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Author: Sarah Hicks Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
In high HIV prevalence settings, women are at elevated risk for HIV during pregnancy and postpartum, and pre-exposure prophylaxis (PrEP) is recommended during this period. Integration of PrEP into maternal and child health (MCH) clinics requires implementation optimization. Furthermore, there is a lack of consensus about how to prioritize potential implementation strategies. The PrEP in Pregnancy, Accelerating Reach and Efficiency study (PrEPARE; NCT04712994) engaged stakeholders to identify determinants of PrEP implementation and identify and prioritize PrEP delivery implementation strategies at 55 facilities in Kenya through quantitative surveys and a stakeholder workshop. Strategies were prioritized using: 1) surveys with experienced practitioners reflecting on implementation experience (N=182); 2 & 3) ranking surveys before and after small group discussion with diverse stakeholders (N=44 & 40); 4) “go-zone” quadrant plots of perceived effectiveness vs feasibility. A stepwise elimination process was used to identify seven strategies for empirical testing. Facilitator debriefing reports from the workshop were used to qualitatively assess the decision-making process. We also compared the four strategy prioritization methods using Kendall’s correlation analysis. Additionally, the participants grouped strategies in three bundles with up to 4 strategies each by phone and online survey. Among 146 health care workers, the strongest reported barriers to PrEP delivery were: insufficient providers and inadequate training, insufficient space, and volume of patients. Sixteen strategies were assessed, 14 of which were included in the final analysis. Using rankings from 182 healthcare workers and 44 PrEP policymakers and implementers, seven strategies were eliminated based on low post-workshop ranking scores (bottom 50th percentile) or falling outside the go-zone (perceived low feasibility and low effectiveness) for at least 50% of the workshop groups. The top three strategies included 1) delivering PrEP within MCH clinics instead of pharmacies, 2) fast tracking PrEP clients to reduce waiting time, and 3) delivering PrEP-related health talks in waiting bays. All top seven ranked strategies were grouped into bundles for subsequent testing. Facilitator debriefing reports generally aligned with go-zone rankings but noted how stakeholders’ decision-making changed when considering the impact of strategies on facility staff and non-PrEP clients. The strategy ranking correlation was strongest between the pre- and post-small group rankings (Tau = 0.648; p
Author: Sarah Hicks Publisher: ISBN: Category : Languages : en Pages : 0
Book Description
In high HIV prevalence settings, women are at elevated risk for HIV during pregnancy and postpartum, and pre-exposure prophylaxis (PrEP) is recommended during this period. Integration of PrEP into maternal and child health (MCH) clinics requires implementation optimization. Furthermore, there is a lack of consensus about how to prioritize potential implementation strategies. The PrEP in Pregnancy, Accelerating Reach and Efficiency study (PrEPARE; NCT04712994) engaged stakeholders to identify determinants of PrEP implementation and identify and prioritize PrEP delivery implementation strategies at 55 facilities in Kenya through quantitative surveys and a stakeholder workshop. Strategies were prioritized using: 1) surveys with experienced practitioners reflecting on implementation experience (N=182); 2 & 3) ranking surveys before and after small group discussion with diverse stakeholders (N=44 & 40); 4) “go-zone” quadrant plots of perceived effectiveness vs feasibility. A stepwise elimination process was used to identify seven strategies for empirical testing. Facilitator debriefing reports from the workshop were used to qualitatively assess the decision-making process. We also compared the four strategy prioritization methods using Kendall’s correlation analysis. Additionally, the participants grouped strategies in three bundles with up to 4 strategies each by phone and online survey. Among 146 health care workers, the strongest reported barriers to PrEP delivery were: insufficient providers and inadequate training, insufficient space, and volume of patients. Sixteen strategies were assessed, 14 of which were included in the final analysis. Using rankings from 182 healthcare workers and 44 PrEP policymakers and implementers, seven strategies were eliminated based on low post-workshop ranking scores (bottom 50th percentile) or falling outside the go-zone (perceived low feasibility and low effectiveness) for at least 50% of the workshop groups. The top three strategies included 1) delivering PrEP within MCH clinics instead of pharmacies, 2) fast tracking PrEP clients to reduce waiting time, and 3) delivering PrEP-related health talks in waiting bays. All top seven ranked strategies were grouped into bundles for subsequent testing. Facilitator debriefing reports generally aligned with go-zone rankings but noted how stakeholders’ decision-making changed when considering the impact of strategies on facility staff and non-PrEP clients. The strategy ranking correlation was strongest between the pre- and post-small group rankings (Tau = 0.648; p
Author: Robert Black Publisher: World Bank Publications ISBN: 1464803684 Category : Medical Languages : en Pages : 419
Book Description
The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.
