July 4, 2017 Africa

Integration of community home based care programmes within national primary health care revitalisation strategies in Ethiopia, Malawi, South-Africa and Zambia: a comparative assessment

In 2008, the WHO facilitated the primary health care (PHC) revitalisation agenda. The purpose was to strengthen African health systems in order to address communicable and non-communicable diseases. The aim of this study was to assess the position of civil society-led community unity home based care programmes (CHBC), which serve the needs of patients with HIV, within this agenda. It examined how their roles and place in health systems evolved, and the prospects for these programmes in national policies and strategies to revitalise PHC, as new health care demands arise. 

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Dec. 2, 2016 Africa

Patient-Centered Care and People-Centered Health Systems in Sub-Saharan Africa: Why So Little of Something So Badly Needed?

Patient–centered care (PCC) is increasingly recognized as a key dimension of quality healthcare, but unfortunately remains poorly implemented in practice. This paper explores the current state of PCC in sub-Saharan Africa and potential barriers to its implementation, with a focus on public first line health services. They develop an analytical framework based on expert knowledge, field experience, and a conceptual literature review. Factors contributing to the (lack of) implementation of PCC are structured in three distinct but interacting layers. The first layer encompasses factors that influence and shape the performance of providers.  The training of health workers is key ...

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Oct. 14, 2016 Africa

A Holistic, Person-Centred Care Model for Victims of Sexual Violence in Democratic Republic of Congo: The Panzi Hospital One-Stop Centre Model of Care

Summary Points

• One-Stop Centre (OSC) is an innovative, holistic, person-centred care model developed in recent years for survivors of violence against women and girls.
• OSC at Panzi Hospital in eastern Democratic Republic of Congo has been developed after years of treating girls and women who have been raped in combination with extreme bodily harm.
• OSC comprises four pillars, covering medical, psychosocial, legal, and socioeconomic care needs, which are fulfilled in partnership. Based on genuine listening to a harmed girl’s or woman’s personal narrative, personalised care is planned, implemented, and documented with the aim of achieving health and reintegration ...

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Sept. 12, 2016 Africa

Health policy and integrated mental health care in the SADC region: strategic clarification using the Rainbow Model

Mental illness is a well-known challenge to global development, particularly in low-to-middle income countries. A key health systems response to mental illness is different models of integrated health care, especially popular in the South African Development Community (SADC) region. This complex construct is often not well-defined in health policy, hampering implementation efforts. A key development in this vein has been the Rainbow Model of integrated care, a comprehensive framework and taxonomy of integrated care based on the integrative functions of primary care. The purpose of this study was to explore the nature and strategic forms of integrated mental health care ...

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May 24, 2016 Africa

Health service planning contributes to policy dialogue around strengthening district health systems: an example from DR Congo 2008–2013

Good governance for health (part of Strategy 3 of the Framework on Integrated People-Centred Health Services) involves broad, continuous and consultative policy dialogue on crucial health sector issues amongst and between all relevant social, technical and political stakeholders. Ideally, policy dialogue should also be based on the best available evidence. This paper demonstrates how building and maintaining data and evidence on relevant health sector issues, in this case the essential health services package in DRC, can contribute to rational policy dialogue over a sustained period of time. 

Background

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April 27, 2016 Africa

People-centred health systems, a bottom-up approach: where theory meets empery

BACKGROUND AND METHODS:

Health systems are complex and constantly adapt to changing demands. These complex-adaptive characteristics are rarely considered in the current bureaucratic top-down approaches to health system reforms aimed to constrain demand and expenditure growth. The economic focus fails to address the needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program ...

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April 26, 2016 Africa

Effects of community health interventions on under-5 mortality in rural Guinea-Bissau (EPICS): a cluster-randomised controlled trial

Background

Evidence suggests that community-based interventions that promote improved home-based practices and care-seeking behaviour can have a large impact on maternal and child mortality in regions where rates are high. We aimed to assess whether an intervention package based on the WHO Integrated Management of Childhood Illness handbook and community mobilisation could reduce under-5 mortality in rural Guinea-Bissau, where the health service infrastructure is weak.

Methods

We did a non-masked cluster-randomised controlled trial (EPICS) in the districts of Tombali and Quinara in Guinea-Bissau. Clusters of rural villages were stratifi ed by ethnicity and distance from a regional health centre, and ...

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March 18, 2016 Africa Europe Western Pacific Global

Barriers and enablers to integrating maternal and child health services to antenatal care in low and middle income countries

For most women in low and middle income countries (LMIC), antenatal care (ANC) plays a highly important dual role: not only does ANC provide effective interventions to reduce the risks associated with pregnancy and childbirth, it can also serve as a delivery platform for other health services. Particularly in settings where the prevalence of HIV/AIDS, sexually transmitted infections (STIs), tuberculosis (TB) and malaria is high, integrating services for these conditions with ANC can significantly expand their reach. In fact, the World Health Organization (WHO) identified integration of ANC with other health programmes as a key strategy for reducing missed ...

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Feb. 11, 2016 Africa

Strategies and incentives for enhancing the application of health impact assessment (HIA) in Nigeria: a view from those who should know

In consonance with the paradigm shift from curative to more preventive healthcare, there has been an increasing application of health impact assessment (HIA) in many developed countries. However, progress towards the integration of HIA into public policy in many developing countries has been comparatively very slow. This article is a primary research to evaluate the barriers and motivational factors; and to proffer effective strategies and incentives for enhancing the application of HIA in health and development policies in Nigeria. Semi-structured questionnaires were designed and primarily disseminated online to a random sample of health and non-health professionals, public service workers, policy-makers ...

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Feb. 10, 2016 Africa

Social solidarity and the right to health: essential elements for people-centred health systems

The right to health has been advanced as one of the key elements to creating pro-poor people-centred health systems (Hunt and Backman 2008; Gruskin et al. 2012). However, one of the challenges for realizing the right to health is the seeming conflict between public health utility and the entitlements afforded by a human rights approach to health. This dichotomy begs two sub-questions, both of which have relevance for building responsive health systems.

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