scholarly journals Budgeting for Environmental Health Services in Healthcare Facilities: A Ten-Step Model for Planning and Costing

2020 ◽  
Vol 17 (6) ◽  
pp. 2075 ◽  
Author(s):  
Darcy M. Anderson ◽  
Ryan Cronk ◽  
Lucy Best ◽  
Mark Radin ◽  
Hayley Schram ◽  
...  
Keyword(s):  
Data Collection ◽  
Health Services ◽  
Environmental Health ◽  
Quality Data ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Good Practices ◽  
Middle Income Countries ◽  
Step Model ◽  
Adequate Provision

Environmental health services (EHS) in healthcare facilities (HCFs) are critical for safe care provision, yet their availability in low- and middle-income countries is low. A poor understanding of costs hinders progress towards adequate provision. Methods are inconsistent and poorly documented in costing literature, suggesting opportunities to improve evidence. The goal of this research was to develop a model to guide budgeting for EHS in HCFs. Based on 47 studies selected through a systematic review, we identified discrete budgeting steps, developed codes to define each step, and ordered steps into a model. We identified good practices based on a review of additional selected guidelines for costing EHS and HCFs. Our model comprises ten steps in three phases: planning, data collection, and synthesis. Costing-stakeholders define the costing purpose, relevant EHS, and cost scope; assess the EHS delivery context; develop a costing plan; and identify data sources (planning). Stakeholders then execute their costing plan and evaluate the data quality (data collection). Finally, stakeholders calculate costs and disseminate findings (synthesis). We present three hypothetical costing examples and discuss good practices, including using costing frameworks, selecting appropriate indicators to measure the quantity and quality of EHS, and iterating planning and data collection to select appropriate costing approaches and identify data gaps.

scholarly journals Safe Healthcare Facilities: A Systematic Review on the Costs of Establishing and Maintaining Environmental Health in Facilities in Low- and Middle-Income Countries

2021 ◽  
Vol 18 (2) ◽  
pp. 817
Author(s):  
Darcy M. Anderson ◽  
Ryan Cronk ◽  
Donald Fejfar ◽  
Emily Pak ◽  
Michelle Cawley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Waste Management ◽  
Vector Control ◽  
Environmental Health ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Middle Income Countries ◽  
Low And Middle Income

A hygienic environment is essential to provide quality patient care and prevent healthcare-acquired infections. Understanding costs is important to budget for service delivery, but costs evidence for environmental health services (EHS) in healthcare facilities (HCFs) is lacking. We present the first systematic review to evaluate the costs of establishing, operating, and maintaining EHS in HCFs in low- and middle-income countries (LMICs). We systematically searched for studies costing water, sanitation, hygiene, cleaning, waste management, personal protective equipment, vector control, laundry, and lighting in LMICs. Our search yielded 36 studies that reported costs for 51 EHS. There were 3 studies that reported costs for water, 3 for sanitation, 4 for hygiene, 13 for waste management, 16 for cleaning, 2 for personal protective equipment, 10 for laundry, and none for lighting or vector control. Quality of evidence was low. Reported costs were rarely representative of the total costs of EHS provision. Unit costs were infrequently reported. This review identifies opportunities to improve costing research through efforts to categorize and disaggregate EHS costs, greater dissemination of existing unpublished data, improvements to indicators to monitor EHS demand and quality necessary to contextualize costs, and development of frameworks to define EHS needs and essential inputs to guide future costing.

Future Issues in Dissemination and Implementation Research

2017 ◽  
Author(s):  
Ross C. Brownson ◽  
Graham A. Colditz ◽  
Enola K. Proctor
Keyword(s):  
Public Health ◽  
Health Services ◽  
Implementation Research ◽  
Clinical Care ◽  
Dissemination And Implementation ◽  
Public Health Services ◽  
Middle Income ◽  
Middle Income Countries ◽  
Dissemination And Implementation Research ◽  
The Many

This chapter highlights just a sample of the many rich areas for dissemination and implementation research that will assist us in shortening the gap between discovery and practice, thus beginning to realize the benefits of research for patients, families, and communities. Greater emphasis on implementation in challenging settings, including lower and middle-income countries and underresourced communities in higher income countries will add to the lessons we must learn to fully reap the benefit of our advances in dissemination and implementation research methods. Moreover, collaboration and multidisciplinary approaches to dissemination and implementation research will help to make efforts more consistent and more effective moving forward. Thus, we will be better able to identify knowledge gaps that need to be addressed in future dissemination and implementation research, ultimately informing the practice and policies of clinical care and public health services.

scholarly journals Global AgeWatch Index and Insights

2020 ◽  
Author(s):  
Gibran Cruz-Martinez ◽  
Gokce Cerev
Keyword(s):  
Older People ◽  
Composite Index ◽  
Quality Data ◽  
Transformative Change ◽  
Middle Income ◽  
Middle Income Countries ◽  
Good Quality Data ◽  
Low And Middle Income

Global AgeWatch Index and Insights by HelpAge International aim to contribute to achievement of long-term transformative change in respect to ageing and the lives of older people by advocating for better production of timely and good quality data to inform policy and program response.The Global AgeWatch Index is a composite index that measures quality of life of older people, and ranks countries based on four domains – income security, health status, enabling environment and capability. The index was developed in partnership with Professor Asghar Zaidi. The index was published during 2013-2015.The Global AgeWatch Insights is a research-based advocacy tool that examines situation of older people in low- and middle-income countries, assesses availability of relevant data and evidence to support the analysis, and identification of policy actions. The Insights are produced in partnership with AARP. The reports were launched in 2018 are planned to be released every three years with a different thematic focus. The first report focuses on the inequities of the health systems in twelve low- and middle-income countries.

Nature and determinants of out-of-pocket health expenditure among older people in a rural Indian community

2012 ◽  
Vol 24 (10) ◽  
pp. 1664-1673 ◽  
Author(s):  
E. M. Brinda ◽  
A. P. Rajkumar ◽  
U. Enemark ◽  
M. Prince ◽  
K. S. Jacob
Keyword(s):  
Health Services ◽  
Older People ◽  
Health Expenditure ◽  
Health Service Utilization ◽  
Care Delivery ◽  
Health Expenditures ◽  
Gastrointestinal Diseases ◽  
Middle Income ◽  
Middle Income Countries ◽  
Catastrophic Health Expenditures

ABSTRACTBackground: Increasing out-of-pocket health expenditure among older people worsens the inequitable access to essential health services in low and middle-income countries (LMIC). We investigated various socioeconomic and health factors associated with out-of-pocket and catastrophic health expenditures among rural older people in India.Methods: We recruited 1,000 participants aged above 65 years from Kaniyambadi block, Vellore, India. We assessed their out-of-pocket health expenditure, health service utilization, socioeconomic profiles, disability, cognition, and health status by standard instruments. We employed appropriate multivariate statistics evaluating these determinants.Results: Male gender, poor sanitation, diabetes, tuberculosis, malaria, respiratory ailments, gastrointestinal diseases, dementia, depression, and disability were associated with higher out-of-pocket expenditures. Illiteracy, tuberculosis, diabetes, and dementia increased the risk for catastrophic health expenditures, while pension schemes protected against it. Income inequalities were associated with inequities on education, disease prevalence, and access to safe water, sanitation, and nutrition.Conclusions: Interactions between determinants of out-of-pocket health expenditure, economic inequality, and inequities on essential health care delivery to older people are complex. We highlight the need for equitable health services and policies, focusing on both medical and social determinants.

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