scholarly journals Health System Building Blocks and Organ Transplantation in India

2021 ◽  
Vol 105 (8) ◽  
pp. 1631-1634
Author(s):  
Smita Divyaveer ◽  
Sanjay Nagral ◽  
K.T. Prasad ◽  
Ashish Sharma ◽  
Vivekanand Jha
Keyword(s):  
Health System ◽  
Organ Transplantation ◽  
Building Blocks ◽  
System Building ◽  
Health System Building Blocks

scholarly journals Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Vaitiare Mulderij-Jansen ◽  
Izzy Gerstenbluth ◽  
Ashley Duits ◽  
Adriana Tami ◽  
Ajay Bailey
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
Entomological Surveillance ◽  
Vector Borne Diseases ◽  
System Building ◽  
Vector Borne ◽  
Dutch Caribbean ◽  
Health System Building Blocks

Abstract Background Vector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore, countries are encouraged to work towards more resilient health systems. This qualitative study aims to examine the performance of the health system of the Dutch Caribbean island of Curaҫao regarding the prevention and control of VBDs in the last decade by using the WHO health system building blocks. Methods From November 2018 to December 2020, a multi-method qualitative study was performed in Curaçao, applying content analysis of documents (n = 50), five focus group discussions (n = 30), interviews with experts (n = 11) and 15 observation sessions. The study was designed based on the WHO framework: health system building blocks. Two cycles of inductive and deductive coding were employed, and Nvivo software was used to analyse the data. Results This study’s data highlighted the challenges (e.g. insufficient oversight, coordination, leadership skills, structure and communication) that the departments of the health system of Curaҫao faced during the last three epidemics of VBDs (2010–2020). Furthermore, low levels of collaboration between governmental and non-governmental organisations (e.g. semi-governmental and private laboratories) and insufficient capacity building to improve skills (e.g. entomological, surveillance skills) were also observed. Lastly, we observed how bottlenecks in one building block negatively influenced other building blocks (e.g. inadequate leadership/governance obstructed the workforce's performance). Conclusions This study uncovers potential organisational bottlenecks that have affected the performance of the health system of Curaҫao negatively. We recommend starting with the reinforcement of oversight of the integrated vector management programme to ensure the development, implementation and evaluation of related legislation, policies and interventions. Also, we recommend evaluating and reforming the existing administrative and organisational structure of the health system by considering the cultural style, challenges and barriers of the current health system. More efforts are needed to improve the documentation of agreements, recruitment and evaluation of the workforce's performance. Based on our findings, we conceptualised actions to strengthen the health system's building blocks to improve its performance for future outbreaks of infectious diseases. Graphical abstract

scholarly journals Evaluating and Strengthening the Health System of Curaҫao to Improve its Performance for Future Outbreaks of Infectious Diseases.

2021 ◽  
Author(s):  
Vaitiare Mulderij-Jansen ◽  
Izzy Gerstenbluth ◽  
Ashley Duits ◽  
Adriana Tami ◽  
Ajay Bailey
Keyword(s):  
Qualitative Study ◽  
Infectious Diseases ◽  
Health System ◽  
Building Blocks ◽  
Healthcare Systems ◽  
Management Program ◽  
Entomological Surveillance ◽  
Vector Borne Diseases ◽  
System Building ◽  
Health System Building Blocks

Abstract BackgroundVector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore countries are encouraged to strengthen their healthcare systems to achieve more resilient systems. This qualitative study aims to examine the performance of the health system of the Dutch Caribbean island of Curaҫao with regards to the prevention and control of VBDs in the last decennium by using the WHO health system building blocks.MethodsFrom January 2019 to February 2020, a multi-method qualitative study was performed in Curaçao., applying content analysis of documents (n = 50), five focus group discussions (n = 30), interviews with experts (n = 11), and fifteen observation sessions. The study was designed based on the WHO framework: health system building blocks. Two cycles of inductive and deductive coding were employed, and Nvivo software was used to analyse the data.ResultsThis study’s data highlighted the challenges (e.g., insufficient oversight, coordination, leadership skills, structure, and communication) that the departments of the health system of Curaҫao faced during the last three epidemics of VBDs (2010–2020). Furthermore, low levels of collaboration between governmental and non-governmental organisations (e.g., semi-governmental and private laboratories) and insufficient capacity building to improve skills (e.g., entomological, surveillance skills) were also observed. Lastly, we observed how bottlenecks in one building block negatively influenced other building blocks (e.g., inadequate leadership/governance obstructed the workforce's performance).ConclusionsThis study uncovers potential organisational bottlenecks that have affected the performance of the health system of Curaҫao negatively. We recommend starting with the reinforcement of oversight of the integrated vector management program to ensure the development, implementation, and evaluation of related legislation, policies, and interventions. Also, we recommend evaluating and reform the existing administrative and organisational structure of the health system by taking the cultural style, challenges, and barriers of the current health system into account. More efforts are needed to improve the documentation of agreements, the recruitment, and evaluation of the workforce's performance. Based on our findings, we conceptualised actions to strengthen the health system's building blocks to improve its performance for future outbreaks of infectious diseases.

