scholarly journals Helping Public Sector Health Systems Innovate: The Strategic Approach to Strengthening Reproductive Health Policies and Programs

2006 ◽  
Vol 96 (3) ◽  
pp. 435-440 ◽  
Author(s):  
Peter Fajans ◽  
Ruth Simmons ◽  
Laura Ghiron
Keyword(s):  
Public Sector ◽  
Reproductive Health ◽  
Health Systems ◽  
Health Policies ◽  
Strategic Approach ◽  
Public Sector Health ◽  
Policies And Programs

scholarly journals Assessing the Integrated Community-Based Health Systems Strengthening initiative in northern Togo: a pragmatic effectiveness-implementation study protocol

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Molly E. Lauria ◽  
Kevin P. Fiori ◽  
Heidi E. Jones ◽  
Sesso Gbeleou ◽  
Komlan Kenkou ◽  
...  
Keyword(s):  
Public Sector ◽  
Health Service ◽  
Community Health ◽  
Health Systems ◽  
Implementation Strategy ◽  
Health Systems Strengthening ◽  
Implementation Study ◽  
Community Based ◽  
Under Five ◽  
Public Sector Health

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

Reproductive Health Policies and Programs in Eight Countries: Progress Since Cairo

1999 ◽  
Vol 25 ◽  
pp. S2 ◽  
Author(s):  
Karen Hardee ◽  
Kokila Agarwal ◽  
Nancy Luke ◽  
Ellen Wilson ◽  
Margaret Pendzich ◽  
...  
Keyword(s):  
Reproductive Health ◽  
Health Policies ◽  
Policies And Programs

scholarly journals Sociocultural Context of Sexual and Reproductive Health (SRH) of Adolescents in Northern Nigeria

2020 ◽  
Vol 18 (2) ◽  
pp. 116-133
Author(s):  
Musa Abubakar ◽  
Aminu Mohammed Dukku
Keyword(s):  
Reproductive Health ◽  
Sexual And Reproductive Health ◽  
Cultural Practices ◽  
Social Contexts ◽  
Health Needs ◽  
Health Policies ◽  
Northern Nigeria ◽  
Sociocultural Context ◽  
The North ◽  
Policies And Programs

Contemporary discourse on Adolescent Sexual and Reproductive Health (SRH) is characterised by its robustness in proffering solutions for healthy adolescents capable of competing physically, economically and socially, globally. However, despite its promising nature, policies and programs pertaining to youth and adolescents’ health needs to be designed in accordance with the cultural practices that prevail in various social contexts. This paper examines the various SRH policies and programs with a view to identifying culturally acceptable means of formulating and delivering SRH services in Northern Nigeria. The SRH health policies and programs and their implementation for adolescents run riot with some cultural practices particularly of the northern part of the country. Issues patterning to non-acceptance of the culture of delayed marriage as a way of attaining good and healthy living make people in the North get married earlier than their counterparts in other parts of the country. The northern culture views the teaching of unmarried adolescents about sex, contraception and abortion as uncalled for because it may be, in a way, an encouragement and motivation for the youth and adolescents alike to be introduced to the sexuality. These and other challenges call for culturally robust strategy(s) for implementing SRH policies and programs for solutions to cultural disparities and divergences that stand in the way to realising enhanced SRH needs of adolescents.

Health Services: Results From the School Health Policies and Programs Study 2006

2007 ◽  
Vol 77 (8) ◽  
pp. 464-485 ◽  
Author(s):  
Nancy D. Brener ◽  
Lani Wheeler ◽  
Linda C. Wolfe ◽  
Mary Vernon-Smiley ◽  
Linda Caldart-Olson
Keyword(s):  
Health Services ◽  
School Health ◽  
Health Policies ◽  
Policies And Programs

Making Thailand’s UHC ‘SAFE’ (sustainable, affordable, fair and efficient)

2020 ◽  
Vol 20 (2) ◽  
pp. 231-236
Author(s):  
Somsak Chunharas
Keyword(s):  
Health Services ◽  
Financial Risk ◽  
National Development ◽  
Financial Risk Protection ◽  
Thai Population ◽  
Health Security ◽  
Strategic Purchasing ◽  
Strategic Approach ◽  
Public Sector Health ◽  
Risk Protection

Thai UHC has been established through national efforts to learn from international as well as national development of how to build a system-wide financial risk protection for the Thai population while also ensuring effective coverage of health services. One of the key strategic approach is establishing a strategic purchasing organization called national health security office (NHSO) since 2002. Many lesson have been learnt and shared here hoping that they are generic enough to guide actions and policy decisions either for countries starting UHC or those who have had some models going on. For example, a professionally run strategic purchasing body with certain degree of autonomy is key but the needs to harmonize multiple schemes are also challenging, technically as well as politically. The effective use of and support for existing public sector health services systems is another key lesson. The challenge of making the systems sustainable, affordable fair and efficient have been with us since the very beginning and we shares some of the approaches to address this issue to ensure that UHC will be properly supported politically, professionally managed while maintaining a well balanced demand side with the view to ensure that UHC is creating better health and not merely more access to services.

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