scholarly journals A conceptual framework for measuring community health workforce performance within primary health care systems

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Smisha Agarwal ◽  
Pooja Sripad ◽  
Caroline Johnson ◽  
Karen Kirk ◽  
Ben Bellows ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Data Collection ◽  
Community Health ◽  
Health Systems ◽  
Health Care Systems ◽  
Primary Health ◽  
Community Health Systems ◽  
Care Systems

Abstract Background With the 40th anniversary of the Declaration of Alma-Ata, a global effort is underway to re-focus on strengthening primary health care systems, with emphasis on leveraging community health workers (CHWs) towards the goal of achieving universal health coverage for all. Institutionalizing effective, sustainable community health systems is currently limited by a lack of standard metrics for measuring CHW performance and the systems they work within. Developed through iterative consultations, supported by the Bill & Melinda Gates Foundation and in partnership with USAID and UNICEF, this paper details a framework, list of indicators, and measurement considerations for monitoring CHW performance in low- and middle-income countries. Methods A review of peer-reviewed articles, reports, and global data collection tools was conducted to identify key measurement domains in monitoring CHW performance. Three consultations were successively convened with global stakeholders, community health implementers, advocates, measurement experts, and Ministry of Health representatives using a modified Delphi approach to build consensus on priority indicators. During this process, a structured, web-based survey was administered to identify the importance and value of specific measurement domains, sub-domains, and indicators determined through the literature reviews and initial stakeholder consultations. Indicators with more than 75% support from participants were further refined with expert qualitative input. Results Twenty-one sub-domains for measurement were identified including measurement of incentives for CHWs, supervision and performance appraisal, data use, data reporting, service delivery, quality of services, CHW absenteeism and attrition, community use of services, experience of services, referral/counter-referral, credibility/trust, and programmatic costs. Forty-six indicators were agreed upon to measure the sub-domains. In the absence of complete population enumeration and digitized health information systems, the quality of metrics to monitor CHW programs is limited. Conclusions Better data collection approaches at the community level are needed to strengthen management of CHW programs and community health systems. The proposed list of metrics balances exhaustive and pragmatic measurement of CHW performance within primary healthcare systems. Adoption of the proposed framework and associated indicators by CHW program implementors may improve programmatic effectiveness, strengthen their accountability to national community health systems, drive programmatic quality improvement, and plausibly improve the impact of these programs.

Hints for Reforming Primary and Community Care in Australia

2008 ◽  
Vol 14 (3) ◽  
pp. 68
Author(s):  
Hal Swerissen
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Outcomes ◽  
Community Care ◽  
Health Care Systems ◽  
Community Services ◽  
Primary Health ◽  
Care Systems

Considerable interest in reform for primary health care and health more generally has emerged recently. There are concerns that primary and community services are fragmented, inequitable and inefficient, particularly for people with chronic and complex conditions. The evidence suggests there will be a significant increase in demand for these services and that stronger primary health care systems lead to better health outcomes. This paper makes a number of suggestions about the development of funding, payment, governance and organisational arrangements that could be part of a National Primary Health Care Strategy for Australia.

Building primary health care systems: A case study from Sweden

Health Policy ◽  
1985 ◽  
Vol 5 (4) ◽  
pp. 313-329 ◽  
Author(s):  
Brogren Per-Olof ◽  
Richard B. Saltman
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Care Systems ◽  
Primary Health ◽  
Care Systems

Integrated primary care organizations: to what extent is integration occurring and why?