scholarly journals Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fariba Mirbaha-Hashemi ◽  
Batool Tayefi ◽  
Zahra Rampisheh ◽  
Arash Tehrani-Banihashemi ◽  
Mozhdeh Ramezani ◽  
...  
Keyword(s):  
Action Plan ◽  
Scale Up ◽  
Newborn Care ◽  
Building Blocks ◽  
Neonatal Care ◽  
Patient Transfer ◽  
Analysis Tool ◽  
System Building ◽  
Bottleneck Analysis ◽  
Health System Building Blocks

Abstract Background Neonatal mortality accounts for more than 47% of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitable and high-quality care for mothers and newborns. We applied the bottleneck analysis tool offered by ENAP to identify obstacles and bottlenecks hindering the scale-up of newborn care across seven health system building blocks. Methods We applied the every newborn bottleneck analysis tool to identify obstacles hindering the scale-up of newborn care across seven health system building blocks. We used qualitative methods to collect data from five medical universities and their corresponding hospitals in three provinces. We also interviewed other national experts, key informants, and stakeholders in neonatal care. In addition, we reviewed and qualitatively analyzed the performance report of neonatal care and services from 16 medical universities around the country. Results We identified many challenges and bottlenecks in the scale-up of newborn care in Iran. The major obstacles included but were not limited to the lack of a single leading and governing entity for newborn care, insufficient financial resources for neonatal care services, insufficient number of skilled health professionals, and inadequate patient transfer. Conclusions To address identified bottlenecks in neonatal health care in Iran, some of our recommendations were as follows: establishing a single national authorizing and leading entity, allocating specific budget to newborn care, matching high-quality neonatal health care providers to the needs of all urban and rural areas, maintaining clear policies on the distribution of NICUs to minimize the need for patient transfer, and using the available and reliable private sector NICU ambulances for safe patient transfer.

scholarly journals What health systems do? Functions as a starting point to assess health systems performance

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
Irini Papanicolas
Keyword(s):  
Health System ◽  
Performance Assessment ◽  
Health Systems ◽  
Building Blocks ◽  
Performance Outcomes ◽  
Starting Point ◽  
Common Framework ◽  
System Assessment ◽  
Health Systems Performance ◽  
Health System Building Blocks

Abstract Health system assessment (HSA) tools are often built around static health system building blocks, which lead to largely descriptive narrative and lack of linkages to health system outcomes. The development of a common framework that would also focus on performance outcomes is long overdue. We analysed the key HSA frameworks and tools based on them, with the purpose of identifying a common approach that would allow to link health system components to specific outcomes. The presentation will focus on using the health system functions as the basis of conducting the performance assessment. In a second step, the presentation will elaborate on the intermediate and final health system goals as part of the HSPA framework. It will explain their links to the four functions and thus, discuss their relevance for performance assessment.

scholarly journals Scaling up integrated primary mental health in six low- and middle-income countries: obstacles, synergies and implications for systems reform

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Inge Petersen ◽  
André van Rensburg ◽  
Fred Kigozi ◽  
Maya Semrau ◽  
Charlotte Hanlon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Chronic Care ◽  
Mental Healthcare ◽  
Building Blocks ◽  
Scaling Up ◽  
Task Sharing ◽  
Middle Income ◽  
Middle Income Countries ◽  
System Building

Background There is a global drive to improve access to mental healthcare by scaling up integrated mental health into primary healthcare (PHC) systems in low- and middle-income countries (LMICs). Aims To investigate systems-level implications of efforts to scale-up integrated mental healthcare into PHC in districts in six LMICs. Method Semi-structured interviews were conducted with 121 managers and service providers. Transcribed interviews were analysed using framework analysis guided by the Consolidated Framework for Implementation Research and World Health Organization basic building blocks. Results Ensuring that interventions are synergistic with existing health system features and strengthening of the healthcare system building blocks to support integrated chronic care and task-sharing were identified as aiding integration efforts. The latter includes (a) strengthening governance to include technical support for integration efforts as well as multisectoral collaborations; (b) ring-fencing mental health budgets at district level; (c) a critical mass of mental health specialists to support task-sharing; (d) including key mental health indicators in the health information system; (e) psychotropic medication included on free essential drug lists and (f) enabling collaborative and community- oriented PHC-service delivery platforms and continuous quality improvement to aid service delivery challenges in implementation. Conclusions Scaling up integrated mental healthcare in PHC in LMICs is more complex than training general healthcare providers. Leveraging existing health system processes that are synergistic with chronic care services and strengthening healthcare system building blocks to provide a more enabling context for integration are important. Declaration of interest None.

