Costs of implementing integrated community case management (iCCM) in six African countries: implications for sustainability

Sub-Saharan Africa still reports the highest rates of under-five mortality. Low cost, high impact interventions exist, however poor access remains a challenge. Integrated community case management (iCCM) was introduce to improve access to essential services for children 2-59 months through diagnosis, treatment and referral services by community health workers for malaria, pneumonia and diarrhea. 

This paper presents the results of an economic analysis of iCCM implementation in regions supported by UNICEF in six countries and assesses country-level sclae-up implications. The paper focuses on costs to provider (healht system andd donors) to inform planning and budgeting, and does not cover cost-effectiveness. 

Lessons from Brazil: on the difficulties of building a universal health care system

A number of developing countries that are often referred to as emerging economies have turned their attention to addressing their public health issues in more comprehensive and systematic ways. While the trajectory of this particular initiative and similar ones elsewhere is yet to be determined, the aim of this piece is to draw some lessons from an emerging economy that, for contingent historical and political reasons, started building a universal public health care system earlier: Brazil. The key argument offered from the Brazilian experience is that building a robust public health care system based on the principles of universality and ...

A new paradigm on health care accountability to improve the quality of the system: four parameters to achieve individual and collective accountability

Healthcare systems the world over are facing significant financial pressures and growing demands for services. Many nations have therefore set common goal of improving the population´s health, the quality of the outcomes, and the containment of costs. So, these changes in the health care systems´priorities have set the ground for an interdisciplinary approach necessary to assess the activities of health care professionals and, in general, of health care systems. 

Centers of excellence in healthcare institutions: what they are and how to assemble them

Centers of excellence-specialized programs within healthcare institutions which supply exceptionally high concentrations of expertise and related resources centered on particular medical areas and delivered in a comprehensive, interdisciplinary fashion-afford many advantages for healthcare providers and the populations they serve. To achieve full value from centers of excellence, proper assembly is an absolute necessity, but guidance is somewhat limited. This effectively forces healthcare providers to pursue establishment largely via trial-and-error, diminishing opportunities for success. 

Behavioural health consultants in integrated primary care teams: a model for future care

Significant challenges exist within primary care services in the United Kingdom (UK). These include meeting current demand, financial pressures, an aging population and an increase in multi-morbidity. Phychological services also struggle to meet waiting time targets and to ensure increased access to phychological therapies. Innovative ways of delivering effective primary care and phychological services are needed to improve health outcomes.

Patient perceptions of innovative longitudinal integrated clerkships based in regional, rural and remote primary care: a qualitative study

Medical students at the University of Wollomgong experience continuity of patien care and clinical supervision during an innovative year-long integrated (community and hospital) clinical clerkship. In this model of clinical education, students are base in a general practice "teaching microsystem" and participate in patient care as part of this community of practice (CoP). This study evaluates patient´s preceptions of the clerkship initiative, and their perspectives in this approach to training´much needed´doctors in their community. 

Health assessments for health governance—concepts and methodologies

For better supporting science-governance interface, the potential of health assessments appear underrated. The aims of this article is to identify what various types of health assessment have in common; how they differ, which assessments to apply for which purpose; and what needs and options there are for future joint development. 

Interventions and approaches to integrating HIV and mental health services: a systematic review

• Available literature on interventions integrating HIV and mental health services reveal that there is much diversity in the approaches adopted in combining treatment modalities; ranging from integration within a single facility, to multi-facility integration, and integrated care coordinated by non-physician case managers.

• Existing evidence, although limited, suggest that integrating HIV and mental health services may be linked to improved patient and service delivery outcomes in diverse settings.

• There is a need for higher quality and robustly designed studies to evaluate and compare integration models at different levels of service delivery in terms ...

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization

The Impact of Primary Care Practice Transformation on Cost, Quality, and Utilization reviews PCMH results from 45 peer-reviewed reports and additional government and state evaluations. Implementation of the PCMH and high performing primary care differs depending upon the needs and preferences of those delivering, receiving, and paying for related care. 

The sixth annual PCPCC report, authored by the Robert Graham Center of the American Academy of Family Physicians and published with support from the Milbank Memorial Fund, employed broader search terms and more rigorous search criteria that evaluated studies, reports, and evaluations published between November 1, 2015 to February 28 ...

A Digital NHS? An introduction to the digital agenda and plans for implementation