2005 ◽  
Vol 18 (1) ◽  
pp. 25-40 ◽  
Author(s):  
Steven Simoens ◽  
Anthony Scott
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Systems ◽  
Integrated Primary Care ◽  
Empirical Literature ◽  
Clear Understanding ◽  
Primary Health ◽  
Care Systems ◽  
Is Integration

Integration in primary health care is occurring in many health-care systems without a clear understanding of the meaning of integration, its form and rationale. This literature review examines the definition and extent of integration, as well as the factors that might encourage it in the context of British integrated primary care organizations (IPCOs). Integration is complex and multifaceted. No commonly agreed definitions of integration have been developed and the range of dimensions examined in the empirical literature was limited. However, some of the dimensions examined in studies of IPCOs may be useful in better understanding the form integration takes. Few studies were designed to examine the determinants of integration or were explicitly based on theory. Research showed that the level of production and transaction costs was not related to the size of the IPCO, although in practice the attitudes of health professionals are likely to be more important influences on the extent of integration. To date, little progress has been made in explaining and measuring integration. If further integration in primary health care is warranted, more research is required to understand its nature, form and rationale.

scholarly journals Performance Evaluation of The District's Primary Health Care System (DPHCS); Case Study Of Southeastern Iran

2021 ◽  
Author(s):  
Hamed Rahimi ◽  
Reza Goudarzi ◽  
Somayeh Noorihekmat ◽  
Aliakbar Haghdoost
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Systems ◽  
Returns To Scale ◽  
Primary Health Care System ◽  
Data Envelopment ◽  
Primary Health ◽  
Care Systems ◽  
Care System

Abstract Background: Managers need to measure and evaluate the performance of their subordinates in order to plan, organize, and improve the performance of their organizations. In this study, the performance and efficiency of the district's primary health care system in the southeast of Iran were evaluated using the data envelopment analysis (DEA) model.Methods: The quantitative non-parametric data envelopment analysis was used to evaluate the performance of the primary care system in the districts. On the hand, human forcess, physical facilities, and vehicles were the variables used as the inputs, and the number of services and service recipients was considered as the outputs to measure efficiency. The data were analyzed using the DEAP software, and performance and efficiency were calculated with the output maximization approach and the assumption of variable returns to scale. It was carried out as linear programming with nine scenarios for nine districts in 2018.Results: The mean efficiency of the studied districts with the assumption of variable returns to scale was 0.76, indicating at least 24% capacity to increase efficiency in the primary care system of Kerman University of Medical Sciences without any increase in production factors. According to the mean values, Kerman and Kuhbanan were efficient while the other 7 districts were inefficient. The districts were divided into three groups: efficient, moderately efficient, and inefficient. Accordingly, the most inefficient primary health care systems were those of Shahr-e Babak, Baft, and Orzooieh.Conclusion: The results of this study showed inefficiency in most primary health care systems of the studied districts, indicating that primary care managers can provide more health services to the community through proper management of available resources. Inefficient districts can compare themselves with successful and reference districts and eliminate their shortcomings in order to improve their performance.

A systematic-qualitative research for diffusion of innovation in the primary healthcare centers

2015 ◽  
Vol 10 (1) ◽  
pp. 105-117 ◽  
Author(s):  
Alireza Aslani ◽  
Marja Naaranoja
Keyword(s):  
Health Care ◽  
Qualitative Research ◽  
Primary Health Care ◽  
Diffusion Of Innovation ◽  
Health Care Systems ◽  
Content Type ◽  
Primary Health ◽  
Care Systems ◽  
Primary Health Care Centers ◽  
Health Care Centers

Purpose – This paper aims to discuss a model for diffusion of innovation among the professionals of primary health-care centers in Finland. The authors answer partially to one of the important questions of the policymakers titled “How primary health-care centers can move toward systems that continuously improve their innovation?”. Design/methodology/approach – A systematic-qualitative framework based on an action research is presented to assess dynamics of diffusion of innovation in the primary health-care centers in Finland. Findings – The authors conceptualize the innovation systems of primary health-care systems by three different diagrams: subsystem diagram, policy structure diagram and causal loop diagram. The investigation reviews innovation process of Finnish professionals (staffs, nurses and doctors) in the frame of a systematic-qualitative analysis. The relationships and consequences of decisions and policies are discussed with a new way of thinking in the health-care sector studies. Originality/value – The implemented systematic-qualitative research in this article is an innovative approach in the innovation studies of the health-care systems.

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