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https://www.readbyqxmd.com/read/29036444/the-elephant-in-the-room-toward-a-more-ethical-approach-with-accountability-toward-intended-beneficiaries-in-humanitarian-aid
#1
Ramin Asgary, Ronald J Waldman
There is considerable tension between the concept of accountability to beneficiaries and its practice in humanitarian aid. The beneficiaries live in a relationship that is asymmetric; upward or horizontal accountability within the aid system alone-even with the best of intentions-might be short-sighted. Could beneficiaries be effectively involved in programing, priority setting or allocation of resources? Is there space for a rights-based approach in aid delivery and operations? The mind-set, governance and structure of operations in aid agencies may need significant institutional reform to share the process of decision-making, and to transform the current dynamic from connecting resources to brokering better governance, true collaboration and co-operation among all stakeholders...
September 28, 2017: International Health
https://www.readbyqxmd.com/read/29030677/safe-surgery-for-all-early-lessons-from-implementing-a-national-government-driven-surgical-plan-in-ethiopia
#2
Daniel Burssa, Atlibachew Teshome, Katherine Iverson, Olivia Ahearn, Tigistu Ashengo, David Barash, Erin Barringer, Isabelle Citron, Kaya Garringer, Victoria McKitrick, John Meara, Abraham Mengistu, Swagoto Mukhopadhyay, Cheri Reynolds, Mark Shrime, Asha Varghese, Samson Esseye, Abebe Bekele
Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29028228/preventing-emergence-of-drug-resistant-tuberculosis-in-myanmar-s-transitioning-health-system
#3
Mishal S Khan, Coll Hutchison, Richard J Coker, Joanne Yoong, Khaung M Hane, Anh L Innes, Tin M Khaing, Sithu Aung
Multidrug-resistant tuberculosis (MDR-TB) is a particular threat to the populations of resource-limited countries. Although inadequate treatment of TB has been identified as a major underlying cause of drug resistance, essential information to inform changes in health service delivery and policy is missing. We investigate factors that may be driving the emergence of MDR-TB in Myanmar, a country where investment and health system reforms are ongoing to address the unexplained, high occurrence of MDR-TB. We conducted a multi-centre, retrospective case-control study in 10 townships across Yangon...
October 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29026739/mohalla-clinics-of-delhi-india-could-these-become-platform-to-strengthen-primary-healthcare
#4
EDITORIAL
Chandrakant Lahariya
The mohalla or community clinics in Delhi, India aims to provide basic health services to underserved population in urban settings. This article reviews and analyzes the strengths & limitations of the concept and explores the role these clinics can play in (1) reforming urban health service delivery, (2) addressing health inequities, and (3) strengthening primary health care. These clinics provide basic healthcare services to people, in underserved areas, in a responsive manner, have brought health higher on the political agenda and the governments of a number of Indian states have shown interest in adoption (of a variant) of this concept...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29026373/how-weight-during-pregnancy-influences-the-association-between-pre-pregnancy-body-mass-index-and-types-of-delivery-and-birth-a-comparison-of-urban-and-rural-areas
#5
Manoochehr Babanezhad
BACKGROUND: Women in study areas suffered from the problems of caesarean delivery (CD), low birth weight (LBW), and macrosomia. OBJECTIVE: To investigate how gestational weight gain (GWG) influences the effect of the pre-pregnancy body mass index (BMI) on the risks of CD, LBW, and macrosomia in urban and rural areas in a city of Iran. METHODS: We used 767 and 612 eligible subjects from the public health care centers in urban and rural areas respectively...
March 2017: African Health Sciences
https://www.readbyqxmd.com/read/28987456/introduction-of-freedom-of-choice-for-hospital-outpatient-care-in-portugal-implications-and-results-of-the-2016-reform
#6
J Simões, G F Augusto, I Fronteira
In Portugal, the National Health Service (NHS) assures universal access to medical treatment and care that is free at the point of delivery - except for relatively small user charges. Freedom of choice is limited and competition between the public and the private sectors is almost non-existent. In May 2016, the Ministry of Health introduced a new law that facilitates the referral of NHS users from primary healthcare units to outpatient consultations in NHS hospitals outside of the referral area. However, for inpatient care, patients are still bound to receive treatment within their referral area, which is determined by place of residence...
