Service Delivery

Unravelling the Quality of HIV Counselling and Testing Services in the Private and Public Sectors in Zambia

Despite the substantial investment for providing HIV counselling and testing (VCT) services in Zambia, there has been little effort to systematically evaluate the quality of VCT services provided by various types of health providers. This study, conducted in 2009, examines VCT in the public and private sectors including private for-profit and NGO/faith-based sectors in Copperbelt and Luapula. [from abstract]

Who Gives Birth in Private Facilities in Asia? A Look at Six Countries

As Asia has shown strong increases in institutional coverage of delivery care in the last decade, we will examine trends in six Asian countries. We hypothesize that if the private sector competes for clients based on perceived quality, their clientele will be wealthier, more educated and live in an area where there are enough health facilities to allow for competition. [from abstract]

Reproductive Health, and Child Health and Nutrition in India: Meeting the Challenge

In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum.

Empirical Investigation of Service Quality in Ghanaian Hospitals

This study was undertaken to assess perceived service quality in hospitals located in the Greater Accra Region of Ghana. The research was a cross-sectional survey which employed the use of a modified SERVQUAL questionnaire that was administered to 400 outpatients in the Greater Accra region of Ghana. Data obtained from the study was analyzed quantitatively using descrip
tive statistics, exploratory factor analysis and multiple regressions. [from abstract]

Health Seeking Behavior, Practices of TB and Access to Health Care Among TB Patients in Machakos County, Kenya. A Cross-Sectional Study

The main objective of this study was to examine the health seeking behavior of TB patients, practices of TB and access to health care. A cross- sectional survey of TB patients was done in Athi River, Machakos level 5 and Mutituni TB treatment health facilities in Machakos County. [from abstract]

Does Involvement of Local NGOs Enhance Public Service Delivery? Cautionary Evidence from a Malaria-Prevention Evaluation in India

Using data from an experimental supportive intervention to India’s malaria control program, this paper studies the impact of leveraging local non-state capacity to promote mosquito net usage and recommended fever care-seeking patterns. The supportive activities were conducted simultaneously by three nongovernmental organizations in two endemic districts in the state of Orissa. The study finds that program impact varied significantly by location. [from abstract]

Strengthening Malaria Service Delivery Through Supportive Supervision and Community Mobilization in an Endemic Indian Setting: An Evaluation of Nested Delivery

This paper tests the effectiveness of two service delivery models designed to promote recommended behaviors, including prompt treatment seeking for febrile illness, in Odisha India. The tested modules include supportive supervision of community health workers and community mobilization promoting appropriate health seeking. [from abstract]

Supply-Side Barriers to Maternit y-Care Provision in India: A Facility-Based Analysis

Our study highlights the importance of supply-side barriers to health services utilization. To meet the Millennium Development Goal of reducing maternal mortality, policymakers should make additional investment in improving the availability of infrastructure. [from abstract]

Integrating Family Planning and Antiretroviral Therapy: A Client-Oriented Service Model

The purpose of this program guide is to assist readers in thinking through a successful and efficient plan for [Family Planning and Antiretroviral Therapy] service integration, but the principles apply for integrating core and additional services, whatever they may be.[adapted from background]

Work Experience, Job-Fulfillment and Burnout among VMMC Providers in Kenya, South Africa, Tanzania and Zimbabwe

This analysis examines this issue of performance and attrition in [voluntary medical male circumcision] programs by looking descriptively at job-fulfillment and burnout. [from introduction]

The Right to Traditional, Complementary, and Alternative Health Care

This paper contributes to the development of the concept and practice of the right to health in all its forms, exploring the right to traditional, complementary, and alternative health (R2TCAH) across different contexts. [from abstract]

Progress Toward the Health MDGs: Are the Poor Being Left Behind?

This paper looks at differential progress on the health Millennium Development Goals between the poor and better-off within countries. [from introduction]

From Policy to Action: Implementing the Kenyan Community Strategy

This technical highlight provides a brief overview of Pathfinder’s experience implementing the Kenyan Community Strategy through the USAID-funded APHIAplus (AIDS, Population, and Health Integrated Assistance Plus) Nairobi-Coast project (2011-2014). [from abstract]

Community Health Workers for Universal Health-Care Coverage: From Fragmentation to Synergy

To achieve universal health coverage, health systems will have to reach into every community, including the poorest and hardest to access. Since Alma-Ata, inconsistent support of community health workers (CHWs) and failure to integrate them into the health system have impeded full realization of their potential contribution in the context of primary health care.

