Collaborating for Our Future

2018 ◽  
Author(s):  
Barbara Gray ◽  
Jill Purdy
Keyword(s):  
Management Education ◽  
Care Delivery ◽  
Scale Up ◽  
Collaborative Governance ◽  
Comprehensive Understanding ◽  
Theoretical Understanding ◽  
Effect Change ◽  
Working Together ◽  
Vantage Points ◽  
Multistakeholder Partnerships

Organizations turn to multistakeholder partnerships (MSPs) to meet challenges they cannot handle alone. By tapping diverse stakeholders’ resources, MSPs develop the capability to address complex issues and problems, such as health care delivery, poverty, human rights, watershed management, education, sustainability, and innovation. This book provides a comprehensive understanding of MSPs, why they are needed, the challenges partners face in working together, and how to design them effectively. Through the process of collaboration partners combine their differing strengths, vantage points, and expertise to craft innovative responses to pressing societal concerns. The book offers valuable advice for leaders about how to design and scale up effective partnerships and how to address potential obstacles partners may face, such as dealing with the conflicts and power issues likely to arise as partners negotiate with each other. Drawing on three comprehensive cases and countless shorter examples from around the world, the book offers practical advice for organizations embarking on an MSP, as well as theoretical understanding of how partnerships function. Using an institutional theory lens, it explains how partnerships can effect change in institutional fields by reducing turbulence and negotiating a common set of norms and routines to govern partners’ future interactions within the field of concern. Topics covered include: the nature of working collaboratively, why partnerships are needed, types of partnerships, guidelines for partnership design, partnerships and field dynamics, how to deal with conflicts among partners, negotiating across power differences, partnerships for sustainability, collaborative governance, working across scale differences, and how partnerships transform fields.

scholarly journals Evaluation of a novel approach to community health care delivery in Ifanadiana District, Madagascar

2020 ◽  
Author(s):  
Bénédicte Razafinjato ◽  
Luc Rakotonirina ◽  
Jafeta Benony Andriantahina ◽  
Laura F. Cordier ◽  
Randrianambinina Andriamihaja ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Community Health ◽  
Access To Health Care ◽  
Care Delivery ◽  
Local Level ◽  
Scale Up ◽  
P Value ◽  
The Impact

AbstractDespite the widespread global adoption of community health (CH) systems, there are evidence gaps in how to best deliver community-based care aligned with global best practice in remote settings where access to health care is limited and community health workers (CHWs) may be the only available providers. PIVOT partnered with the Ministry of Public Health to pilot a new two-pronged approach for care delivery in rural Madagascar: one CHW provided care at a stationary CH site while 2-5 additional CHWs provided care via proactive household visits. The pilot included professionalization of the CHW workforce (i.e. recruitment, training, financial incentive) and twice monthly supervision of CHWs. We evaluated the impact of the CH pilot on utilization and quality of integrated community case management (iCCM) in the first six months of implementation (October 2019-March 2020).We compared utilization and proxy measures of quality of care (defined as adherence to the iCCM protocol for diagnosis, classification of disease severity, treatment) in the intervention commune and five comparison communes, using a quasi-experimental study design and relying on routinely collected programmatic data. Average per capita monthly under-five visits were 0.28 in the intervention commune and 0.22 in the comparison communes. In the intervention commune, 40.0% of visits were completed at the household via proactive care. CHWs completed all steps of the iCCM protocol in 77.8% of observed visits in the intervention commune (vs 49.5% in the comparison communes, p-value=<0.001). A two-pronged approach to CH delivery and professionalization of the CHW workforce increased utilization and demonstrated satisfactory quality of care. National stakeholders and program managers should evaluate program re-design at a local level prior to national or district-wide scale-up.

scholarly journals Improving primary health care delivery in Bihar, India: Learning from piloting and statewide scale-up of Ananya

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Gary L Darmstadt ◽  
Kevin T Pepper ◽  
Victoria C Ward ◽  
Sridhar Srikantiah ◽  
Tanmay Mahapatra ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Delivery ◽  
Care Delivery ◽  
Scale Up ◽  
Primary Health

