scholarly journals Key factors to facilitate locally driven family planning programming: a qualitative analysis of urban stakeholder perspectives in Africa and Asia

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Lisa Mwaikambo ◽  
Sarah Brittingham ◽  
Saori Ohkubo ◽  
Ruwaida Salem ◽  
Denis Joel Sama ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Systems ◽  
Thematic Analysis ◽  
Urban Areas ◽  
Local Governments ◽  
Scale Up ◽  
Analytical Framework ◽  
Essential Elements ◽  
Evidence Based ◽  
Country Ownership

Abstract Background There has been greater recognition of the importance of country ownership in global health and development. However, operationalising country ownership to ensure the scale up and sustainability of proven interventions remains elusive at best. To address this challenge, we undertook a thematic analysis of interviews collected from representatives of local governments, public health systems, and communities in poor urban areas of East Africa, Francophone West Africa, India, and Nigeria, supported by The Challenge Initiative (TCI), aiming to rapidly and sustainably scale up evidence-based reproductive health and family planning solutions. Methods The main objective of this study was to explore critical elements needed for implementing and scaling evidence-based family planning interventions. The research team conducted thematic analysis of 96 stories collected using the Most Significant Change (MSC) technique between July 2018 and September 2019. After generating 55 unique codes, the codes were grouped into related themes, using TCI’s model as a general analytical framework. Results Five key themes emerged: (1) strengthening local capacity and improving broader health systems, (2) shifting mindsets of government and community toward local ownership, (3) institutionalising the interventions within existing government structures, (4) improving data demand and use for better planning of health services, and (5) enhancing coordination of partners. Conclusion While some themes feature more prominently in a particular region than others, taken together they represent what stakeholders perceive to be essential elements for scaling up locally-driven health programmes in urban areas in Africa and Asia.

scholarly journals Key Factors to Facilitate Locally Driven Family Planning Programming: A Qualitative Analysis of Urban Stakeholder Perspectives in Africa and Asia

2020 ◽  
Author(s):  
Lisa Mwaikambo ◽  
Sarah Brittingham ◽  
Saori Ohkubo ◽  
Ruwaida Salem ◽  
Denis Joel Sama ◽  
...  
Keyword(s):  
Family Planning ◽  
Health Systems ◽  
Urban Areas ◽  
Local Governments ◽  
Scale Up ◽  
Essential Elements ◽  
Evidence Based ◽  
Country Ownership ◽  
Stakeholder Perspectives ◽  
Most Significant Change

Abstract BackgroundThere has been greater recognition of the importance of country ownership in global health and development. However, operationalising country ownership to ensure the scale up and sustainability of proven interventions remains elusive at best. To address this challenge, we undertook a thematic analysis of interviews collected from representatives of local governments, public health systems, and communities in poor urban areas of East Africa, Francophone West Africa, India, and Nigeria, supported by The Challenge Initiative, aiming to rapidly and sustainably scale up evidence-based reproductive health and family planning solutions. MethodsThe main objective of this study was to explore critical elements needed for implementing and scaling evidence-based family planning interventions. The research team conducted interviews and collected 96 stories using the Most Significant Change (MSC) technique between July 2018 and September 2019, and coded and analyzed the stories. Most frequently used codes were identified and grouped into emerging themes.ResultsFive key themes emerged: (1) strengthening local capacity and improving broader health systems, (2) shifting mindsets of government and community toward local ownership, (3) institutionalizing the interventions within existing government structures, (4) improving data demand and use for better planning of health services, and (5) enhancing coordination of partners. Conclusion While some themes feature more prominently in a particular region than others, taken together they represent what stakeholders perceive to be essential elements for scaling up locally-driven health programmes in urban areas in Africa and Asia.

scholarly journals Essential elements to “design for dissemination” within a research network—a modified Delphi study of the Community-Academic Aging Research Network (CAARN)

