Página 1 dos resultados de 1238 itens digitais encontrados em 0.019 segundos

Interrogando a operação da rede de serviços de saúde; Inquiring the health service network operation

Saúde, Maria Isabel Borges Moreira
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 22/12/2006 PT
Relevância na Pesquisa
55.94%
Este estudo qualiquantitativo teve por objetivo geral analisar a conformação da rede de serviços de saúde que fazem atenção à saúde da gestante em Uberaba-MG. Teve como suporte teórico as categorias rede, integralidade e poder. Foi realizado estudo de caso tomando por referência os serviços de atenção básica de um Distrito Sanitário, sendo os dados de fontes primárias obtidos por entrevistas semi-estruturadas de trabalhadores de unidades de saúde de diferentes níveis de densidade tecnológica e de gestantes, e realização de grupo de discussão com gestantes. As fontes secundárias foram representadas por documentos oficiais e informações de bancos de dados das três esferas de governo. Os dados quantitativos foram analisados considerando sua distribuição de freqüência, e o material empírico das entrevistas e do grupo de discussão foi submetido à análise temática. Na análise documental identificamos que a política de atenção à gestante tem acontecido principalmente pela indução do financiamento, ou pela necessidade de superação de situações emergenciais. Identificamos, entretanto, tentativas de articulação de serviços e de atores, trabalhadores e usuários nos distintos espaços de construção desta política. Os dados e as informações de bancos de dados municipais e nacionais apontam para baixa cobertura e qualificação da assistência pré-natal de baixo e alto risco...

Promoção da saúde e a reorientação dos serviços de saúde no município de Fortaleza: a hipertensão arterial como analisador; Health promotion and reorientation of health services in the city of Fortaleza: hypertension as an analyzer

Almeida, Ana Mattos Brito de
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 19/11/2010 PT
Relevância na Pesquisa
55.85%
Introdução: A Hipertensão Arterial - HA, doença crônica cujas taxas de morbidade atingem no Brasil aproximadamente 17 milhões de pessoas, é um dos principais fatores de risco para doenças do aparelho circulatório. Sua determinação multifatorial exige a adoção de estratégias de controle complexas, que deem conta dos fatores e condições de risco, o que remete a ações sobre estilo de vida e seus determinantes psicossociais, econômicos e ambientais. Nesse sentido, as práticas da Promoção da Saúde, fundadas em um conceito ampliado de saúde, colocam em pauta, juntamente com as ações de prevenção, a discussão sobre a qualidade de vida, relacionando-a às condições de vida e saúde da população. Objetivo: Identificar e analisar as práticas da Promoção de Saúde e sua utilização para reorientação dos serviços de saúde no município de Fortaleza com foco no controle da Hipertensão Arterial. Metodologia: Estudo de caso, contendo em seu desenho três fases: identificação através de análise documental de políticas, planos e ações no nível nacional, estadual e do município de Fortaleza, além de entrevistas em profundidade com gestores ligados ao controle da HA; aplicação de questionários semiestruturados com coordenadores dos Centros de Saúde do município sobre as estratégias de Promoção da Saúde utilizadas no controle da HA; entrevistas em profundidade com enfermeiros...

Identification of American Indian and Alaska Native Veterans in Administrative Data of the Veterans Health Administration and the Indian Health Service

Kramer, B. Josea; Wang, Mingming; Hoang, Tuyen; Harker, Judith O.; Finke, Bruce; Saliba, Debra
Fonte: © American Journal of Public Health 2006 Publicador: © American Journal of Public Health 2006
Tipo: Artigo de Revista Científica
Publicado em /09/2006 EN
Relevância na Pesquisa
55.89%
We sought to determine the extent to which the Indian Health Service (IHS) identified enrollees who also use the Veterans Health Administration (VHA) as veterans. We used a bivariate analysis of administrative data from fiscal years 2002–2003 to study the target population. Of the 32259 IHS enrollees who received care as veterans in the VHA, only 44% were identified by IHS as veterans. IHS data underestimates the number of veterans, and both IHS and VHA need mechanisms to recognize mutual beneficiaries in order to facilitate better coordination of strategic planning and resource sharing among federal health care agencies.

