Página 1 dos resultados de 295 itens digitais encontrados em 0.014 segundos

Intergenerational impacts of maternal mortality: Qualitative findings from rural Malawi

Bazile, Junior; Rigodon, Jonas; Berman, Leslie; Boulanger, Vanessa M; Maistrellis, Emily; Kausiwa, Pilira; Yamin, Alicia Ely
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
Relevância na Pesquisa
56.09%
Background: Maternal mortality, although largely preventable, remains unacceptably high in developing countries such as Malawi and creates a number of intergenerational impacts. Few studies have investigated the far-reaching impacts of maternal death beyond infant survival. This study demonstrates the short- and long-term impacts of maternal death on children, families, and the community in order to raise awareness of the true costs of maternal mortality and poor maternal health care in Neno, a rural and remote district in Malawi. Methods: Qualitative in-depth interviews were conducted to assess the impact of maternal mortality on child, family, and community well-being. We conducted 20 key informant interviews, 20 stakeholder interviews, and six sex-stratified focus group discussions in the seven health centers that cover the district. Transcripts were translated, coded, and analyzed in NVivo 10. Results: Participants noted a number of far-reaching impacts on orphaned children, their new caretakers, and extended families following a maternal death. Female relatives typically took on caregiving responsibilities for orphaned children, regardless of the accompanying financial hardship and frequent lack of familial or governmental support. Maternal death exacerbated children’s vulnerabilities to long-term health and social impacts related to nutrition...

Republic of Burundi : Health Financing Study

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
56.2%
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.

Key Issues in Central America Health Reforms : Diagnosis and Strategic Implications, Volume 1. Synthesis of Findings

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
56.22%
The main objective of this report is to identify and analyze the most pressing health sector issues in the sub region of El Salvador, Guatemala, Honduras, and Nicaragua (referred to as CA4) while building on the successes already attained, in order to lay the groundwork for discussing and refining strategies and policies in CA4. It will focus on analyzing (a) CA4 health sector performance, measured by financial protection and a subset of health indicators; and (b) health system functions of financing and service delivery. The report also addresses three topics that CA4 stakeholders selected as their main areas of interest: (a) decentralization processes initiated in these countries; (b) the design and implementation of alternative strategies to improve access to basic maternal and child health care services: and (c) the high prevalence of malnutrition. The synthesis of findings can be found in volume 1 of the report. In volume 2, aside from the introduction, the report comprises five chapters: Chapter 2 discusses the different aspects that characterize the health sector of these countries: health care financing...

Using Performance Incentives to Improve Health Outcomes

Gertler, Paul; Vermeersch, Christel
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
56.16%
This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effect on the weight-for-age of children 0-11 months and on the height-for-age of children 24-49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill.

Impact Evaluation of the Egyptian Health Sector Reform Project : Pilot Phase

Grun, Rebekka; Ayala, Javier
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
56.1%
In 1997, the Government of Egypt (GoE) launched the Health Sector Reform Program (HSRP). Under the program, persistent needs in maternal and child health were addressed through an emphasis on primary health care, as well as through the introduction of the family health model as the principle of primary care. The World Bank, in co-operation with the Technical Support Office (TSO) of the HSRP at the Ministry of Health (MoH), has conducted an impact evaluation of the different interventions under the reform, focusing on the service delivery component. The evaluation has examined the impact of the HSRP on targeting those in need; coverage and utilization of primary health care, its quality of service and maternal and child health. It has also compared costs and benefits of the interventions and derived lessons for policy going forward. Key suggestions include: 1) human resource development should be extended to include staffing mechanisms, 2) supervision of Quality of Care could be strengthened locally through empowering citizens...

Maternal Health Out-of-Pocket Expenditure and Service Readiness in Lao PDR : Evidence for the National Free Maternal and Child Health Policy from a Household and Health Center Survey

World Bank
Fonte: Washington, DC Publicador: Washington, DC
EN_US
Relevância na Pesquisa
66.19%
Although Lao PDR has made notable progress in improving maternal and child health (MCH), attainment of the Millennium Development Goal 5 (MDG5) still remains a challenge. This is largely due to the barriers imposed by financial restrictions. In order to address these financial barriers, the Government of Lao PDR has introduced a national free MCH policy. However, certain non-financial barriers are also impediments to the achievement of this goal, such as physical access to remote communities, especially during rainy season, cultural practices and beliefs, and poor educational outcomes. In seeking to inform the implementation and scale-up of this national free MCH policy at this crucial initial stage, this paper reports on findings from a household, village and health center survey The policy implications of the findings from the survey are: 1) although financial protection implied by the national free MCH policy is strong, reducing financial barriers alone would not be sufficient to increase the utilization of services...

