Service Delivery

Performance-Based Financing (PBF) has been advanced as a solution to contribute to improving the performance of health systems in developing countries. This is the case in Benin. This study aims to analyse how two PBF approaches, piloted in Benin, behave during implementation and what effects they produce, through investigating how local stakeholders perceive the introduction of PBF, how they adapt the different approaches during implementation, and the behavioural interactions induced by PBF. [from abstract]

In the 20 years since South Africa underwent a peaceful transition from apartheid to a constitutional democracy, considerable social progress has been made toward reversing the discriminatory practices that pervaded all aspects of life before 1994.1-5 Yet the health and well-being of most South Africans remain plagued by a relentless burden of infectious and noncommunicable diseases, persisting social disparities, and inadequate human resources to provide care for a growing population with a rising tide of refugees and economic migrants. [from abstract]

The development of comprehensive community based health information systems is increasingly becoming important for measuring and improving the quality of health services. Many developing countries including Kenya have made efforts to strengthen their national health information systems to provide information
for decision-making in managing health care services. The purpose of this paper is to explore how data collected at the community level is utilised by various stakeholders within the community in order to produce actionable information for decision making. [from abstract]

Health navigation is an approach to improving healthcare delivery that helps individuals access the care they need.People called navigators work with each client to identify and reduce any barriers they may face that make it difficult for them to get quality, timely care. Services are tailored to each individual and may include appointment scheduling, transportation, accompaniment, referrals, health education, and counselling. [from introduction]

Qualified and motivated human resource (HR) is essential for a qualitative and robust health care delivery. Understanding the constraints and difficulties of health managers is essential for effective and efficient management of health care services. The present study is aimed at understanding the various constraints and difficulties of human resource management (HRM) in the public health sector. [from abstract]

Pharmacist participation in ward rounds is of increasing interest for better pharmaceutical care, yet most pharmacists do not engage in this activity. The objective was to obtain public sector pharmacists’ views and perceptions on their involvement in ward rounds. [from abstract]

In the last decade, evidence has emerged that user fees are regressive and undermine equitable access to essential health services, particularly for women and children. It is against this background that the government of Kenya took decisive action to remove user fees in dispensaries and health centers and to provide free maternal health services at all public health facilities in an effort to increase access to essential health services and reduce maternal mortality. [adopted from introduction]

Community-based monitoring and planning (CBMP) of health services in Maharashtra state, India represents an innovative participatory approach to improving accountability and healthcare delivery. This paper examines the successes and challenges of this process, discussing lessons learned and the potential for generalizing such initiatives to other sectors and regions. Maharashtra’s experiment could inform ‘communitization’ of health services in diverse contexts, as an alternative to
privatization and as a means to enhancing the ‘publicness’ of health services. [from summary]

Evidence-based behavior change interventions addressing health systems must be identified and disseminated to improve child health outcomes. Studies of the efficacy of such interventions were identified from systematic searches of the published literature. Two hundred twenty-nine of the initially identified references were judged to be relevant and were further reviewed for the quality and strength of the evidence.

Interactions between patients and service providers frequently influence uptake of prevention of mother-to-child
transmission (PMTCT) HIV services in sub-Saharan Africa, but this process has not been examined in depth. [from abstract]

Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence,and treatment completion. In this study,we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. One of the worst performance indicators was low percentage of cure.

Implicit rationing of nursing care is the withholding of or failure to carry out all necessary nursing measures due to lack of resources. There is evidence supporting a link between rationing of nursing care, nurses’ perceptions of their professional environment, negative patient outcomes, and placing patient safety at risk. [from abstract]

The Ebola epidemic has highlighted the importance of bridging trust and building common goals between the health profession and the communities they serve. [from introduction]

This research was aimed mainly at determining the significance of the primary health care learning programme in health care service delivery, focusing mainly in the Ehlanzeni Health district of Mpumalanga Province [South Africa]. The focus was on how professional nurses trained in the Primary Health Care programme confidently apply the skills and expertise to the benefit of clients in community health facilities. [from abstract]

Indonesia is one of the countries in the world which has a decentralized model of government. The decentralization in the form of regional autonomy aims to improve the public welfare through public services. The services, especially the health service depends much on the wide area and also the geographical condition of the regional. Thus, it is necessary to do an analysis of systems towards the health service from the catchment area perspectives to solve the present and future problems. [adapted from abstract]