Education and Health Services in Uganda : Data for Results and Accountability

The Service Delivery Indicators provide a set of metrics for benchmarking service delivery performance in
education and health in Africa. The overall objective of the indicators is to gauge the quality of service
delivery in primary education and basic health services. [from introduction]

South Africa’s Protracted Struggle for Equal Distribution and Equitable Access – Still Not There

The purpose of this contribution is to analyse and explain the South African HRH case, its
historical evolution, and post-apartheid reform initiatives aimed at addressing deficiencies
and shortfalls. [from abstract]

Social Deterministic Factors to Participation in the National Health Insurance Scheme in the Context of Rural Ghanaian Setting

The primary purpose of this study is to identify predictors of complete household enrollment into the National Health Insurance Scheme (NHIS) among inhabitants of the Barekese sub-district in the Ashanti Region of Ghana. [from abstract]

Does the Design and Implementation of Proven Innovations for Delivering Basic Primary Health Care Services in Rural Communities Fit the Urban Setting: The Case of Ghana’s Community-based Health Planning and Services (CHPS)

This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. [from abstract]

Engaging with Health Markets in Low and Middle-Income Countries

Many low and middle-income countries have pluralistic health systems with a variety of providers of health-related goods and services in terms of their level of training, their ownership (public or private) and their relationship with the regulatory system. The development of institutional arrangements to influence their performance has lagged behind the spread of these markets. This paper presents a framework for analysing a pluralistic health system. [adapted from introduction]

Fragmented Governance and Local Service Delivery in Malawi

This study helps government and donors to understand how local government and service delivery work and to assess whether the return of local councils is likely to improve their functioning. [from introduction]

Accelerating Progress On Maternal Health In Africa: Lessons From Emerging Policy And Institutional Innovations

This paper examines three groups of innovative ideas have been institutionalized in African countries to improve maternal health: policy, institutional and experimental innovations. [adapted from abstract]

Localization of Health Systems in Low- and Middle-Income Countries in Response to Long-Term Increases in Energy Prices

External challenges to health systems have received little attention in recent years, including the increase of prices for petroleum-based products. Health systems are significant consumers of fossil fuels in the form of petroleum-based medical supplies; transportation of goods, personnel and patients; and fuel for lighting, heating, cooling and medical equipment. Long-term increases in petroleum prices in the global market will have potentially devastating effects on health sectors who already struggle to deliver services to remote parts of their catchment areas. [adapted from abstract]

Widening Disparity in the Geographic Distribution of Pediatricians in Japan

The purpose of this study was to investigate recent changes in the geographic distribution of pediatricians and the factors underlying this change. [from abstract]

Twenty Years of Health System Reform in Brazil An Assessment of the Sistema Único de Saúde

It has been more than 20 years since the 1988 Constitution formally established the Brazilian Unified Health System (Sistema Único de Saúde, SUS), which established health as a fundamental right and duty of the state and started a process of fundamentally transforming Brazil’s health system. The report assesses whether the SUS reforms have transformed the health system as envisaged more than 20 years ago and whether the reforms have led to improved outcomes with regard to access to services, financial protection, and health status. [adapted from introduction]

Improving Health through the Social Quality Approach in 800 Communes in Madagascar

The social quality approach is a community-based approach for encouraging service recipients to get involved in the availability, use, and quality of health services. This report, based on Santenet2 project data, correlation analysis, and qualitative data collection, illustrates the implementation process, successes and essential components to the successful implementation of the social quality approach. [from executive summary]

Integrating HIV Treatment with Primary Care Outpatient Services: Opportunities and Challenges from a Scaled-Up Model in Zambia

This paper examines the effect of the integrated model for HIV treatment with other primary care services on the organization of clinic services, and explores service providers’ perceptions of the integrated model. [adapted from abstract]

Integration of HIV Care into Primary Care in South Africa: Effect on Survival of Patients Needing Antiretroviral Treatment

This study measured the impact of integration of HIV care into primary care during a randomized controlled trial of task shifting and decentralization of HIV care in South Africa. [adapted from abstract]

Does Implementation of a Hospitalist Program in a Canadian Community Hospital Improve Measures of Quality of Care and Utilization? An Observational Comparative Analysis of Hospitalists vs. Traditional Care Providers

The objective of this study is to compare measures of cost and quality of care (in-hospital mortality, 30-day same-facility readmission, and length of stay) of hospitalists vs. traditional physician providers in a large Canadian community hospital setting. [from abstract]

Working for Health Equity: The Role of Health Professionals

This report launches a new program of activities to tackle health inequalities through action by health professionals on the social determinants of health. [from summary]

Integrating HIV Care into Nurse-Led Primary Health Care Services in South Africa: A Synthesis of Three Linked Qualitative Studies

This study documents different factors influencing models of integration within clinics of HIV care into nurse-led primary care services to increase access to treatment for people living with HIV/AIDS in high HIV burden countries. [adapted from abstract]