South Asia

A Study of Human Resource Policies and Practices for Primary Health Care System in Delhi

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]

Strengthening the Pharmaceutical Sector in Afghanistan: A Study Tour of the Afghan National Medicines Services Organization to Turkey

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]

The “Empty Void” is a Crowded Space: Health Service Provision at the Margins of Fragile and Conflict Affected States

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]

Engaging Frontline Health Providers in Improving the Quality of Health Care Using Facility-Based Improvement Collaboratives in Afghanistan: Case Study

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]

Progress, Challenges and Opportunities for HIV Prevention and Control Among High Risk Groups: A Public Health Perspective

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.

Does Involvement of Local NGOs Enhance Public Service Delivery?: Cautionary Evidence From A Malaria-Prevention Evaluation in India

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]

Assessment of Present Health Status in Bangladesh and the Applicability of E-Health in Healthcare Services: A Survey of Patients' Expectation Toward E-Health

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.

Nepalese Health Workers’ Migration to the United Kingdom: A Qualitative Study

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]

Human Resource Management in Primary Health Care System

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]

Human Resources Information Systems (HRIS): A Review across States of India

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.

Reclaiming Public Health Through Community-Based Monitoring: The Case of Maharashtra, India

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 Service Utilization for Childhood Illness-Improving Quality of Health Services Only is Not Enough: A Cross-Sectional Study in Mid-Western Region, Nepal

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]

A New Ten-Layer ICT Model For Health Communication In Fatal Disease Management

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.

The Correlation of Health Spending and Infant Mortality Rate in Asian Countries

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]

Advancing the Application of Systems Thinking in Health: A Realist Evaluation of a Capacity Building Programme for District Managers in Tumkur, India

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.

Balancing Authority, Deference and Trust Across the Public–Private Divide in Health Care: Tuberculosis Health Visitors in Western Maharashtra, India

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).

Comparative Assessment of Health Care Delivery Systems of Developing Countries: Pakistan versus Cuba

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: The way forward

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]

Islam and Family Planning: Changing Perceptions of Health Care Providers and Medical Faculty in Pakistan

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]

Capacity Building of Institutions in the Health Sector: Review of Experiences in Uttar Pradesh, Uttarakhand and Jharkhand.

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]

Context-specific, Evidence-Based Planning for Scale-Up of Family Planning Services to Increase Progress to MDG 5: Health Systems Research

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]

Improving Access to Family Planning Services in Rural Areas

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]

Retention of Female Volunteer Community Health Workers in Dhaka Urban Slums: a Prospective Cohort Study

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]

Informal Rural Healthcare Providers in North and South India

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]

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]

Expansion in the Private Sector Provision of Institutional Delivery Services and Horizontal Equity: Evidence from Nepal and Bangladesh

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]

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.

Role of Private Sector for HRH (Human Resource for Health) Production in Nepal

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]

What a Difference a State Makes: Health Reform in Andhra Pradesh

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]

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]