Governance in Health Care Delivery : Raising Performance

Lewis, Maureen; Pettersson, Gunilla
Fonte: Banco Mundial Publicador: Banco Mundial
Relevância na Pesquisa
56%
The impacts of health care investments in developing and transition countries are typically measured by inputs and general health outcomes. Missing from the health agenda are measures of performance that reflect whether health systems are meeting their objectives; public resources are being used appropriately; and the priorities of governments are being implemented. This paper suggests that good governance is central to raising performance in health care delivery. Crucial to high performance are standards, information, incentives and accountability. This paper provides a definition of good governance in health and a framework for thinking about governance issues as a way of improving performance in the health sector. Performance indicators that offer the potential for tracking relative health performance are proposed, and provide the context for the discussion of good governance in health service delivery in the areas of budget and resource management, individual provider performance, health facility performance, informal payments...

Republic of Burundi : Health Financing Study

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
55.95%
During the conflict, public expenditure on health drastically decreased weakening the health system at a time when needs were growing. With increasing peace and stability in the country, foreign aid and public resources allocated to the sector have started to increase. However, health authorities still face the challenge of mobilizing extra resources to reverse the damage to the health system and to progress towards achieving the Millennium Development Goals (MDGs). Nevertheless, more resources allocated to the sector will not necessarily improve health outcomes, especially for the poor, if weaknesses in public expenditure management and inefficiencies in the allocation of resources for the sector are not reduced. These challenges become more acute in the context of the presidential measure of eliminating user fees for deliveries and for child health service.

Romania - Functional Review : Health Sector

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
55.97%
This Functional Review was carried by a Bank team upon request by the Government of Romania. As a starting point, it shows that: (i) health outcomes in Romania lag behind those of the EU; (ii) users are not satisfied with its lack of responsiveness - long lines, informal payments, discourteous handling of patients, poor cleanliness, lack of maintenance, and breach of safety measures; (iii) the poor and other vulnerable groups (for example Roma communities) suffer from a significant lack of access to services; and (iv) the fiscal contraction of 2008-2010 exposed the weakness of financial controls in the health sector. The Review examines four health functions in depth: service delivery, financing, stewardship and resources (including pharmaceuticals). Based on our findings, we present recommendations categorized by the three set of challenges that the sector is facing: (i) improving governance and management; (ii) streamlining the health service network and re-launching quality control systems; and (iii) increasing preventive services and equity. For any expansion of the sector to be sustainable...

Raising Returns : The Distribution of Health Financing and Outcomes in Yemen

Elgazzar, Heba A.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
55.97%
Given relatively few resources and lagging health outcomes in Yemen, the quest for equitable, cost-effective health care delivery continues as long-term, sustainable development remains a priority. This paper assesses overall value for money of the health system mainly as indicated by an analysis of public expenditure trends from 1997 until 2008 and by the degree to which health care benefits are conferred equitably to the population. Total health expenditure in 2007 accounted for 5.2 percent of Gross Domestic Product (GDP), or only PPP$ 41 per capita, with nearly 70 percent sourced by direct household payments (67 percent). Despite recent improvements in health status, Yemen continues to lag behind countries of similar or lower income and health expenditure levels. Levels of health outcomes in Vietnam, Indonesia and the Kyrgyz Republic are 2 to 6 times better than levels found in Yemen regarding the proportion of infants with low birth weight, the prevalence of malnutrition amongst children, the rate of births delivered by skilled attendants...

