Training leads to improved performance of Health Unit Management Committees in south western Uganda manuscript

2020 ◽  
Author(s):  
Teddy Kyomuhangi ◽  
Kimberly Manalili ◽  
Jerome Kabakyenga ◽  
Samuel Maling ◽  
George Muganga ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Management Training ◽  
Performance Outcomes ◽  
Training Methods ◽  
Health Unit ◽  
District Health ◽  
Unit Management ◽  
Southwestern Uganda ◽  
Delivery Of Health Services

Abstract Background: A quality health workforce is critical for the development of health systems and effective delivery of health services. In southwestern Uganda, Health Unit Management Committees (HUMCs) are central to the delivery of health care. They also play a key role in facilitating links between health centres and the community, as they comprised of community members. While these teams took part in planning and management training between 2012-2015, no analysis had been done with regards to the outcomes of these training. This study sought, therefore, to determine whether HUMC members saw increased performance outcomes as a result of their training. Methods: The study followed a cross sectional evaluation design and adopted qualitative methods, including Focus Group Discussions (FGDs), Key Informant Interviews (KIIs) and In-Depth Interviews with health unit In-charges (managers), district health team members and project intervention staff. Evaluation was conducted in July 2016 in Bushenyi district in southwestern Uganda. Evaluation was completed in all levels of health care centers and in both urban and rural settings. Data was collected by members of the research team in both Runyankole and English, and translated into English. Results: Findings revealed that HUMCs reported to be more capable of handling issues at the facility as a result of knowledge and skills acquired during trainings. HUMCs identified several key learning themes, including: conflict resolution, strengthened relationships between members and increased community engagement. The training also resulted in several initiatives for increased health care outcomes, including saving schemes for emergency transportation of referrals, construction of placenta pit and canteen, and beautification projects. Overall there were positive feelings towards the training and its relevance for HUMCs’ job performance. Discussion: In examining the results of the study, conclusions can be drawn that training for HUMCs, which had been the first of their kind in this area, increased performance outcomes in health centers. This aligns with similar research, which identified management training for health care management teams as an important factor for improving the delivery of health services.

scholarly journals Building trust and enhancing localization to improve access to women’s health services in Afghanistan

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
F R Rab ◽  
S S Stranges ◽  
A D Thind ◽  
S S Sohani
Keyword(s):  
Health Care ◽  
Health Services ◽  
Vulnerable Populations ◽  
Time Trend ◽  
Health Workers ◽  
Healthcare Services ◽  
Delivery Of Healthcare ◽  
Care Services ◽  
Women And Children ◽  
Delivery Of Health Services

Abstract Background Over 34 million people in Afghanistan have suffered from death and devastation for the last four decades as a result of conflict. Women and children have borne the brunt of this devastation. Afghanistan has some of the poorest health indicators in the world for women and children. In the midst of armed conflict, providing essential healthcare in remote regions in the throws of conflict remains a challenge, which is being addressed the Mobile Health Teams through Afghan Red Crescent (ARCS). To overcome socio-cultural barriers, ARCS MHTs have used local knowledge to hire female staff as part of the MHTs along with their male relatives as part of MHT staff. The present study was conducted to explore the impact of engaging female health workers as part of MHTs in conflict zones within Afghanistan on access, availability and utilization of maternal and child health care. Methods Quantitative descriptive and time-trend analysis were used to evaluate impact of introduction of female health workers. Qualitative data is being analyzed to assess the possibilities and implications of engaging female health workers in the delivery of health services. Results Preliminary results show a 96% increase in uptake of services for expectant mothers over the last four years. Average of 18 thousand services provided each month by MHTs, 70% for women and children. Service delivery for women and children significantly increased over time (p < 0.05) after inclusion of female health workers in MHTs. Delivery of maternity care services showed a more significant increase (p < 0.001). Time trend and qualitative analyses is ongoing. Conclusions Introduction of female health workers significantly improved uptake of health care services for women and children especially in extremely isolated areas controlled by armed groups in Afghanistan. Engaging with local stakeholders is essential for delivery of health services for vulnerable populations in fragile settings like Afghanistan. Key messages Understanding cultural norms results in socially acceptable solutions to barriers in delivery of healthcare services and leads to improvements in access for women and children in fragile settings. Building local partnerships and capacities and using local resources result in safe, efficient and sustainable delivery of healthcare services for vulnerable populations in fragile settings.

scholarly journals Adherence to clinical guidelines in integration of mental health services into primary health care in Mbarara, southwestern Uganda: a medical records review

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Edith K. Wakida ◽  
Moses Ocan ◽  
Godfrey Z. Rukundo ◽  
Samuel Maling ◽  
Peter Ssebutinde ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Clinical Guidelines ◽  
Common Mental Disorders ◽  
Primary Health ◽  
Southwestern Uganda

