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Showing results 66422 to 66441 of 201821 < previous   next >
Health systems performance assessment : debates, methods and empiricism / edited by Christopher J. L. Murray, David B. Evans
Murray, Christopher J. L; Evans, David B; World Health Organization. Global Programme on Evidence for Health Policy ( 2003 )
Health systems performance assessment: report by the Secretariat
Executive Board, 107 ( 2001 )
Health systems priorities in the Eastern Mediterranean region: challenges and strategic directions
World Health Organization, Regional Office for the Eastern Mediterranean ( 2004 )
Health systems readiness and management of febrile outpatients under low malaria transmission in Vanuatu
Donald, Wesley; Malinga, Josephine; Zurovac, Dejan; Taleo, George; Guintran, Jean-Olivier; Naket, Esau ( 2015-12-02 )

Vanuatu, an archipelago country in Western Pacific harbouring low Plasmodium falciparum and Plasmodium vivax malaria transmission, has been implementing a malaria case management policy, recommending parasitological testing of patients with fever and anti-malarial treatment for test-positive only patients. A health facility survey to evaluate the health systems readiness to implement the policy and the quality of outpatient management for patients with fever was undertaken.A cross-sectional, cluster sample survey, using a range of quality-of-care methods, included all health centres and hospitals in Vanuatu. The main outcome measures were coverage of health facilities and health workers with commodities and support interventions, adherence to test and treatment recommendations, and factors influencing malaria testing.The survey was undertaken in 2014 during the low malaria season and included 41 health facilities, 67 health workers and 226 outpatient consultations for patients with fever. All facilities had capacity for parasitological diagnosis, 95.1 % stocked artemether-lumefantrine and 63.6 % primaquine. The coverage of health workers with support interventions ranged from 50 to 70 %. Health workers' knowledge was high only regarding treatment policy for uncomplicated P. falciparum malaria (83.4 %). History taking and clinical examination practices were sub-optimal. Some 35.0 % (95 % CI 23.4-48.6) of patients with fever were tested for malaria, of which all results were negative and only one patient received anti-malarial treatment. Testing was significantly higher for patients age 5 years and older (OR = 2.33; 95 % CI 1.48-5.02), seen by less qualified health workers (OR = 2.73; 95 % CI 1.48-5.02), health workers who received malaria case management training (OR = 2.39; 95 % CI 1.28-4.47) and patients with increased temperature (OR = 2.56; 95 % CI 1.17-5.57), main complaint of fever (OR = 5.82; 95 % CI 1.26-26.87) and without runny nose (OR = 3.75; 95 % CI 1.36-10.34). Antibiotic use was very high (77.4 %) with sub-optimal dispensing and counselling practices.Health facility and health worker readiness to implement policy is higher for falciparum than vivax malaria. Clinical and malaria testing practices are sub-optimal, however adherence to test negative results is nearly universal. Use of antibiotics is irrational. Quantitative and qualitative improvements of ongoing interventions are needed to re-inforce clinical practices in this area characterized by difficult access, human resource shortages but aspiring towards malaria elimination.

Health systems research - a key to progress / Stephen G. Karel & Jane A. Thomason
Karel, Stephen G; Thomason, Jane Abigail ( 1992 )
Health systems research : approaches and pitfalls / Abdel R. Omran
Omran, Abdel-Rahmin ( 1990 )
Health systems research : does it make a difference?
Joint WHO/DGIS/RTI Project on Health Systems Research for the South African Region; World Health Organization. Health Systems Research and Development Unit ( 1992 )
Health systems research : does it make a difference? / the Joint Project on Health Systems Research for Eastern and Southern Africa
Joint Programme on Health Systems Research for Eastern and Southern Africa (Zimbabwe); World Health Organization. Programme on Health Systems Research and Development; Netherlands. Ministry for Development Cooperation; Koninklijk Instituut voor de Tropen ( 1997 )
Health Systems Research Advisory Group, first meeting, Geneva, 7-10 April 1986 : report and working document
Health Systems Research Advisory Group. Meeting (1st: 1986 : Geneva); World Health Organization. Health Systems Research and Development Unit ( 1986 )
Health Systems Research Advisory Group, second meeting, Gabarone, Botswana, 19-25 June 1988 : report
Health Systems Research Advisory Group. Meeting (2nd: 1988 : Gaborone, Botswana); World Health Organization. Health Systems Research and Development Unit ( 1988 )
Health systems research and intersectoral collaboration in veterinary public health : report of a WHO consultation held in Geneva from 4 to 8 December 1989
World Health Organization. Veterinary Public Health Unit ( 1990 )
Health systems research as part of the managerial process in support of the strategy for health for all
World Health Organization ( 1987 )
Health systems research as part of the managerial process in support of the strategy for health for all: progress report
World Health Organization ( 1989 )
Health systems research as part of the managerial process in support of the strategy for HFA-progress report
World Health Organization ( 1989 )
Health systems research for eliminating leprosy as a public health problem : a workshop manual
World Health Organization. Action Programme for the Elimination of Leprosy ( 1997 )
Health systems research for policy change: lessons from the implementation of rapid assessment protocols for diabetes in low- and middle-income settings
Bigdeli, Maryam; Cardenas, Maria Kathia; Miranda, J Jaime; Beran, David ( 2015-10-01 )

