scholarly journals Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

2015 ◽  
Vol 13 (1) ◽  
Author(s):  
Venkatraman Chandra-Mouli ◽  
Subidita Chatterjee ◽  
Krishna Bose
Keyword(s):  
Health Service ◽  
Health Services ◽  
Service Quality ◽  
Service Utilization ◽  
Service Provision ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Challenges Affecting Health Referral Systems in Low-And Middle-Income Countries: A Systematic Literature Review

2021 ◽  
Vol 6 (3) ◽  
pp. 33-44
Author(s):  
Mildred Nakayuki ◽  
Annabella Basaza ◽  
Hasifah Namatovu
Keyword(s):  
Health Service ◽  
Service Provision ◽  
Inclusion Criteria ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries ◽  
Emergency Units ◽  
Impaired Health ◽  
Referral Systems ◽  
Low And Middle Income

Aims: Low and middle-income countries are still facing challenges of dysfunctional referral systems which have impaired health service provision. This review aimed at investigating these challenges to understand their nature, cause, and the impacts they have on health service provision. Methods: Database search was made in Google scholar, ACM Library, PubMed health, and BMC public health, and a total of 123 papers were generated. Only 14 fitted the inclusion criteria. Inclusion criteria included studies that were both quantitative and qualitative addressing challenges facing referral systems or health referral systems, studies describing the barriers to effective referral systems, and studies describing factors that affect referral systems. The review only included studies conducted in LMICs and included literature between January 2010 and February 2021. Findings: Results revealed that human resource and financial constraints, non-compliance, and communication are the key challenges affecting referral systems in LMICs. Recommendation: Countries that are facing these challenges need to overhaul the system and improve end-to-end communication between hospitals, improve capacity specifically in referral and emergency units, and sensitizing patients on the adherence to emergency protocols.

scholarly journals Looking ahead in the COVID-19 pandemic: emerging lessons learned for sexual and reproductive health services in low- and middle-income countries

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Sanni Yaya
Keyword(s):  
Reproductive Health ◽  
Service Provision ◽  
Sexual And Reproductive Health ◽  
Lessons Learned ◽  
Safe Abortion ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries ◽  
Published Evidence ◽  
Low And Middle Income

AbstractThe COVID-19 pandemic has caused widespread disruption to essential health service provision globally, including in low- and middle-income countries (LMICs). Recognising the criticality of sexual and reproductive health (SRH) services, we review the actual reported impact of the COVID-19 pandemic on SRH service provision and evidence of adaptations that have been implemented to date. Across LMICs, the available data suggests that there was a reduction in access to SRH services, including family planning (FP) counselling and contraception access, and safe abortion during the early phase of the pandemic, especially when movement restrictions were in place. However, services were quickly restored, or alternatives to service provision (adaptations) were explored in many LMICs. Cases of gender-based violence (GBV) increased, with one in two women reporting that they have or know a woman who has experienced violence since the beginning of the pandemic. As per available evidence, many adaptations that have been implemented to date have been digitised, focused on getting SRH services closer to women. Through the pandemic, several LMIC governments have provided guidelines to support SRH service delivery. In addition, non-governmental organisations working in SRH programming have played significant roles in ensuring SRH services have been sustained by implementing several interventions at different levels of scale and to varying success. Most adaptations have focused on FP, with limited attention placed on GBV. Many adaptations have been implemented based on guidance and best practices and, in many cases, leveraged evidence-based interventions. However, some adaptations appear to have simply been the sensible thing to do. Where evaluations have been carried out, many have highlighted increased outputs and efficiency following the implementation of various adaptations. However, there is limited published evidence on their effectiveness, cost, value for money, acceptability, feasibility, and sustainability. In addition, the pandemic has been viewed as a homogenous event without recognising its troughs and waves or disentangling effects of response measures such as lockdowns from the pandemic itself. As the pandemic continues, neglected SRH services like those targeting GBV need to be urgently scaled up, and those being implemented with any adaptations should be rigorously tested.

scholarly journals Cost of maternal health services in low and middle-income countries: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027822 ◽  
Author(s):  
Aduragbemi Banke-Thomas ◽  
Ibukun-Oluwa Omolade Abejirinde ◽  
Oluwasola Banke-Thomas ◽  
Adamu Maikano ◽  
Charles Anawo Ameh
Keyword(s):  
Systematic Review ◽  
Maternal Health ◽  
Health Service ◽  
Health Services ◽  
Maternal Health Services ◽  
Maternal Health Service ◽  
Economic Evaluations ◽  
Middle Income ◽  
Health Service Provision ◽  
Middle Income Countries

