scholarly journals The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jenelle M. Clarke ◽  
Justin Waring ◽  
Simon Bishop ◽  
Jean Hartley ◽  
Mark Exworthy ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Services ◽  
Mixed Methods Research ◽  
Political Skill ◽  
Group Processes ◽  
Healthcare Services ◽  
Narrative Synthesis ◽  
Five Dimensions ◽  
Individual Level ◽  
Health System Change

Abstract Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature. Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in healthcare services. Results Sixty-two papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is comprised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through five dimensions of leadership: personal performance; contextual awareness; inter-personal influence; stakeholder engagement, networks and alliances; and influence on policy processes. Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

scholarly journals The contribution of political skill to the implementation of health services change: a systematic review and narrative synthesis

2020 ◽  
Author(s):  
Jenelle Marie Clarke ◽  
Justin Waring ◽  
Simon Bishop ◽  
Jean Hartley ◽  
Mark Exworthy ◽  
...  
Keyword(s):  
Leadership Development ◽  
Health Services ◽  
Mixed Methods Research ◽  
Health Care Services ◽  
Political Skill ◽  
Group Processes ◽  
Narrative Synthesis ◽  
Individual Level ◽  
Health System Change ◽  
Care Services

Abstract Background The implementation of strategic health system change is often complicated by informal ‘politics’ in healthcare organisations. Leadership development programmes increasingly call for the development and use of ‘political skill’ as a means for understanding and managing the politics of healthcare organisations. The primary purpose of this review is to determine how political skill contributes to the implementation of health services change, within and across organisations. The secondary purpose is to demonstrate the conceptual variations within the literature.Methods The article is based upon a narrative synthesis that included quantitative, qualitative and mixed methods research papers, review articles and professional commentaries that deployed the concept of political skill (or associated terms) to describe and analyse the implementation of change in health care services.Results 62 papers were included for review drawn from over four decades of empirically and conceptually diverse research. The literature is compromised of four distinct literatures with a lack of conceptual coherence. Within and across these domains, political skill is described as influencing health services change through six dimensions of leadership: personal performance, contextual awareness, inter-personal influence, stakeholder engagement, networking and policy influence.Conclusion There is a growing body of evidence showing how political skill can contribute to the implementation of health services change, but the evidence on explanatory processes is weak. Moreover, the conceptualisation of political skill is variable making comparative analysis difficult, with research often favouring individual-level psychological and behavioural properties over more social or group processes.

scholarly journals Covid-19 pandemic impact on maternal and child health services access in Nampula, Mozambique: a mixed methods research

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Paulo Henrique das Neves Martins Pires ◽  
Cynthia Macaringue ◽  
Ahmed Abdirazak ◽  
Jaibo Rassul Mucufo ◽  
Martins Abudo Mupueleque ◽  
...  
Keyword(s):  
Health Care ◽  
Child Health ◽  
Health Services ◽  
Maternal And Child Health ◽  
Mixed Methods Research ◽  
Health Centre ◽  
Healthcare Services ◽  
Child Health Services ◽  
Child Healthcare ◽  
And Child Health

Abstract Background The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people’s movements and reduced public services, leading to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community. Methods Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March–May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites. Results Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%. Conclusion Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.

Utilization Of Healthcare Services To General Patient At Inpatient Unit of Anutapura General Hospital, Palu City

2020 ◽  
Vol 10 (1) ◽  
pp. 35-44
Author(s):  
Fausiah Fausiah
Keyword(s):  
Health Services ◽  
General Hospital ◽  
Health Beliefs ◽  
Secondary Data ◽  
Healthcare Services ◽  
Primary Data ◽  
Utilization Of Health Services ◽  
The People ◽  
Quantitative Descriptive ◽  
Utilization Of Healthcare

The number of inpatient visits in RSU Anutapura Palu, where in 2015 inpatient visits of 5,640, then in 2016 patient visits decreased to 5,451, in 2017 also decreased to 3,999 and in 2018 also decreased Drastic to 1,146 patient visits. This research aims to determine the utilization of health services in patients in general hospitalization in RSU Anutapura Palu. This type of research is quantitative descriptive. Research was conducted from May-June 2019. The population in the study is a visitor (number of hospitalizations) at the General Hospital (RSU) Anutapura Palu. In this case the people who use health services in the General Hospital (RSU) Anutapura Palu recorded as many as 1,146 visitors (patients) in the year 2018. Primary data collection is through questionnaires and secondary data through the study of patient record documents and other supporting documents. The utilization of health services in patients in general hospitalization in RSU Anutapura Palu is well from the aspects of health beliefs, abilities and needs. RSU Anutapura Palu is expected to be able to improve the promotion of health services so that people use the health services provided.  

