Developing and deploying a community healthcare worker-driven, digitally- enabled integrated care system for municipalities in rural Nepal

Integrating care at the home and facility level is a critical yet neglected function of healthcare delivery systems. There are few examples in practice or in the academic literature of affordable, digitally-enabled integrated care approaches embedded within healthcare delivery systems in low- and middle-income countries. Simultaneous advances in affordable digital technologies and community healthcare workers offer an opportunity to address this challenge. This article describe the development of an integrated care system involving community healthcare worker networks that utilize a home-to-facility electronic health record platform for rural municipalities in Nepal.

Aspects of Multicomponent Integrated Care Promote Sustained Improvement in Surrogate Clinical Outcomes: A Systematic Review and Meta-analysis

The implementation of the Chronic Care Model (CCM) improves health care quality. This study examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes. Despite the small effect size of multicomponent integrated care team-based care with better information flow may improve patient-provider communication and self-management in patients who are young, with suboptimal control, and in low-resource settings. 

International healthcare worker migration in Asia Pacific: International policy responses

The growth of the international migration of health workers in recent decades has taken place in the context of the transnationalisation of healthcare provision as well as of governance and policy responses. This paper examines international policy responses to cross-border health worker migration in the Asia Pacific region. These include multilateral (global and regional) and bilateral policy agreements, policy dialogue, "circular" and key themes of health workforce planning and management.

‘We have the internet in our hands’: Bangladeshi college students’ use of ICTs for health information

Innovations in Information and Communications Technologies (ICTs), and especially mobile health, have been predicted to transform provider-patient relationships through the dissemination of health information, and by encouraging patient autonomy , self-management, and self-care. People´s capacity to access health information is informed by power inequalities in health systems. 

The effect of community health worker–led education on women’s health and treatment– seeking: A cluster randomised trial and nested process evaluation in Gujarat, India

A community-based health insurance scheme operated by the Self-Employed Women´s Association in Gujarat, India reported that the leading reasons for inpatient hospitalisation claims by its members were diarrhoea, fever and hysterectomy- the latter at the average age of 37. This claims pattern raised concern regarding potentially unnecessary hospitalisation amongst low-income women. 

Approaches towards improving the quality of maternal and newborn health services in South Asia: challenges and opportunities for healthcare systems

South Asia is experiencing a dismal state of maternal and newborn health (MNH) as the region has been falling behind in reducing the levels of maternal and neonatal mortality. Most of the efforts are focused on enhancing coverage of MNH services; however, quality remains a serious concern if the region is to achieve expected outcomes in terms of standardised MNH services within healthcare delivery systems. This research consists of a review of south Asian quality improvement approaches/interventions, specifically implemented for MNH improvement. 

Financing Long-Term Services and Supports: Ideas From Singapore

Financing long-term services and supports (LTSS) for the elderly is a pressing issue in the Unites States with reforms of long-term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore. 

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

Mental illnesess are the largest contributors to the global burden of non-communicable diseases. However, there is extremly limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation

Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study

Enhancing governance and health system accountability for people centered healthcare: an exploratory study of community scorecards in Afghanistan

BACKGROUND:

The premise of patient-centered care is to empower patients to become active participants in their own care and receive health services focused on their individual needs and preferences. Afghanistan has evidenced enormous gains in coverage and utilization, but the quality of care remains suboptimal, as evidenced in the balanced scorecard (BSC) performance assessments. In the United States and throughout Africa and Asia, community scorecards (CSC) have proved effective in improving accountability and responsiveness of services. This study represents the first attempt to assess CSC feasibility in a fragile context (Afghanistan) through joint engagement of service providers and community members ...