Abstract Background The Ugandan Ministry of Health decentralized mental healthcare to the district level; developed the Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, and referral of individuals with common mental disorders. This was intended to promote integration of mental health services into PHC in the country. ‘Common mental disorders’ here refers to mental, neurological and substance use conditions as indicated in the UCG. However, the extent of integration of mental health into general healthcare remains unknown. This study aimed to establish the level of adherence of PHC providers to the UCG in the identification and management of mental disorders. Methods This was a prospective medical record review of patient information collected in November and December 2018, and March and April 2019 at two health centers (III and IV) in southwestern Uganda. Data (health facility level; sex and age of the patient; and mental disorder diagnosis, management) was collected using a checklist. Continuous data was analyzed using means and standard deviation while categorical data was analyzed using Chi-square. Multivariable logistic regression analysis was performed to establish predictors of PHC provider adherence to the clinical guidelines on integration of mental health services into PHC. The analysis was conducted at a 95% level of significance. Results Of the 6093 records of patients at the study health facilities during the study period, 146 (2.4%) had a mental or neurological disorder diagnosis. The commonly diagnosed disorders were epilepsy 91 (1.5%) and bipolar 25 (0.4%). The most prescribed medications were carbamazepine 65 (44.5%), and phenobarbital 26 (17.8%). The medicines inappropriately prescribed at health center III for a mental diagnosis included chlorpromazine for epilepsy 3 (2.1%) and haloperidol for epilepsy 1 (0.7%). Female gender (aOR: 0.52, 95% CI 0.39–0.69) and age 61+ years (aOR: 3.02, 95% CI 1.40–6.49) were predictors of a mental disorder entry into the HMIS register. Conclusion There was a noticeable change of practice by PHC providers in integrating mental health services in routine care as reflected by the rise in the number of mental disorders diagnosed and treated and entered into the modified paper based HMIS registers.

Health Portals

2011 ◽  
pp. 57-64
Author(s):  
Daniel Carbone
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Professionals ◽  
Health Knowledge ◽  
Health Care Systems ◽  
Efficient Technology ◽  
Technical Content ◽  
Care Systems ◽  
Barriers And Opportunities ◽  
Delivery Of Health Services

A lack of health services has long been the thorn in the side of many communities, especially rural and regional communities. The high costs of treating ever growing chronic and complex conditions in traditional settings, where rural allied health services providers are non-existent and doctors are already overcommitted, are prompting a shift in focus to more efficient technology driven delivery of health services. Moreover, these days it is also increasingly unlikely that health professionals will encounter patients who have not used information technology to influence their health knowledge, health behaviour, perception of symptoms, and illness behaviour. Advances in Internet technologies offer promise towards the development of an e-health care system. This article will postulate whether portal technologies can play a role facilitating the transition to such e-health care systems. This article aims at reviewing the literature to present to the reader the barriers and opportunities out here for effective health portals. However, the article does not intend to provide a one-fits-all technical/content solution, only to make implementers and developers aware of the potential implications.

Dr. Nathan's Assumptions Attacked

PEDIATRICS ◽  
1974 ◽  
Vol 54 (2) ◽  
pp. 251-251
Author(s):  
Ayrum L. Katcher
Keyword(s):  
Health Care ◽  
Health Services ◽  
Biomedical Research ◽  
Delivery Of Health Care ◽  
Research Process ◽  
Research Area ◽  
Scientific Methods ◽  
Rational Application ◽  
Delivery Of Health Services

David G. Nathan's commentary (Pediatrics, 52:768, 1973) on problems of delivery of health care suggests that the rational application of scientific methods which have been so successful in the biomedical research area to the problems of the delivery of health services to our population, will produce comparable achievements in this new arena. Nathan may well be correct in his faith in the research process. However, he also seems to believe that persons engaged in research possess talent ("the cream") which is equipotential in all areas.

DESIGNING AN INTEGRATED HEALTH CARE STRATEGY

2020 ◽  
Vol 21 (1) ◽  
pp. 65-76
Author(s):  
Małgorzata Dymyt
Keyword(s):  
Health Care ◽  
Health Services ◽  
Health Systems ◽  
Health Sector ◽  
Integrated Health Care ◽  
Integrated Healthcare ◽  
Care Integration ◽  
Integrated Health ◽  
Key Aspects ◽  
Delivery Of Health Services

The article concerns the strategic dimension of the integration of health care. The concept of integrated health care plays a key role in the improvement of health systems. The complexity of the health care system makes a coherent, comprehensive and coordinated approach to health services necessary. The integration of health care consists in the management and delivery of health services in such a way that patients receive continuity of health care, coordinated at various levels, within and outside the health sector and as needed throughout their lives. The purpose of the article is to present the essence of health care integration and key aspects of the design of integrated healthcare strategy, identify its assumptions and main elements.