Improving use of maternal care services among married adolescent girls: an intervention study in rural India

2020 ◽  
pp. 1-20
Author(s):  
Ashok Dyalchand ◽  
Rohini Prabha Pande ◽  
Gopal Kulkarni ◽  
Manisha Khale
Keyword(s):  
Antenatal Care ◽  
Community Health ◽  
Community Health Workers ◽  
Adolescent Girls ◽  
Maternal Care ◽  
Health Workers ◽  
Care Delivery ◽  
Scale Up ◽  
Care Services ◽  
Study Sites

Abstract This study examined the effect of the Safe Adolescent Transition and Health Initiative (SATHI) programme on the use of maternal care services among rural, pregnant adolescents in India. This was an intensive community-based, multi-site intervention project conducted in Maharashtra state between 2008 and 2011. Its aims were to improve the reproductive health of married adolescent girls and avert the adverse consequences of early motherhood. It had a quasi-experimental, case-control, pre-post design to enable rigorous evaluation. This study used cross-sectional data from 644 married girls aged under 19 years at baseline and 802 at endline to assess the maternal care outcomes of antenatal care, delivery and postnatal services and nutrition during pregnancy. Difference-in-differences analysis showed that all outcomes improved significantly in the study sites between baseline and endline, and the improvement in study sites was significantly larger than in the control sites. Multivariate analysis showed a statistically significant dose–response effect of intervention participation for antenatal care, pregnancy nutrition and postnatal care. Study participation was not statistically significantly associated with higher rates of safe or institutional delivery. The analysis suggests that training and supporting community health workers to work with married adolescent girls using interpersonal communication and interacting frequently with them and their families and communities can significantly improve the use of maternal care services among this population. With almost a million community health workers and 200,000 auxiliary nurse midwives at the community level providing primary level care in India, this intervention offers a proven strategy to replicate and scale-up to reach large numbers of married adolescent girls who do not currently use maternal care services.

Integrating Concurrent Palliative Care into Cancer Care Delivery Settings

2018 ◽  
Author(s):  
Meagan Whisenant ◽  
Kathi Mooney
Keyword(s):  
Palliative Care ◽  
Advanced Cancer ◽  
Care Delivery ◽  
Scale Up ◽  
Fee For Service ◽  
National Guidelines ◽  
Reimbursement Mechanisms ◽  
Early Integration ◽  
Home Based

This case study reviews the evidence for adoption of concurrent palliative care (CPC) during treatment for advanced cancer. Increasing research evidence and expert panel consensus has resulted in national guidelines and professional society endorsement of early integration of palliative care into oncology care. However, there is variable uptake of these guidelines and penetration of CPC into practice. Barriers to implementation include the need to increase awareness of existing evidence and guidelines, stigma, adequacy of a workforce for scale-up, lack of models for integration and delivery, and restrictive reimbursement mechanisms. Changing health care models that emphasize value-based care over fee-for-service can accelerate adoption. Use of technology can also overcome barriers related to scalability and resource use. The case study concludes with the recommendation that implementation science methodologies be used to guide successful integration of CPC in outpatient and home-based settings for patients with advanced cancer and their family caregivers.

scholarly journals Implementing TB preventive treatment within differentiated HIV service delivery models in global programs

2020 ◽  
Vol 10 (3) ◽  
pp. 104-110
Author(s):  
A. T. Boyd ◽  
B. Moore ◽  
M. Shah ◽  
C. Tran ◽  
H. Kirking ◽  
...  
Keyword(s):  
Service Delivery ◽  
Care Delivery ◽  
Scale Up ◽  
Preventive Treatment ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Emergency Plan ◽  
The Us ◽  
Living With Hiv ◽  
Delivery Models