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

scholarly journals Effect of the COVID-19 on perceptions of health, anticipated need for health services, and cost of healthcare

2021 ◽  
pp. 1-28
Author(s):  
Natalia Rekhter ◽  
Natalia Ermasova
Keyword(s):  
Health Services ◽  
Healthcare Services ◽  
Care Seeking ◽  
Financial Barriers ◽  
Health Concerns ◽  
Anova Test ◽  
Targeted Interventions ◽  
Early Stages ◽  
Care Seeking Behavior ◽  
Related Stress

Abstract Objective: This article investigates how perceived vulnerability to the COVID-19 pandemic at its early stages is associated with people’s perception of their health, the need for healthcare services, and expenses related to addressing the COVID-19 impact on their health. Methods: The results are based on the analysis of surveys that were distributed among members of 26 random Facebook groups in April-May, 2020. Perceived COVID-19 pandemic related stress and health concerns were examined by using the ANOVA test. Results: Among 315 respondents, 64% have experienced COVID-19 related stress and identified anxiety, headache, insomnia, and weight gain as their primary health concerns. The ANOVA test revealed that females are more impacted by the COVID-19 stress than males. Around 40% of respondents believed that the COVID-19 would lead to an increase in the cost of health services, and 20% of respondents anticipated that the COVID-19 pandemic would increase their need for health services. Conclusions: Learning about how people perceive the COVID-19 pandemic impact on their health, particularly in the pandemic’s early stages can allow health professionals to develop targeted interventions that can influence pandemic preventative behaviors among different population groups. This study can help understand utilization patterns and mitigate financial barriers that could interfere with patients’ care-seeking behavior.

scholarly journals Evaluation of e-health (Seha) application: a cross-sectional study in Saudi Arabia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abeer Alharbi ◽  
Joharah Alzuwaed ◽  
Hind Qasem
Keyword(s):  
Saudi Arabia ◽  
Health Services ◽  
Healthcare Services ◽  
Cross Sectional Study ◽  
Advanced Technology ◽  
Sectional Study ◽  
Cross Sectional ◽  
Technical Problems ◽  
Significant Difference ◽  
Ease Of Access

Abstract Background The Ministry of Health in Saudi Arabia is expanding the country’s telemedicine services by using advanced technology in health services. In doing so, an e-health application (app), Seha, was introduced in 2018 that allows individuals to have face-to-face visual medical consultations with their doctors on their smartphones. Objective This study evaluated the effectiveness of the app in improving healthcare delivery by ensuring patient satisfaction with the care given, increasing access to care, and improving efficiency in the healthcare system. Methods A cross-sectional study design was used to assess the perceptions of users of the Seha app and non-users who continued with traditional health services. The data were collected using an online survey via Google Forms between June 2020 and September 2020. Independent t tests and chi-square (χ2) tests were conducted to answer the research questions. Results There was a significant difference between users and non-users in terms of ease of access to health services (t =  − 9.38, p < 0.05), with app users having a higher mean score (4.19 ± 0.91) than non-users (3.41 ± 1.00); satisfaction with health services (t =  − 6.33, p < 0.05), with users having a higher mean score (3.96 ± 0.91) than non-users (3.45 ± 0.94); and efficiency (only one visit needed for treatment) (t =  − 3.20, p < 0.05), with users having a higher mean score (3.71 ± 0.93) than non-users (3.45 ± 0.93). There were significant associations between the use of the Seha app and age (χ2 = 8.79, p < 0.05), gender (χ2 = 22.19, p < 0.05), region (χ2 = 19.74, p < 0.05), and occupation (χ2 = 22.05, p < 0.05). There were significant relationships between the three items (on access, satisfaction, and efficiency) and experiencing technical issues (t = 4.47, t = 8.11, and t = 3.24, respectively, p < 0.05), with users who faced technical problems having significantly lower mean scores for all three items. Conclusion This study provided evidence that the Seha app improved the delivery of healthcare in Saudi Arabia. Users of the app had a better health experience in terms of their perceived ease of access to healthcare services; their satisfaction with healthcare services; and the efficiency of the system, measured by the number of required doctor visits. Other factors that appeared to influence the use of the app included age, gender, usual source of care, and technical difficulties.