Reform and counter reform: How sustainable is New Zealand&s latest health system restructuring?

2002 ◽  
Vol 7 (1_suppl) ◽  
pp. 46-55 ◽  
Author(s):  
Jackie Cumming ◽  
Nicholas Mays
Keyword(s):  
Primary Care ◽  
Health Care ◽  
New Zealand ◽  
Health Services ◽  
Community Health Services ◽  
Public Hospitals ◽  
District Health ◽  
Potential Conflict ◽  
Feasible Option ◽  
New System

New Zealand's health care sector has undergone almost continual restructuring since the early 1980s. In the latest set of reforms, 21 district health boards (DHBs) have been established with responsibility for promoting health, purchasing services for their populations and delivering publicly owned health services. Boards will be governed by a mix of elected and appointed members, will be responsible for arranging the delivery of primary and community health services, and will own and run public hospitals and related facilities. We clarify the differences and continuities between earlier reforms and the 2000/01 structures, as well as the current reforms’ potential strengths and weaknesses. The paper discusses whether the DHB model was the only feasible option for restructuring and whether the dynamics of the new system may lead to further changes, particularly on the purchaser side of the system. Given that DHBs face potential conflict between their purchasing and provision roles, and given the potential advantages that primary care organisations may have as purchasers, we conclude that it is possible that all or part of the purchasing function of DHBs might eventually shift to primary care organisations, leaving the DHBs as hospital-based provider organisations.

Diagnostics of the XXI century: application of tele-ultrasound in modern healthcare

2021 ◽  
Vol 1 ◽  
pp. 41-60
Author(s):  
Kirill Arzamasov ◽  
◽  
Alexandra Demkina ◽  
Sofia Simenyura ◽  
Evgeniya Kostenko ◽  
...  
Keyword(s):  
Health Care ◽  
Health Services ◽  
Healthcare System ◽  
Portable Ultrasound ◽  
Network Bandwidth ◽  
National Healthcare ◽  
National Healthcare System ◽  
Delivery Of Health Services

In recent years, telemedicine has been widely used in the national healthcare system. Remote delivery of health services reduces the gap in their effectiveness and increases accessibility to the population, ensuring equitable health care everywhere. Tele-ultrasound examinations are a type of telemedicine. The development of this direction was the appearance of portable ultrasound scanners and an increase network bandwidth. This article discusses the possibilities of using tele-ultrasound in the national healthcare system. One of the priority directions for the introduction of tele-ultrasound is highlighted — cardiology.

scholarly journals Adherence to Clinical Guidelines in Integration of Mental Health Services Into Primary Health Care in Mbarara, Southwestern Uganda: a Medical Record Review

2021 ◽  
Author(s):  
Edith K Wakida ◽  
Moses Ocan ◽  
Godfrey Zari Rukundo ◽  
Peter Sebutinde ◽  
Samuel Maling ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Clinical Guidelines ◽  
Primary Health ◽  
Record Review ◽  
Southwestern Uganda

Abstract Background: The Ugandan Ministry of Health decentralized mental health care delivery to the district level; developed the Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, and referral of individuals with common mental disorders. This was intended to promote the integration of mental health services into PHC in the country. However, the extent of integration of mental health into general health care service delivery remains unknown. This study aimed to establish the level of adherence of PHC providers to the UCG in the identification and management of mental disorders. Methods: This was a prospective medical record review study of patient information collected in November and December 2018, and March and April 2019 at two health centers (III and IV) in southwestern Uganda. Data (health facility level; sex and age of the patient; and mental disorder diagnosis, management) was collected using a checklist. Continuous data was analyzed using means and standard deviation while categorical data was analyzed using Chi-square. Multivariable logistic regression analysis was performed to establish predictors of PHC provider adherence to the clinical guidelines on integration of mental health services into PHC. The analysis was conducted at a 95% level of significance.Results: Of the 6093 records of patients at the study health facilities during the study period, 146 (2.4%) had a mental or neurological disorder diagnosis. The commonly diagnosed disorders were epilepsy 91 (1.5%) and bipolar 25 (0.4%). The most prescribed medications were carbamazepine 65 (44.5%), and phenobarbital 26 (17.8%). The medicines inappropriately prescribed at health center III for a mental diagnosis included chlorpromazine for epilepsy 3 (2.1%) and haloperidol for epilepsy 1 (0.7%). Female gender (aOR: 0.52, 95%CI: 0.39 -0.69) and age 61+ years (aOR: 3.02, 95%CI: 1.40 – 6.49) were predictors of a mental disorder entry into the HMIS register.Conclusion: There was a noticeable change of practice by PHC providers in integrating mental health services in routine care as reflected by the rise in the number of mental disorders diagnosed and treated and entered into the modified paper based HMIS registers.

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