Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
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This working paper is a case study on South Sudan as an important refugee country of origin. The case study looks at issues of forced displacement in South Sudan and underscores the linkages between internally displaced persons and South Sudanese refugees. The case study highlights the importance of... understanding local contexts and root drivers of conflict and displacement. It reviews evaluations of programmes in South Sudan, including past efforts at state building and refugee resettlement to look at learning within the international community. The study was undertaken as part of a wider research project on learning from evaluations to improve responses to situations of forced displacement .
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We systematically reviewed Medline as well as the references of published review articles for relevant studies of adherence to multidrug treatment of both drug-susceptible and drug-resistant TB through February 3, 2018. We included randomized controlled trials (RCTs) as well as prospective and retro...spective cohort studies (CSs) with an internal or external control group that evaluated any adherence intervention and conducted a meta-analysis of their impact on TB treatment outcomes. Our search identified 7,729 articles, of which 129 met the inclusion criteria for quantitative analysis. Seven adherence categories were identified, including DOT offered by different providers and at various locations, reminders and tracers, incentives and enablers, patient education, digital technologies (short message services [SMSs] via mobile phones and video-observed therapy [VOT]), staff education, and combinations of these interventions.
https://doi.org/10.1371/journal.pmed.1002595
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In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a...nd grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
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The provision of safe and efficacious blood and blood components for transfusion or manufacturing use involves a number of processes, from the selection of blood donors and the collection, processing and testing of blood donations to the testing of patient samples, the issue of compatible blood and ...its administration to the patient. There is a risk of error in each process in this “transfusion chain” and a failure at any of these stages can have serious implications for the recipients of blood and blood products. Thus, while blood transfusion can be life-saving, there are associated risks, particularly the transmission of bloodborne infections.
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels.
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External quality assessment (EQA) is an important component of quality systems for blood transfusion services. Establishing external quality assessment programmes for screening of donated blood for transfusion-transmissible infections (TTI): implementation guide aims to support WHO member States in ...establishing and operating EQA programmes for screening donated blood for TTI. The guides has been designed for use by national health authorities and EQA organizing institutions in the development of EQA programme. It will also give participating laboratories an insight into the organization of EQA programmes for TTI screening and an understanding of the benefits of participation.
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The National Guidelines for HIV-1 Viral Load Laboratory Testing support plans to scale up viral load (VL) testing to reach the 90-90-90 targets in India. This phased scale-up includes the setup of 70 additional VL testing laboratories nationally. These guidelines include laboratory design considerat...ions, a summary of VL technologies, and specimen collection and handling as well as transportation and storage guidance. Quality control and quality assurance requirements are described as well as laboratory safety issues. The guidelines also describe the VL laboratory network to be developed with supply chain management issues and commodities described. Annexes include laboratory registers and reporting forms.
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In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care and treatment in Ghana. The purpose of this analysis was to identify the gaps within the current delivery of paediatric HIV care and support system and develop a road map for effecti...ve implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept).
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The overall goal of the programme, to reduce the malaria morbidity and mortality by 75% (using 2012 as baseline) by the year 2020, continued to be pursued in 2014. The following areas were identified as some of the priorities for the year: Malaria Case Management under which we have Malaria in Pregn...ancy (MIP), Home Based Care and Diagnostics.
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This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment,... design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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The toolkit is a collection of assessment tools and checklists that describe the key considerations to be taken into account when transitioning to Option B/B+. The toolkit provides a roadmap to support the planning and implementation of Option B/B+, and to help countries scale up more effective inte...rventions and programs to achieve the goals of the Global Plan Towards the Elimination of New HIV Infections among Children by 2015 and Keeping their Mothers Alive.
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The overall goal of the Kenya Health Sector Referral Strategy is to improve client access to referral. The objectives of the strategy are to realise improved capacity of health providers to identify clients who require referral, develop protocols that will lead to referral system efficiency and effe...ctiveness, and promote and facilitate information and communication technology (ICT) to manage referrals, improve care, enhance capacity of the referral system in Kenya, provide communication and related equipment, and promote research and innovation for referrals.
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USAID/KENYA Evaluation Services and Program Support (ESPS)
The United States Agency for International Development (USAID) has a solid track record of supporting health and development initiatives in Kenya. AIDS, Population, and Health Integrated Assistance (APHIA) is the agency’s flagship hea...lth initiative in the country. APHIA is currently in its third iteration, APHIAPlus, which began in January 2011 and is slated to end in December 2015. APHIAPlus was designed to contribute to Result 3 (“Increased use of quality health services, products, and information”) and Result 4 (“Social determinants of health”) of USAID/Kenya’s implementation framework. The main technical areas of focus are HIV/AIDS; malaria; family planning (FP); tuberculosis (TB); maternal, newborn, and child health (MNCH); and water, sanitation, and hygiene (WASH).
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This external performance evaluation of the Malawi Girls’ Empowerment through Education and Health Activity (ASPIRE), conducted 2.5 years after ASPIRE began, establishes the activity’s progress against its objectives, proposes adaptations for the final year, and captures lessons for application ...in future girls’ empowerment, health, and education programming in Malawi.
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WASH Ex-Post Evaluation Series - Water Communications and Knowledge Management (CKM) Project
This evaluation examines the sustainability of selected components of the USAID/Indonesia Environmental Services Program (ESP), which was implemented from 2004–2010. Among other objectives, this activ...ity sought to improve health and livelihoods of Indonesians through enhanced and expanded access to key environmental services.
Following up on the program seven years after it ended, this evaluation addresses the sustainability of ESP’s capacity-building efforts with Indonesian municipal water utilities, known as Perusahaan Daerah Air Minum (PDAM), and financial mechanisms to improve utility management and expanded water access in urban areas.
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