scholarly journals Transformational improvement in quality care and health systems: the next decade

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Jeffrey Braithwaite ◽  
Charles Vincent ◽  
Ezequiel Garcia-Elorrio ◽  
Yuichi Imanaka ◽  
Wendy Nicklin ◽  
...  
Keyword(s):  
Health Systems ◽  
Action Plan ◽  
Quality Care ◽  
The United States ◽  
Care Quality ◽  
World Health ◽  
Main Body ◽  
Health Coverage ◽  
High Quality ◽  
The World

Abstract Background Healthcare is amongst the most complex of human systems. Coordinating activities and integrating newer with older ways of treating patients while delivering high-quality, safe care, is challenging. Three landmark reports in 2018 led by (1) the Lancet Global Health Commission, (2) a coalition of the World Health Organization, the Organisation for Economic Co-operation and Development and the World Bank, and (3) the National Academies of Sciences, Engineering and Medicine of the United States propose that health systems need to tackle care quality, create less harm and provide universal health coverage in all nations, but especially low- and middle-income countries. The objective of this study is to review these reports with the aim of advancing the discussion beyond a conceptual diagnosis of quality gaps into identification of practical opportunities for transforming health systems by 2030. Main body We analysed the reports via text-mining techniques and content analyses to derive their key themes and concepts. Initiatives to make progress include better measurement, using the capacities of information and communications technologies, taking a systems view of change, supporting systems to be constantly improving, creating learning health systems and undergirding progress with effective research and evaluation. Our analysis suggests that the world needs to move from 2018, the year of reports, to the 2020s, the decade of action. We propose three initiatives to support this move: first, developing a blueprint for change, modifiable to each country’s circumstances, to give effect to the reports’ recommendations; second, to make tangible steps to reduce inequities within and across health systems, including redistributing resources to areas of greatest need; and third, learning from what goes right to complement current efforts focused on reducing things going wrong. We provide examples of targeted funding which would have major benefits, reduce inequalities, promote universality and be better at learning from successes as well as failures. Conclusion The reports contain many recommendations, but lack an integrated, implementable, 10-year action plan for the next decade to give effect to their aims to improve care to the most vulnerable, save lives by providing high-quality healthcare and shift to measuring and ensuring better systems- and patient-level outcomes. This article signals what needs to be done to achieve these aims.

scholarly journals IOT IN THE WAKE OF COVID-19

2021 ◽  
Vol XLVI-4/W5-2021 ◽  
pp. 103-107
Author(s):  
K. Belasri ◽  
T. Mazri
Keyword(s):  
Quality Care ◽  
Health Sector ◽  
World Health ◽  
Contact Tracing ◽  
High Quality ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization ◽  
The Internet Of Things ◽  
Shed Light

Abstract. Healthcare is an imperative portion of life. Tragically, the exceptional outbreak of the 2019 novel coronavirus, named as COVID-19 by the World Health Organization (WHO), has strained the largest part of health systems and the request for resources from hospital packs to specialists and nurses have become extremely high. However, With the rise of the Internet of Things, new services in healthcare will be accessible and existing systems will be coordinated within the IoT system, giving automated medical supervision and efficient medical treatment, it is evident that a solution is necessary and required to promote the health sector in the era of Covid-19 pandemic whereas proceeding to supply a high-quality care to patients. In this article, we shed light on a few of the issues and challenges related to the appropriation of portable contact tracing and monitoring of patients’ arrangements for fighting COVID-19.

scholarly journals “Health Technology Assessment in High, Middle and Low-income Countries: New Systematic and Interdisciplinary Approach for Sound Informed-policymaking”

2020 ◽  
Author(s):  
Mohammed AlKhaldi ◽  
Sara Ahmed ◽  
Aisha Al Basuoni ◽  
Marcel Tanner
Keyword(s):  
Health Technology Assessment ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Technology Assessment ◽  
Social Systems ◽  
Health Technology ◽  
World Health ◽  
Health Coverage ◽  
The World ◽  
Universal Health

