5,378 research outputs found

    A cost and technical efficiency analysis of two alternative models for implementing the basic package of health services in Afghanistan.

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    Since 2003, the Afghan Ministry of Public Health (MoPH) and international partners have directed a contracting-out model through which non-governmental organisations (NGOs) deliver the Basic Package of Health Services (BPHS) in 31 of the 34 Afghan provinces. The MoPH also managed health service delivery in three provinces under an alternative initiative entitled Strengthening Mechanisms (SM). In 2011, under the authority of the MoPH and Delegation of the European Union to Afghanistan, EPOS Health Management conducted a cost and technical efficiency study of the contracting-out and SM mechanisms in six provinces to examine economic trade-offs in the provision of the BPHS. The study provides analyses of all resource inputs and primary outputs of the BPHS in the six provinces during 2008 and 2009. The authors examined technical efficiency using Data Envelopment Analysis (DEA) at the BPHS facility level. Cost analysis results indicate that the weighted average cost per BPHS outpatient visit totalled 3.41intheSMprovincesand3.41 in the SM provinces and 5.39 in the NGO-led provinces in 2009. Furthermore, the data envelopment analyses (DEAs) indicate that facilities in the three NGO-led provinces scored 0.168 points higher on the DEA scale (0-1) than SM facilities. The authors conclude that an approximate 60% increase in costs yielded a 16.8% increase in technical efficiency in the delivery of the BPHS during 2009 in the six provinces

    Iowa Department of Corrections Annual Performance Report, 2004

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    Iowa Department of Corrections Annual Performance Report FY 200

    Quality of Neonatal Health Care: Learning From Health Workers’ Experiences in Critical Care in Kilimanjaro Region, Northeast Tanzania

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    Neonatal deaths are generally attributed to suboptimal standards of health care. Health care worker motivation and adherence to existing guidelines are rarely studied. To assess the performance of health workers for neonatal health care in the hospitals of Kilimanjaro region. A descriptive study using a semi-structured interview for health care workers at a tertiary referral hospital and peripheral health facilities (regional referral, district hospitals and health centres).was used. Health Care Workers (HCW) were asked to recall a scenario of a critically ill neonate admitted in the wards and the treatment that was provided. The WHO Emergency Triage Assessment and Treatment (ETAT) guidelines were used as a standard reference for knowledge of critical care. Birth asphyxia was the most recalled health problem requiring critical care, reported by 27.5% of 120 HCW at both peripheral hospitals and by 46.4% of 28 health workers in tertiary referral centres. Half of the HCW commented on their own performance (47.5%, n=140). HCW presented with low to moderate levels of knowledge for critical care were at 92%. Supplementary training was associated with a higher levels of knowledge of neonatal critical care (p value = 0.05). HCW in peripheral hospital had lower levels of knowledge (only 44.7% at peripheral hospitals had sufficient ratings compared to 82.1% at the referral centre). [Pearson χ2 (2) = 12.10, p value = 0.002]. Guided Practical-Competence Diagnostic Specific neonatal health care training is highly needed in the peripheral facilities of rural Kilimanjaro region

    Information systems for the city of New York

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    Originally published by: Touche, Ross, Bailey & Originally publish by: Touche, Ross, Bailey & Smar

    Human Resource for Health: Strategic Plan 2008 – 2013

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    Stress, Motivation and Professional Satisfaction among Health Care Workers in HIV/AIDS Care and Treatment Centers in Urban Tanzania: A Cross-Sectional Study.

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    Shortages of health care workers (HCWs) represents a serious challenge to ensuring effective HIV care in resource-limited settings (RLS). Stress, motivation, and job satisfaction have been linked with HCW retention and are important in addressing HCW shortages. In this cross-sectional study HCW stress, motivation and perceived ability to meet patient needs were assessed in PEPFAR-supported urban HIV care and treatment clinics (CTCs) in Tanzania. A self-administered questionnaire measuring motivation, stress, and perceived ability to and meet patient needs was given to HCWs at 16 CTCs. Scales measuring HCW satisfaction, motivation, and stress were developed using principle components analysis. Hierarchical linear models were used to explore the association of HCW and site characteristics with reported satisfaction, stress, motivation, and ability to meet patients' needs.\ud Seventy-three percent (279) of HCWs completed the questionnaire. Most (73%) HCWs reported minimal/no work-related stress, with 48% reporting good/excellent motivation, but 41% also reporting feeling emotionally drained. Almost all (98%) reported feeling able to help their patients, with 68% reporting work as rewarding. Most reported receipt of training and supervision, with good availability of resources. In the multivariate model, direct clinical providers reported lower motivation than management (p < 0.05) and HCWs at medium-sized sites reported higher motivation than HCWs at larger sites (p < 0.05). HCWs at small and medium sites were more likely to feel able to help patients than those from larger sites (p < 0.05 and p < 0.001 respectively). Despite significant patient loads, HCWs in these PEPFAR-supported CTCs reported high levels of motivation, job satisfaction, ability to meet patients' needs, low levels of stress but significant emotional toll. Understanding the relationship between support systems such as strong supervision and training and these outcomes is critical in designing interventions to improve motivation, reduce stress and increase retention of HCWs

    The role of incident reporting in continuous quality improvement in the intensive care setting

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    Publisher's copy made available with the permission of the publisherU. Beckman, W.B. Runcimanhttp://www.aaic.net.au/Article.asp?D=199606

    The strategy of the International Irrigation Management Institute

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    Research institutes / Research priorities / Strategy planning / Financial resources / Institutional development / Irrigated farming / Irrigation management

    A Quantitative Study of Relationships Between Compassion Fatigue and Burnout to Turnover Intention in Alabama Trauma Center Nurses

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    Registered nurses are fundamental members of the care team who provide skilled healthcare services in trauma centers. Research reports that trauma center nurses demonstrate high levels of compassion fatigue, burnout, and turnover. Turnover among trauma center nurses results in patient care challenges and increased healthcare costs. Although there have been multiple studies on burnout, compassion fatigue, and turnover, literature did not reveal research on how compassion fatigue, burnout, and turnover intention relates to nurses in trauma centers. Turnover intention is a concept that assesses why people stay with their job. Turnover intention has been established to rationalize intent to depart and voluntary turnover above and beyond the conventional indicators of organizational loyalty and job satisfaction. This quantitative, non-experimental correlational research study examined the relationship between compassion fatigue, burnout, and turnover intention. The analysis established that there is a relationship between CF, BO, and TI. The results may be advantageous to trauma center leaders as they evaluate and amend their human resource management practices that are designed at increasing retention and decreasing turnover
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