Assessment of Health Financing Options : Papua New Guinea

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
56.02%
Papua New Guinea s (PNG) health system is characterized by low health inputs per capita, low health service contact rates and significant inequities in health care use. Health spending relative to GNI per capital and as a revenue share of GDP is low. Government spending as a share of total health expenditure is, however, high and the financing system is dependent on a number of complex interactions between a number of agencies, both at the national and subnational level. Anecdotal evidence suggests that out-of-pocket (OOP) spending is minimal. The current system of health financing has not delivered improved health outcomes; in fact health outcomes in PNG have been stagnant in recent decades. PNG is not on track to meet any of the health-related Millennium Development Goals (MDGs). Significant investment in the heath sector is needed to address the decline, meet current demographic trends and address inefficiencies and inequities. These additional resource requirements will have to be met while maintaining the high levels of financial risk protection and relatively equitable access to health care. The additional resource requirements will have to be financed in a sustainable manner. This report examines three broad health financing options in PNG: (i) increasing the level of general revenue spending; (ii) introducing contributory...

Performance-Based Contracting in Health : The Experience of Three Projects in Africa

Johannes, Lars; Mullen, Patrick; Okwero, Peter; Schneidman, Miriam
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
ENGLISH
Relevância na Pesquisa
55.97%
Performance-based contracting in health is an example of a results-based financing approach to improving health service delivery. In 2003 and 2004 the Global Partnership on Output-Based Aid (GPOBA) supported the design of three schemes using performance-based contracting in Uganda, the Democratic Republic of Congo, and Rwanda. GPOBA's technical assistance has led to three innovative projects funded by the World Bank and the Canadian International Development Agency (CIDA). This note reviews early lessons from these schemes.

Improving Health Service Delivery in Developing Countries : From Evidence to Action

Peters, David H.; El-Saharty, Sameh; Siadat, Banafsheh; Janovsky, Katja; Vujicic, Marko
Fonte: Washington, DC: World Bank Publicador: Washington, DC: World Bank
Tipo: Publications & Research :: Publication; Publications & Research
EN_US
Relevância na Pesquisa
55.91%
Decision makers and the public are in need of information to guide their decisions about how to strengthen health services. This book pulls together available evidence concerning strategies to improve health services delivery in low- and middle-income countries (LMICs), using current methods to assemble a knowledge base and analyze the findings. It describes the results of reviews of such strategies, and how such strategies can produce gains for the poor. This type of information is intended to help decision makers in LMICs learn from others and from their own experiences, so that they may develop and implement strategies that will improve health services in their own setting. The book provides some suggestions for what works and how to improve implementation, as the evidence does not hold up for 'blueprint' planning. It finds that there are many ways that can succeed in improving health services. But not nearly enough attention has been paid to demonstrating how to improve services for the poor. Approaches that ask difficult questions, use information intelligently, and involve key stakeholders and institutions are critical to 'learning and doing' practices that underlie successful implementation of health services.

Improving Access to Health Care Services through the Expansion of Coverage Program : The Case of Guatemala

Lao Pena, Christine
Fonte: World Bank, Washington DC Publicador: World Bank, Washington DC
Tipo: Publications & Research :: Working Paper
EN_US
Relevância na Pesquisa
56.05%
Since the signing of the 1996 Peace Accords, Guatemala has made efforts to establish economic and political stability, and to improve its social indicators. The country's Constitution states that access to health care is a basic right of all Guatemalans. In practice, however, it has been challenging for the Government of Guatemala to guarantee this right using public facilities. As a result, it has been trying to improve access to health services using both Ministry of Public Health and Social Assistance (MOH) facilities and staff, and alternative health service providers, particularly nongovernmental organizations (NGOs). This case study reviews the experience implementing the Expansion of Coverage Program (Programa de Extension de Cobertura, PEC) that was established by the Government of Guatemala in 1997 to improve coverage of health and nutrition services to poor, rural, and largely indigenous areas by contracting NGOs. It describes its origins; its package of services; contracting, financing, monitoring, and supervision mechanisms; and its contributions to improving access and strengthening primary health care services in Guatemala. It also discusses opportunities and challenges that need to be addressed to continue to improve health services coverage in the country.