September 20, 2017: Health Policy
https://www.readbyqxmd.com/read/28984493/integration-of-tuberculosis-and-hiv-services-exploring-the-perspectives-of-co-infected-patients-in-ghana
#7
Prince Justin Anku, Joshua Amo-Adjei, David Teye Doku, Akwasi Kumi-Kyereme
Scaling up of integrated tuberculosis (TB)-human immunodeficiency virus (HIV) services remains sub-optimal in many resource-limited countries, including Ghana, where the two conditions take a heavy toll on the financial resources of health systems as well as infected persons. Previous studies have documented several implementation challenges towards TB-HIV service integration, but views of patients on integrated service delivery have not received commensurate research attention. This paper explored the experiences of 40 TB-HIV co-infected patients at different stages of treatment in Ghana...
October 6, 2017: Global Public Health
https://www.readbyqxmd.com/read/28981661/municipal-health-services-provision-by-local-governments-a-systematic-review-of-experiences-in-decentralized-sub-saharan-african-countries
#8
Hilaire Zon, Milena Pavlova, Koiné Maxime Drabo, Wim Groot
'Four' types of decentralization are distinguished in health care: deconcentration when the shift in authority is to regional or district offices; devolution when the shift is to state, provincial or municipal governments; delegation when semi-autonomous agencies are granted new powers; and privatization when ownership is granted to private entities. This article systematically reviews the experiences of local governments of Sub-Saharan African countries with the provision of health services during and after decentralization reforms...
November 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28980271/the-evolution-of-mhealth-solutions-for-heart-failure-management
#9
Evanthia E Tripoliti, Georgia S Karanasiou, Fanis G Kalatzis, Katerina K Naka, Dimitrios I Fotiadis
In the last decade, the uptake of information and communication technologies and the advent of mobile internet resulted in improved connectivity and penetrated different fields of application. In particular, the adoption of the mobile devices is expected to reform the provision and delivery of healthcare, overcoming geographical, temporal, and other organizational limitations. mHealth solutions are able to provide meaningful clinical information allowing effective and efficient management of chronic diseases, such as heart failure...
October 5, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28975012/costs-and-effectiveness-of-mindfulness-based-art-therapy-versus-standard-breast-cancer-support-group-for-women-with-cancer
#10
Katherine M Prioli, Laura T Pizzi, Kathryn M Kash, Andrew B Newberg, Anna Marie Morlino, Michael J Matthews, Daniel A Monti
BACKGROUND: The results of several studies have demonstrated that women and men with a cancer diagnosis benefit from interventions to reduce distress and improve quality of life (QOL). However, little is known about the costs and effectiveness of such interventions. Identifying a stress-reduction program that is low cost and effective is important for payers, employers, and healthcare professionals, as well as for patients with cancer. OBJECTIVE: To evaluate the direct costs and effectiveness of the mindfulness-based art therapy (MBAT) program compared with the cost and effectiveness of a breast cancer support group (BCSG)...
September 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28960630/patient-family-advisors-perspectives-on-engagement-in-health-care-quality-improvement-initiatives-power-and-partnership
#11
Donna Goodridge, Tanner Isinger, Thomas Rotter
BACKGROUND: Engagement of the public in defining and shaping the organization and delivery of health care is increasingly viewed as integral to improving quality and promoting transparent decision making. Meaningful engagement of the public in health-care reform is predicated on shifting entrenched power imbalances between health-care systems and those it claims to serve. OBJECTIVES: To describe the expressions, forms and spaces of power from the perspectives of persons who participated as Patient/Family Advisors (PFAs) in Rapid Process Improvement Workshops (RPIWs) within Saskatchewan, Canada...
September 28, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28952981/reporting-from-the-front-lines-implementing-oregon-s-alternative-payment-methodology-in-federally-qualified-health-centers
#12
Erika K Cottrell, Jennifer D Hall, Glenn Kautz, Heather Angier, Sonja Likumahuwa-Ackman, Laura Sisulak, Sara Keller, David C Cameron, Jennifer E DeVoe, Deborah J Cohen
Alternative payment models have been proposed as a way to facilitate patient-centered medical home model implementation, yet little is known about how payment reform translates into changes in care delivery. We conducted site visits, observed operations, and conducted interviews within 3 Federally Qualified Health Center organizations that were part of Oregon's Alternative Payment Methodology demonstration project. Data were analyzed using an immersion-crystallization approach. We identified several care delivery changes during the early stages of implementation, as well as challenges associated with this new model of payment...
