scholarly journals Hospitals in Integrated Health Service Delivery Networks: Strategic Recommendations

2021 ◽  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Organization And Management ◽  
Structural Problems ◽  
The People ◽  
Integrated Health ◽  
Specialized Institutions ◽  
Care Technology ◽  
Delivery Network

In 2007, PAHO launched the Integrated Health Service Delivery Network (IHSDN) initiative to address the problems derived from the fragmentation of health services and to overcome the structural problems stemming from the widespread segmentation of health systems in the countries of the Region. In the IHSDN initiative, hospitals are an aggregate of specialized institutions that support a highly effective first level of care. Hospitals themselves are defragmented, which is theoretically correct, innovative, and even visionary. However, the IHSDN initiative does not seek to diminish the influence of hospitals in the health system or the importance of their role, but to integrate these institutions so that all their efforts are aligned with the needs of the people and communities they serve through the development of IHSDNs. It is obvious that without hospitals there can be no IHSDNs; however, it should also be recognized that without effective networks, hospitals cannot do their job. The IHSDN initiative presents a change in the role assigned to hospitals, in which they are no longer considered the apex of a pyramid in which the hierarchy is based on specialization to successfully treat disease. Instead, the hospital becomes a very important participant in a service organized as a network, performing specific tasks in a series of processes that cut repeatedly across the health service delivery network and include the participation of individuals and communities. The product of an intense debate and joint effort, this work contains a series of proposals in the six areas considered a priority for developing the new role of hospitals in IHSDNs: governance, resource allocation and incentives, the model of care, technology and infrastructure, human resources, and organization and management.

scholarly journals Describing the Health Service Delivery Network of an Urban Poor Area and a Rural Poor Area

2018 ◽  
Vol 52 (5) ◽  
Author(s):  
Hilton Y. Lam ◽  
Roberto De Vera ◽  
Adovich S. Rivera ◽  
Tyrone Reden Sy ◽  
Kent Jason G. Cheng ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Urban Poor ◽  
Health Workers ◽  
Health Service Delivery ◽  
Care Staff ◽  
Health Care Staff ◽  
Rural Poor ◽  
Poor Area ◽  
Delivery Network

Objectives. This study aimed to assess the health workforce’s service capacities within a health Service Delivery Network (SDN) of an urban poor and a rural poor setting. Methods. This is a concurrent mixed-methods study implemented in Navotas and Masbate, an urban poor and a rural poor area, respectively. Health needs of the residents were assessed through records review, qualitative methods and a household survey. Health facilities in the identified SDN were assessed using the Service Availability and Readiness Assessment (SARA) tool. Training data of Human Resource for Health (HRH) were also obtained. Results. SDN in the two areas are different in terms of formality where memoranda of agreement were prepared between Masbate facilities but not in Navotas. Health worker to population ratios were 12.1 per 10,000 in Navotas and 2.7 in Masbate, respectively. The primary care facilities in the two sites met the recommended level of trainings for health workers in obstetric care, immunization, childhood nutrition and tuberculosis. There was a lack of post-graduate training in non-communicable diseases in all facilities. Poverty and geography were significant factors affecting health service delivery. Conclusion. In terms of human resources, both sites have limited number of health workers and the ratios fall far below WHO guideline. Recommendations include: Primary health care staff complement should be increased in the two SDNs. HHRDB should conduct a study to settle the issue of continuing medical education requirements that are not congruent with WHO recommendations. The SDNs should include the access of medicines and commodities by poor patients in private facilities during times of stock outs. Also, during stock outs or unavailability of government health personnel, transportation should be made available via the SDN to transport poor patients to private or nongovernment facilities with the needed personnel. The DOH and HHRDB should investigate innovative strategies for telehealth services that do not require continuous electricity, nor telephone or cellphone signal.

scholarly journals Factors Influencing the Implementation of Foreign Innovations in Organization and Management of Health Service Delivery in China: A Systematic Review