Maternal and Child Survival : Findings from Five Countries Experience in Addressing Maternal and Child Health Challenges

Cortez, Rafael; Saadat, Seemeen; Chowdhury, Sadia; Sarker, Intissar
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
66.19%
Considerable progress has been made towards the achievement of the Millennium Development Goals (MDGs) since 1990. Although advances in improving MDG 4 and MDG 5a (reducing child and maternal mortality, respectively) have been made, progress is some countries have been insufficient. While some countries have made substantial gains, others have not. This paper is part of a larger study that aims to address this gap in knowledge. The paper discusses the findings from qualitative case studies of five countries that are either on track to meet MDGs 4 and 5a by 2015 or have made significant progress to this end (Bolivia, China, Egypt, Malawi and Nepal). Although they have different socio-economic characteristics, all have made significant advancements due to a strong commitment to improving maternal and child health. To do this, strong political commitment, through policies backed by financial and programmatic support, was critical. In addition, focusing on the most vulnerable populations helped increase access to and use of services. Empowering women and families through education...

Universal Health Coverage for Inclusive and Sustainable Development

Wang, Huihui; Ramana, G.N.V.
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Trabalho em Andamento
EN_US
Relevância na Pesquisa
56.27%
A low-income country, Ethiopia has made impressive progress in improving health outcomes. The Inter-agency Group for Child Mortality Estimation reported that Ethiopia has achieved Millennium Development Goal (MDG) 4, three years ahead of target, with under-5 mortality at 68 per 1,000 live births in 2012. Significant challenges remain, however, with the maternal mortality ratio at 420 out of 100,000 live births. The government has introduced a three-tier public health care delivery system to deliver essential health services and ensure referral linkages, with level three as specialized hospitals (one per 3.5 million 5 million population), level two as general hospitals (one per 1 million 1.5 million), level one as primary hospitals (one per 60,000 100,000) with satellite health centers (one per 15,000 25,000) and health posts (one per 3,000 5,000). One initiative contributing greatly toward universal health coverage (UHC) is the Health Extension Program (HEP) that provides free primary care services at health posts and communities. The country is at its early stage initiating insurance schemes to provide financial protection for its citizens: Social Health Insurance (SHI) for formal sector employees and Community-Based Health Insurance (CBHI) for rural residents and informal sector employees. Public facilities are expected to provide exempted services for free...

Maternal Health, Child Health and Nutrition in Lao PDR : Evidence from a Household Survey in Six Central and Southern Provinces

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Other Health Study; Economic & Sector Work
ENGLISH; EN_US
Relevância na Pesquisa
66.32%
Despite being on-track on the child- and maternal-health Millennium Development Goals (MDGs), Lao PDR continues to have some of the worst maternal and child health (MCH) and nutrition outcome indicators, both globally as well as in the East Asia and Pacific (EAP) region. This report presents results from a household, village, and facility survey on Maternal and Child Health (MCH) and nutrition in mostly rural areas of six central and southern provinces of Lao People's Democratic Republic (PDR). The information in this report localizes MCH and nutrition-related information that are typical for sampled catchment areas of selected health centers in six central and southern provinces of the country. In addition, the report summarizes data on service availability and readiness of health centers in terms of their ability to provide key MCH & nutrition-related services. The results from this survey thus shed light on what it would take to attain the health-related MDGs. In order to improve the level and equity of maternal and child health indicators...

Health, Nutrition, and Population in Madagascar 2000-09

Sharp, Maryanne; Kruse, Ioana
Fonte: World Bank Publicador: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH
Relevância na Pesquisa
56.25%
With an income per capita US$400 in 2008, Madagascar is one of the poorest countries in the world. Poverty is widespread but with significant urban-rural differences (52 percent versus 74 percent). Health, nutrition, and the fight against communicable diseases and HIV/AIDS are key goals of the country's poverty reduction strategy, the Madagascar Action Plan 2007-2012. The National Health Sector and Social Protection Development Plan 2007-2011 was developed to strengthen the health system and improve service delivery to reduce neonatal, child and maternal mortality, address malnutrition and control communicable illnesses. The health sector has benefited from increasing investment over the last years, and a number of studies and surveys have been carried out, providing a wealth of information that is yet to be analyzed in a complementary way. This Country Status Report (CSR) seeks to capitalize on all of the existing data in the health sector, compare Madagascar to countries of similar income levels and assess the results achieved by the health system. The CSR provides an analysis of the population's health and nutrition status by linking health outcomes...

