A systematic review of strategies to increase access to health services among children in low and middle income countries

Universal Health Coverage is widely endorsed as the pivotal goal in global health, however substantial barriers to accessing health services for children in low and middle-income countries exist. Failure to access healthcare is an important contributor to child mortality in these settings. Demand side interventions included: educational programmes, text messages, and financial or other incentives. Interventions that delivered services at or closer to home and text messages were in general associated with a significant improvement in relevant outcomes.

There are some intervention areas that seem to show encouraging trends including text message reminders and delivery of services at or close ...

The role of organizational structure in readiness for change: A conceptual integration

The purpose of this review is to extend extant conceptualizations of readiness for change as an individual-level phenomenon. This review-of-reviews focuses on existing conceptual frameworks from the dissemination, implementation, quality improvement, and organizational trasformation literatures in order to integrate theoretical rationales for how organization structure, a key dimension of the organizational context, may impact readiness for change. They propose that the organization structure dimensions of differentiation and integration impact readiness for change at the indicidual level of analysis by influencing four key concepts of relevance, legitimacy, preceived need for change, and resource allocation. 

Understanding and Evaluating the Implementation on Integrated Care: A "Three Pipe Problem"

Altought we have come a long way in being able to articulate the key building blocks of integrated care, the interplay between them is so complex and interwined that it seems an impossible challenge to create any simple implementation model. Yet, if integrated care is to advance, we must become better at smoothing over the many obstacles and challenges to implementation that have bedevilled the uptake and roll-out of even the most proven of integrated care interventions.

This is quite the "three-pipe problem" for integrated care since science has yet to make the real breakthrough to address how we might ...

Integrated Diabetes Care: A Multidisciplinary Approach

Integrated care is an approach that seeks to improve the quality of care for people with diabetes by ensuring that services are well coordinated around their needs. Healthcare professionals, people with diabetes and the system must be aligned to support improvement both in the delivery of care and in achieving better outcomes for people with diabetes.

People-centred integration in a refugee primary care service: A complex adaptive systems perspective

Services for refugees and asylum seekers frequently experience gaps in delivery and access, poor coordination, and service stress. The purpose of this paper is to examine the approach to integrated care within Companion House (CH), a refugee primary care service, whose service mix includes counselling, medical care, community development, and advocacy. CH has created fluid links between teams, and encouraged open dialogue with client populations. There is a high level of networking between staff, much of it informal. This is underpinned by horizontal management and staff commitment to a shared mission and an ethos of mutual respect. The clinical teams ...

Intruments measuring integrated care: A systematic review of measurement properties

Integrated care is an important strategy for increasing health system preformance. Despite its growing significance, detailed evidence on the measurement properties of integrated care instruments remains vague an limited. This systematic review found 209 index instruments measuring different constructs related to integrated care which suggest that the quality of measurement properties of instruments measuring integrate care is in need of improvement with the less-studied constructs and domains to become part of newly developed instruments. 

From vision to action. Making patient-centred care a reality

The NHS have worked with The King´s Fund to translate their themes into outcomes for patients and set out the most important priorities for action to achieve these outcomes. Under each of their five themes: 

- Co-ordinated care

- Patients engaged decisions about their care

- Supported self-management

- Prevention, early diagnosis and intervention

- Emotional, psychological and practical support

they have described the outcomes that they most want to achieve for patients. In order to achieve these outcomes, they hace then selected the service improvements that, if met, will have a major impact on the quality and cost-effectiveness of care. 

Understanding the role of community hospitals: an analysis of experiences in five countries

A policy focus on moving heathcare closer to people´s homes has led to renewed interest in community hospitals and their potential role in delivering more integrated care at local level, but models and approaches differ across countries. 

This study explores the policy drivers behind the implementation or advancement of these models; their function and role within the wider system of service provision; and the degree to which community hospitals contribute to enhanced integration of service delivery and benefit the population. 

How a Gender-sensitive Quality Improvement Approach Supports Integrated People-centered Health Services

Clients, family and friends, communities, and health providers are all influenced by the culture they live in and by that culture’s perspectives on gender. To ignore gender is to ignore a vital part of the people and their local context that the WHO framework aims to center. Gender must be considered in order to have truly people-centered health services. A gender-sensitive approach takes the different needs, constraints, and opportunities of women, men, girls, and boys into account and responds to them strategically in program design, implementation, and evaluation. By considering and responding to these differences, health services are more ...

Developing a Patient-Centered Benefit-Risk Survey: A Community-Engaged Process

The Objectives

The objective of this article is to provide a community-engaged process to inform the design of a stated-preferences experiment. The process involved integrating patients and caregivers of people with Duchenne/Becker muscular dystrophy, advocates, clinicians, and the sponsor in conceptualizing and developing a benefit-risk survey on the basis of phase III trial results.

Methods

Our community-engagement process for the development of a stated-preference survey included a set of five guiding principles with a foundation in the principles of community-engaged research. Engagement efforts were carried out through an informal network of three committees. Members of the leadership, stakeholder, and ...