Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities
This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and strengthen services and systems in resource-limited countries. (Source: Health Policy and Planning)
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Fronczak, N., Oyediran, K. A., Mullen, S., Kolapo, U. M. Tags: Original Articles Source Type: research
Participatory planning of a primary care service for people with severe mental disorders in rural Ethiopia
Little is understood about the feasibility and acceptability of primary care-based models of task-sharing care for people with severe mental disorders (SMDs) in low- and middle-income countries (LMICs). A participatory planning approach was adopted in preparation for the transition from hospital-delivered psychiatric care for SMD to a primary care-based, task-sharing model in a rural Ethiopian community. In this article, we present findings from community consultation meetings (n = 4), focus group discussions (n = 7) and in-depth interviews (n = 11) with key stakeholders (healthcare administrators and providers, caregivers...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Mayston, R., Alem, A., Habtamu, A., Shibre, T., Fekadu, A., Hanlon, C. Tags: Original Articles Source Type: research
The path dependence of district manager decision-space in Ghana
This study demonstrates that the rhetoric of decentralization does not always mirror actual implementation, nor always result in empowered local actors. (Source: Health Policy and Planning)
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Kwamie, A., van Dijk, H., Ansah, E. K., Agyepong, I. A. Tags: Original Articles Source Type: research
User experience with a health insurance coverage and benefit-package access: implications for policy implementation towards expansion in Nigeria
Conclusion: This study revealed that coverage of family members was relatively poor, while benefit-package access was more adequate. Non-inclusion of family members could hinder effective coverage by the scheme. Potential policy implications towards effective coverage and benefit-package access are discussed. (Source: Health Policy and Planning)
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Mohammed, S., Aji, B., Bermejo, J. L., Souares, A., Dong, H., Sauerborn, R. Tags: Original Articles Source Type: research
'The government cannot do it all alone: realist analysis of the minutes of community health committee meetings in Nigeria
Since the mid-1980s, the national health policy in Nigeria has sought to inspire community engagement in primary health care by bringing communities into partnership with service providers through community health committees. Using a realist approach to understand how and under what circumstances the committees function, we explored 581 meeting minutes from 129 committees across four states in Nigeria (Lagos, Benue, Nasarawa and Kaduna). We found that community health committees provide opportunities for improving the demand and supply of health care in their community. Committees demonstrate five modes of functioning: thr...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Abimbola, S., Molemodile, S. K., Okonkwo, O. A., Negin, J., Jan, S., Martiniuk, A. L. Tags: Original Articles Source Type: research
Does the antenatal care visit represent a missed opportunity for increasing contraceptive use in Pakistan? An analysis of household survey data from Sindh province
This study uses data from a large-scale survey conducted in Sindh province in 2013 to examine whether ANC utilization is a significant predictor of subsequent contraceptive use among women. In an analysis which controls for a range of variables known to be important for family planning adoption, the findings show that ANC is the strongest predictor of subsequent family planning use among women in Sindh. The antenatal visit represents an enormous opportunity to promote the adoption of family planning in Pakistan. The family planning programme should ensure that high-quality family planning counselling is provided to women d...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Agha, S., Williams, E. Tags: Original Articles Source Type: research
Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal
Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicin...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Thorsen, R. S., Pouliot, M. Tags: Original Articles Source Type: research
Behaviours and opinions towards outdoor smoking bans and cigarette littering in Baja California, Mexico
Conclusions: Outdoor smoking is still frequent in outdoor areas where people gather, and an important source of littering. We found substantial public support towards the outdoor smoking ban, which should translate into easier implementation and compliance in Baja California, Mexico. (Source: Health Policy and Planning)
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Basto-Abreu, A. C., Christine, P. J., Zepeda-Tello, R., Romero-Martinez, M., Aguilar Duque, J. I., Reynales-Shigematsu, L. M., Barrientos-Gutierrez, T. Tags: Original Articles Source Type: research
Improving referrals and integrating family planning and HIV services through organizational network strengthening
