Archive | Health Systems

Learning from evidence: Advice-seeking behaviour among Primary Health Care physicians in Pakistan.

Access to information is critical for creating and maintaining high performing Primary Health Care (PHC) systems. Among multiple sources of information, advice-seeking from humans posses a significant importance for the physicians in their clinical settings because they are looking for readily available answers to their questions. We used Tuberculosis and measles as a lens for […]

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Exploring Primary Care: System Dynamics in USA and Romania.

Policy-makers are better able to identify and implement effective health system strengthening (HSS) efforts when they have an accurate understanding of the dynamic, emergent behavior of the system they are attempting to strengthen. Achieving such an understanding is difficult. Yet, without it, decisions can easily result in unintended consequences or policy resistance. This paper describes […]

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Dual practice in Uganda: the evolution and management of a complex phenomenon.

Dual practice is widespread in developing countries, yet it is seldom accounted for in health workforce policies. A systems lens guided the development of a qualitative research design to describe how dual practice evolved and how it is currently managed in urban Uganda. We found that dual practice is deeply embedded in the Ugandan health […]

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The ESTHER European Alliance: a decade of hospital partnerships assessed

To evaluate a decade of activities, better define the current environment and its future, the ESTHER European Alliance, an initiative based on hospital/institutional partnerships with low resources countries, requested an external, qualitative assessment. Results showed that added value of these partnerships and of the EEA were well perceived. EEA seems in line with the current […]

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Administrative Integration of HIV Monitoring And Evaluation: A Case Study From South Africa.

With increasing global focus on integration of vertical programmes within health systems, methods are needed to analyse whether general health service (horizontal) managers at district level exercise administrative authority over disease programmes (administrative integration). This study adapts “decision space” analysis to measure administrative integration of HIV programme monitoring and evaluation (M&E). The study shows that […]

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Integration and Convergence in the context of National AIDS Program Planning in Resource-constrained Settings.

Using the principles of public health ethics, particulalry resource allocation ethics, this paper conducts a conceptual analysis of Integration and Convergence in the light of National AIDS Program Planning in Resource-constrained Settings. Sustaining and maximizing current achievements equitably in a resource constrained environment is indeed a challenge. Resorting to a fair and legitimate priority setting […]

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Equitable Access to Controlled Medicines in Nigeria: Assessment of access barriers.

Nigeria is currently undergoing critical shortage of controlled medicines especially in the management of moderate and acute pain. National policies and regulations on controlled medicines focus mainly on preventing the diversion of the products to illicit channels without corresponding efforts to promote availability for medical use. Several strategies for control have been instituted which serve […]

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Eldercare in Cameroon: attendance of a proximity hospital in Yaoundé.

Cameroon is entering the demographic transition era as elsewhere in Subsaharan Africa with more old personns in terms of proportion in general population. But, our hospitals are not prepared for elderly care in terms of attendance, since there are no baseline data. This study examined the attendance of a proximity district urban hospital, and gives […]

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Why Educational Interventions Fail in Changing Treatment Practices in Rural Hospitals: Evidence from Sri Lanka.

Non-adherence to education interventions is a barrier in improving hospital treatment. This qualitative exploration reveals that education interventions are capable of improving knowledge, but success of the intervention in rural hospitals depends on social dynamics of hospital and influence from the community. In these hospitals, introducing new practices was easier than changing established practices. Treatments […]

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New Model of Formative Supervision to Improve Health Outcomes in Ukraine

Swiss-Ukrainian Mother & Child Health Programmes aims to improve the quality of MCH care in Ukraine. One of the tools is formative supervision: regular structured visits to hospitals. The visits are provided by trained team according to developed guideline. The following results are observed: improved clinical skills and practices of personnel, more comfortable, friendly & […]

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