scholarly journals Implementing Evidence-Based Task Strengthening Strategies for Hypertension Control within Ghana’s Community-Based Health Planning Services: A Concept Mapping Analysis

2021 ◽  
Author(s):  
Solomon Nyame ◽  
Juliet Iwelunmor ◽  
Kwaku Poku Asante ◽  
Joyce Gyamfi ◽  
Kwame Adjei ◽  
...  
Keyword(s):  
Capacity Building ◽  
Concept Mapping ◽  
Policy Reform ◽  
Health Planning ◽  
Local Context ◽  
Evidence Based ◽  
Health Coverage ◽  
Hypertension Control ◽  
District Health ◽  
Community Based

Abstract Background: As efforts are made to systematically implement an evidence-based task-strengthening strategy for hypertension control (TASSH) in Ghana, understanding their content can help national, regional and district health stakeholders within Ghana’s Health Services (GHS) identify strategies for enhancing intervention uptake and sustainability in their local context. This study sought to describe national, regional and district health stakeholders’ perspectives and characterize the array of strategies needed to enhance the uptake of evidence-based TASSH within Ghana’s Community-based Health and Planning Services (CHPS) zones. Methods: This qualitative study was conducted among national, regional and district health stakeholders within GHS serving patients who utilize CHPS zones. The CHPS initiative is Ghana’s flagship strategy for achieving universal health coverage. Semi-structured interviews were conducted with 22 national, regional and district health stakeholders identified via purposive sampling. Interviews were conducted in 2018. Data analysis was conducted between July 2019 and December 2019. Data was analyzed using group concept mapping systems to identify major themes and subthemes.Results: About 68 % of participants were male with mean age of 40 years and mean years of experience providing hypertension-related care within GHS of 9 years. A conceptual map emerged, consisting of 46 strategies needed for implementing evidence-based TASSH, organized into 6 clusters: 1) Referral Systems; 2) Availability of Equipment; 3) Protocols and Guidelines; 4) Capacity Building/Training; 5) Policy Reform, and 6) Technical Support and Supervision. Availability of equipment was rated as the most important strategy (mean 4.80 out of 5) needed to implement evidence-based TASSH, while Capacity Building/Training was rated as the most feasible strategy (mean 4.20 out of 5) to address. Although important (mean 4.40 out of 5), Policy reform was rated as the least important and feasible strategy to address. Conclusions: These findings demonstrate strategies that can help inform future interventions focused on the adoption and sustainability of evidence-based TASSH within Ghana’s CHPS zones. Also, national, regional and district health stakeholders can support healthcare workers by facilitating access to equipment and strategies for enhancing capacity and training with implementing evidence-based task-shifting hypertension interventions in Ghana.

scholarly journals Implementing evidence-based task-strengthening strategies for hypertension control within Ghana’s Community-based Health Planning Services: a concept mapping analysis

2021 ◽  
Author(s):  
Solomon Nyame ◽  
Juliet Iwelunmor ◽  
Kwaku Poku Asante ◽  
Joyce Gyamfi ◽  
Kwame Adjei ◽  
...  
Keyword(s):  
Capacity Building ◽  
Concept Mapping ◽  
Policy Reform ◽  
Health Planning ◽  
Local Context ◽  
Evidence Based ◽  
Health Coverage ◽  
Hypertension Control ◽  
District Health ◽  
Community Based

Abstract Background As efforts are made to systematically implement an evidence-based task-strengthening strategy for hypertension control (TASSH) in Ghana, understanding their content can help national, regional and district health stakeholders within Ghana’s Health Services (GHS) identify strategies for enhancing intervention uptake and sustainability in their local context. This study sought to describe national, regional and district health stakeholders’ perspectives and characterize the array of strategies needed to enhance the uptake of evidence-based TASSH within Ghana’s Community-based Health and Planning Services (CHPS) zones. Methods This qualitative study was conducted among national, regional and district health stakeholders within GHS serving patients who utilize CHPS zones. The CHPS initiative is Ghana’s flagship strategy for achieving universal health coverage. Semi-structured interviews were conducted with 22 national, regional and district health stakeholders identified via purposive sampling. Interviews were conducted in 2018. Data analysis was conducted between July 2019 and December 2019. Data was analyzed using group concept mapping systems to identify major themes and subthemes. Results About 68 % of participants were male with mean age of 40 years and mean years of experience providing hypertension-related care within GHS of 9 years. A conceptual map emerged, consisting of 46 strategies needed for implementing evidence-based TASSH, organized into 6 clusters: 1) Referral Systems; 2) Availability of Equipment; 3) Protocols and Guidelines; 4) Capacity Building/Training; 5) Policy Reform, and 6) Technical Support and Supervision. Availability of equipment was rated as the most important strategy (mean 4.80 out of 5) needed to implement evidence-based TASSH, while Capacity Building/Training was rated as the most feasible strategy (mean 4.20 out of 5) to address. Although important (mean 4.40 out of 5), Policy reform was rated as the least important and feasible strategy to address. Conclusions These findings demonstrate strategies that can help inform future interventions focused on the adoption and sustainability of evidence-based TASSH within Ghana’s CHPS zones. Also, national, regional and district health stakeholders can support healthcare workers by facilitating access to equipment and strategies for enhancing capacity and training with implementing evidence-based task-shifting hypertension interventions in Ghana.

