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This open access book is a collection of 12 case studies capturing decades of experience improving health care and outcomes in low- and middle-income countries. Each case study is written by healthcare managers and providers who have implemented health improvement projects using quality improvement methodology, with analysis from global health experts on the practical application of improvement methods. The book shows how frontline providers in health and social services can identify gaps in care, propose changes to address those gaps, and test the effectiveness of their changes in order to improve health processes and outcomes. The chapters feature cases that provide real-life examples of the challenges, solutions, and benefits of improving healthcare quality and clearly demonstrate for readers what quality improvement looks like in practice:Addressing Behavior Change in Maternal, Neonatal, and Child Health with Quality Improvement and Collaborative Learning Methods in GuatemalaHaiti’s National HIV Quality Management Program and the Implementation of an Electronic Medical Record to Drive Improvement in Patient CareScaling Up a Quality Improvement Initiative: Lessons from Chamba District, IndiaPromoting Rational Use of Antibiotics in the Kyrgyz RepublicStrengthening Services for Most Vulnerable Children through Quality Improvement Approaches in a Community Setting: The Case of Bagamoyo District, TanzaniaImproving HIV Counselling and Testing in Tuberculosis Service Delivery in Ukraine: Profile of a Pilot Quality Improvement Team and Its Scale‐Up JourneyImproving Health Care in Low- and Middle-Income Countries: A Case Book will find an engaged audience among healthcare providers and administrators implementing and managing improvement projects at Ministries of Health in low- to middle-income countries. The book also aims to be a useful reference for government donor agencies, their implementing partners, and other high-level decision makers, and can be used as a course text in schools of public health, public policy, medicine, and development. ACKNOWLEDGMENT:This work was conducted under the USAID Applying Science to Strengthen and Improve Systems (ASSIST) Project, USAID Award No. AID-OAA-A-12-00101, which is made possible by the generous support of the American people through the U.S. Agency for International Development (USAID). DISCLAIMER:The contents of this book are the sole responsibility of the Editor(s) and do not necessarily reflect the views of USAID or the United States Government. div=""^
Outlines the key aspects & issues concerning health systems of low- & middle-income countries, recognising the current global context within which these systems operate & the dynamics of this context. It brings together a set of renowned authors to tackle the issues that face population health & health care in the twenty-first century
In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.
Over the past twenty years, many low- and middle-income countries have experimented with health insurance options. While their plans have varied widely in scale and ambition, their goals are the same: to make health services more affordable through the use of public subsidies while also moving care providers partially or fully into competitive markets. Colombia embarked in 1993 on a fifteen-year effort to cover its entire population with insurance, in combination with greater freedom to choose among providers. A decade later Mexico followed suit with a program tailored to its federal system. Several African nations have introduced new programs in the past decade, and many are testing options for reform. For the past twenty years, Eastern Europe has been shifting from government-run care to insurance-based competitive systems, and both China and India have experimental programs to expand coverage. These nations are betting that insurance-based health care financing can increase the accessibility of services, increase providers' productivity, and change the population's health care use patterns, mirroring the development of health systems in most OECD countries. Until now, however, we have known little about the actual effects of these dramatic policy changes. Understanding the impact of health insurance–based care is key to the public policy debate of whether to extend insurance to low-income populations—and if so, how to do it—or to serve them through other means. Using recent household data, this book presents evidence of the impact of insurance programs in China, Colombia, Costa Rica, Ghana, Indonesia, Namibia, and Peru. The contributors also discuss potential design improvements that could increase impact. They provide innovative insights on improving the evaluation of health insurance reforms and on building a robust knowledge base to guide policy as other countries tackle the health insurance challenge.
Sixth edition of the hugely successful, internationally recognised textbook on global public health and epidemiology, with 3 volumes comprehensively covering the scope, methods, and practice of the discipline
Quality of care is a priority for U.S. Agency for International Development (USAID). The agency's missions abroad and their host country partners work in quality improvement, but a lack of evidence about the best ways to facilitate such improvements has constrained their informed selection of interventions. Six different methods - accreditation, COPE, improvement collaborative, standards-based management and recognitions (SBM-R), supervision, and clinical in-service training - currently make up the majority of this investment for USAID missions. As their already substantial investment in quality grows, there is demand for more scientific evidence on how to reliably improve quality of care in poor countries. USAID missions, and many other organizations spending on quality improvement, would welcome more information about how different strategies work to improve quality, when and where certain tools are most effective, and the best ways to measure success and shortcomings. To gain a better understanding of the evidence supporting different quality improvement tools and clarity on how they would help advance the global quality improvement agenda, the Institute of Medicine convened a 2-day workshop in January 2015. The workshop's goal was to illuminate these different methods, discussing their pros and cons. This workshop summary is a description of the presentations and discussions.
Over half the world's rural population, and many in urban slums, have minimal access to health services. This book describes how to set up new, and develop existing, community-based health care for, by and with, the community.
In this book, an international team of authors have sought to understand how five countries have made progress towards the ultimate goal of Good health at low cost in recent decades (and what happened to others that were viewed as successes 25 years ago). They take a holistic approach, demonstrating the strengths of collaboration across disciplines and continents. In doing so, they provide important lessons for other countries seeking to emulate success.
This book contains a collection of works showcasing the latest research into global health economics conducted by leading experts in the field from the Centre for Health Economics (CHE) at the University of York and other partner research institutions. Each chapter focuses upon an important topic in global health economics and a number of separate research projects. The discussion delves into health care policy evaluation; economic evaluation; econometric and other analytic methods; health equity and universal health coverage; consideration of cost-effectiveness thresholds and opportunity costs in the health sector; health system challenges and possible solutions; and others. Case study examples from a variety of low- and middle-income countries (LMIC) settings are also showcased in the final part of this volume.The research presented seeks to contribute toward increasing understanding on how health policy can be enhanced to improve the welfare of LMIC populations. It is strongly recommended for public health policymakers and analysts in low- and middle-income country settings and those affiliated to international health organizations and donor organizations.
The global health community is broadly in agreement that achievement of the health-related Sustainable Development Goals (SDGs) hinges upon both an escalation of the financial resources dedicated to primary health care (PHC) and a more effective use of those resources: more money, better spent. This book introduces and explicates the end-to-end resource tracking and management (RTM) framework, which includes five components that determine effective and efficient financing for PHC: resource mobilization, allocation, utilization, productivity, and targeting.In addition, this book compiles detailed results from the most recent RTM-based resource tracking efforts for PHC in selected countries. This is to demonstrate how the RTM framework can be used to bring a set of separate resource tracking efforts at different stages of flow of funds into a comprehensive process with an end-to-end 'storyline'. In order to build a functional PHC system that addresses access, quality, and equity issues, this book highlights the key (public) financing issues that researchers, technical advisors, and policy makers would need to address in addition to more resources.