Infant Mortality Rate (IMR) is one of the most vital health indicators. A number of factors impact and
influence IMR. One of the most important ones could be public health spending. Health spending however is not
uniform throughout Asia and varies from region to region. [from abstract]

Medicines are a major driver of quality, safety, equity, and cost of care in low and middle-income country health systems. Universal health coverage implementers must explicitly address appropriate use of medicines to realize the health benefits of medicines, avoid wasting scarce resources, and sustain the financial viability of universal health coverage schemes. [from abstract]

The health systems of most countries in the region are characterized by the provision of services through both public and private providers, often in parallel or in competition with each other. This has raised the option for governments to purchase services from the private sector, to address gaps in services particularly for the poor and underserved. This policy brief reviews the evidence base of government purchasing primary care services from the private sector.

The healthcare system of developing countries are immersed in the complex issues of governance and financing of health care, human resource inequity and lack of access to quality health services, which are significantly impacting on the delivery of health services to the consumers. This paper will highlight on of health care system of Pakistan and Cuba under the spheres of their health care delivery system, organizational structure, authority and power structure, decision making process, future challenges and their resolutions. [from abstract]

What does the population health approach in action look like in the health care context? This study looks at applying a population health approach in a health care setting. The study articulates the merits of applying a population health approach and brings to light associated barriers and opportunities. It also features patient- and program-level perspectives and population health insights from senior health care leaders at The Ottawa Hospital who were instrumental in establishing OICH.[from introduction]

[Accountable Care Organ] ACOs are promising vehicles for aligning physician and hospital interests in improving quality and reducing cost. However, successful implementation and realization of the ACO mission requires that attention be paid to supporting capacity building within the ACOs, development of a culture of learning and improvement, as well as rigorous monitoring and evaluation. [from executive summary]

This guidebook is intended to complement the many excellent health literacy resources that already exist and are emerging every day, and to help organizations of any size use them to become health literate health care organizations. Health literate health care organizations “make it easier for people to navigate, understand, and use information and services to take care of their health. [from introductions]

Local health planners are in a prime position to devise feasible context-specific activities to overcome
constraints and increase met need for family planning to accelerate progress towards MDG 5. [from abstract]

The study was conducted to better understand the roles and functions of the health workforce responsible for managing patient transitions to and from hospitals and nursing homes in New York’s downstate region to reduce the number of readmissions and to improve care transitions. [adapted from introduction]

The Ugandan Government has an ambitious goal to reduce unmet need for family planning (FP) from its current 34% to 10% over the next 10 years. This brief shares experiences and lessons from capacity building for Family Planning at the national and district levels in Uganda.[adapted from introduction]

In Taiwan, volunteers make a significant contribution to the health workforce. In this paper, we explain the volunteer’s role and describe both the benefits and barriers associated with volunteering as a health worker in Taiwan. We also outline the crucial function of volunteers in supporting community nursing work. [from abstract]

This study examines the delivery of health services by faith-based organizations (FBOs) as a possible alternative to privatization in Uganda, where these not-for-profit health providers have been servicing communities since the second half of the 19th century. Their facilities focus on primary care and operate in rural, under-serviced areas, charging affordable user fees, while also treating those who cannot pay. [from executive summary]

Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. A case–control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. [adapted from abstract]

Performance-based incentives (PBIs) aim to counteract weak providers’ performance in health systems of many developing countries by providing rewards that are directly linked to better health outcomes for mothers and their newborns. This paper analyzes and synthesizes the available evidence from published studies on the impact of supply-side PBIs on the quantity and quality of health services for mothers and newborns. This paper reviews evidence from published and grey literature that spans PBI for public-sector facilities, PBI in social insurance reforms, and PBI in NGO contracting.

Physician dual practice, a combination of public and private practice, has attracted attention due to fear of reduced work supply and a lack of key personnel in the public system, increase in low priority treatments, and conflicts of interest for physicians who may be competing for their own patients when working for private suppliers. In this article, we analyze both choice of dual practice among hospital physicians and the dual practices’ effect on work supply in public hospitals. [from abstract]