scholarly journals Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meredith P. Fort ◽  
William Mundo ◽  
Alejandra Paniagua-Avila ◽  
Sayra Cardona ◽  
Juan Carlos Figueroa ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Needs Assessment ◽  
Public Health System ◽  
Building Blocks ◽  
Hypertension Control ◽  
The Public ◽  
Multi Level ◽  
Health System Building Blocks

Abstract Background Uncontrolled hypertension represents a substantial and growing burden in Guatemala and other low and middle-income countries. As a part of the formative phase of an implementation research study, we conducted a needs assessment to define short- and long-term needs and opportunities for hypertension services within the public health system. Methods We conducted a multi-method, multi-level assessment of needs related to hypertension within Guatemala’s public system using the World Health Organization’s health system building blocks framework. We conducted semi-structured interviews with stakeholders at national (n = 17), departmental (n = 7), district (n = 25), and community (n = 30) levels and focus groups with patients (3) and frontline auxiliary nurses (3). We visited and captured data about infrastructure, accessibility, human resources, reporting, medications and supplies at 124 health posts and 53 health centers in five departments of Guatemala. We conducted a thematic analysis of transcribed interviews and focus group discussions supported by matrix analysis. We summarized quantitative data observed during visits to health posts and centers. Results Major challenges for hypertension service delivery included: gaps in infrastructure, insufficient staffing and high turnover, limited training, inconsistent supply of medications, lack of reporting, low prioritization of hypertension, and a low level of funding in the public health system overall. Key opportunities included: prior experience caring for patients with chronic conditions, eagerness from providers to learn, and interest from patients to be involved in managing their health. The 5 departments differ in population served per health facility, accessibility, and staffing. All but 7 health posts had basic infrastructure in place. Enalapril was available in 74% of health posts whereas hydrochlorothiazide was available in only 1 of the 124 health posts. With the exception of one department, over 90% of health posts had a blood pressure monitor. Conclusions This multi-level multi-method needs assessment using the building blocks framework highlights contextual factors in Guatemala’s public health system that have been important in informing the implementation of a hypertension control trial. Long-term needs that are not addressed within the scope of this study will be important to address to enable sustained implementation and scale-up of the hypertension control approach.

scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

scholarly journals Diagnostics and monitoring tools for noncommunicable diseases: a missing component in the global response

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Antonio Bernabé-Ortiz ◽  
Jessica H. Zafra-Tanaka ◽  
Miguel Moscoso-Porras ◽  
Rangarajan Sampath ◽  
Beatrice Vetter ◽  
...  
Keyword(s):  
Health System ◽  
New Technologies ◽  
Action Plan ◽  
Building Blocks ◽  
Communicable Diseases ◽  
Noncommunicable Disease ◽  
World Health ◽  
Noncommunicable Diseases ◽  
Diagnostic Tools ◽  
Monitoring Tools

AbstractA key component of any health system is the capacity to accurately diagnose individuals. One of the six building blocks of a health system as defined by the World Health Organization (WHO) includes diagnostic tools. The WHO’s Noncommunicable Disease Global Action Plan includes addressing the lack of diagnostics for noncommunicable diseases, through multi-stakeholder collaborations to develop new technologies that are affordable, safe, effective and quality controlled, and improving laboratory and diagnostic capacity and human resources. Many challenges exist beyond price and availability for the current tools included in the Package of Essential Noncommunicable Disease Interventions (PEN) for cardiovascular disease, diabetes and chronic respiratory diseases. These include temperature stability, adaptability to various settings (e.g. at high altitude), need for training in order to perform and interpret the test, the need for maintenance and calibration, and for Blood Glucose Meters non-compatible meters and test strips. To date the issues surrounding access to diagnostic and monitoring tools for noncommunicable diseases have not been addressed in much detail. The aim of this Commentary is to present the current landscape and challenges with regards to guidance from the WHO on diagnostic tools using the WHO REASSURED criteria, which define a set of key characteristics for diagnostic tests and tools. These criteria have been used for communicable diseases, but so far have not been used for noncommunicable diseases. Diagnostic tools have played an important role in addressing many communicable diseases, such as HIV, TB and neglected tropical diseases. Clearly more attention with regards to diagnostics for noncommunicable diseases as a key component of the health system is needed.

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