Analytic Network Process (ANP) for Housing Quality Evaluation: A Case Study in Ghana

Quality of housing is crucial to an individual\u27s quality of life as it is known to affect human health and well-being. Several studies have employed different methods to assess housing quality. These methods, however, failed to account for the interdependence among the factors (criteria) used for evaluating the quality of housing. This thesis proposes an Analytic Network Process (ANP)-based framework, integrated into Geographic Information Systems (GIS), to assess housing quality. ANP is a multicriteria analysis method. It provides a tool for identifying the relative importance of all the elements (criteria) influencing a goal of decision/evaluation problem (e.g., the problem of evaluating housing quality). The method allows for incorporating dependence relationships into the multicriteria evaluation procedure. A case study of housing quality evaluation at the district level in Ghana using the framework is presented. A set of quality based indicators related to the physical (structural material, dwelling types, housing services), socio-economic (tenure and household density (overcrowding) and environmental (modes of solid waste and liquid waste disposal) aspects of dwellings was used for the evaluation. The results demonstrate the effectiveness of the proposed approach. The GIS-based ANP approach allows for examining spatial distribution of housing quality. It also identifies the most important factors (indicators) contributing to the variability of housing quality in Ghana

Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger.

In 2008, Africa accounted for 94% of the cholera cases reported worldwide. Although the World Health Organization currently recommends the oral cholera vaccine in endemic areas for high-risk populations, its use in Sub-Saharan Africa has been limited. Here, we provide the principal results of an evaluation of the cholera surveillance system in the region of Maradi in Niger and an analysis of its data towards identifying high-risk areas for cholera

Gap Analysis of Environmental Health Research in Malawi : Report to the National Commission of Science and Technology

The aim of this consultancy was to assess the current gaps in research for the environmental health sector in Malawi, and to recommend research priorities and an effective action plan to address these gap

Disease Surveillance Networks Initiative Africa: Final Evaluation

The overall objective of the Foundation's Disease Surveillance Networks (DSN) Initiative is to strengthen technical capacity at the country level for disease surveillance and to bolster response to outbreaks through the sharing of technical information and expertise. It supports formalizing collaboration, information sharing and best practices among established networks as well as trans-national, interdisciplinary and multi-sectoral efforts, and is experienced in developing and fostering innovative partnerships. In order to more effectively address disease threats, the DSN has four key outcome areas:(1) forming and sustaining trans-boundary DSN;(2) strengthening and applying technical and communication skills by local experts and institutions;(3) increasing access and use of improved tools and methods on information sharing, reporting and monitoring; and(4) emphasizing One Health and transdisciplinary approaches to policy and practice at global, regional and local levels

Performance-Based Financing: Report on Feasibility and Implementation Options Final September 2007