September 25, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28952049/getting-off-the-carousel-exploring-the-wicked-problem-of-curriculum-reform
#13
Lorraine Hawick, Jennifer Cleland, Simon Kitto
INTRODUCTION: Making substantial changes to the form and delivery of medical education is challenging. One reason for this may be misalignment between existing conceptualizations of curricula and curriculum reform in medical education, with the former perceived as 'complex' yet the latter as linear. Reframing curriculum reform as a process-driven, complex entity may enhance the possibility of change. To explore the utility of this approach, we carried out an exploratory case study of curriculum reform in a real-life context...
September 26, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28949462/peruvian-mental-health-reform-a-framework-for-scaling-up-mental-health-services
#14
Mauricio Toyama, Humberto Castillo, Jerome T Galea, Lena R Brandt, María Mendoza, Vanessa Herrera, Martha Mitrani, Yuri Cutipé, Victoria Cavero, Francisco Diez-Canseco, J Jaime Miranda
BACKGROUND: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face...
January 22, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28938243/creating-a-learning-culture-for-medical-consortia-in-china
#15
Guozhong He, Zimin Chen
In China's recent health care reforms, both individuals and organizations have shown an ever-growing desire and demand for new knowledge and skills. A health care delivery system (HCDS) should explore new ways for creating a learning organization (LO) and should organically combine HCDS culture construction with the LO construction to build a cultural atmosphere that is conducive to the development of the LO. This article describes the implementation phase, characteristics, and realization strategy of an HCDS construction for the ultimate purpose of enhancing HCDS cohesion, solidarity, and sustainable development...
September 21, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28930760/medical-education-and-health-care-delivery-a-call-to-better-align-goals-and-purposes
#16
David P Sklar, Paul A Hemmer, Steven J Durning
The transformation of the U.S. health care system is under way, driven by the needs of an aging population, rising health care spending, and the availability of health information. However, the speed and effectiveness of the transformation of health care delivery will depend, in large part, upon engagement of the health professions community and changes in clinicians' practice behaviors. Current efforts to influence practice behaviors emphasize changes in the health payment system with incentives to move from fee-for-service to alternative payment models...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28919056/an-exploration-of-person-centred-concepts-in-human-services-a-thematic-analysis-of-the-literature
#17
REVIEW
Rebecca A Waters, Angus Buchanan
Being 'person-centred' in the delivery of health and human services has become synonymous with quality care, and it is a core feature of policy reform in Australia and other Western countries. This research aimed to identify the uses, definitions and characteristics of the term 'person-centred' in the ageing, mental health and disability literature. A thematic analysis identified seven common core themes of person-centredness: honouring the person, being in relationship, facilitating participation and engagement, social inclusion/citizenship, experiencing compassionate love, being strengths/capacity focussed, and organisational characteristics...
October 2017: Health Policy
https://www.readbyqxmd.com/read/28911328/devolution-and-its-effects-on-health-workforce-and-commodities-management-early-implementation-experiences-in-kilifi-county-kenya
#18
Benjamin Tsofa, Catherine Goodman, Lucy Gilson, Sassy Molyneux
BACKGROUND: Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28910495/nursing-service-innovation-a-case-study-examining-emergency-nurse-practitioner-service-sustainability
#19
Amanda Fox, Glenn Gardner, Sonya Osborne
AIM: This research aimed to explore factors that influence sustainability of health service innovation, specifically emergency nurse practitioner service. BACKGROUND: Planning for cost effective provision of healthcare services is a concern globally. Reform initiatives are implemented often incorporating expanding scope of practice for health professionals and innovative service delivery models. Introducing new models is costly in both human and financial resources and therefore understanding factors influencing sustainability is imperative to viable service provision...
September 14, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28893261/a-tale-of-two-systems-practice-patterns-of-a-single-group-of-emergency-medical-physicians-in-taiwan-and-china
#20
I-Anne Huang, Tang-Her Jaing, Chang-Teng Wu, Chee-Jen Chang, Shan-Hsuan Hsia, Nicole Huang
BACKGROUND: The quality of pediatric emergency care has been a major concern in health care. Following a series of health system reforms in China, it is important to do this assessment of pediatric emergency care, and to explore potential influences of health care system. This study aimed to compare practice differences in treating children with respiratory illnesses in two emergency department (ED) settings within different health care systems: China and Taiwan. METHODS: A pooled cross-sectional hospital-based study was conducted in two tertiary teaching hospitals in Xiamen, China and Keelung, Taiwan belong to the same hospital chain group...
September 11, 2017: BMC Health Services Research
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