South Asia

A comprehensive health care services requires effective human resource (HR) management policy to ensure organizational success. Government is primarily concerned with the size of the workforce rather than the contemporary HR practices. This resulted into lack of attention to HR management in health sector. [from abstract]

Staff from the Afghan government’s General Director of Pharmaceutical Affairs undertook a five-day study tour to engage with peers in Turkey. They they learned how to design and create relevant strategies, services and partnerships, with a focus on the private sector. Many ways forward emerged that can realistically support a financially sustainable national supply of key pharmaceuticals—many manufactured in Afghanistan. [adapted from resource]

Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential
services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. ]from abstract]

Quality of care can be significantly improved by engaging teams of frontline workers to identify problems and find local solutions for those problems. Based on the results achieved in Kunduz, Balkh, and Kabul, the collaborative improvement work was expanded from 2010–2012 to seven more provinces. The results achieved on the ground also led the MoPH to establish a unit for quality and a national health care quality improvement strategy for Afghanistan. [from abstract]

There are various socio-cultural issues/obstacles in prevention of HIV-AIDS in high risk group for e.g., gender inequality, power inequalities and male dominance; condom use believed to be in conflict with the cultural importance for procreation; poverty, illiteracy, increase in migrant population and unemployment; poor knowledge and awareness of reproductive and sexual health and sexuality; emergence of new urban sub-culture and physical or mental abuse at a young age.

The study observed the impact of an experimental supportive intervention to India’s malaria control program by location on the individual level. There are various possible reasons that account for the observed divergence across districts. [from abstract]

Bangladesh is facing a lot of challenges in quality healthcare management. The recent advances in information and communication technologies (ICT) could play vital role in improving healthcare services and reaching them to the doorstep of the marginalized people. This research aims to evaluate the present health status of the country and explores the applicability of e-Health as well as the challenges and issues of electronic healthcare development. This study has conducted a survey on patient’s views and expectations toward e-Health for quality healthcare management.

International migration of health workers is a controversial issue globally. It has both negative and positive impact on both source and destination countries. The shortfall of health workers in the developed countries has led to the accusation of poaching health workers from the developing countries where health care systems are struggling. The causes and consequences of health workers’ migration vary in different countries. This study explored the reasons why a group of Nepalese health workers migrated to the United Kingdom (UK).[from abstract]

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]

India faces critical human resources shortages for key cadres such as doctors, specialists, nurses, and midwives. Other key challenges include suboptimal deployment of staff exacerbated by a skewed urban-rural distribution, gaps in certain specialties, and inefficient use of staff due to poor rationalization of tasks. Lack of comprehensive, reliable, and up-to-date data and an absence of commonly agreed definitions and analytical tools make the task of managing the health workforce more difficult.

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]

Female Community Health Volunteers (FCHVs) are considered service providers for major health problems at the community level in Nepal. However, few studies have been conducted about the roles of FCHVs from the users’perspective. This study sought to examine the current status of FCHV service utilization and identify the determinants of caregivers’utilization of FCHVs’health services in the mid-western region of Nepal. [from abstract]

There is an evolving need for better utilization of ICT resources which are direct, cost effective, time-saving, and highly persuasive in pursuit of quality healthcare delivery. Therefore this research proposes a ten-layer ICT model converging advanced Mobile and Internet interventions, to disseminate health messages for patients suffering from fatal diseases. Using breast cancer as an instance, a communication strategy is exemplified using the ten-layer model.

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]

Health systems interventions, such as capacity-building of health workers, are implemented across districts in order to improve performance of healthcare organisations. However, such interventions often work in some settings and not in others. Local health systems could be visualised as complex adaptive systems that respond variously to inputs of capacity building interventions, depending on their local conditions and several individual, institutional, and environmental factors.

While concepts such as ‘partnership’ are central to the terminology of private–public mix (PPM), little attention has been paid to how social relations are negotiated among the diverse actors responsible for implementing these inter-sectoral arrangements. India’s Revised National Tuberculosis Control Programme (RNTCP) has used intermediary agents to facilitate the involvement of private providers in the expansion of Directly Observed Therapy, Short-Course (DOTS).

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]

Universal health coverage (UHC) is the means to provide accessible and appropriate health services to all citizens without financial hardships. India, an emerging economy with demographic window of opportunity has been facing dual burden of diseases in midst of multiple transitions. Health situation in the country despite quantum improvements in recent past has enormous challenges with urban-rural and interstate differentials. Successful national programs exists, but lack ability to provide and sustain UHC.[from abstract]

Training health care providers and medical college faculty about the supportive nature of Islam toward
family planning principles addressed their misconceptions and enhanced their level of comfort in providing
family planning services and teaching the subject. [from synopsis]

This report documents the efforts and contributions made by USAID through the Innovations in Family Planning Services (IFPS) Project towards capacity building and strengthening of public and private institutions in the health sector
in India. The report highlights the support rendered at the national level and in three Indian states: Uttar
Pradesh, Uttarakhand, and Jharkhand. [from introduction]

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]

Family planning (FP) services have been available in Nepal for over 50 years, most extensively from the public sector health system, with nongovernmental agencies involved from the very beginning. These services are largely delivered by
facility-based service providers, except for the distribution of condoms and pills and, occasionally,
injectables. Community workers such as VHWs and MCHWs could potentially fill the gap if they were given the necessary knowledge and skills. [adapted from resource]

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]

Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. Their numbers far exceed those of formal providers. Our study reports on the education, knowledge, practices and relationships of informal providers (IPs) in two very different districts: Tehri Garhwal in Uttarakhand (north) and Guntur in Andhra Pradesh (south). [from abstract]

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]

One strategic approach to increase the use of appropriate maternal healthcare services is to encourage the expansion of the role of the private sector. However, critics of such an approach argue that increasing the role of the private sector will lead to increased inequity in the use of maternal healthcare services. This article explores this issue in two South Asian countries that have traditionally had high rates of maternal mortality—Nepal and Bangladesh. [from abstract]

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.

Human Resource for Health production was started in Nepal in a limited way some eighty years ago and picked up a
somewhat faster pace from the 1950s as per the requirements at that time. The establishment of the Institute of Medicine
led to some diversification but it was only after 1990 that there has been a much larger involvement of the private sector
in the production of Human Resources for Health. Although a number of categories have been listed in this article, the
position of doctors, dentists and nurses has been dealt with in more detail. [from abstract]

This paper describes and analyzes Andhra Pradesh’s Aarogyasri scheme [in India], which covers against the costs of around 900 high-cost procedures delivered in secondary and tertiary hospitals. Using a new household survey, the authors find that 80 percent of families are eligible, equal to about 68 million people, and 85 percent of these families know they are covered; only one-quarter, however, know that the benefit package is limited. [adapted from abstract]

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]