2021 ◽  
Vol 1 ◽  
Author(s):  
Wenxing Wang ◽  
Jeroen van Wijngaarden ◽  
Hujie Wang ◽  
Martina Buljac-Samardzic ◽  
Shasha Yuan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Service ◽  
Service Delivery ◽  
Human Resources ◽  
Financial Incentives ◽  
Health Service Delivery ◽  
Urban China ◽  
Organizational Policies ◽  
Organization And Management ◽  
Factors Influencing

Background: China has been encouraged to learn from international innovations in the organization and management of health service delivery to achieve the national health reform objectives. However, the success and effectiveness of implementing innovations is affected by the interactions of innovations with the Chinese context. Our aim is to synthesize evidence on factors influencing the implementation of non-Chinese innovations in organization and management of health service delivery in mainland China.Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched seven databases for peer-reviewed articles published between 2009 and 2020. Data were analyzed and combined to generate a list of factors influencing the implementation of foreign innovations in China. The factors were classified in the categories context, system, organization, innovation, users, resources, and implementation process.Results: The 110 studies meeting the inclusion criteria revealed 33 factors. Most supported by evidence is the factor integration in organizational policies, followed by the factors motivation & incentives and human resources. Some factors (e.g., governmental policies & regulations) were mentioned in multiple studies with little or no evidence.Conclusion: Evidence on factors influencing the implementation of foreign innovations in organization and management of health service delivery is scarce and of limited quality. Although many factors identified in this review have also been reported in reviews primarily considering Western literature, this review suggests that extrinsic motivation, financial incentives, governmental and organizational policies & regulations are more important while decentralization was found to be less important in China compare to Western countries. In addition, introducing innovations in rural China seems more challenging than in urban China, because of a lack of human resources and the more traditional rural culture.

scholarly journals Evidence of integrated health service delivery during COVID-19 in low- and middle-income countries: protocol for a scoping review

2020 ◽  
Author(s):  
Rachel Neill ◽  
Md Zabir Hasan ◽  
Priyanka Das ◽  
Vasuki Venugopal ◽  
Nishant Jain ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health Systems ◽  
Scoping Review ◽  
Health Service Delivery ◽  
World Health ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Integrated Health

Introduction The importance of integrated, people-centered health systems has been recognized as a central component of achieving Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can stand the shock of health emergencies. However, there is dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness in low- and low-middle income countries (LMICs). Thus, the authors are organizing a scoping review aiming to explore application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs. Methods and analysis This scoping review adheres to the six steps for scoping reviews from Arksey and OMalley (2005). Peer reviewed scientific literature will be systematically assembled utilizing a standardized and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the World Health Organization Global Research Database on COVID-19, and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrices. Ethics and dissemination No ethical approval is required for the review. The study will be conducted from June to December 2020. Results from this study will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic. The findings will be developed into reports and a peer-reviewed articles and will assist policy makers in making pragmatic and evidence-based decisions for current and future pandemic response.

scholarly journals Assessment of the coordination of integrated health service delivery networks by the primary health care: COPAS questionnaire validation in the Brazilian context

2015 ◽  
Vol 16 (1) ◽  
Author(s):  
Ludmila Barbosa Bandeira Rodrigues ◽  
Claudia Benedita dos Santos ◽  
Sueli Leiko Takamatsu Goyatá ◽  
Marcela Paschoal Popolin ◽  
Mellina Yamamura ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Health Service ◽  
Service Delivery ◽  
Health Service Delivery ◽  
Questionnaire Validation ◽  
Primary Health ◽  
Integrated Health ◽  
Delivery Networks

scholarly journals Evidence of integrated health service delivery during COVID-19 in low and lower-middle-income countries: protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042872
Author(s):  
Rachel Neill ◽  
Md Zabir Hasan ◽  
Priyanka Das ◽  
Vasuki Venugopal ◽  
Nishant Jain ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health Systems ◽  
Scoping Review ◽  
Health Service Delivery ◽  
Data Matrix ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Integrated Health