Community Capacity to Provide Mental/Behavioral Health Services for People With IDD Transitioning From State-Operated Developmental Centers

2021 ◽  
Vol 59 (3) ◽  
pp. 224-238
Author(s):  
Amie Lulinski ◽  
Tamar Heller
Keyword(s):  
Health Services ◽  
Behavioral Health ◽  
Psychiatric Diagnosis ◽  
Technical Assistance ◽  
Community Capacity ◽  
Intellectual And Developmental Disabilities ◽  
Community Based ◽  
Individual Level ◽  
Lengths Of Stay ◽  
Survey Results

Abstract The study's aim was to explore the capacity of community-based providers of residential supports and services to support people with intellectual and developmental disabilities who transitioned out of state-operated institutions into community-based settings. Receiving agency survey results from 65 agencies and individual-level variables of 2,499 people who had transitioned from an institution to a community-based setting indicated that people who returned to an institution post-transition tended to be younger, have a higher IQ score, were more likely to have a psychiatric diagnosis, tended to have shorter previous lengths of stay at an institution, transitioned to larger settings, and received services from an agency receiving behavioral health technical assistance as compared to those who remained in their transition settings.

Understanding Reproductive Health Services in Eastern Uttar Pradesh, India: A Dalit Feminist Approach

2021 ◽  
pp. 2455328X2110281
Author(s):  
Priti Chandra
Keyword(s):  
Reproductive Health ◽  
Health Services ◽  
Participant Observation ◽  
Uttar Pradesh ◽  
Healthcare Services ◽  
Indian Society ◽  
Reproductive Health Services ◽  
Qualitative Research Design ◽  
Dalit Women ◽  
Eastern Uttar Pradesh

The identity of women cannot be seen in isolation but one that exists along with other constituents that intersects with class, race, sexuality and caste also. Being a woman, a person is already at periphery, adding caste to it makes more vulnerable. Thus, Dalit women are more subjugated in Indian society whether it is about leading a normal life or availing reproductive health services. This study primarily draws from a Dalit feminist perspective to understand the subjectivity and nuisances of the Dalit women who avail reproductive health services. While availing reproductive health services, the sort of discrimination the Dalit women face are denial in providing reproductive health services, creating and observing distance with the Dalit women by the health practitioners, and also promotion of privatization of healthcare services. The study is based on qualitative research design basically, participant observation, in which the total 27 married women were selected for the in-depth interview, among them 16 women were from the Dalit community and 9 women were from the so-called upper caste community. This research was conducted from February to April 2015 in Mau district of Eastern Uttar Pradesh, India.

COVID’s Effect on India’s Health Services: A Commentary

Social Change ◽  
2021 ◽  
Vol 51 (4) ◽  
pp. 483-492
Author(s):  
Imrana Qadeer
Keyword(s):  
Public Sector ◽  
Health Services ◽  
Healthcare Services ◽  
The Public ◽  
State Authority ◽  
Comprehensive Framework ◽  
The Impact ◽  
Second Wave

Using a comprehensive framework (the state’s will to deliver, its institutional strength and its legitimacy), this article assesses the impact of the COVID-19 pandemic on public sector healthcare services in India. The power to deliver was explicit when the interventions were harsh, increasing the burden of death and disease on health services. But when it came to healthcare by the public sector we find a worsening of achievements of non-COVID ailments during the pandemic and an inability to tackle the second wave due to gaps in the nation's infrastructure, a centralised control undermining state authority; and visible results of a flawed policy that pushed further the agenda of making healthcare a profitable business.

Digital Mega-Studies as a New Research Paradigm: Governing the Health Research of the Future

2021 ◽  
pp. 155626462110414
Author(s):  
Jessica Bell ◽  
Megan Prictor ◽  
Lauren Davenport ◽  
Lynda O’Brien ◽  
Melissa Wake
Keyword(s):  
Large Scale ◽  
Group Processes ◽  
Research Paradigm ◽  
Multiple Sources ◽  
Individual Level ◽  
Key Characteristics ◽  
Governance Challenges ◽  
Technological Developments ◽  
Multi Stakeholder ◽  
New Research

‘Digital Mega-Studies’ are entirely or extensively digitised, longitudinal, population-scale initiatives, collecting, storing, and making available individual-level research data of different types and from multiple sources, shaped by technological developments and unforeseeable risks over time. The Australian ‘Gen V’ project exemplifies this new research paradigm. In 2019, we undertook a multidisciplinary, multi-stakeholder process to map Digital Mega-Studies’ key characteristics, legal and governance challenges and likely solutions. We conducted large and small group processes within a one-day symposium and directed online synthesis and group prioritisation over subsequent weeks. We present our methods (including elicitation, affinity mapping and prioritisation processes) and findings, proposing six priority governance principles across three areas—data, participation, trust—to support future high-quality, large-scale digital research in health.

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