Sustaining Nurse-Led Task-Shifting Strategies for Hypertension Control: A Concept Mapping Study to Inform Evidence-Based Practice

2017 ◽  
Vol 14 (5) ◽  
pp. 350-357 ◽  
Author(s):  
Sarah Blackstone ◽  
Juliet Iwelunmor ◽  
Jacob Plange-Rhule ◽  
Joyce Gyamfi ◽  
Nana Kofi Quakyi ◽  
...  
Keyword(s):  
Concept Mapping ◽  
Evidence Based Practice ◽  
Task Shifting ◽  
Evidence Based ◽  
Hypertension Control ◽  
Mapping Study

scholarly journals Key considerations for designing capacity-building interventions to support evidence-based programming in underserved communities: a qualitative exploration

2020 ◽  
Author(s):  
Shoba Ramanadhan ◽  
Kayoll Galbraith-Gyan ◽  
Anna Revette ◽  
Alisa Foti ◽  
Charlotte Rackard James ◽  
...  
Keyword(s):  
Capacity Building ◽  
Resource Constraints ◽  
Community Based Participatory Research ◽  
Good Health ◽  
Evidence Based ◽  
Community Based ◽  
Underserved Communities ◽  
Program Coordinators ◽  
Multi Stage ◽  
The Impact

Abstract Increasing the use of evidence-based programs (EBPs) in community settings is critical for improving health and reducing disparities. Community-based organizations (CBOs) and faith-based organizations (FBOs) have tremendous reach and trust within underserved communities, but their impact is constrained by limited staff capacity to use EBPs. This exploratory study sought to identify design and delivery considerations that could increase the impact of capacity-building interventions for CBOs and FBOs working with underserved communities. Data come from a community-based participatory research project addressing cancer disparities in Black, Latino, and Brazilian communities from Greater Boston and Greater Lawrence, Massachusetts. We conducted four focus group discussions with program coordinators in CBOs and FBOs (n = 27) and key informant interviews with CBO and FBO leaders (n = 15). Three researchers analyzed the data using a multi-stage coding process that included both prefigured and emergent codes. Key design considerations included embedding customized capacity-building interventions into community networks with local experts, supporting ongoing engagement with the intervention via a range of resources and communication channels, and addressing resource constraints. Regarding the contextual factors that should influence capacity-building intervention content, participants highlighted resource constraints, environments in which EBP use is not the norm, and challenges linking available programs with the multi-level barriers to good health faced by community members. Overall, the study highlights the need for integrated, long-term capacity-building efforts developed in partnership with, and ultimately sustained by, local organizations.

scholarly journals Stakeholders’ perspectives on training over the counter medicine sellers and Community-based Health Planning and Services facilities to dispense antibiotics in Ghana

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Samuel Afari-Asiedu ◽  
Marlies Hulscher ◽  
Martha Ali Abdulai ◽  
Ellen Boamah-Kaali ◽  
Heiman F. L. Wertheim ◽  
...  
Keyword(s):  
Health Services ◽  
Health Planning ◽  
National Level ◽  
Public Health Education ◽  
Antibiotic Use ◽  
District Health ◽  
Community Based ◽  
Over The Counter ◽  
Middle Income ◽  
Pharmacy Council

Abstract Background Dispensing of antibiotics by over the counter medicine sellers (OTCMS) is a major driver of inappropriate use and resistance in low and middle income countries. Recent studies in Ghana revealed the need to consider training OTCMS and Community-based Health Planning and Services (CHPS)/health posts to dispense some antibiotics. Feasibility of training OTCMS and CHPS to dispense some antibiotics was explored in this study. Methods This was an explorative study involving 10 in-depth interviews (IDIs) among staff of Ghana health services (GHS), pharmacy council and the association of OTCMS at the district and regional levels. Next, findings were presented to the Ghana Antimicrobial Resistance (AMR) platform for further discussions at the national level. Five IDIs were also performed among selected members of the AMR platform as a follow-up on emerging issues. Data were thematically analysed and presented as narratives with quotes to support the findings. Results Two opposing views were found in our study. Leadership of OTCMS and GHS staff at the district health directorate supported the suggestion that OTCMS and CHPS should be trained to dispense specific antibiotics because they are already dispensing them. The leadership of OTCMS explained that some of their members are experienced and could be trained to improve their practices. In contrast, participants from pharmacy council, GHS in the region and national AMR platform generally alluded that OTCMS and CHPS should not be trained to dispense antibiotics because their level of education is inadequate. GHS personnel from the region further explained that training OTCMS could further compromise inappropriate antibiotic use in the context of already weak regulation enforcement. GHS and pharmacy council in the region rather suggested that OTCMS and CHPS should focus on public health education on disease prevention and appropriate antibiotic use. Conclusions There is general lack of consensus among stakeholders on whether OTCMS and CHPS should be trained to dispense specific antibiotics. Further stakeholder engagement is required to carefully consider this suggestion as views on feasibility differ. Ministries of health and healthcare agencies in Ghana and LMIC should improve access to approved health services to improve antibiotic use in rural settings.

