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 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 Influence of community scorecards on maternal and newborn health service delivery and utilization

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth Ekirapa Kiracho ◽  
Noel Namuhani ◽  
Rebecca Racheal Apolot ◽  
Christine Aanyu ◽  
Aloysuis Mutebi ◽  
...  
Keyword(s):  
Health Service ◽  
Service Delivery ◽  
Repeated Measures ◽  
Qualitative Data ◽  
Health Workers ◽  
Statistical Significance ◽  
Health Service Delivery ◽  
Collaborative Problem Solving ◽  
Maternal And Newborn Health ◽  
Maternal And Newborn

Abstract Introduction The community score card (CSC) is a participatory monitoring and evaluation tool that has been employed to strengthen the mutual accountability of health system and community actors. In this paper we describe the influence of the CSC on selected maternal and newborn service delivery and utilization indicators. Methods This was a mixed methods study that used both quantitative and qualitative data collection methods. It was implemented in five sub-counties and one town council in Kibuku district in Uganda. Data was collected through 17 key informant interviews and 10 focus group discussions as well as CSC scoring and stakeholder meeting reports. The repeated measures ANOVA test was used to test for statistical significance. Qualitative data was analyzed manually using content analysis. The analysis about the change pathways was guided by the Wild and Harris dimensions of change framework. Results There was an overall improvement in the common indicators across sub-counties in the project area between the 1st and 5th round scores. Almost all the red scores had changed to green or yellow by round five except for availability of drugs and mothers attending Antenatal care (ANC) in the first trimester. There were statistically significant differences in mean scores for men escorting their wives for ante natal care (ANC) (F(4,20) = 5.45, P = 0.01), availability of midwives (F(4,16) =5.77, P < 0.01), availability of delivery beds (F(4,12) =9.00, P < 0.01) and mothers delivering from traditional birth attendants (TBAs), F(4,16) = 3.86, p = 0.02). The qualitative findings suggest that strengthening of citizens’ demand, availability of resources through collaborative problem solving, increased awareness about targeted maternal health services and increased top down performance pressure contributed to positive changes as perceived by community members and their leaders. Conclusions and recommendations The community score cards created opportunities for community leaders and communities to work together to identify innovative ways of dealing with the health service delivery and utilization challenges that they face. Local leaders should encourage the availability of safe spaces for dialogue between communities, health workers and leaders where performance and utilization challenges can be identified and solutions proposed and implemented jointly.

scholarly journals Community mental health services in Pakistan: Review study from Muslim world 2000-2015

2018 ◽  
Vol 7 (1) ◽  
pp. 57-71 ◽  
Author(s):  
Tahir Mahmood Ali ◽  
Sana Gul
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Mental Health Services ◽  
Health Service ◽  
Health Services ◽  
Service Delivery ◽  
Health Workers ◽  
Religious Faith ◽  
Health Service Delivery ◽  
Mental Health Service Delivery

Aim This study attempted to analyse the potential of two primary sources of mental health service delivery at a grassroots level, religious/faith healers and community/lady health workers, and how they can be effectively used to deliver mental health services in a resource-scarce country like Pakistan. Method A literature review was carried out for relevant studies conducted in Muslim countries between 2000 to 2015 reporting empirical results. Using the inclusion criteria, thirteen studies were selected for the review. Results The presented studies suggest that the main proportion of mental health patients in countries with major Muslim population including Pakistan, visit religious/faith healers first for treatment, however all studies are silent about the outcomes through these healers. The only potential visible outcome of contacting religious/faith healers is the identification of mental health cases. However, community/lady health workers with minimal training appeared to be a beneficial source of mental health service delivery in communities. Conclusion In a resource scarce country like Pakistan, networking with religious/faith healers can be established for effective identification and referral of mental health cases whereas strong and already existing community/lady health workers system can be used as a first level to deliver mental health service at the doorstep.

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