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Publication Years
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1
There is a crucial need to initiate and sustain fistula programs that increase access and strengthen the capacity of the health care system to provide high quality services for repair and care of wo
...
men living with female genital fistula. Therefore, it is important to pay particular attention to the quality of training, and to proactively determine how this training fits into the health care system. Furthermore, the quality of training is improved by committing adequate resources to ensure competent trainers, able to train and follow-up their trainees. Women with genital fistulae, their families and the community need to have confidence in the health care system. It is therefore necessary to have pro-active discussions about the quality of training with relevant stakeholders. These fistula training guidelines and standards go towards harmonizing the training approach and to improving the quality of training and hence, service 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 associa
...
ted 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.
more
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement
...
of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future development needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
more
Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates
...
of the additional resources needed to strengthen comprehensive health service delivery towards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Summary of National Priorities - Malawi
Community Health Roadmap
United States Agency for International Development; Bill & Melinda Gates Foundation; The Rockefeller Foundation; World Bank Group; community health acceleration partnership; unicef
(2021)
CC
Malawi’s first National Community Health Strategy (NCHS, 2017-2022) defines a new community health system in which community health cadres, both formal and non-formal, deliver services of the Essential Health Package, with a focus on child and mat
...
ernal health. It envisages an integrated approach to service delivery and is embedded in Malawi’s Health Sector Strategic Plan (HSSPII).
more
July 2023 version .The 2023 ART guideline introduces simplified ART provision and harmonised methods of management of children, adolescents and adults, as well as pregnant women living with HIV/AIDS
...
, TB and other common opportunistic infections.
The guidelines also provide guidance on the use of Dolutegravir (DTG) dispersible tablets for children from 3kg and 4 weeks old.
These guidelines have been revised with the Differentiated Models of Care SOPs to ensure simultaneous consideration and alignment of clinical, adherence and service delivery updates.
more
The role of an essential health benefit in health systems in east and southern Africa: Learning from regional research
R. Loewenson, M. Mamdani and others
Regional Network for Equity in Health in east and southern Africa (EQUINET)
(2018)
C1
Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 113
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for deve ... loping EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. more
This report synthesises the learning across the full programme of work. It presents the methods used, the context and policy motivations for deve ... loping EHBs; how they are being defined, costed, disseminated and used in health systems, including for service provision and quality, resourcing and purchasing services and monitoring and accountability on service delivery and performance, and for learning, useful practice and challenges faced. more
International Journal of Mental Health Systems December 2011, 5:3
Community mental health programs in low-income countries face a number of challenges. Using a case study methodology developed for
...
this purpose, it is possible to compare programs and begin to assess the effectiveness of diverse service delivery models
more
AHRO Reviews of Nursing
recommended
AHRO Reviews of Nursing is an international open-access journal that promotes the dissemination of quality knowledge in all aspects of nursing pra
...
ctice
The AHRO Review of Nursing (ARN) is an international, open-access, peer reviewed, scientific journal that seeks to promote the dissemination of quality knowledge related to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, ARN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
ARN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to ARN's scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
more
Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery
...
of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovascular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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Hum Resour Health 20, 37 (2022). https://doi.org/10.1186/s12960-022-00735-y.
For countries to achieve universal health coverage, they need to have well-functioning and resilient health systems. Achieving this requires a sufficient number of qualifi
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ed health workers and this necessitates the importance of investments in producing and regulating health workers. It is projected that by 2030, Africa would need additional 6.1 million doctors, nurses, and midwives. However, based on the current trajectory, only 3.1 million would be trained and ready for service delivery. To reduce current shortages of the health workforce, Africa needs to educate and train 3.0 million additional health workers by 2030. This study was conducted to describe the distribution and ownership of the health training institutions, production of health workers, and the availability of accreditation mechanisms for training programmes in the WHO African Region.
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USAID/Afghanistan’s $443 million investment in the Afghan Sustainable Water Supply and Sanitation (SWSS) activity is one of the Agency’s largest single investments in sustainable rural water supply del
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ivery. The project installed about 2,123 wells with hand pumps across Afghanistan from 2009–2012. This report presents findings from a retrospective evaluation of a random selection of wells with hand pumps installed under the SWSS project.
This evaluation’s key purpose is to identify factors that support and hinder sustainable water service delivery in different contexts. more
This evaluation’s key purpose is to identify factors that support and hinder sustainable water service delivery in different contexts. more
This policy brief describes key HIV viral load thresholds and the available viral load testing approaches for monitoring how well antiretroviral therapy is working for people living with HIV. It provides clarification for and elaborates upon the current treatment monitoring algorithm from the Consol
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idated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach.
This information can help people living with HIV to live healthy lives, ensure that HIV is not transmitted to other people and support policy-makers in determining the optimal allocation of resources for viral load testing and communicating the results.
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All young people, including those with special needs and from the most vulnerable groups, have the right to quality health care services. Unfortunately, this right is not a reality, particularly in the case of sexual and reproductive health services
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. Many youth in need of sexual and reproductive health care may either decline or be denied access to health services for a variety of reasons: Providers are often biased and do not feel comfortable serving youth who are sexually active; youth do not feel comfortable accessing existing services because they are not "youth-friendly" and may not meet their needs; and, often, community members do not feel that youth should have access to sexual and reproductive health services.
To address provider and site bias toward serving youth, EngenderHealth created a training curriculum intended to sensitize all staff at a health care facility on the provision of youth-friendly services. The curriculum was created as a result of the participatory work that we have been doing with youth in Nepal to address the needs of all levels of providers at different service-delivery settings. The curriculum has been field-tested and used in Nepal, Russia, Mongolia, and the United States.
Youth-Friendly Services allows staff to reflect upon and assess their own beliefs about adolescent sexuality while ensuring that those values and attitudes do not compromise the basic sexual and reproductive health rights to which youth are entitled. The curriculum also helps providers understand cross-cultural principles of adolescent development and health needs specific to youth. Once participant knowledge, attitudes, and skills are improved, sites conduct a self-assessment on the youth-friendliness of their services and create an action plan for specific improvements.
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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number
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of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disabili
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ty for some people infected. However, disruption to essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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This report describes efforts in nine countries, supported by the 2gether 4 SRHR programme and other partners, highlighting the results achieved and learning on improving the health and wellbeing of adolescent and young mothers and their families. K
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ey insights include the importance of responsive service delivery and social support as well as service provision across sectors.
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Ending the neglect to attain the Sustainable Development Goals: a road map for neglected tropical diseases 2021–2030 (“the road map”) sets explicit targets for the elimination of onchocerciasis by 2030, including eliminating the need for mass
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drug administration (MDA) of ivermectin in at least one focus in 34 countries, in more than 50% of the population in at least 16 countries, and in the entire endemic population in at least 12 countries. The road map also targets interruption of onchocercal transmission in 12 countries by 2030. Achieving these targets and milestones will require a number of critical actions. These include establishing a well-coordinated global partnership to connect stakeholders and existing partnerships at all levels in order to improve coordination and collaboration, accelerate technical progress, implement a harmonized research agenda and enhance service delivery.
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Int. J. Environ. Res. Public Health 2022, 19(4), 2359; https://doi.org/10.3390/ijerph19042359.
With improved access to antiretroviral treatment (ART), adults with HIV live longer to reach older age. The number of older adults living with HIV is inc
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reasing steadily, giving rise to a new population of interest in HIV research and for invigorated considerations in health service delivery and policy. We analysed the profile of comorbidities in older people (50 years and older) living with HIV in South Africa.
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