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Maria C. Mora Pinzon ◽  
Shannon Myers ◽  
Jill Renken ◽  
Erin Eggert ◽  
Betty Chewning ◽  
...  
Keyword(s):  
Scale Up ◽  
Essential Elements ◽  
Research Network ◽  
Community Research ◽  
Evidence Based ◽  
Aging Research ◽  
Community Partners ◽  
Modified Delphi ◽  
Evidence Based Programs

Abstract Background The Community-Academic Aging Research Network (CAARN) was developed in 2010 to build partnerships, facilitate research, and ultimately accelerate the pace of development, testing, and dissemination of evidence-based programs related to healthy aging. CAARN has facilitated development and testing of 32 interventions, two of which are being packaged for scale-up, and three of which are being scaled up nationally by non-profit organizations. The purpose of this study is to describe CAARN’s essential elements required to replicate its success in designing for dissemination. Methods We conducted a modified Delphi technique with 31 participants who represented CAARN’s organization (staff and Executive Committee) and academic and community partners. Participants received three rounds of a web-based survey to rate and provide feedback about the importance of a list of potential key elements compiled by the authors. The criterion for establishing consensus was 80% of responses to consider the element to be extremely or very important. Results Response rate was 90% in Round 1, 82% in Round 2, and 87% in Round 3. A total of 115 items were included across rounds. Overall, consensus was achieved in 77 (67%) elements: 8 of 11 elements about academic partners, 8 of 11 about community partners, 29 of 49 about the role of the community research associate, 16 of 21 about the role of the director, 9 of 17 about the purveyor (i.e., the organization that scales up an intervention with fidelity), and 7 of 7 about the overall characteristics of the network. Conclusions The development of evidence-based programs designed for dissemination requires the involvement of community partners, the presence of a liaison that facilitates communications among academic and community stakeholders and a purveyor, and the presence of a pathway to dissemination through a relationship with a purveyor. This study delineates essential elements that meet the priorities of adopters, implementers, and end-users and provide the necessary support to community and academic partners to develop and test interventions with those priorities in mind. Replication of these key elements of the CAARN model may facilitate quicker development, testing, and subsequent dissemination of evidence-based programs that are feasible to implement by community organizations.

scholarly journals Permasalahan dalam Perencanaan Kebutuhan Sumber Daya Manusia Kesehatan di Kabupaten/Kota

2020 ◽  
pp. 182-192
Author(s):  
Mimi Sumiarsih ◽  
Iin Nurlinawati
Keyword(s):  
Thematic Analysis ◽  
Local Governments ◽  
Planning Process ◽  
Health Workers ◽  
Human Resources For Health ◽  
Health Sector ◽  
Evidence Based ◽  
Regional Government ◽  
Literature Study ◽  
Needs Planning

