scholarly journals Integrated health service delivery during COVID-19: a scoping review of published evidence from low-income and lower-middle-income countries

2021 ◽  
Vol 6 (6) ◽  
pp. e005667
Author(s):  
Md Zabir Hasan ◽  
Rachel Neill ◽  
Priyanka Das ◽  
Vasuki Venugopal ◽  
Dinesh Arora ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health System ◽  
Scoping Review ◽  
Low Income ◽  
Building Blocks ◽  
Health Service Delivery ◽  
Middle Income ◽  
Published Evidence ◽  
Integrated Health

BackgroundIntegrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features.MethodsA systematic scoping review of peer-reviewed literature, published in English between 1 December 2019 and 12 June 2020, from seven electronic databases was conducted to explore the evidence of IHSD implemented in L-LMICs during the COVID-19 pandemic. Data were systematically charted, and key features of IHSD systems were presented according to the postulated research questions of the review.ResultsThe literature search retrieved 1487 published articles from which 18 articles met the inclusion criteria and included in this review. Service delivery, health workforce, medicine and technologies were the three most frequently integrated health system building blocks during the COVID-19 pandemic. While responding to COVID-19, the L-LMICs principally implemented the IHSD system via systematic horizontal integration, led by specific policy measures. The government’s stewardship, along with the decentralised decision-making capacity of local institutions and multisectoral collaboration, was the critical facilitator for IHSD. Simultaneously, fragmented service delivery structures, fragile supply chain, inadequate diagnostic capacity and insufficient workforce were key barriers towards integration.ConclusionA wide array of context-specific IHSD approaches were operationalised in L-LMICs during the early phase of the COVID-19 pandemic. Emerging recommendations emphasise the importance of coordination and integration across building blocks and levels of the health system, supported by a responsive governance structure and stakeholder engagement strategies. Future reviews can revisit this emerging evidence base at subsequent phases of COVID-19 response and recovery in L-LMICs to understand how the approaches highlighted here evolve.

scholarly journals Evidence of integrated health service delivery during COVID-19 in low- and middle-income countries: protocol for a scoping review

2020 ◽  
Author(s):  
Rachel Neill ◽  
Md Zabir Hasan ◽  
Priyanka Das ◽  
Vasuki Venugopal ◽  
Nishant Jain ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health Systems ◽  
Scoping Review ◽  
Health Service Delivery ◽  
World Health ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Integrated Health

Introduction The importance of integrated, people-centered health systems has been recognized as a central component of achieving Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can stand the shock of health emergencies. However, there is dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness in low- and low-middle income countries (LMICs). Thus, the authors are organizing a scoping review aiming to explore application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs. Methods and analysis This scoping review adheres to the six steps for scoping reviews from Arksey and OMalley (2005). Peer reviewed scientific literature will be systematically assembled utilizing a standardized and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the World Health Organization Global Research Database on COVID-19, and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrices. Ethics and dissemination No ethical approval is required for the review. The study will be conducted from June to December 2020. Results from this study will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic. The findings will be developed into reports and a peer-reviewed articles and will assist policy makers in making pragmatic and evidence-based decisions for current and future pandemic response.

scholarly journals Evidence of integrated health service delivery during COVID-19 in low and lower-middle-income countries: protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042872
Author(s):  
Rachel Neill ◽  
Md Zabir Hasan ◽  
Priyanka Das ◽  
Vasuki Venugopal ◽  
Nishant Jain ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health Systems ◽  
Scoping Review ◽  
Health Service Delivery ◽  
Data Matrix ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Integrated Health

IntroductionThe importance of integrated, people-centred health systems has been recognised as a central component of Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can withstand the shock of health emergencies. However, there is a dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness, response, and recovery in low-income and lower-middle-income countries (LMICs). Thus, the authors are organising a scoping review aiming to explore the application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs.Methods and analysisThis scoping review adheres to the six steps for scoping reviews from Arksey and O’Malley. Peer-reviewed scientific literature will be systematically assembled using a standardised and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the WHO’s Global Research Database on COVID-19 and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full-text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrix.Ethics and disseminationNo ethical approval is required for the review. The study will be conducted from June 2020 to May 2021. Results from this scoping review will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic in LMICs. The findings will be developed into reports and a peer-reviewed article and will assist policy-makers in making pragmatic and evidence-based decisions for current and future pandemic responses.

scholarly journals Health service delivery and workforce in northern Australia: a scoping review

2020 ◽  
Author(s):  
Alexandra Edelman ◽  
John Grundy ◽  
Sarah Larkins ◽  
Stephanie Topp ◽  
David Atkinson ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Scoping Review ◽  
Health Service Delivery ◽  
Northern Australia

scholarly journals Primary healthcare system performance in low-income and middle-income countries: a scoping review of the evidence from 2010 to 2017