The Health Workforce in Ethiopia : Addressing the Remaining Challenges

Feysia, Berhanu; Herbst, Christopher H.; Lemma, Wuleta; Soucat, Agnes
Fonte: World Bank Publicador: World Bank
Tipo: Publications & Research :: Publication; Publications & Research :: Publication
ENGLISH
Relevância na Pesquisa
56.14%
Health indicators in Ethiopia, particularly on child health and malaria, have improved significantly in recent years, with the next challenge now focused on improving maternal health indicators. Improvements in child health and malaria in particular can be attributed to strong government commitment towards health results, reflected in a number of notable policies and programs related to Human Resources for Health (HRH), in particular the health extension worker program. However, indicators related to maternal health remain problematic. Ethiopia has one of the lowest levels of assisted deliveries in the region. Although increases in the number of health workers particularly in rural areas may have contributed to improving access to some health services, it is in the government's interest to further improve the stock, distribution, and performance of relevant health workers in Ethiopia, particularly to bring about improvement in access to maternal health services for the poor. This document reviews the current HRH situation in Ethiopia...

Tajikistan - Quality of Child Health Services

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Health Sector Review; Economic & Sector Work
ENGLISH
Relevância na Pesquisa
66.23%
The Government of Tajikistan has identified Primary Heath Care (PHC), and Maternal and Child Health (MCH) as top priorities in its first Comprehensive National Health Sector Strategy (2010-2020). The study findings which closely mirror those of the 2009 World Health Organization (WHO)/United Nation children's Fund (UNICEF) Integrated Management of Childhood Illness (IMCI) survey will be of great concern to the Ministry of Health and should provide the impetus to take immediate remedial actions. Much remains to be done to improve the overall quality of primary health care services for under-five children. Two main issues are highlighted by this study. Firstly, the quality of primary health care services provided to children is lacking in many areas, irrespective of the PHC provider's type of training. Second, is that the family medicine and IMCI training programs and methods require further enhancement to ensure that the service quality for children improves. The study also finds that supervision of PHC workers is irregular...

Tajikistan - Feasibility Study for Results-Based Financing (RBF) In the Health Sector

World Bank
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Other Health Study
ENGLISH
Relevância na Pesquisa
56.19%
The purpose of this study is to examine the feasibility of introducing Results-Based Financing (RBF) in Tajikistan's health sector. Several countries have experience with RBF in low-income settings, and lessons learned can be interesting for Tajikistan. Technically, RBF is a retrospective provider payment that can be designed to reimburse providers for contractually defined services and specific compliance targets, including for efficiency and quality targets. In Tajikistan RBF will be linked to ongoing provider payment reforms. Therefore, the chapter also provides a brief overview on provider payment mechanisms and experience with provider payment reforms and treatment patterns from middle- and higher-income countries. The objective of this feasibility study is to propose a sustainable RBF pilot program for two oblasts (Khatlon and Sughd), to cost-effectively improve maternal and child health (MCH) outcomes. The study aims to inform the health sector strategy and help the Government and partners to effectively design and use RBF mechanisms at three potential levels. First...

Argentina - Provincial Maternal and Child Health Insurance : A Results-Based Financing Project at Work

Cortez, Rafael
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
ENGLISH
Relevância na Pesquisa
56.19%
During the early 2000s, Argentina's total expenditures on health, as a percentage of Gross Domestic Product (GDP), placed it among the top-20 countries in the world in per capita health spending. For example, Argentina spent 8.9 percent of GDP in 2000 and 10.1 percent in 2006. The per-capita government expenditures on health were US$382 in 2000 and US$251 in 2006. Yet, despite sweeping healthcare reforms, relatively high public health expenditures compared to other countries in the region, and a restructuring of the country's insurance policy, quality and access to service remained a problem throughout the decade. Almost one third of the population lacked access to basic healthcare. Although the reforms improved access to healthcare for those employed in the formal sectors, they were not enough to provide access for the poor, and they lacked the necessary incentives to improve the quality of service provision. Moreover, the poor continued to be excluded from the health insurance system and had worse than average health indicators.