Abstract Technological innovation has a significant role in improving health systems (HSs) and achieving universal health coverage. The World Health Organization (WHO) has declared resolutions on Health Technology Assessment (HTA) and other global organizations emphasized on HTA systems to achieve the Sustainable Development Goals (SDGs). HTA is a modern multidisciplinary decision-making framework linking knowledge and policymaking in order to provide evidence to leaders and ensuring the value of resources by evaluating properties, effects, and/or impacts. The scope of HTA focuses on conducting assessments and analyses to investigate the medical, social, economic, organizational and ethical issues within health and social systems for generating management and technical solutions. HTA is important as it is rapidly growing and is seen as an essential development approach to tackle existing challenges, particularly in developing countries as they share most of the health burdens worldwide. The research aims to comprehensively evaluate HTA within the health and social systems and understand HTA within the national health system with regards to the level of knowledge about HTA, current HTA practices, application, capacity, gaps, and solutions by investigating the perceptions of health systems’ stakeholders in five countries, Canada, Switzerland, Lebanon, Palestine, and Tanzania selected according to the World Bank income classification. The project will last 12 months starts in January 2021 and ends in January 2022. A mixed-methods, quantitative and qualitative, along with a scoping review will be applied. In each country, fifty semi-structured questionnaires, twenty in-depth interviews, and one national focus group discussion will be conducted with health experts, managers, and policymakers selected purposively from the 1st and 2nd levels of the HS structure. Excel, IBM Statistical Package for the Social Sciences (SPSS), and MAXQDA 12 (VERBI GmbH, Berlin) software programs will be used for data management and analysis. The research will form cutting-edge evidence and reference not only for the six countries, but also for the global, regional, and national endeavors with regards to opening a room for HTA best application and optimization based on the produced knowledge from this research. It will reveal lessons learned, determine gaps, and set an applicable strengthening framework for HTA. This framework will eventually aid the decision and policymakers in these countries, and other similar countries and international organizations to build a well-enabled and institutionalized HTA for better universal health coverage, health systems, and multi-sectoral development.

scholarly journals Universal Health Coverage- A Case Study of Indian Healthcare System during COVID-19 Pandemic

2021 ◽  
pp. 1-6
Author(s):  
Rashika Nandwani
Keyword(s):  
Healthcare System ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Building Blocks ◽  
Health Systems Strengthening ◽  
World Health ◽  
Health Coverage ◽  
The World ◽  
The Government ◽  
Universal Health

Aim: The main purpose of this paper is to look at the Indian healthcare system during the COVID-19 pandemic and how COVID-19 acts as barrier and also presents some opportunities towards the road of Universal Health Coverage (UHC). Background: COVID-19 has exposed the vulnerability of health systems across the world and India is no exception. The World Health Organization (WHO) has kept the definition of UHC very flexible and has left on the country which is implementing it as to how much of the population and which services should be included in the scheme.  Discussion: India already has a unique flagship program Ayushman Bharat where it is trying to cover her most vulnerable population against catastrophic expenditure of health. This paper further investigates the progress of India towards UHC and how COVID-19 is acting as an impediment for India to progress towards it. On the other hand, it also poses some opportunities which had not been explored in the past. Health Systems Strengthening is the path towards the achievement of UHC and due to COVID-19, India has touched upon all the six building blocks which are needed to strengthen our system towards the achievement of UHC. Recommendations and Conclusion: It recommends that Indian system should be more proactive than reactive; it also suggests following a systems-based approach and to not target the problem in silos. It also suggests increasing the government funding as well as establishment of proper public health cadre. To conclude, this paper also suggests that the government should include outpatient expenses into their scheme, and they should also concentrate towards building adequate infrastructure in order to face future pandemics like COVID-19.

scholarly journals ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

2021 ◽  
Vol 6 (4) ◽  
pp. e004360
Author(s):  
Dumisani MacDonald Hompashe ◽  
Ulf-G Gerdtham ◽  
Carmen S Christian ◽  
Anja Smith ◽  
Ronelle Burger
Keyword(s):  
Health Systems ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Quality Care ◽  
Public Healthcare ◽  
Health Coverage ◽  
Access To Health Services ◽  
Healthcare Provision ◽  
Healthcare Facilities ◽  
Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

scholarly journals Importance of immunoglobulin therapy for COVID-19 patients with lymphocytopenia

