Abstract:
Background:Quality improvement (QI) methods engage stakeholders in identifying problems, creating strategies called change ideas to address those problems, testing those change ideas and scaling them up where successful. These methods have rarely been used at the community level in low-income country settings. Here we share experiences from rural Tanzania and Uganda, where QI was applied as part of the Expanded Quality Management Using Information Power (EQUIP) intervention with the aim of improving maternal and newborn health. Village volunteers were taught how to generate change ideas to improve health-seeking behaviours and home-based maternal and newborn care practices. Interaction was encouraged between communities and health staff. Aim:To describe experiences implementing EQUIP's QI approach at the community level. Methods:A mixed methods process evaluation of community-level QI was conducted in Tanzania and a feasibility study in Uganda. We outlined how village volunteers were trained in and applied QI techniques and examined the interaction between village volunteers and health facilities, and in Tanzania, the interaction with the wider community also. Results:Village volunteers had the capacity to learn and apply QI techniques to address local maternal and neonatal health problems. Data collection and presentation was a persistent challenge for village volunteers, overcome through intensive continuous mentoring and coaching. Village volunteers complemented health facility staff, particularly to reinforce behaviour change on health facility delivery and birth preparedness. There was some evidence of changing social norms around maternal and newborn health, which EQUIP helped to reinforce. Conclusions:Community-level QI is a participatory research approach that engaged volunteers in Tanzania and Uganda, putting them in a central position within local health systems to increase health-seeking behaviours and improve preventative maternal and newborn health practices.
journal_name
Health Policy Planjournal_title
Health policy and planningauthors
Tancred T,Mandu R,Hanson C,Okuga M,Manzi F,Peterson S,Schellenberg J,Waiswa P,Marchant T,EQUIP Study Team .doi
10.1093/heapol/czu070subject
Has Abstractpub_date
2018-01-01 00:00:00pages
e1-e13issue
1eissn
0268-1080issn
1460-2237pii
2907826journal_volume
33pub_type
杂志文章abstract::Although many public hospital physicians in Vietnam offer private service on the side, little is known about the magnitude and nature of the phenomenon so-called dual practice, let alone the dynamics between the public and private health sectors. This study investigates how and to what degree public hospital physician...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czy075
更新日期:2018-10-01 00:00:00
abstract::This study compares the quality of services provided by public and private hospitals in Bangladesh. The premise of the paper was that the quality of hospital services would be contingent on the incentive structure under which these institutions operate. Since private hospitals are not subsidized and depend on income f...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.1.95
更新日期:2000-03-01 00:00:00
abstract::Indonesia has seen an emergence of local health care financing schemes over the last decade, implemented and operated by district governments. Often motivated by the local political context and characterized by a large degree of heterogeneity in scope and design, the common objective of the district schemes is to addr...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czw101
更新日期:2017-02-01 00:00:00
abstract::The burden of disease due to injuries has elicited virtually no public health response in the countries of central and eastern Europe, even though injuries have long been a much greater problem in the east of Europe than in the west, with children especially affected. This paper seeks to identify factors that have inh...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/15.3.263
更新日期:2000-09-01 00:00:00
abstract::Despite efforts taken by the Government of India, mothers and newborns are excluded from the maternal and child health services, especially those in poorer and weaker sections of the society. Hence, we have utilized the most recent National Family Health Survey (NFHS-4) data to assess the socio-economic inequities in ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa020
更新日期:2020-06-01 00:00:00
abstract::Although logic models are now touted as an important component of health promotion planning, implementation and evaluation, there are few published manuscripts that describe the process of logic model development, and fewer which do so with community involvement, despite the increasing emphasis on participatory resear...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czr001
更新日期:2011-11-01 00:00:00
abstract::Poor mental health is a pressing global health problem, with high prevalence among poor populations from low-income countries. Existing studies of conditional cash transfer (CCT) effects on mental health have found positive effects. However, there is a gap in the literature on population-wide effects of cash transfers...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa079
更新日期:2020-11-20 00:00:00
abstract::Decentralization of the health care system in China has led to an increasing need for income generation at all operational levels, both for curative services and for public health programmes. In general, people have accepted the costs of curative services, although the impact of charges on health-seeking behaviour has...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/16.3.292
更新日期:2001-09-01 00:00:00
abstract::The 2011 United Nations (UN) General Assembly Political Declaration on Prevention and Control of Non-Communicable Diseases (NCDs) brought NCDs to the global health agenda. Essential medicines are central to treating chronic diseases such as hypertension and diabetes. Our study aimed to quantify access to essential med...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czu107
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To estimate and compare the cost-effectiveness of selected interventions to reduce mother-to-child transmission (MTCT) of HIV in Mexico. METHODS:A spreadsheet-based model was used to examine five scenarios, each estimated using both zidovudine (ZDV) and nevirapine (NVP). Scenarios differ according to coverag...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czg035
更新日期:2003-09-01 00:00:00
abstract::Contracting non-governmental organizations (NGOs) has been shown to increase health service delivery output considerably over relatively short time frames in low-income countries, especially when applying performance-related pay as a stimulus. A key concern is how to manage the transition back to government-operated s...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czp049
更新日期:2010-05-01 00:00:00
abstract::The redistributive effects of a social insurance programme are determined by how the programme is paid for-who pays and how much do they pay?-and how the benefits are distributed. As a result, the redistributive effects of a social health insurance programme should be evaluated on the basis of its net benefit-the diff...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czl037
更新日期:2007-01-01 00:00:00