IntroductionThe importance of integrated, people-centred health systems has been recognised as a central component of Universal Health Coverage. Integration has also been highlighted as a critical element for building resilient health systems that can withstand the shock of health emergencies. However, there is a dearth of research and systematic synthesis of evidence on the synergistic relationship between integrated health services and pandemic preparedness, response, and recovery in low-income and lower-middle-income countries (LMICs). Thus, the authors are organising a scoping review aiming to explore the application of integrated health service delivery approaches during the emerging COVID-19 pandemic in LMICs.Methods and analysisThis scoping review adheres to the six steps for scoping reviews from Arksey and O’Malley. Peer-reviewed scientific literature will be systematically assembled using a standardised and replicable search strategy from seven electronic databases, including PubMed, Embase, Scopus, Web of Science, CINAHL Plus, the WHO’s Global Research Database on COVID-19 and LitCovid. Initially, the title and abstract of the collected literature, published in English from December 2019 to June 2020, will be screened for inclusion which will be followed by a full-text review by two independent reviewers. Data will be charted using a data extraction form and reported in narrative format with accompanying data matrix.Ethics and disseminationNo ethical approval is required for the review. The study will be conducted from June 2020 to May 2021. Results from this scoping review will provide a snapshot of the evidence currently being generated related to integrated health service delivery in response to the COVID-19 pandemic in LMICs. The findings will be developed into reports and a peer-reviewed article and will assist policy-makers in making pragmatic and evidence-based decisions for current and future pandemic responses.

scholarly journals Integrated health service delivery during COVID-19: a scoping review of published evidence from low-income and lower-middle-income countries

2021 ◽  
Vol 6 (6) ◽  
pp. e005667
Author(s):  
Md Zabir Hasan ◽  
Rachel Neill ◽  
Priyanka Das ◽  
Vasuki Venugopal ◽  
Dinesh Arora ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Health System ◽  
Scoping Review ◽  
Low Income ◽  
Building Blocks ◽  
Health Service Delivery ◽  
Middle Income ◽  
Published Evidence ◽  
Integrated Health

BackgroundIntegrated health service delivery (IHSD) is a promising approach to improve health system resilience. However, there is a lack of evidence specific to the low/lower-middle-income country (L-LMIC) health systems on how IHSD is used during disease outbreaks. This scoping review aimed to synthesise the emerging evidence on IHSD approaches adopted in L-LMIC during the COVID-19 pandemic and systematically collate their operational features.MethodsA systematic scoping review of peer-reviewed literature, published in English between 1 December 2019 and 12 June 2020, from seven electronic databases was conducted to explore the evidence of IHSD implemented in L-LMICs during the COVID-19 pandemic. Data were systematically charted, and key features of IHSD systems were presented according to the postulated research questions of the review.ResultsThe literature search retrieved 1487 published articles from which 18 articles met the inclusion criteria and included in this review. Service delivery, health workforce, medicine and technologies were the three most frequently integrated health system building blocks during the COVID-19 pandemic. While responding to COVID-19, the L-LMICs principally implemented the IHSD system via systematic horizontal integration, led by specific policy measures. The government’s stewardship, along with the decentralised decision-making capacity of local institutions and multisectoral collaboration, was the critical facilitator for IHSD. Simultaneously, fragmented service delivery structures, fragile supply chain, inadequate diagnostic capacity and insufficient workforce were key barriers towards integration.ConclusionA wide array of context-specific IHSD approaches were operationalised in L-LMICs during the early phase of the COVID-19 pandemic. Emerging recommendations emphasise the importance of coordination and integration across building blocks and levels of the health system, supported by a responsive governance structure and stakeholder engagement strategies. Future reviews can revisit this emerging evidence base at subsequent phases of COVID-19 response and recovery in L-LMICs to understand how the approaches highlighted here evolve.

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