Abstrak Perencanaan kebutuhan sumber daya manusia kesehatan (SDMK) berdasarkan Permenkes No. 33 Tahun 2015 tentang Pedoman Penyusunan Rencana Kebutuhan SDMK, belum berjalan baik. Tujuan studi ini adalah menilai kegiatan perencanaan kebutuhan SDMK yang berbasis bukti di kabupaten/kota. Berdasarkan temuan yang diperoleh dalam studi ini diharapkan dapat menjadi masukan kebijakan dalam proses perencanaan kebutuhan SDMK. Metode kajian ini berupa studi literatur terhadap luaran Riset Ketenagaan di Bidang Kesehatan (Risnakes), hasil-hasil penelitian yang relevan, kepustakaan dan dokumen-dokumen terkait perencanaan SDMK, baik di tingkat nasional maupun daerah. Analisis data dari hasil studi literatur dibuat menggunakan tematik analisis. Pengembangan subtema yang ditetapkan dalam tematik analisis difokuskan untuk menggali permasalahan pada aspek input, proses, dan output dari pelaksanaan perencanaan kebutuhan SDMK pada kabupaten/kota di Indonesia. Hasil kajian memperlihatkan, permasalahan perencanaan kebutuhan SDMK pada input meliputi kebijakan pemerintah daerah dan manajemen ASN yang kompleks, kompetensi tenaga perencana yang rendah, dukungan pembiayaan yang minim, serta pemanfaatan data dan sistem informasi yang belum optimal. Permasalahan pada proses mencakup belum dipahami dan dilaksanakannya penyusunan kebutuhan SDMK secara tepat. Permasalahan pada output adalah kesenjangan SDMK terkait kecukupan jumlah dan jenis tenaga kesehatan di tingkat kabupaten/kota di Indonesia. Menyikapi hal tersebut, pemerintah daerah sebaiknya melakukan perencanaan kebutuhan SDMK berbasis bukti, sehingga dokumen perencanaan mampu memproyeksikan kebutuhan SDMK yang sesuai dengan situasi kesehatan terkini. Kata kunci: SDM Kesehatan (SDMK); perencanaan SDMK, kebutuhan SDMK Abstract Planning for human health resources (HRK) based on Permenkes No. 33 of 2015 concerning Guidelines for the Preparation of HRH Needs Plans, has not gone well. The purpose of this study is to assess the evidence-based HR planning activities in the district / city. Based on the findings obtained in this study it is expected to be a policy input in the HRH needs planning process. The method of this study is in the form of a literature study of Workforce Research on Health Sector (Risnakes), relevance research results, literature and documents related to HRH planning both at national and regional levels. Data analysis of the results of the literature study was made using thematic analysis. The development of subthemes set in the thematic analysis is focused on exploring issues in the aspects of input, process, and output from the implementation of HRH needs planning in districts / cities in Indonesia. The results of the study show that HRK needs planning problems in the input include complex regional government and ASN management policies, low competency of planning personnel and lack of financial support and lack of optimal use of data and information systems. Problems in the process include not yet understood and implemented the preparation of HRH needs appropriately. The problem with outputs is the gap in HRH related to the adequacy of the number and type of health workers at the municipal district level in Indonesia. In response to this, local governments should plan evidence-based HRH planning, so that planning documents are able to project HRH needs in accordance with the current health situation. Keywords: Human Resources for Health (HRH), HRH planning, HRH Need

Moving Beyond Inclusion to Participation: Essential Elements

2019 ◽  
pp. 54-67
Author(s):  
Toby Long
Keyword(s):  
Early Childhood ◽  
Early Childhood Education ◽  
Education System ◽  
Children With Disabilities ◽  
Essential Elements ◽  
Evidence Based ◽  
Childhood Education ◽  
Everyday Activities ◽  
Meaningful Participation ◽  
Full Participation

This paper discusses the evolution of the early childhood education system from excluding children with disabilities to fully including them in a manner emphasizing full participation.  Evidence indicates meaningful participation in everyday activities is necessary for development to occur. The essential elements needed to bring about participation will be presented as well as specific evidence-based strategies used to promote inclusion and participation.

Application of the Non-adoption, Abandonment, Scale-up, Spread and, Sustainability (NASSS) Framework to evaluate the role of technology in the Pathways to Comorbidity Care (PCC) implementation project to improve management of comorbid substance use and mental disorders

2020 ◽  
Author(s):  
MariaGabriela Uribe Guajardo ◽  
Andrew James Baillie ◽  
Eva Louie ◽  
Vicki Giannopoulos ◽  
Katie Wood ◽  
...  
Keyword(s):  
Substance Use ◽  
Clinical Supervision ◽  
Mental Health Problems ◽  
Scale Up ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Self Report ◽  
Evidence Based ◽  
Face To Face ◽  
Drug And Alcohol