Health Service Delivery in China : A Literature Review

Eggleston, Karen; Ling, Li; Qingyue, Meng; Lindelow, Magnus; Wagstaff, Adam
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH
Relevância na Pesquisa
55.97%
The authors report the results of a review of the Chinese-language and English-language literatures on service delivery in China, asking how well China's health care providers perform, what determines their performance, and how the government can improve it. They find current performance leaves room for improvement in terms of quality, responsiveness to patients, efficiency, cost escalation, and equity. The literature suggests that these problems will not be solved by simply shifting ownership to the private sector, or by simply encouraging providers-public and private-to compete with one another for individual patients. In contrast, substantial improvements could be (and in some places have already been) made by changing the way providers are paid-shifting away from fee-for-service and the distorted price schedule toward prospective payments. Active purchasing by insurers could further improve outcomes.

Below the Glass Floor : Analytical Review of Expenditure by Provincial Administrations on Rural Health from Health Function Grants and Provincial Internal Revenue

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Publications & Research; Publications & Research :: Working Paper
ENGLISH; EN_US
Relevância na Pesquisa
56.01%
Below the glass floor is a report that explores the impact of recent increases in operational function grant funding to provinces to support rural health service delivery. It seeks to identify what expenditure provinces have made to support and enable key front line service delivery activities such as; facility operations, patrols, medical supply distribution, emergency patient transfer, rural water supply and facility supervision. This top down trend analysis seeks to identify whether spending has been made in these areas as a first step in understanding the effectiveness of the governments' financial arrangements. The next step is to triangulate the findings using field-based research that assesses what impact the funding is having at the facility level.

Avaliação da Melhoria da Qualidade na Estratégia Saúde da Família: Visão do Enfermeiro da Administração Regional de Saúde Oeste II Goiás; Evaluation of Quality Improvement in Family Health Strategy: a view of the nurses West Regional Health II Goiás

OLIVEIRA, Wágna Maria de Araújo
Fonte: Universidade Federal de Goiás; BR; UFG; Mestrado em Enfermagem; Cuidado em Enfermagem Publicador: Universidade Federal de Goiás; BR; UFG; Mestrado em Enfermagem; Cuidado em Enfermagem
Tipo: Dissertação Formato: application/pdf
POR
Relevância na Pesquisa
55.92%
The Health Family Strategy (HFS) it is pointed as an institutional policy of health services and assistance model of reguindance, focused in the family. This study has as general objective analyze the context of the Health Family Strategy in thedistricts that compose the Regional Administration of Health of west II of Goiás State (RAH west II), based in aspects of Technical Recommendations of a Project of Ministry of Health about, Quality of the Family Health Improvement Strategy (AMQ). It is a descriptive research, exploratory of quantitative nature, accomplished with all working nurses from the health family team of the 13 districts that compose RAH west II of Goiás. The data collected was accomplished from May to June of 2009, assisted by self applicable questionnaire with affirmatives in form of Likert type scale. The data were codified, inserted in the database produced in the Epi Info Software (CDC) Atlanta, 3.5.1 version, simple descriptive analysis was accomplished and the results presented in tables. Participated in the research 32 nurses that represents 100% of the professionals that act in HFS, mostly young women, with less than five years of graduation and of team working. By the results it was demonstrated that the context of the family health units presents difficulties related to physical structure that doesn't favor the team work...