This study examines the feasibility of introducing a performance-related bonus scheme in the health sector. After describing the Tanzania health context, we define “Performance-Based Financing”, examine its rationale and review the evidence on its effectiveness. The following sections systematically assess the potential for applying the scheme in Tanzania. On the basis of risks and concerns identified, detailed design options and recommendations are set out. The report concludes with a (preliminary) indication of the costs of such a scheme and recommends a way forward for implementation. We prefer the name “Payment for Performance” or “P4P”. This is because what is envisaged is a bonus payment that is earned by meeting performance targets1. The dominant financing for health care delivery would remain grant-based as at present. There is a strong case for introducing P4P. Its main purpose will be to motivate front-line health workers to improve service delivery performance. In recent years, funding for council health services has increased dramatically, without a commensurate increase in health service output. The need to tighten focus on results is widely acknowledged. So too is the need to hold health providers more accountable for performance at all levels, form the local to the national. P4P is expected to encourage CHMTs and health facilities to “manage by results”; to identify and address local constraints, and to find innovative ways to raise productivity and reach under-served groups. As well as leveraging more effective use of all resources, P4P will provide a powerful incentive at all levels to make sure that HMIS information is complete, accurate and timely. It is expected to enhance accountability between health facilities and their managers / governing committees as well as between the Council Health Department and the Local Government Authority. Better performance-monitoring will enable the national level to track aggregate progress against goals and will assist in identifying under-performers requiring remedial action. We recommend a P4P scheme that provides a monetary team bonus, dependent on a whole facility reaching facility-specific service delivery targets. The bonus would be paid quarterly and shared equally among health staff. It should target all government health facilities at the council level, and should also reward the CHMT for “whole council” performance. All participating facilities/councils are therefore rewarded for improvement rather than absolute levels of performance. Performance indicators should not number more than 10, should represent a “balanced score card” of basic health service delivery, should present no risk of “perverse incentive” and should be readily measurable. The same set of indicators should be used by all. CHMTs would assist facilities in setting targets and monitoring performance. RHMTs would play a similar role with respect to CHMTs. The Council Health Administration would provide a “check and balance” to avoid target manipulation and verify bonus payments due. The major constraint on feasibility is the poor state of health information. Our study confirmed the findings of previous ones, observing substantial omission and error in reports from facilities to CHMTs. We endorse the conclusion of previous reviewers that the main problem lies not with HMIS design, but with its functioning. We advocate a particular focus on empowering and enabling the use of information for management by facilities and CHMTs. We anticipate that P4P, combined with a major effort in HMIS capacity building – at the facility and council level – will deliver dramatic improvements in data quality and completeness. We recommend that the first wave of participating councils are selected on the basis that they can first demonstrate robust and accurate data. We anticipate that P4P for facilities will not deliver the desired benefits unless they have a greater degree of control to solve their own problems. We therefore propose - as a prior and essential condition – the introduction of petty cash imprests for all health facilities. We believe that such a measure would bring major benefits even to facilities that have not yet started P4P. It should also empower Health Facility Committees to play a more meaningful role in health service governance at the local level. We recommend to Government that P4P bonuses, as described here, are implemented across Mainland Tanzania on a phased basis. The main constraint on the pace of roll-out is the time required to bring information systems up to standard. Councils that are not yet ready to institute P4P should get an equivalent amount of money – to be used as general revenue to finance their comprehensive council health plans. We also recommend that up-to-date reporting on performance against service delivery indicators is made a mandatory requirement for all councils and is also agreed as a standard requirement for the Joint Annual Health Sector Review. P4P can also be applied on the “demand-side” – for example to encourage women to present in case of obstetric emergencies. There is a strong empirical evidence base from other countries to demonstrate that such incentives can work. We recommend a separate policy decision on whether or not to introduce demand-side incentives. In our view, they are sufficiently promising to be tried out on an experimental basis. When taken to national scale (all councils, excepting higher level hospitals), the scheme would require annual budgetary provision of about 6 billion shillings for bonus payments. This is equivalent to 1% of the national health budget, or about 3% of budgetary resources for health at the council level. We anticipate that design and implementation costs would amount to about 5 billion shillings over 5 years – the majority of this being devoted to HMIS strengthening at the facility level across the whole country

A systematic review of speech recognition technology in health care

BACKGROUND To undertake a systematic review of existing literature relating to speech recognition technology and its application within health care. METHODS A systematic review of existing literature from 2000 was undertaken. Inclusion criteria were: all papers that referred to speech recognition (SR) in health care settings, used by health professionals (allied health, medicine, nursing, technical or support staff), with an evaluation or patient or staff outcomes. Experimental and non-experimental designs were considered. Six databases (Ebscohost including CINAHL, EMBASE, MEDLINE including the Cochrane Database of Systematic Reviews, OVID Technologies, PreMED-LINE, PsycINFO) were searched by a qualified health librarian trained in systematic review searches initially capturing 1,730 references. Fourteen studies met the inclusion criteria and were retained. RESULTS The heterogeneity of the studies made comparative analysis and synthesis of the data challenging resulting in a narrative presentation of the results. SR, although not as accurate as human transcription, does deliver reduced turnaround times for reporting and cost-effective reporting, although equivocal evidence of improved workflow processes. CONCLUSIONS SR systems have substantial benefits and should be considered in light of the cost and selection of the SR system, training requirements, length of the transcription task, potential use of macros and templates, the presence of accented voices or experienced and in-experienced typists, and workflow patterns.Funding for this study was provided by the University of Western Sydney. NICTA is funded by the Australian Government through the Department of Communications and the Australian Research Council through the ICT Centre of Excellence Program. NICTA is also funded and supported by the Australian Capital Territory, the New South Wales, Queensland and Victorian Governments, the Australian National University, the University of New South Wales, the University of Melbourne, the University of Queensland, the University of Sydney, Griffith University, Queensland University of Technology, Monash University and other university partners