Abstract (250 words)In substance use treatment settings, there is a high prevalence of comorbid mental health problems. Yet an integrated approach for managing comorbidity, implementation of evidence-based intervention in drug and alcohol settings remains problematic. Technology can help the adoption of evidence-based practice and successfully implement effective treatment health care pathways. This study sought to examine aspects of electronic resources utilisation (barriers and facilitators) by clinicians participating in the PCC training. MethodA self-report questionnaire and a semi-structured interview was designed to measure overall satisfaction with the PCC portal and e-resources available throughout the 9-month intervention for participating clinicians. An adapted version of the ‘Non-adoption, Abandonment, Scale-up, Spread and, Sustainability’ (NASSS) framework was used to facilitate discussion in regards to the study findings. ResultsA total of 20 clinicians from drug and alcohol services responded to all the measures. Facilitators of portal use included: i. clinician acceptance of the PCC portal; ii. guidance from the clinical supervisor or clinical champion that encouraged the use of e-resources. Some of the barriers included: i. complexity of the illness (condition), ii. clinicians’ preference (adopter system) for face-to-face resources and training modes (e.g. clinical supervision, clinical champion workshops), and iii. lack of face-to-face training on how to use the portal (technology and organisation).ConclusionBased on the NASSS framework, we were able to identify several barriers and facilitators including such as the complexity of the illness, lack of face-to-face training and clinician preference for training mediums. Recommendations include ongoing consultation of clinicians to assist in the development of tailored e-health resources and offering in-house training on how to operate and effectively utilise these resources.

scholarly journals Adopt, adapt, or abandon technology-supported person-centred care initiatives: healthcare providers’ beliefs matter

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kari Dyb ◽  
Gro Rosvold Berntsen ◽  
Lisbeth Kvam
Keyword(s):  
Information Technologies ◽  
Scale Up ◽  
Healthcare Providers ◽  
Healthcare Services ◽  
Analytical Framework ◽  
Development Project ◽  
Technology Support ◽  
Care Needs ◽  
Term Care

Abstract Background Technology support and person-centred care are the new mantra for healthcare programmes in Western societies. While few argue with the overarching philosophy of person-centred care or the potential of information technologies, there is less agreement on how to make them a reality in everyday clinical practice. In this paper, we investigate how individual healthcare providers at four innovation arenas in Scandinavia experienced the implementation of technology-supported person-centred care for people with long-term care needs by using the new analytical framework nonadoption, abandonment, and challenges to the scale-up, spread, and sustainability (NASSS) of health and care technologies. We also discuss the usability and sensitivity of the NASSS framework for those seeking to plan, implement, and evaluate technology-supported healthcare programmes. This study is part of an interdisciplinary research and development project called Patients and Professionals in Partnership (2016–2020). It originates at one of ten work packages in this project. Method The main data consist of ethnographic field observations at the four innovation arenas and 29 interviews with involved healthcare providers. To ensure continuous updates and status on work in the four innovation arenas, we have also participated in a total of six annual network meetings arranged by the project. Results While the NASSS framework is very useful for identifying and communicating challenges with the adoption and spread of technology-supported person-centred care initiatives, we found it less sensitive towards capturing the dedication, enthusiasm, and passion for care transformation that we found among the healthcare providers in our study. When it comes to technology-supported person-centred care, the point of no return has passed for the involved healthcare providers. To them, it is already a definite part of the future of healthcare services. How to overcome barriers and obstacles is pragmatically approached. Conclusion Increased knowledge about healthcare providers and their visions as potential assets for care transformation might be critical for those seeking to plan, implement, and evaluate technology-supported healthcare programmes.

scholarly journals Maternal depression and loss of children under the one-child family planning policy in China: a cross-sectional study of 300 000 women

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048554
Author(s):  
Hanyu Wang ◽  
Eric Frasco ◽  
Jie Shang ◽  
Minne Chen ◽  
Tong Xin ◽  
...  
Keyword(s):  
Family Planning ◽  
Maternal Depression ◽  
Urban Areas ◽  
The Elderly ◽  
Population Based ◽  
Cross Sectional Study ◽  
Only Child ◽  
Cross Sectional ◽  
Live Births ◽  
Child Group

