Tackling the hard problems: implementation experience and lessons learned in newborn health from the African Health Initiative
Autor: | Bradley H. Wagenaar, Elizabeth F. Jackson, Almamy Malick Kanté, Roma Chilengi, Hema Magge |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
medicine.medical_specialty
Psychological intervention Zambia Population health Tanzania Health informatics Ghana Health administration 03 medical and health sciences 0302 clinical medicine Nursing Health facility medicine Humans Infant Health 030212 general & internal medicine Newborn health Mozambique Newborn infants--Health and hygiene Neonatal mortality Public health biology business.industry Maternal child health Research 030503 health policy & services Health Policy Nursing research Infants--Mortality--Prevention lcsh:Public aspects of medicine Rwanda Infant Newborn Quality of care lcsh:RA1-1270 biology.organism_classification Child health services Health system strengthening Health Services Research 0305 other medical science business |
Zdroj: | BMC Health Services Research, Vol 17, Iss S3, Pp 39-52 (2017) BMC Health Services Research |
ISSN: | 1472-6963 |
Popis: | Background The Doris Duke Charitable Foundation’s African Health Initiative supported the implementation of Population Health Implementation and Training (PHIT) Partnership health system strengthening interventions in designated areas of five countries: Ghana, Mozambique, Rwanda, Tanzania, and Zambia. All PHIT programs included health system strengthening interventions with child health outcomes from the outset, but all increasingly recognized the need to increase focus to improve health and outcomes in the first month of life. This paper uses a case study approach to describe interventions implemented in newborn health, compare approaches, and identify lessons learned across the programs’ collective implementation experience. Methods Case studies were built using quantitative and qualitative methods, applying the World Health Organization Health Systems Strengthening Framework, and maternal, newborn and child health continuum of care framework. We identified the following five primary themes in health systems strengthening intervention strategies used to target improvement in newborn health, which were incorporated by all PHIT projects with varying results: health service delivery at the community level (Tanzania), combining community and health facility level interventions (Zambia), participatory information feedback and clinical training (Ghana), performance review and enhancement (Mozambique), and integrated clinical and system-level improvement (Rwanda), and used individual case studies to illustrate each of these themes. Results Tanzania and Zambia included significant community-based components, including mobilization and sensitization for increased uptake of essential services, while Ghana, Mozambique, and Rwanda focused more efforts on improving the quality of services delivered once a patient enters a health facility. All countries included aspects that improved communication across levels of the health system, whether through district-wide data sharing and peer learning networks in Mozambique and Rwanda, or improved referral processes and systems in Tanzania, Zambia, and Ghana. Conclusion Key lessons learned include the importance of focusing intervention components on addressing drivers of neonatal mortality across the maternal and newborn care continuum at all levels of the health system, matching efforts to improve service utilization with provision of high quality facility-based services, and the critical role of leadership to catalyze improvements in newborn health. |
Databáze: | OpenAIRE |
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