Global HIV program stakeholders, including the US President’s Emergency Plan for AIDS Relief (PEPFAR), are undertaking efforts to ensure that eligible people living with HIV (PLHIV) receiving antiretroviral treatment (ART) receive a course of TB preventive treatment (TPT). In PEPFAR programming, this effort may require providing TPT not only to newly diagnosed PLHIV as part of HIV care initiation, but also to treatment-experienced PLHIV stable on ART who may not have been previously offered TPT. TPT scale-up is occurring at the same time as a trend to provide more person-centered HIV care through differentiated service delivery (DSD). In DSD, PLHIV stable on ART may receive less frequent clinical follow-up or receive care outside the traditional clinic-based model. The misalignment between traditional delivery of TPT and care delivery in innovative DSD may require adaptations to TPT delivery practices for PLHIV. Adaptations include components of planning and operationalization of TPT in DSD, such as determination of TPT eligibility and TPT initiation, and clinical management of PLHIV while on TPT. A key adaptation is alignment of timing and location for TPT and ART prescribing, monitoring, and dispensing. Conceptual examples of TPT delivery in DSD may help program managers operationalize TPT in HIV care.

Population Health: The Diabetes Educator’s Evolving Role

2019 ◽  
Vol 45 (4) ◽  
pp. 333-348 ◽  
Author(s):  
Teresa L. Pearson ◽  
Joan Bardsley ◽  
Susan Weiner ◽  
Leslie Kolb
Keyword(s):  
Health Care ◽  
Population Health ◽  
Diabetes Management ◽  
Management Education ◽  
Care Delivery ◽  
Population Level ◽  
Cost Effective ◽  
Self Management ◽  
Quality Initiatives ◽  
Diabetes Educators

Purpose The US health care system’s focus on high-quality, efficient, and cost-effective care has led payers and provider groups to identify new models with a shift toward value-based care. This perspective on clinical practice describes the population health movement and the opportunities for diabetes educators beyond diabetes self-management education, as well as steps to engage in and drive new care models to demonstrate individual, organizational, and payer value. Conclusion Diabetes educators have an opportunity to position themselves as diabetes specialists for diabetes management, education, and population health care delivery. With expertise that extends beyond diabetes self-management education and with a wide variety of skills, diabetes educators recognize that there is a range of personal, social, economic, and environmental factors that influence diabetes health outcomes. Diabetes educators should align with organizational strategic plans and support the population-level performance measures and quality initiatives, thus enhancing the value that diabetes educators bring to health care organizations.

scholarly journals Scaling up quality improvement intervention for perinatal care in Nepal (NePeriQIP); study protocol of a cluster randomised trial

2017 ◽  
Vol 2 (3) ◽  
pp. e000497 ◽  
Author(s):  
Ashish KC ◽  
Anna Bergström ◽  
Dipak Chaulagain ◽  
Olivia Brunell ◽  
Uwe Ewald ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health System ◽  
Care Delivery ◽  
Perinatal Care ◽  
Randomised Trial ◽  
Scale Up ◽  
Public Hospitals ◽  
Quality Improvement Intervention ◽  
Improvement Project ◽  
Cluster Randomised

IntroductionNepal Perinatal Quality Improvement Project (NePeriQIP) intends to scale up a quality improvement (QI) intervention for perinatal care according to WHO/National guidelines in hospitals of Nepal using the existing health system structures. The intervention builds on previous research on the implementation of Helping Babies Breathe-quality improvement cycle in a tertiary healthcare setting in Nepal. The objective of this study is to evaluate the effect of this scaled-up intervention on perinatal health outcomes.Methods/designCluster-randomised controlled trial using a stepped wedged design with 3 months delay between wedges will be conducted in 12 public hospitals with a total annual delivery rate of 60 000. Each wedge will consist of 3 hospitals. Impact will be evaluated on intrapartum-related mortality (primary outcome), overall neonatal mortality and morbidity and health worker’s performance on neonatal care (secondary outcomes). A process evaluation and a cost-effectiveness analysis will be performed to understand the functionality of the intervention and to further guide health system investments will also be performed.DiscussionIn contexts where resources are limited, there is a need to find scalable and sustainable implementation strategies for improved care delivery. The proposed study will add to the scarce evidence base on how to scale up interventions within existing health systems. If successful, the NePeriQIP model can provide a replicable solution in similar settings where support and investment from the health system is poor, and national governments have made a global pledge to reduce perinatal mortality.Trial registration numberISRCTN30829654.