ObjectivesThis study aims to explore the association between maternal depression and the loss of the only child under the family-planning (FP) policy.DesignCross-sectional data from a Chinese population-based study were analysed.SettingPopulation from 10 (5 rural and 5 urban) areas in China.ParticipantsAround 300 000 females were included in the study. The FP group was defined as women with one or two live births. Those with no surviving child were classified into the loss-of-only-child group. The non-FP group included women who had more than two live births. Logistic regression was used to assess the relationship between major depressive disorder (MDD) and family types, after stratification and adjustment.OutcomeMDD was assessed using the Composite International Diagnostic Inventory.ResultsThe odds of MDD are 1.42 times higher in the FP group in general (OR=1.42, 95% CI: 1.28 to 1.57), as opposed to the non-FP group. In particular, the odds of MDD are 1.36 times greater in the non-loss-of-only-child group (OR=1.36, 95% CI: 1.21 to 1.51) and 2.80 (OR=2.80, 95% CI: 0.88 to 8.94) times greater in the loss-of-only-child group, compared with the non-FP group. The associations between FP groups and MDD appeared to be stronger in the elderly population, in those who were married, less educated and those with a higher household income. The association was found progressively stronger in those who lost their only child.ConclusionsPeople in the FP group, especially those who lost their only child, are more susceptible to MDD than their counterparts in the non-FP group. Mental health programmes should give special care to those who lost their only child and take existing social policies and norms, such as FP policies, into consideration.

scholarly journals Cost-efficient factors in local public spending: Detecting relationships between local environments, population size and urban area category

2021 ◽  
pp. 239980832110038
Author(s):  
Hiroki Baba ◽  
Yasushi Asami
Keyword(s):  
Population Size ◽  
Urban Area ◽  
Urban Areas ◽  
Local Governments ◽  
Statistical Significance ◽  
Population Decline ◽  
Public Spending ◽  
Local Environment ◽  
Environment Factors ◽  
Major Factors

This study examines regional differences in local environment factors to better understand the sustainability of local governments indexed by per capita public spending. Under the condition of heterogeneous population size, we examine how factor characteristics differ depending on the spatial context represented by the urban area category. By employing a Cobb–Douglas cost function with congestion effects on public service provision, the estimated factors enable us to articulate major factors and differences in cost-efficiency between urban area categories. We found that statistical significance and even the signatures of local environment factors differ depending on the urban employment area category. Regarding factors such as the ratios of employees in secondary and tertiary industries, these did not tend to be statistically significant in small-sized urban areas, while small-sized cities in large-sized urban areas were likely to gain confidence intervals. Moreover, we did not observe any statistical significance for the ratio of elderly people due to the balance of spending between national and local governments. These findings could contribute to sustainable management of cities in the advent of population decline.

scholarly journals Community Perceptions and Knowledge of Modern Stormwater Treatment Assets

Urban Science ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 5
Author(s):  
Hadi Zamanifard ◽  
Edward A. Morgan ◽  
Wade L. Hadwen
Keyword(s):  
Urban Design ◽  
Urban Space ◽  
Urban Areas ◽  
Local Governments ◽  
Urban Runoff ◽  
Community Perceptions ◽  
Stormwater Treatment ◽  
Runoff Water ◽  
Community Acceptance ◽  
Water Sensitive Urban Design

Modern stormwater treatment assets are a form of water sensitive urban design (WSUD) features that aim to reduce the volumes of sediment, nutrients and gross pollutants discharged into receiving waterways. Local governments and developers in urban areas are installing and maintaining a large number of stormwater treatment assets, with the aim of improving urban runoff water quality. Many of these assets take up significant urban space and are highly visible and as a result, community acceptance is essential for effective WSUD design and implementation. However, community perceptions and knowledge about these assets have not been widely studied. This study used a survey to investigate community perceptions and knowledge about stormwater treatment assets in Brisbane, Australia. The results suggest that there is limited community knowledge of these assets, but that communities notice them and value their natural features when well-maintained. This study suggests that local governments may be able to better inform residents about the importance of these assets, and that designing for multiple purposes may improve community acceptance and support for the use of Council funds to maintain them.

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