scholarly journals Healthcare equity analysis: applying the Tanahashi model of health service coverage to community health systems following devolution in Kenya

Author(s):  
Rosalind McCollum ◽  
Miriam Taegtmeyer ◽  
Lilian Otiso ◽  
Maryline Mireku ◽  
Nelly Muturi ◽  
...  
The Lancet ◽  
2020 ◽  
Vol 396 (10245) ◽  
pp. 150-152
Author(s):  
Lyudmila Nepomnyashchiy ◽  
Bernice Dahn ◽  
Rachel Saykpah ◽  
Mallika Raghavan

2009 ◽  
Vol 25 (1) ◽  
pp. 34-41 ◽  
Author(s):  
Lawrence D. Prybil ◽  
Richard Peterson ◽  
Paul Brezinski ◽  
Gideon Zamba ◽  
William Roach ◽  
...  

Author(s):  
Manya van Ryneveld ◽  
Eleanor Whyle ◽  
Leanne Brady

The coronavirus disease 2019 (COVID-19) pandemic has exposed the wide gaps in South Africa’s formal social safety net, with the country’s high levels of inequality, unemployment and poor public infrastructure combining to produce devastating consequences for a vast majority in the country living through lockdown. In Cape Town, a movement of self-organising, neighbourhood-level community action networks (CANs) has contributed significantly to the community-based response to COVID-19 and the ensuing epidemiological and social challenges it has wrought. This article describes and explains the organising principles that inform this community response, with the view to reflect on the possibilities and limits of such movements as they interface with the state and its top-down ways of working, often producing contradictions and complexities. This presents an opportunity for recognising and understanding the power of informal networks and collective action in community health systems in times of unprecedented crisis, and brings into focus the importance of finding ways to engage with the state and its formal health system response that do not jeopardise this potential.


2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Molly E. Lauria ◽  
Kevin P. Fiori ◽  
Heidi E. Jones ◽  
Sesso Gbeleou ◽  
Komlan Kenkou ◽  
...  

Abstract Background Over the past decade, prevalence of maternal and child morbidity and mortality in Togo, particularly in the northern regions, has remained high despite global progress. The causes of under-five child mortality in Togo are diseases with effective and low-cost prevention and/or treatment strategies, including malaria, acute lower respiratory infections, and diarrheal diseases. While Togo has a national strategy for implementing the integrated management of childhood illness (IMCI) guidelines, including a policy on integrated community case management (iCCM), challenges in implementation and low public sector health service utilization persist. There are critical gaps to access and quality of community health systems throughout the country. An integrated facility- and community-based initiative, the Integrated Community-Based Health Systems Strengthening (ICBHSS) initiative, seeks to address these gaps while strengthening the public sector health system in northern Togo. This study aims to evaluate the effect and implementation strategy of the ICBHSS initiative over 48 months in the catchment areas of 21 public sector health facilities. Methods The ICBHSS model comprises a bundle of evidence-based interventions targeting children under five, women of reproductive age, and people living with HIV through (1) community engagement and feedback; (2) elimination of point-of-care costs; (3) proactive community-based IMCI using community health workers (CHWs) with additional services including family planning, HIV testing, and referrals; (4) clinical mentoring and enhanced supervision; and (5) improved supply chain management and facility structures. Using a pragmatic type II hybrid effectiveness-implementation study, we will evaluate the ICBHSS initiative with two primary aims: (1) determine effectiveness through changes in under-five mortality rates and (2) assess the implementation strategy through measures of reach, adoption, implementation, and maintenance. We will conduct a mixed-methods assessment using the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework. This assessment consists of four components: (1) a stepped-wedge cluster randomized control trial using a community-based household survey, (2) annual health facility assessments, (3) key informant interviews, and (4) costing and return-on-investment assessments for each randomized cluster. Discussion Our research is expected to contribute to continuous quality improvement initiatives, optimize implementation factors, provide knowledge regarding health service delivery, and accelerate health systems improvements in Togo and more broadly. Trial registration ClinicalTrials.gov, NCT03694366, registered 3 October 2018


Author(s):  
Richard Alweis ◽  
Anthony Donato ◽  
Richard Terry ◽  
Christina Goodermote ◽  
Farrah Qadri ◽  
...  

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