Filters

2014 - 20193
Reset filters

Settings

End date: 2019 × Subject: Public health ×

Search Results

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Accreditation as a path to achieving universal quality health coverage
    (Global. Health, 2014) Kedar S. Mate; Anne L. Rooney; Anuwat Supachutikul; Girdhar Gyani
    As many low-and middle-income countries (LMICs) pursue health care reforms in order to achieve universal health coverage (UHC), development of national accreditation systems has become an increasingly common quality-enhancing strategy endorsed by payers, including Ministries of Health. This article describes the major considerations for health system leaders in developing and implementing a sustainable and successful national accreditation program, using the 20-year evolution of the Thai health care accreditation system as a model. The authors illustrate the interface between accreditation as a continuous quality improvement strategy, health insurance and other health financing schemes, and the overall goal of achieving universal health coverage.
  • No Thumbnail Available
    Item
    Acceptability and feasibility of using non-specialist health workers to deliver mental health care: Stakeholder perceptions from the PRIME district sites in Ethiopia, India, Nepal, South Africa, and Uganda
    (Soc. Sci. Med., 2014) Emily Mendenhall; Mary J. De Silva; Charlotte Hanlon; Inge Petersen; Rahul Shidhaye; Mark Jordans; Nagendra Luitel; Joshua Ssebunnya; Abebaw Fekadu; Vikram Patel; Mark Tomlinson
    Three-quarters of the global mental health burden exists in low- and middle-income countries (LMICs), yet the lack of mental health services in resource-poor settings is striking. Task-sharing (also, task-shifting), where mental health care is provided by non-specialists, has been proposed to improve access to mental health care in LMICs. This multi-site qualitative study investigates the acceptability and feasibility of task-sharing mental health care in LMICs by examining perceptions of primary care service providers (physicians, nurses, and community health workers), community members, and service users in one district in each of the five countries participating in the PRogramme for Improving Mental health carE (PRIME): Ethiopia, India, Nepal, South Africa, and Uganda. Thirty-six focus group discussions and 164 in-depth interviews were conducted at the pre-implementation stage between February and October 2012 with the objective of developing district level plans to integrate mental health care into primary care. Perceptions of the acceptability and feasibility of task-sharing were evaluated first at the district level in each country through open-coding and then at the cross-country level through a secondary analysis of emergent themes. We found that task-sharing mental health services is perceived to be acceptable and feasible in these LMICs as long as key conditions are met: 1) increased numbers of human resources and better access to medications; 2) ongoing structured supportive supervision at the community and primary care-levels; and 3) adequate training and compensation for health workers involved in task-sharing. Taking into account the socio-cultural context is fundamental for identifying local personnel who can assist in detection of mental illness and facilitate treatment and care as well as training, supervision, and service delivery. By recognizing the systemic challenges and sociocultural nuances that may influence task-sharing mental health care, locally-situated interventions could be more easily planned to provide appropriate and acceptable mental health care in LMICs. (C) 2014 The Authors. Published by Elsevier Ltd.
  • No Thumbnail Available
    Item
    Adaptation to health outcomes of climate change and variability at the city level: An empirical decision support tool
    (Sust. Cities Soc., 2019) Samraj Sahay
    Adaptation to health risk due to climate variability and change at the city level is inadequate, particularly in developing economies. Here, coping strategies with short-term benefits, adopted by the residents contribute significantly to their resilience. Decision on effective adaptation, therefore, requires economic evaluation of the coping and adaptation strategies in practise. In the present paper a novel framework using household health production function (HPF) approach has been developed for evaluation of coping and adaptation strategies to serve as a decision tool for planners. The outcome informs decision makers about the benefits and effectiveness of coping, and shortcomings in the existing adaptation strategies, thus, contributing to stocktaking. The approach has been validated using a case of vector-borne disease of dengue, an important climate-sensitive health impact of climate change. A five step cyclical framework has been proposed which addresses uncertainty by avoiding the need for future projection of health outcomes and scenario building as it can be applied at any point of time in future and considers the current risk only. The strengths and weaknesses of the proposed tool are compared with other similar tools. The decision support tool has applicability for all climate-sensitive health outcomes at the city level.