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22 minutes | 4 months ago
Series 3, episode 2 – Funding, equity, and quality: how the government in Delta State, Nigeria, is partnering with private providers to address a primary health care gap
In Nigeria’s Delta State, a public/private partnership is rehabilitating 25 defunct health facilities to provide quality primary health care services to remote and underserved communities. The Primary Health Care Revitalization and Access to Finance Scheme hands over public health facilities to private providers and outsources primary health care services to these providers. Dr. Ibironke Dada, Director for quality activities, MNCH projects at the Pharmacess Foundation, tells us how the scheme combines innovative financing, enrollment in a public health insurance scheme and a quality improvement plan to increase both access to health care and the quality of the services provided.
16 minutes | 6 months ago
Series 3, episode 1 – COVID-19 lockdown and pregnancy complications: Findings from Nepal on providing quality intrapartum care in extraordinary times
A recent study conducted in Nepal assessed the indirect impact of the COVID-19 lockdown on the quality of intrapartum care that women received in health facilities. The study, published in The Lancet, looks at the implications of a reduced access to care, but also at the gaps in the quality of the care provided. Dr. Ashish K.C, who led the study, is a perinatal epidemiologist and a researcher specializing in quality of care, based in the Department of Women’s and Children’s Health, University of Uppsala, Sweden. He tells us about the study’s findings, their implications during the COVID-19 lockdown, and how health workers have developed solutions to provide quality intrapartum care even under extraordinary circumstances.
25 minutes | a year ago
Series 2, episode 5 – In Sierra Leone, an emergency triage system is driving child mortality down: what we can learn from ‘ETAT+’ whole systems approach
Many children’s deaths could be prevented if the most sick children were identified soon after their arrival in a health facility, and were prioritized to be treated immediately. The Emergency Triage Assessment and Treatment (ETAT) programme was initially designed by the World Health Organization in 2005 to drastically reduce waiting time, improve flow and access to quality protocol-driven care for children presenting to hospitals in resource-limited settings, and thereby improve pediatric care and outcomes. Many countries have since adapted it for implementation in their context; in Sierra Leone, it is implemented as ETAT+. ETAT+ whole systems approach has become an integral component of Sierra Leone’s efforts to improve the quality of pediatric care. In district hospitals implementing the programme, the proportion of children who died after arrival in hospital dropped by nearly 40%. The programme’s lessons are now being applied to other areas of care, with a similar initiative being implemented for obstetric care (obstetric ETAT). In this episode, Dr. James Bunn, Child Health Specialist at the World Health Organization in Sierra Leone explains the changes that ETAT+ has brought about through improving patient flow, task shifting, and responding to bottlenecks which delay treatment. This has been implemented through new on-the job training methods including mentoring. He describes how improving quality of care can be possible even in facilities with scarce resources.
28 minutes | a year ago
Series 2, episode 4 – When birth companions are part of the problem: a story of disrespect and abuse during childbirth in Western Tanzania
A recent study conducted in Ghana, Guinea, Myanmar and Nigeria and published in the Lancet showed that one in three women experienced physical or verbal mistreatment during childbirth in health facilities. Adrienne Strong is a medical anthropologist and Assistant Professor of Anthropology at the University of Florida who studies maternal mortality and women’s health in Tanzania, and the notions of ideal comfort, care, and support for pregnant women in labour. She observed a birth companionship programme run by an NGO in maternity wards in the Kigoma region of Tanzania in 2018. She explains how the programme designed to improve both the women’s experience of care and clinical outcomes failed to reduce the disrespect and abuse directed at the patients. In fact, in some cases, the birth companions themselves justified the mistreatment or took part in it, targeting the very women they were meant to support. For more on respectful maternal care from Adrienne Strong, check out her new book: Documenting Death: Maternal Mortality and the Ethics of Care in Tanzania. Strong, A. 2020;Berkeley, CA: University of California Pres, which will be available in the Spring of 2020 at this address https://www.ucpress.edu/discipline/antmaj/anthropology
10 minutes | a year ago
Series 2, episode 3 – In India, a group of medical and nursing students bring quality improvement skills in their life and work
Chhavi Sharma, a medical student at the Lady Hardinge Medical College in New Delhi, explains how learning Quality Improvement skills, in addition to her clinical skills, is changing the way she approaches patients, and preparing her to be a better medical professional. Chhavi is a founding member of Be the Change, a group of medical and nursing students committed to improving quality of care and supported by India’s Nationwide Quality of Care Network.
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