As many challenges exist for access to diabetes care in developing countries, the International Insulin Foundation developed a Rapid Assessment tool and implemented this approach to identify barriers to care and propose concrete recommendations for decision makers. The objective of this paper is to identify the factors that contributed to informing and influencing policymakers with regards to this work.A documentary review comprised Stage 1. Stage 2 used an online questionnaire to gain insight from users of the Rapid Assessment results. Based on Stages 1 and 2, Stage 3 comprised in-depth interviews with a total of nine individuals (one individual each from the six participating countries; two individuals from the World Health Organization; one "Global Diabetes Advocate"). Interviews were analyzed based on a list of themes developed from Stage 2.Stage 1 led to the identification of various types of documents referring to the results. The online questionnaire had a response rate of 33%. Respondents directly involved in the assessment had a "Good" or "Very Good" appreciation of most aspects and scored these higher than those not directly involved. From the interviews, formalized methods and close collaboration between the international team and local partners were strengths. Trust and a relationship with local partners were also seen as assets. All stakeholders valued the results and the credibility of the data generated. Local partners felt that more could have been done for dissemination.This study shows the importance of specific results from the different assessments. In addressing complex issues having external experts involved was seen as an advantage. The uptake of results was due to the credibility of the research which was influenced by a mix of the people involved, past assessments, trusted local partners, and the use of the results by knowledge brokers, such as the World Health Organization. Through these brokers, others gained ownership of the data. The methods used and the fact that this data was grounded in a local context also reinforced its value. Despite limitations, this study offers a unique perspective where a similar research approach was taken in six countries.

Health systems research in action : case studies from Botswana, Colombia, Egypt, Indonesia, Malaysia, the Netherlands, Norway and the United States of America
World Health Organization. Programme on Health Systems Research and Development ( 1988 )
Health systems research in maternal and child health including family planning : issues and priorities, report
World Health Organization. Task Force on Health Systems Research in Maternal and Child Health including Family Planning. Steering Committee . Meeting (1984: New Delhi); World Health Organization. Maternal and Child Health Unit ( 1985 )
Health systems research in the time of health system reform in India: a review
Arora, Radhika; Ghaffar, Abdul; Rao, Krishna D ( 2014-08-09 )

BACKGROUND: Research on health systems is an important contributor to improving health system performance. Importantly, research on program and policy implementation can also create a culture of public accountability. In the last decade, significant health system reforms have been implemented in India. These include strengthening the public sector health system through the National Rural Health Mission (NRHM), and expansion of government-sponsored insurance schemes for the poor. This paper provides a situation analysis of health systems research during the reform period. METHODS: We reviewed 9,477 publications between 2005 and 2013 in two online databases, PubMed and IndMED. Articles were classified according to the WHO classification of health systems building blocks. RESULTS: Our findings indicate the number of publications on health systems progressively increased every year from 92 in 2006 to 314 in 2012. The majority of papers were on service delivery (40%), with fewer on information (16%), medical technology and vaccines (15%), human resources (11%), governance (5%), and financing (8%). Around 70% of articles were lead by an author based in India, the majority by authors located in only four states. Several states, particularly in eastern and northeastern India, did not have a single paper published by a lead author located in a local institution. Moreover, many of these states were not the subject of a single published paper. Further, a few select institutions produced the bulk of research. Of the foreign author lead papers, 77% came from five countries (USA, UK, Canada, Australia, and Switzerland). CONCLUSIONS: The growth of published research during the reform period in India is a positive development. However, bulk of this research is produced in a few states and by a few select institutions Further strengthening health systems research requires attention to neglected health systems domains like human resources, financing, and governance. Importantly, research capacity needs to be strengthened in states and institutions that have a scarcity of researchers, as well as states that have been the focus of little research. While more funding for health systems research is required, this funding needs to be targeted at deficient health systems domains, geographical areas, and institutions.

Health systems research training course : adaptation for district level of the health services research course developed by the WHO Regional Office for Africa and the Project for Strengthening Health Delivery Systems in Central and West Africa (WHO/AFRO-SHDS
World Health Organization. Health Systems Research and Development Unit; Joint World Health Organization/Royal Tropical Institute/Dutch Technical Cooperation Project on Health Systems Research for the Southern African Region ( 1988 )
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