Author: Ebongué Mbondji Publisher: ISBN: Category : Maternal health services Languages : en Pages :
Book Description
In 2000, United Nations member states committed in the fifth Millennium Development Goal (MDG 5) to improve maternal health in order to combat poverty. Despite this strong commitment, the number of maternal deaths is still high in Sub-Saharan Africa. Monitoring indicators shows that Cameroon will not reach the 2015 s target for MDG 5. The Demography Health Surveys conducted in Cameroon show an increasing maternal mortality since 1998 while several studies show that most of the maternal deaths are preventable and occur at peripheral level. In view of the age-old problem of limited clinical capacities at the peripheral level, the optimal and effective use of public health evidence to develop strong and efficient local reproductive/maternal health strategic plans, appears as a supplementary option to address maternal health issues. The overall goal of this research was to develop a tool that will enable district managers to strengthen maternal health planning and practices in their district. We examined the barriers limiting the planning process at district level and we explored the opportunities to improve it. Methodology: A cross sectional, descriptive and process based research analysis was conducted through a literature review followed by interviews of stakeholders. A tool was then developed based on analysing the results from the interviews. The tool was reviewed during a national workshop by the relevant stakeholders involved in the policy and planning process in Cameroon, and tested by two district teams before its finalization. Findings The research revealed that the subject of maternal health is covered as a component of the reproductive health policy, which was developed with contributions from all the key stakeholders identified by the Ministry of Health. However, some limitations in the process tend to narrow the scope of the policy; the peripheral level had little involvement in the process and there was no national strategic and implementation plan; which explains the failure of the implementation of the policy by the peripheral level. Prioritization at the peripheral level is likely to be mostly influenced by the availability of funds. The planning at peripheral level is done by a district team, with very little support from the higher level or the local partners. Outcome The tool was developed in the form of an integrated matrix of priority activities, introducing the concept of Package of Priority Activities (PPA), and designed as a dynamic cross-table. The whole idea was to identify priority activities for each national health programme in a cross table, and see which under-resourced priority activity can be covered by similar or overlapping resourced programme s priority activity. The tool was tested by districts before its finalization. Conclusion The tool is designed to enable implementation of priority maternal health interventions. The tool should also contribute to improving the effectiveness of the integrated primary healthcare system, which is the ideal way to go in order to reduce the burden of maternal mortality in Sub-Saharan Africa.
Author: Niyi Awofeso Publisher: Routledge ISBN: 0415521793 Category : Medical Languages : en Pages : 306
Book Description
Capacity building - which focuses on understanding the obstacles that prevent organisations from realising their goals, while promoting those features that help them to achieve measurable and sustainable results - is vital to improve the delivery of health care in both developed and developing countries. Organisations are important structural building blocks of health systems because they provide platforms for delivery of curative and preventive health services, and facilitate health workforce financing and functions. Organisational capacity building involves more than training and equipment and this book discusses management capacity to restructure systems, structures and roles strategically to optimise organisational performance in healthcare. Examining the topic in a practical and comprehensive way, Organisational Capacity Building in Health Systems is divided into five parts, looking at: What health organisations are and do Management and leadership in health organisations How to build capacity in health systems Building capacity in a range of health system contexts Dealing with challenges in building capacity and evaluating work Looking at how to effectively design, implement and evaluate organisational capacity building initiatives, this book is ideal for public health, health promotion and health management researchers, students and practitioners.