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Heba K. Nabih
Keyword(s):  
Passive Immunization ◽  
Immunoglobulin Therapy ◽  
World Health ◽  
Clinical Feature ◽  
Main Body ◽  
Plasma Therapy ◽  
Rapid Spread ◽  
The World ◽  
Health Organization

Abstract Background The global coronavirus disease 2019 (COVID-19) was announced as pandemic by the World Health Organization (WHO). With the increased number of infected and dead victims daily all over the world, it becomes necessary to stop or overcome its rapid spread. Main body Although the production of vaccine or even specified effective anti-virus may take about six months to a year, intravenous immunoglobulin (IVIg) may be clinically used as a safe treatment to save and improve the quality of life of patients with a variety of immunodeficiency diseases such as lymphocytopenia, which is a common clinical feature in COVID-19. Conclusion Through the current review, it was concluded that this passive immunization may promote the immunity to better fight against the virus, so the survival of the patients could be kept longer. The efficacy of immunotherapy with IVIg would be greater if the immune IgG antibodies were collected from convalescent plasma therapy.

scholarly journals Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 256
Author(s):  
Pedro Plans-Rubió
Keyword(s):  
Vaccination Coverage ◽  
Action Plan ◽  
Herd Immunity ◽  
World Health ◽  
Immunization Programs ◽  
National Immunization ◽  
The World ◽  
Measles Vaccination ◽  
The Mean ◽  
Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

The Ethics of COVID-19 Vaccine Passports

2021 ◽  
Vol 46 (4) ◽  
pp. 1-2
Author(s):  
Joseph Meaney ◽  
Keyword(s):  
United States ◽  
World Health Organization ◽  
The United States ◽  
Scientific Data ◽  
World Health ◽  
Medical Decisions ◽  
The Poor ◽  
Divided Society ◽  
The World ◽  
Health Organization

COVID-19 vaccine passports run the risk of creating a divided society where social privileges or restrictions based on “fitness” lead to discrimination based on immunization status. Individuals have a strong right to be free of coercion to take a COVID-19 vaccine, and we should be very leery of further invasion of private medical decisions. These concerns are shared both internationally and in the United States, and the World Health Organization, the Biden administration, and many US governors oppose COVID-19 vaccine credentials. In addition, regulations for COVID-19 vaccine credentials face practical barriers, including lack of access globally, especially among the poor; and lack of scientific data on the efficacy of these vaccines.

(Mis)Information on Digital Platforms: Lessons from Twitter and Sina Weibo in the COVID-19 Pandemic (Preprint)

2021 ◽  
Author(s):  
Sarah Kreps
Keyword(s):  
Public Health ◽  
World Health Organization ◽  
Public Discourse ◽  
The United States ◽  
World Health ◽  
Sina Weibo ◽  
Digital Platforms ◽  
The World ◽  
Health Organization ◽  
Relative Prevalence

BACKGROUND Misinformation about COVID-19 has presented challenges to public health authorities during pandemics. Understanding the prevalence and type of misinformation across contexts offers a way to understand the discourse around COVID-19 while informing potential countermeasures. OBJECTIVE The aim of the study was to study COVID-19 content on two prominent microblogging platform, Twitter, based in the United States, and Sina Weibo, based in China, and compare the content and relative prevalence of misinformation to better understand public discourse of public health issues across social media and cultural contexts. METHODS A total of 3,579,575 posts were scraped from both Weibo and Twitter, focusing on content from January 30th, 2020, when the World Health Organization (WHO) declared COVID-19 a “Public Health Emergency of International Concern” and February 6th, 2020. A 1% random sample of tweets that contained both the English keywords “coronavirus” and “covid-19” and the equivalent Chinese characters was extracted and analyzed based on changes in the frequencies of keywords and hashtags. Misinformation on each platform was compared by manually coding and comparing posts using the World Health Organization fact-check page to adjudicate accuracy of content. RESULTS Both platforms posted about the outbreak and transmission but posts on Sina Weibo were less likely to reference controversial topics such as the World Health Organization and death and more likely to cite themes of resisting, fighting, and cheering against the coronavirus. Misinformation constituted 1.1% of Twitter content and 0.3% of Weibo content. CONCLUSIONS Quantitative and qualitative analysis of content on both platforms points to cross-platform differences in public discourse surrounding the pandemic and informs potential countermeasures for online misinformation.

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