abstract::Social accountability is increasingly invoked as a way of improving health services. This article presents a theory-driven qualitative study of the context, mechanisms and outcomes of a social accountability program, Citizen Voice and Action (CVA), implemented by World Vision (WV) in Zambia. Primary data were collecte...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx024
更新日期:2017-07-01 00:00:00
abstract::OBJECTIVES We describe modern and alternative health services use in terminal illness of adults, and assess whether utilization patterns of TB/AIDS patients are distinct from those of patients suffering from other illnesses. METHODS Data are from post-mortem interviews with close relatives or caretakers of the decease...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czp015
更新日期:2009-07-01 00:00:00
abstract::When seeking to ensure financial sustainability of a health programme, existence of a line item in the Ministry of Health (MOH) budget is often seen as an essential, first step. We used immunization as a reference point for cross-country comparison of budgeting methods in Sub-Saharan African countries. Study objective...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa040
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:In Nepal, women residing in rural areas tend to bypass local birth centres and deliver at urban hospitals, despite the availability of obstetric care in these centres. This study investigated the incidence of bypassing, characteristics of bypassers and their reasons for bypassing the birth centres. METHODS:...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt090
更新日期:2015-02-01 00:00:00
abstract::OBJECTIVES Like many other developing countries, South Africa provides free medicines through its public health care facilities. Recent policies encourage generic substitution in the private sector. This study explored South African consumer perceptions of drug quality and whether these perceptions influenced how peop...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czp039
更新日期:2010-01-01 00:00:00
abstract::Three broad strategies for health financing reform include: 1) cost recovery through user fees to expand access and improve quality of health services along with means testing to increase equity; 2) reallocation of existing resources to improve efficiency and access; and 3) assessment of the efficiency and quality of ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/10.3.213
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:To estimate the cost-effectiveness of introducing hepatitis B vaccine into routine infant immunization services in Mozambique, which took place in the year 2001. METHODS:A decision analytic model was used to estimate the impact of hepatitis B vaccination. This model was developed for the WHO to estimate the ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czi006
更新日期:2005-01-01 00:00:00
abstract::The persistently low quality and inadequacy of health services provided in public facilities has made the private sector an unavoidable choice for consumers of health care in Nigeria. Ineffective state regulation, however, has meant little control over the clinical activities of private sector providers while the pric...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/14.2.174
更新日期:1999-06-01 00:00:00
abstract::The Syrian conflict has caused enormous displacement of a population with a high non-communicable disease (NCD) burden into surrounding countries, overwhelming health systems' NCD care capacity. Médecins sans Frontières (MSF) developed a primary-level NCD programme, serving Syrian refugees and the host population in I...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czaa050
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVE:Irrational use of medicines is a serious problem in China and has been the primary target of China's national essential medicines programme (NEMP). The aim of this study was to evaluate the effect of the NEMP on rational use of medicines in China. METHODS:A nationwide sample of 3 76 700 prescriptions written...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv008
更新日期:2016-02-01 00:00:00
abstract::Realist evaluation furnishes valuable insight to public health practitioners and policy makers about how and why interventions work or don't work. Moving beyond binary measures of success or failure, it provides a systematic approach to understanding what goes on in the 'Black Box' and how implementation decisions in ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czv053
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVE:We examine socio-economic status (SES) and geographic differences in willingness of respondents to pay for community-based health insurance (CBHI). METHODS:The study took place in Anambra and Enugu states, south-east Nigeria. It involved a rural, an urban and a semi-urban community in each of the two states....
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czp046
更新日期:2010-03-01 00:00:00
abstract::As growth in development assistance for health levels off, development assistance partners must make allocation decisions within tighter budget constraints. Furthermore, with the advent of comprehensive and comparable burden of disease and health financing estimates, empirical evidence can increasingly be used to dire...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czx165
更新日期:2018-02-01 00:00:00
abstract::Neonatal deaths account for about half of all deaths among children under 5 years of age in Bangladesh, making prevention a major priority. This paper reports on a study of neonatal deaths in 12 areas of Bangladesh served by a large NGO programme, which had high coverage of reproductive health outreach services and re...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czl024
更新日期:2006-11-01 00:00:00
abstract::Evidence suggests that a regular and reliable transfer of cash to households with orphaned and vulnerable children has a strong and positive effect on child outcomes. However, conditional cash transfers are considered by some as particularly intrusive and the question on whether or not to apply conditions to cash tran...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/czt060
更新日期:2014-10-01 00:00:00
abstract::National Health Accounts (NHA) are an important tool to demonstrate how a country's health resources are spent, on what services, and who pays for them. NHA are used by policy-makers for monitoring health expenditure patterns; policy instruments to re-orientate the pattern can then be further introduced. The National ...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/14.4.342
更新日期:1999-12-01 00:00:00
abstract::In 1998 Bangladesh began a sector wide approach (SWAp) to the extension of health care to vulnerable groups in the country. The central feature of this approach is the funding of an essential service package (ESP) emphasizing maternal care, certain communicable diseases and child health. This study examines the way in...
journal_title:Health policy and planning
pub_type: 杂志文章
doi:10.1093/heapol/17.3.247
更新日期:2002-09-01 00:00:00
abstract::There is increasing interest in the prospects for managed market reforms in developing countries, stimulated by current reforms and policy debates in developed countries, and by perceptions of widespread public sector inefficiency in many countries. This review examines the prospects for such reforms in a developing c...
journal_title:Health policy and planning
pub_type: 杂志文章,评审
doi:10.1093/heapol/9.3.237
更新日期:1994-09-01 00:00:00