Author: Ana-Maria Vranceanu Publisher: Humana Press ISBN: 3319292943 Category : Medical Languages : en Pages : 338
Book Description
This text outlines the importance of biopsychosocial factors in improving medical care, and illustrates evidence-based, state-of-the-art interventions for patients with a variety of medical conditions. Each chapter is focused on a particular health concern or illness, which is described both in terms of prevalence and frequent psychological and psychiatric comorbidities that may present to clinicians working with these populations. Consistent with evidence-based care, information on the efficacy of the treatments being described is presented to support their continued use. To accommodate the needs of clinicians, we describe population specific approaches to treatment, including goal settings, modules and skills as well as strategies to assess and monitor progress. To facilitate learning, each chapter contains one or more case examples that explicate the skills described to convey change within a behavioral medicine protocol. Each chapter also includes resources in the form of books and websites to gain additional knowledge and detail as needed. Authors are experts in the field of each chapter, ensuring that information presented is recent and of high quality.
Author: Martin P. Charns Publisher: Jossey-Bass ISBN: Category : Business & Economics Languages : en Pages : 352
Book Description
Shows how health care administrators and clinical leaders can improve organizational effectiveness and responsiveness by fostering collaboration among different disciplines within their institutions. Provides six original case studies that show how integrative approaches can be applied in practice. Offers useful guidelines for choosing people to serve in key integrative positions, supporting the new structure through reward and information systems, and carrying out the change process.
Author: UNICEF. Publisher: UNICEF ISBN: 9280644424 Category : Business & Economics Languages : en Pages : 100
Book Description
On 20 November 2009, the global community celebrates the 20th anniversary of the adoption by the United Nations General Assembly of the Convention on the Rights of the Child, the unique document that sets international standards for the care, treatment and protection of all individuals below age 18. To celebrate this landmark, the United Nations Children's Fund is dedicating a special edition of its flagship report The State of the World's Children to examining the Convention's evolution, progress achieved on child rights, challenges remaining, and actions to be taken to ensure that its promise becomes a reality for all children.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309166837 Category : Medical Languages : en Pages : 270
Book Description
Each year more than 4 million children are born with birth defects. This book highlights the unprecedented opportunity to improve the lives of children and families in developing countries by preventing some birth defects and reducing the consequences of others. A number of developing countries with more comprehensive health care systems are making significant progress in the prevention and care of birth defects. In many other developing countries, however, policymakers have limited knowledge of the negative impact of birth defects and are largely unaware of the affordable and effective interventions available to reduce the impact of certain conditions. Reducing Birth Defects: Meeting the Challenge in the Developing World includes descriptions of successful programs and presents a plan of action to address critical gaps in the understanding, prevention, and treatment of birth defects in developing countries. This study also recommends capacity building, priority research, and institutional and global efforts to reduce the incidence and impact of birth defects in developing countries.
Author: World Health Organization Publisher: World Health Organization ISBN: 9241507365 Category : Health & Fitness Languages : en Pages : 62
Book Description
Optimizing outcomes for women in labor at the global level requires evidence-based guidance of health workers to improve care through appropriate patient selection and use of effective interventions. In this regard, the World Health Organization (WHO) published recommendations for induction of labor in 2011. The goal of the present guideline is to consolidate the guidance for effective interventions that are needed to reduce the global burden of prolonged labor and its consequences. The primary target audience includes health professionals responsible for developing national and local health protocols and policies, as well as obstetricians, midwives, nurses, general medical practitioners, managers of maternal and child health programs, and public health policy-makers in all settings.
Author: Sarah Hicks
Author: Sarah Hicks
Author: Robert Black
Author: Ebongué Mbondji
Author: Niyi Awofeso
Author: Ana-Maria Vranceanu
Author: Renee Heffron
Author: Martin P. Charns
Author: UNICEF.
Author: Institute of Medicine
Author: World Health Organization