scholarly journals Challenges to achieving universal health coverage through community-based health planning and services delivery approach: a qualitative study in Ghana

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024845 ◽  
Author(s):  
Abraham Assan ◽  
Amirhossein Takian ◽  
Moses Aikins ◽  
Ali Akbarisari
Keyword(s):  
Qualitative Study ◽  
Universal Health Coverage ◽  
Low Income ◽  
Health Planning ◽  
National Level ◽  
Health Coverage ◽  
Community Based ◽  
Services Delivery ◽  
Universal Health ◽  
Local Levels

ObjectiveCommunity-based initiatives have enormous potential to facilitate the attainment of universal health coverage (UHC) and health system development. Yet key gaps exist and threaten its sustainability in many low-income and middle-income countries. This study is first of its kind (following the launch of the Sustainable Developments Goal [SDG]) and aimed to holistically explore the challenges to achieving UHC through the community-based health planning and service (CHPS) initiative in Ghana.DesignA qualitative study design was adopted to explore the phenomenon. Face-to-face indepth interviews were conducted from April 2017 until February 2018 through purposive and snowball sampling techniques. Data were analysed using inductive and deductive thematic analysis approach.SettingData were gathered at the national level, in addition to the regional, district and subdistrict/local levels of four regions of Ghana. Sampled regions were Central Region, Greater Accra Region, Upper East Region and Volta Region.ParticipantsIn total, 67 participants were interviewed: national level (5), regional levels (11), district levels (9) and local levels (42). Interviewees were mainly stakeholders—people whose actions or inactions actively or passively influence the decision-making, management and implementation of CHPS, including policy makers, managers of CHPS compound and health centres, politicians, academics, health professionals, technocrats, and community health management committee members.ResultsBased on our findings, inadequate understanding of CHPS concept, major contextual changes with stalled policy change to meet growing health demands, and changes in political landscape and leadership with changed priorities threaten CHPS sustainability.ConclusionUHC is a political choice which can only be achieved through sustainable and coherent efforts. Along countries’ pathways to reach UHC, coordinated involvement of all stakeholders, from community members to international partners, is essential. To achieve UHC within the time frame of SDGs, Ghana has no choice but to improve its national health governance to strengthen the capacity of existing CHPS.

scholarly journals The development of community based adult mental health services — a research contribution

1989 ◽  
Vol 13 (12) ◽  
pp. 662-666 ◽  
Author(s):  
Jackie Powell ◽  
Robin Lovelock
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Service Providers ◽  
Health Problems ◽  
Community Context ◽  
Local Context ◽  
District Health ◽  
Community Based ◽  
Adult Mental Health ◽  
Disciplinary Area

The desire to provide care and services for people with mental health problems in a community context, rather than in large institutions, is a long-established feature of Government policy. In the more local context of the Portsmouth and South East Hampshire District Health Authority, a strategy of decentralising both the organisation and the delivery of services for adults with mental health problems began to be implemented early in 1986. Five multi-disciplinary area community mental health teams would work with and alongside other service-providers in their localities to provide a range of support, including residential, day and other community and domiciliary services.

scholarly journals Developing Theory to Guide Building Practitioners’ Capacity to Implement Evidence-Based Interventions

2016 ◽  
Vol 44 (1) ◽  
pp. 59-69 ◽  
Author(s):  
Jennifer Leeman ◽  
Larissa Calancie ◽  
Michelle C. Kegler ◽  
Cam T. Escoffery ◽  
Alison K. Herrmann ◽  
...  
Keyword(s):  
Public Health ◽  
Capacity Building ◽  
Iterative Process ◽  
Technical Assistance ◽  
Evidence Based ◽  
Community Based ◽  
Adoption And Implementation ◽  
Stakeholder Support ◽  
General Capacity ◽  
Or Practice

Public health and other community-based practitioners have access to a growing number of evidence-based interventions (EBIs), and yet EBIs continue to be underused. One reason for this underuse is that practitioners often lack the capacity (knowledge, skills, and motivation) to select, adapt, and implement EBIs. Training, technical assistance, and other capacity-building strategies can be effective at increasing EBI adoption and implementation. However, little is known about how to design capacity-building strategies or tailor them to differences in capacity required across varying EBIs and practice contexts. To address this need, we conducted a scoping study of frameworks and theories detailing variations in EBIs or practice contexts and how to tailor capacity-building to address those variations. Using an iterative process, we consolidated constructs and propositions across 24 frameworks and developed a beginning theory to describe salient variations in EBIs (complexity and uncertainty) and practice contexts (decision-making structure, general capacity to innovate, resource and values fit with EBI, and unity vs. polarization of stakeholder support). The theory also includes propositions for tailoring capacity-building strategies to address salient variations. To have wide-reaching and lasting impact, the dissemination of EBIs needs to be coupled with strategies that build practitioners’ capacity to adopt and implement a variety of EBIs across diverse practice contexts.

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