The State and medical care in Britain: political processes and the structuring of the National Health Service

Lowe, Keith William
Fonte: University of Cambridge; Wolfson College Publicador: University of Cambridge; Wolfson College
Tipo: Thesis; doctoral; PhD
EN
Relevância na Pesquisa
65.97%
The original printed copy of this thesis is held in Cambridge University Library - details at http://search.lib.cam.ac.uk/?itemid=|manuscrpdb|10974; The creation of the National Health Service is treated, analytically and historically, as a planning process involving major changes in the social organisation of health as a part of the larger set of social and economic reconstruction policies undertaken by the wartime Coalition and postwar Labour governments. Definitions of 'health' are considered as relative both to social expectations and ideology, and to theoretical models of the organisation of health services. These models are identified with certain socio-political agents or interests in the providing and consuming of health services: professional groups, public and private authorities, non-professional workers, and the public. The models of the health service advocates and of the medical profession are considered as reference points. A framework is presented for the analysis of the representation of these interests, by the state, in the planning and operation of the NHS, and as beneficiaries of its services. Through a detailed historical consideration of internal health service planning documents of the major interests...

The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban Aboriginal medical service

Brady, Margaret; Sibthorpe, Beverly; Bailie, Ross; Ball, Sherry; Sumnerdodd, Polly
Fonte: Carfax Publishing, Taylor & Francis Group Publicador: Carfax Publishing, Taylor & Francis Group
Tipo: Artigo de Revista Científica
Relevância na Pesquisa
55.94%
We report on the feasibility and perceived acceptability of brief motivational interviewing for hazardous alcohol use in an urban Aboriginal health service. General practitioners (GPs) were trained in brief motivational interviewing, and health workers in other aspects of the intervention. Screening was initially carried out using the AUDIT, but subsequently reduced to two simple questions. Information was obtained through a combination of participant observation by the study team, ongoing ad hoc review and feedback from staff, periodic group meetings, and one-on-one interviews with health workers and GPs. The AUDIT was felt to be intrusive and some questions were poorly understood. Brief intervention seemed to be culturally appropriate, but barriers to wider administration included lack of time and the complexity of patients' presenting health problems. As a result of the research there was an increase in general awareness and acceptability of addressing alcohol issues at the health service. This study raises a number of issues that both support and threaten the wide implementation of brief intervention in urban Aboriginal primary care settings. [Brady M., Sibthorpe B., Bailie R., Ball S., Sumnerdodd P. The feasibility and acceptability of introducing brief intervention for alcohol misuse in an urban Aboriginal medical service.

Avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa, Rio de Janeiro: estudo da população coberta e análise operacional de um subprograma; Preliminary evaluation of State of Rio de Janeiro's Ninth Administrative Region's School Health Service: study of the covered population and operational analysis of a subprogramme

Gaspar, Eneida Duarte; Almeida, Márcio José de; Taddei, José Augusto A. C.; Ribeiro, Eliana Cláudia O.; Pereira, Sandra da Silva; Vilanova, Maria Cristina T.; Cordeiro, Hésio de Albuquerque; Souza, Jeiel C. Ferreira de
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf
Publicado em 01/12/1975 POR
Relevância na Pesquisa
65.9%
Foi realizada uma avaliação preliminar do Serviço de Saúde Escolar da IX Região Administrativa do Estado do Rio de Janeiro, como resultado do convênio firmado entre o Instituto de Medicina Social da Universidade do Estado do Rio de Janeiro e a Secretaria de Saúde do Estado. Através de estudo do nível de saúde entre os escolares e da análise operacional do subprograma de Registro de Saúde, diagnosticaram-se elevados índices de morbidade e pequena proporção de crianças com assistência médica prévia, além de determinar-se a efetividade do programa e de identificar-se problemas no processo técnico-administrativo do Serviço. Dentre as conclusões destaca-se a necessidade de completar a avaliação do Serviço, através da determinação dos critérios de eficiência, eficácia e rendimento, tendo em vista o fornecimento de subsídios para as tarefas de planejamento e administração. É enfatizada a necessidade de ampliação das medidas integradoras dos serviços universitários com os serviços da comunidade, no sentido de fornecer aos primeiros as condições de realizar, através de prestação de serviços, uma formação dos recursos humanos de acordo com a situação de saúde da comunidade, e aos segundos a necessária implementação de novas técnicas e modelos de assistência.; A preliminary evaluation of the School Health Service of the State of Rio de Janeiro's Ninth Administrative Region was performed as result of an agreement between the Institute of Social Medicine belonging to the State of Rio de Janeiro University and the State Department of Health. Through an analysis of the school-children's health level and an operational study of the health register subprogramme...

