarian settings. It provides a framework for essential steps and components, with asso
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ciated key guidance and resources, that strengthen the integration process, and is primarily intended for (1) implementing agencies, but may also be useful for (2) donors, and (3) government actors. Users can access the three steps & three cross cutting components relevant to current program needs, or stages of programming.
Accessed August 7, 2019
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CHWs demonstrated social commitment and purpose in the short term observed. The evaluation of the training of CHWs revealed that most demonstrated the necessary skills for referrals to prevent complications, caring for newborns and their mothers at
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home immediately after discharge from health care centers. CHW upskilling training on maternal-newborn services should be prioritized in the most affected areas.
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This field study to assess the pharmaceutical situation was undertaken in Ghana in May-June 2008 using a standardized methodology developed by the World Health Organization. Th
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e study assessed medicines availability and affordability, geographical accessibility, quality and rational use among other issues. The survey was conducted in six regions. In each region, 6 public health care facilities, 12 private pharmacies and 1 warehouse were surveyed.
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As the culminating volume in the DCP3 series, volume 9 will provide an overview of DCP3 findings and methods, a summary of messages and substantive lessons to be taken from DCP3, and a further discussion of cross-cutting and synthesizing topics acro
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ss the first eight volumes. The introductory chapters (1-3) in this volume take as their starting point the elements of the Essential Packages presented in the overview chapters of each volume. First, the chapter on intersectoral policy priorities for health includes fiscal and intersectoral policies and assembles a subset of the population policies and applies strict criteria for a low-income setting in order to propose a "highest-priority" essential package. Second, the chapter on packages of care and delivery platforms for universal health coverage (UHC) includes health sector interventions, primarily clinical and public health services, and uses the same approach to propose a highest priority package of interventions and policies that meet similar criteria, provides cost estimates, and describes a pathway to UHC.
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Background document to the 2018 joint statement by WHO, UNFPA, UNICEF, ICM, ICN, FIGO and IPA: definition of skilled health personnel providing care
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during childbirth
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