2019 ◽  
Vol 4 (Suppl 8) ◽  
pp. e001551 ◽  
Author(s):  
Asaf Bitton ◽  
Jocelyn Fifield ◽  
Hannah Ratcliffe ◽  
Ami Karlage ◽  
Hong Wang ◽  
...  
Keyword(s):  
Service Delivery ◽  
Scoping Review ◽  
Low Income ◽  
Primary Healthcare ◽  
Recent Literature ◽  
Future Research ◽  
Topic Area ◽  
Middle Income ◽  
Ample Evidence ◽  
Middle Income Countries

IntroductionThe 2018 Astana Declaration reaffirmed global commitment to primary healthcare (PHC) as a core strategy to achieve universal health coverage. To meet this potential, PHC in low-income and middle-income countries (LMIC) needs to be strengthened, but research is lacking and fragmented. We conducted a scoping review of the recent literature to assess the state of research on PHC in LMIC and understand where future research is most needed.MethodsGuided by the Primary Healthcare Performance Initiative (PHCPI) conceptual framework, we conducted searches of the peer-reviewed literature on PHC in LMIC published between 2010 (the publication year of the last major review of PHC in LMIC) and 2017. We also conducted country-specific searches to understand performance trajectories in 14 high-performing countries identified in the previous review. Evidence highlights and gaps for each topic area of the PHCPI framework were extracted and summarised.ResultsWe retrieved 5219 articles, 207 of which met final inclusion criteria. Many PHC system inputs such as payment and workforce are well-studied. A number of emerging service delivery innovations have early evidence of success but lack evidence for how to scale more broadly. Community-based PHC systems with supportive governmental policies and financing structures (public and private) consistently promote better outcomes and equity. Among the 14 highlighted countries, most maintained or improved progress in the scope of services, quality, access and financial coverage of PHC during the review time period.ConclusionOur findings revealed a heterogeneous focus of recent literature, with ample evidence for effective PHC policies, payment and other system inputs. More variability was seen in key areas of service delivery, underscoring a need for greater emphasis on implementation science and intervention testing. Future evaluations are needed on PHC system capacities and orientation toward social accountability, innovation, management and population health in order to achieve the promise of PHC.

scholarly journals Influence of Politics on Accountability of Health Professionals in Bangladesh: An Analysis of the Quality of Health Service Delivery

2017 ◽  
Vol 12 (1) ◽  
pp. 75-82
Author(s):  
Mohammad Shafiqul Islam
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health System ◽  
Healthcare Delivery ◽  
Health Service Delivery ◽  
Elected Officials ◽  
Political Commitment ◽  
Healthcare Provision ◽  
Administrative Authority ◽  
Political Actors

This study explored the role and responsibility of elected officials including political actors and addressed the factors of politics, decentralisation, bureaucratic management, and political commitment to understanding accountability in health service delivery. This study used qualitative case studies for which a total of 68 in-depth interviews and five focus group discussions were conducted in two areas of rural and urban Bangladesh. The findings show that political actors have poor commitment to improving accountability and healthcare delivery. The elected officials are not interested in organising regular meetings and they are even reluctant to organise a health service committee to make health officials accountable. The opposition political parties have no participation in health service organisations as the existing political culture does not allow it. Moreover, elected officials have a limited administrative authority because of an inadequate decentralised health system that leads to poor accountability and inadequate healthcare delivery. Further, bureaucrats want to capture power and are unwilling to decentralise the health system. The policy recommendation includes the decentralisation of healthcare provision and increased participation of elected representatives in a decentralised system. Abbreviations: ADP – Annual Development Plan; MP – Member of Parliament; NGO – Non Government Organisation; UHC – Upazilia Health Complex; UP – Upazilia Parishad.

scholarly journals Hospitals in Integrated Health Service Delivery Networks: Strategic Recommendations

2021 ◽  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Organization And Management ◽  
Structural Problems ◽  
The People ◽  
Integrated Health ◽  
Specialized Institutions ◽  
Care Technology ◽  
Delivery Network

In 2007, PAHO launched the Integrated Health Service Delivery Network (IHSDN) initiative to address the problems derived from the fragmentation of health services and to overcome the structural problems stemming from the widespread segmentation of health systems in the countries of the Region. In the IHSDN initiative, hospitals are an aggregate of specialized institutions that support a highly effective first level of care. Hospitals themselves are defragmented, which is theoretically correct, innovative, and even visionary. However, the IHSDN initiative does not seek to diminish the influence of hospitals in the health system or the importance of their role, but to integrate these institutions so that all their efforts are aligned with the needs of the people and communities they serve through the development of IHSDNs. It is obvious that without hospitals there can be no IHSDNs; however, it should also be recognized that without effective networks, hospitals cannot do their job. The IHSDN initiative presents a change in the role assigned to hospitals, in which they are no longer considered the apex of a pyramid in which the hierarchy is based on specialization to successfully treat disease. Instead, the hospital becomes a very important participant in a service organized as a network, performing specific tasks in a series of processes that cut repeatedly across the health service delivery network and include the participation of individuals and communities. The product of an intense debate and joint effort, this work contains a series of proposals in the six areas considered a priority for developing the new role of hospitals in IHSDNs: governance, resource allocation and incentives, the model of care, technology and infrastructure, human resources, and organization and management.

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