Service Delivery

The Significance of Community Engagement in Strengthening Health Systems

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]

The Effect of Primary Health Care Learning Programme in Health Care Service Delivery: Case Study of Ehlanzeni Health District in Mpumalanga Province

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]

Health Service from Catchment Area Perspective: An Analysis of System

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]

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]

Quality Use of Medicines within Universal Health Coverage: Challenges and Opportunities

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]

Purchasing Arrangements with the Private Sector to Provide Primary Health Care in Underserved Areas

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.

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]

Innovations to Reduce Hospital Readmissions and Avoidable Hospitalizations from Nursing Homes: Implications for the Health Workforce

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]

Focus on Community-based Family Planning: Partnership with Uganda Ministry of Health

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]

Community Health Promotion Volunteers in Taiwan: Their Value to Nurses

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]

Faith-Based Health Services as an Alternative to Privatization? A Ugandan Case Study

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]

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]

Performance-based Incentives to Improve Health Status of Mothers and Newborns: What Does the Evidence Show?

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.

Physicians’ Engagement in Dual Practices and the Effects on Labor Supply in Public Hospitals: Results from a Register-Based Study

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]

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]

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]

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]