Discussion: This quasi experiment demonstrated that (1) an organizational network analysis can inform an intervention, (2) a modest network strengthening intervention can enhance client referrals in the network, (3) improvement in client referrals was accompanied by a decrease in atient-reported unmet needs and (4) a series of network analyses can be a useful evaluation tool. (Source: Health Policy and Planning)
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Thomas, J. C., Reynolds, H. W., Alterescu, X., Bevc, C., Tsegaye, A. Tags: Original Articles Source Type: research
Factors influencing modes of transport and travel time for obstetric care: a mixed methods study in Zambia and Uganda
Transportation is an important barrier to accessing obstetric care for many pregnant and postpartum women in low-resource settings, particularly in rural areas. However, little is known about how pregnant women travel to health facilities in these settings. We conducted 1633 exit surveys with women who had a recent facility delivery and 48 focus group discussions with women who had either a home or a facility birth in the past year in eight districts in Uganda and Zambia. Quantitative data were analysed using univariate statistics, and qualitative data were analysed using thematic content analysis techniques. On average, w...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Sacks, E., Vail, D., Austin-Evelyn, K., Greeson, D., Atuyambe, L. M., Macwangi, M., Kruk, M. E., Grepin, K. A. Tags: Original Articles Source Type: research
The enigmatic nodding syndrome outbreak in northern Uganda: an analysis of the disease burden and national response strategies
To date, the cause of nodding syndrome (NS) remains unknown; however, efforts continue to establish risk factors and optimal symptomatic treatments. We documented the burden and national response strategies including involvement of key stakeholders in the management of the NS epidemic in order to inform future interventions against epidemics of undetermined aetiology. Data were collected through semi-structured interviews with selected leaders in the affected districts and at the Ministry of Health, and through review of documents. We participated in and analysed the proceedings of the first international scientific confer...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Deogratius, M. A., David, K. L., Christopher, O. G. Tags: Original Articles Source Type: research
Do antenatal care visits always contribute to facility-based delivery in Tanzania? A study of repeated cross-sectional data
This study analysed repeated cross-sectional (RCS) data from Tanzania to explore the relationship between antenatal care (ANC) visits, facility-based delivery and the reasons for home births in women who had made ANC visits. We used data from RCS Demographic and Health Surveys spanning 20 years and a cluster sample of 30 830 women from ~52 districts of Tanzania. The relationship between the number of ANC visits (up to four) and facility delivery in the latest pregnancy was explored. Regional changes in facility delivery and related variables over time in urban and rural areas were analysed using linear mixed models. T...
Source: Health Policy and Planning - March 4, 2016 Category: Health Management Authors: Choe, S.-A., Kim, J., Kim, S., Park, Y., Kullaya, S. M., Kim, C.-y. Tags: Original Articles Source Type: research
Lessons learned in using realist evaluation to assess maternal and newborn health programming in rural Bangladesh
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 real life contexts can affect intervention effectiveness. This paper reflects on an experience in applying the tenets of realist evaluation to identify optimal implementation strategies for scale-up of Maternal and Newborn Health (MNH) programmes in rural Bangladesh. Supported by UNICEF, the ...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Adams, A., Sedalia, S., McNab, S., Sarker, M. Tags: Methodological Musings Source Type: research
Developing citizen report cards for primary care: evidence from qualitative research in rural Tajikistan
We report on results from focus groups and key informant interviews in rural areas of two Tajik provinces, Soghd and Khatlon, with regards to three important initial considerations for developing a report card initiative for primary health care in this setting: selecting indicators for the report card, collecting data, and working with existing institutions and stakeholders. The findings suggest that citizens are able to articulate and prioritize concerns with respect to local health care services. Participants indicated a preference for arms-length collection of sensitive feedback on local providers. Because citizens and ...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Bauhoff, S., Tkacheva, O., Rabinovich, L., Bogdan, O. Tags: Original Articles Source Type: research
A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana
Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the ...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Ahiabu, M.-A., Tersbol, B. P., Biritwum, R., Bygbjerg, I. C., Magnussen, P. Tags: Original Articles Source Type: research