Regionalização dos serviços de Saúde Pública: a experiência do estado da Bahia, Brasil; Regionalization of public health service: the experience of the State of Bahia, Brazil

Araújo, José Duarte de; Ferreira, Emerson S. M.; Nery, Gabriel Cedraz
Fonte: Universidade de São Paulo. Faculdade de Saúde Pública Publicador: Universidade de São Paulo. Faculdade de Saúde Pública
Tipo: info:eu-repo/semantics/article; info:eu-repo/semantics/publishedVersion; Artigo Avaliado pelos Pares Formato: application/pdf
Publicado em 01/03/1973 POR
Relevância na Pesquisa
55.83%
After making a historic review of Public Health Service organization in Bahia, the Administrative Reform enacted in 1966, was analized and studied in particular the system of regionalization of Public Health Services, through Regional Executive Centers in the interior. Besides presenting the various aspects of the new structure, the difficulties presented in implantation, and the various advantages resulting from its application were commented. It was concluded that the regionalization of Public Health Services is advantageous not only for a more efficient delivery of health services, but also as a basis to stablish a process of health planning.; Após historiar a evolução dos serviços de Saúde Pública no Estado da Bahia, no aspecto de sua estrutura administrativa, foi apreciada a Reforma Administrativa do Estado (1966) no setor saúde, e analisado em pormenor o sistema de regionalização através da implantação de centros regionais no interior do Estado. Ao lado da apresentação da nova estrutura administrativa foram comentadas as dificuldades surgidas na implantação do novo sistema, bem como as numerosas vantagens dele decorrentes. Concluiu-se que a regionalização administrativa mostrou-se vantajosa não só para uma mais efetiva prestação de serviços de saúde no interior do Estado...

The implications of health sector reform for human resources development

Alwan,Ala'; Hornby,Peter
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2002 EN
Relevância na Pesquisa
65.93%
The authors argue that "health for all" is not achievable in most countries without health sector reform that incorporates a process of coordinated health and human resources development. They examine the situation in countries in the Eastern Mediterranean Region of the World Health Organization. Though advances have been made, further progress is inhibited by the limited adaptation of traditional health service structures and processes in many of these countries. National reform strategies are needed. These require the active participation of health professional associations and academic training institutions as well as health service managers. The paper indicates some of the initiatives required and suggests that the starting point for many countries should be a rigorous appraisal of the current state of human resources development in health.

The research agenda for improving health policy, systems performance, and service delivery for tuberculosis control: a WHO perspective

Nunn,Paul; Harries,Anthony; Godfrey-Faussett,Peter; Gupta,Raj; Maher,Dermot; Raviglione,Mario
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2002 EN
Relevância na Pesquisa
55.83%
The development of WHO's DOTS strategy for the control of tuberculosis (TB) in 1995 led to the expansion, adaptation and improvement of operational research in this area. From being a patchwork of small-scale studies concerned with aspects of service delivery, TB operational research shifted to larger-scale, often multicountry projects that were also concerned with health policy and the needs of health systems. The results are now being put into practice by national TB control programmes. In 1998 an ad hoc committee identified the chief factors inhibiting the expansion of DOTS: lack of political will and commitment, poor financial support for TB control, poor organization and management of health services, inadequate human resources, irregular drug supplies, the HIV epidemic, and the rise of multidrug resistance. An analysis of current operational research on TB is presented on the basis of these constraints, and examples of successful projects are outlined in the article. We discuss the prerequisites for success, the shortcomings of this WHO- supported programme, and future challenges and needs.