Perceived acceptability and experience of COPe-support - a digital psychoeducation and peer support intervention: Interview study with carers supporting individuals with psychosis (Preprint)

2021 ◽  
Author(s):  
Rachel Batchelor ◽  
Sarah Gulshan ◽  
Halpana Shritharan ◽  
Elen Williams ◽  
Claire Henderson ◽  
...  
Keyword(s):  
Mental Health ◽  
Computer Literacy ◽  
Care Delivery ◽  
Controlled Trial ◽  
Scale Up ◽  
Well Being ◽  
Online Chat ◽  
Loved One ◽  
Self Confidence ◽  
Randomised Controlled

BACKGROUND Digital mental health interventions offer a novel, accessible and self-paced approach to care delivery to family carers, i.e., relatives and close friends who support a loved one with psychosis. We co-produced COPe-support, a psychoeducational intervention delivered via an enriched online environment with network support from professionals and peers. In addition to rigorous investigation of the effectiveness of COPe-support on carers’ wellbeing and mental health outcomes, it is imperative to understand carers’ experiences in using the digital intervention and its associated online implementation and facilitation strategies. OBJECTIVE This study aimed to explore (1) carers’ experience and perceived acceptability of COPe-support and its different components, and (2) how they found engagement with COPe-support affected their own wellbeing and caregiving. METHODS We conducted a qualitative study, individually interviewing 35 carers after their use of COPe-support for 8 months through an online randomised controlled trial across England. A semi-structured guide with open-ended questions was used to explore carers’ experience and perceived acceptability of the intervention, and their ideas to improve the provision. All interviews were conducted remotely through mobile phone or internet communication media, audio-recorded, and transcribed verbatim. We used the thematic analysis framework approach to analyse the data. RESULTS Three key themes were identified: (i) remote, flexible and personalised, (ii) impacts on well-being and outlook on caregiving, and (iii) future implementation and integration with existing services. Overall, carers identified COPe-support as a helpful resource for themselves and for their caregiving role. Participants’ experiences, usage and activity on COPe-support varied a great deal and differed amongst carers of various ages and level of computer literacy. CONCLUSIONS Carers found COPe-support a flexible source of knowledge and support from professionals and peers which they can personalise to suit their own needs and convenience. Participants described gaining self-confidence, hope, and a sense of connectivity with others in a similar situation which helped ameliorate isolation and perceived stigma. Most importantly, COPe-support promoted self-care in the carers themselves. While nearly all participants had a positive experience with COPe-support and supported its wider implementation as a beneficial adjunctive support resource for carers in the future, they suggested some improvements. These include having more graphics and visual-audio content materials, improving the navigation and building in more interactional and customisation options to suit various users’ style (e.g. emoji reactions, live online chat, opting in-and-out of updates and choosing frequency of reminders). Any future scale-up of such an intervention should also consider factors pertinent to reaching more carers and integrating the digital resource with other conventional services. CLINICALTRIAL Current Controlled Trials registration ISRCTN 89563420.

Governing EU employment policy: does collaborative governance scale up?

2018 ◽  
Author(s):  
Eva Sørensen ◽  
Peter Triantafillou ◽  
Bodil Damgaard
Keyword(s):  
Scale Up ◽  
National Policy ◽  
Collaborative Governance ◽  
Collaborative Effort ◽  
The European Union ◽  
Employment Policy ◽  
Implementation Phase ◽  
Policy Objectives ◽  
National Governments ◽  
Coordination And Collaboration

In the European Union (EU), employment policy is a prerogative of the member states. Therefore the EU’s ability to govern in this area depends on its capability to involve national governments and relevant stakeholders in a collaborative effort to formulate and implement shared policy objectives. Drawing an analytical distinction between cooperation, coordination and collaboration, the chapter analyses the formulation and implementation of EU employment policies. It concludes that while the formulation of policy objectives and the discussion of national policy approaches do involve elements of collaboration, the implementation phase mainly consists in the less demanding forms of cooperation and coordination.

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