39,656 research outputs found

    Addendum to Informatics for Health 2017: Advancing both science and practice

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    This article presents presentation and poster abstracts that were mistakenly omitted from the original publication

    Population, health, and nutrition : fiscal 1991 sector review

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    The theme of this year's annual sector review blends two special topics: poverty alleviation and the development of management and institutional capacity. Based on a review of project experience, both within and outside of the population, health and nutrition (PHN) sector, this report distills lessons that should assist task managers in the design and implementation of interventions to develop poverty-sensitive management and institutional capacity in the PHN sector. The Bank's ability to strengthen institutions, especially those needed to alleviate poverty, are constrained by the number and the skills mix of PHN staff, by the absence of standards and guidelines for analyzing and addressing institutional and management issues, and by too little time to spend on institutional and management issues. Therefore, the sector review recommends : a) improving the sector staff not only in numbers but in access to guidelines and training; b) revising Bank priorities and practices to ensure that enough time is spent on supervision and on upstream diagnostic work; c) grounding PHN policies in a macroeconomic and multisectoral framework oriented toward growth with poverty reduction, together with a sound strategy for building institutions and the capacity to implement and manage policy; and d) seeking more creative use of Bank instruments through a review and assessment of the best use of lending instruments for PHN sector interventions.Banks&Banking Reform,Poverty Assessment,Urban Services to the Poor,Health Monitoring&Evaluation,Health Economics&Finance

    Randomised controlled trials of complex interventions and large-scale transformation of services

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    Complex interventions and large-scale transformations of services are necessary to meet the health-care challenges of the 21st century. However, the evaluation of these types of interventions is challenging and requires methodological development. Innovations such as cluster randomised controlled trials, stepped-wedge designs, and non-randomised evaluations provide options to meet the needs of decision-makers. Adoption of theory and logic models can help clarify causal assumptions, and process evaluation can assist in understanding delivery in context. Issues of implementation must also be considered throughout intervention design and evaluation to ensure that results can be scaled for population benefit. Relevance requires evaluations conducted under real-world conditions, which in turn requires a pragmatic attitude to design. The increasing complexity of interventions and evaluations threatens the ability of researchers to meet the needs of decision-makers for rapid results. Improvements in efficiency are thus crucial, with electronic health records offering significant potential

    Techniques for improving client relations in family planning programs

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    Demand for children and demand for contraceptives are not independent of the system of supply. And client transactions are the major means for lowering costs. Family planning workers, providers of services and mass media campaigns, are the harbingers of new ideas and new delivery systems that could modify the demand for fertility regulation and patterns of contraceptive use. The authors describe four broad techniques for improving client relations, emphasizing their potential as entry points into program development (systematic change). These techniques are presented as a sampling of experience that can be brought to bear on dysfunctional client relations. Among examples described: Patient flow analysis (PFA). A self-administered time-and-motion diagnosis that allows computerized documentation of patient flow and personnel use in health service clinics. Using relatively unobtrusive data collection, PFA seeks to get a representative snapshot of a program and its dysfunctions, replicating a typical clinic session. Data are later diagnosed and remedies proposed for bottlenecks and inefficiencies. Training and visit (T&V). A managerial approach for dealing with geographically scattered outreach programs. The four main principles of T&V: focus on a few key tasks, frequent in-service training and supervision, regularity and predictability, and face-to-face communication. The T&V model focuses on what workers should be doing with their time in the field to meet client needs. A goal of T&V: to enable all clients to name their worker and the day of the week s/he visits, and identify a few themes from their most recent encounter. Activity planning. The antithesis of T&V, activity planning calls for abandoning rigid time-place-movement schedules and specific messages and replacing them with a fluid work schedule adapted to local conditions. Workers must be well-trained in collecting data, listening and building rapport, and communicating with conviction. The quality of the worker-client relationship is all-important. A weakness is that if the workers have no objective they lose control of the exchange with clients. Training and worker empowerment. Training by itself is not enough for systematic change - training for what? But training can serve as an entry point into organizational development when it is rooted in methodologies that help to develop the participant's technical and interpersonal skills and ability to innovate. But training must be accompanied by changes in the system of supply that supports and facilitates innovation and quality of care. Techniques to improve client relations can address either the client-provider interface directly or the system of underlying determinants. It is important to ask basic questions: Is the idea to fix a single worker-client dysfunction or is it to provide a continuous program for modification and growth? Who will be affected by the change? Whoor what will be responsible for initiating and overseeing the course of action? What are the short- and long-run goals of intervention?Health Monitoring&Evaluation,ICT Policy and Strategies,Adolescent Health,Poverty Monitoring&Analysis,Geographical Information Systems
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