IntroductionThere is substantial evidence that maternal health services across the continuum of care are effective in reducing morbidities and mortalities associated with pregnancy and childbirth. There is also consensus regarding the need to invest in the delivery of these services towards the global goal of achieving Universal Health Coverage in low/middle-income countries (LMICs). However, there is limited evidence on the costs of providing these services. This protocol describes the methods and analytical framework to be used in conducting a systematic review of costs of providing maternal health services in LMICs.MethodsAfrican Journal Online, CINAHL Plus, EconLit, Embase, Global Health Archive, Popline, PubMed and Scopus as well as grey literature databases will be searched for relevant articles which report primary cost data for maternal health service in LMICs published from January 2000 to June 2019. This search will be conducted without implementing any language restrictions. Two reviewers will independently search, screen and select articles that meet the inclusion criteria, with disagreements resolved by discussions with a third reviewer. Quality assessment of included articles will be conducted based on cost-focused criteria included in globally recommended checklists for economic evaluations. For comparability, where feasible, cost will be converted to international dollar equivalents using purchasing power parity conversion factors. Costs associated with providing each maternal health services will be systematically compared, using a subgroup analysis. Sensitivity analysis will also be conducted. Where heterogeneity is observed, a narrative synthesis will be used. Population contextual and intervention design characteristics that help achieve cost savings and improve efficiency of maternal health service provision in LMICs will be identified.Ethics and disseminationEthical approval is not required for this review. The plan for dissemination is to publish review findings in a peer-reviewed journal and present findings at high-level conferences that engage the most pertinent stakeholders.PROSPERO registration numberCRD42018114124

scholarly journals How does performance-based financing affect the availability of essential medicines in Cameroon? A qualitative study

2019 ◽  
Vol 34 (Supplement_3) ◽  
pp. iii4-iii19 ◽  
Author(s):  
Isidore Sieleunou ◽  
Anne-Marie Turcotte-Tremblay ◽  
Manuela De Allegri ◽  
Jean-Claude Taptué Fotso ◽  
Habakkuk Azinyui Yumo ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Healthcare Providers ◽  
Study Data ◽  
Essential Medicines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Performance Based Financing ◽  
Low And Middle Income

Abstract Performance-based financing (PBF) is being implemented across low- and middle-income countries to improve the availability and quality of health services, including medicines. Although a few studies have examined the effects of PBF on the availability of essential medicines (EMs) in low- and middle-income countries, there is limited knowledge of the mechanisms underlying these effects. Our research aimed to explore how PBF in Cameroon influenced the availability of EMs, and to understand the pathways leading to the experiential dimension related with the observed changes. The design was an exploratory qualitative study. Data were collected through in-depth interviews, using semi-structured questionnaires. Key informants were selected using purposive sampling. The respondents (n = 55) included health services managers, healthcare providers, health authorities, regional drugs store managers and community members. All interviews were recorded, transcribed and analysed using qualitative data analysis software. Thematic analysis was performed. Our findings suggest that the PBF programme improved the perceived availability of EMs in three regions in Cameroon. The change in availability of EMs experienced by stakeholders resulted from several pathways, including the greater autonomy of facilities, the enforced regulation from the district medical team, the greater accountability of the pharmacy attendant and supply system liberalization. However, a sequence of challenges, including delays in PBF payments, limited autonomy, lack of leadership and contextual factors such as remoteness or difficulty in access, was perceived to hinder the capacity to yield optimal changes, resulting in heterogeneity in performance between health facilities. The participants raised concerns regarding the quality control of drugs, the inequalities between facilities and the fragmentation of the drug management system. The study highlights that some specific dimensions of PBF, such as pharmacy autonomy and the liberalization of drugs supply systems, need to be supported by equity interventions, reinforced regulation and measures to ensure the quality of drugs at all levels.

Factors Influencing Health Service Provision In Pastoral Communities In Kenya: A Case Study Of Wajir County

GIS Business ◽  
2019 ◽  
Vol 14 (4) ◽  
pp. 138-154
Author(s):  
AHMED ABDIKADIR ORE ◽  
DR. EMMANUEL AWUOR ◽  
JUSTER GATUMI NYAGA
Keyword(s):  
Health Service ◽  
Health Services ◽  
Human Resource ◽  
Service Provision ◽  
Research Study ◽  
Human Resource Practices ◽  
Health Service Provision ◽  
Pastoral Communities ◽  
Quality Of Health Services

The study seeks to find out factors affecting health service provision in pastoral communities, it                   is focusing Wajir County. The County Government is mandated to provide services including the                     health services which have been enabled by devolution functions such as transfer of funds.              However, Counties especially within the patrol communities have been faced with myriad of                       challenges in obtaining the standard services from the County offices such as medical and                         education services. Some of the mentioned causes of poor  services to the community from the                literature has been leaders  who are not objective in practicing the best human resource practices, poor communication facilities in the County thus community are not able to access the needed services in timely manner and lot of corruptions in the County offices. In addition, there is lack of proper structures or systems put in place to account for the resources allocated. From the past studies in the related fielded also present a methodological gap where most analysis is based on County reports lacking quantitative analysis while others uses only descriptive statistics to analyze the data.  This study thus, fills the gap by looking at broad construct which give a broader picture of the health service provision. In addition, this study combines both descriptive and inferential statistics to determine the relationships between the study variables.  The study therefore hypothesizes that: There is no relationship between devolved resource allocation and quality of health services provision (H01) and there is no relationship between human resource practices and quality of health services provision (H02); Research study was anchored on institutional theory. Descriptive survey was used; The findings of the research will be used by other researcher’s  as a reference to what they will do in future not forgetting that it was used as a source of literature review to their studies. 65 respondents were chosen through random sampling that was stratified. The research questionnaires were administered by the researcher himself to the respondents. Focus group discussion was also done to the community members. Data was analyzed through f(n) and descriptive statistics and presented using tables and graphs. The research study established that resource allocation and human resource practices have a great influence in the provision of health services. The study recommends that Governor   of Wajir County should develop and formulate guidelines, governing structure and strategic plans for effective implementation of county resources and revenue that will enable provision of quality healthcare.

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