World Bank study : A Health Sector in Transition to Universal Coverage in Ghana

Saleh, Karima
Fonte: World Bank Publicador: World Bank
Tipo: Economic & Sector Work :: Other Health Study
ENGLISH
Relevância na Pesquisa
56.2%
Ghana has come a long way in improving health outcomes and it performs reasonably well when compared to the other countries in Sub-Saharan Africa (SSA). However, when its health outcomes are compared to other countries globally with similar incomes and health spending levels, its performance is more mixed. Ghana's health outcome performances, in terms of child health and maternal health, are worse than the levels found in other comparable lower middle income and health spending countries, but life expectancy is better. Ghana's demographic profile is changing, and demographic, epidemiological, and nutrition transitions are well underway. The dependency ratio is expected to be favorably affected by the expanding large numbers of individuals entering the labor force, while fertility albeit still high continues to decline. It is the right time for Ghana to take advantage of this potential demographic dividend. Taking appropriate steps to improve employment opportunities is critical or else the country will face economic pressures as well as political unrest. There is a funding shortage for public health goods. Many public health goods...

Ethiopia : A Country Status Report on Health and Poverty, Volume 1, Executive Summary

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Economic & Sector Work :: Health Sector Review; Economic & Sector Work
ENGLISH; EN_US
Relevância na Pesquisa
56.13%
The Government of Ethiopia has recently confirmed its commitment to accelerate progress on maternal and child health outcomes. A reduction in child and maternal mortality rates is among the key objectives of the Ethiopia Poverty Reduction Strategy (PRSP) published in 2002. This strategy outlines the Government's key policy objectives and strategic options for the next five years. One key PRSP strategic option for reducing maternal and child mortality is to expand the provision of essential health and nutrition services to the country's rural poor. Health outcomes are slowly improving but remain low, particularly among rural dwellers and the very poor.

The Impact of Price Subsidies on Child Health Care Use : Evaluation of the Indonesian Healthcard

Somanathan, Aparnaa
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
Tipo: Publications & Research :: Policy Research Working Paper; Publications & Research
ENGLISH
Relevância na Pesquisa
66.11%
Financial barriers to seeking care are frequently cited as one of the main causes of underutilization of child health care services. This paper estimates the impact of Indonesia's healthcard on health care use by children. Evaluation of the healthcard effect is complicated by the fact that card allocation was non-random. The analysis uses propensity score matching to control for systematic differences between treatment and control groups. A second potential source of bias is related to contemporaneous, exogenous influences on health care use unrelated to the healthcard itself. Using panel data collected prior to and after the introduction of the healthcard, a difference-in-differences estimator is constructed to eliminate the effects of exogenous changes over time. The author finds that although health care use declined for all children during the crisis years of 1997-2000, use of public sector outpatient services declined much less for children with healthcards. The protective effect of the healthcard on public sector use was concentrated among children aged 0-5 years. The healthcard had no significant impact on use of private sector services. The results highlight the need to provide adequate protection against the financial burden of health care costs...

Papel do fisioterapeuta na área de saúde materno-infantil; em busca da dignificação de uma área profissional

Rocha, Maria Manuela Alves da
Fonte: [s.n.] Publicador: [s.n.]
Tipo: Dissertação de Mestrado
Publicado em //2014 POR
Relevância na Pesquisa
56.11%
Trabalho de Projeto apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Fisioterapia, ramo de Fisioterapia Materno-Infantil; O papel do Fisioterapeuta na saúde materno-infantil ainda é pouco conhecido e valorizado, quer pela população em geral quer por profissionais de saúde. Assim, foram objetivos do trabalho perceber, em três grupos de pessoas, o papel atribuído ao Fisioterapeuta nesta área e as razões pelas quais persiste a falta de reconhecimento profissional. Metodologia: Estudo 1) Foi aplicado um questionário a profissionais de saúde de dois hospitais do distrito de Aveiro; Estudo 2) Realizaram-se entrevistas a especialistas portuguesas da área da saúde da mulher; Estudo 3) Foram recolhidos dados de arquivo referentes à opinião de grávidas/casais que frequentaram um programa de preparação para o nascimento nos dois hospitais referidos. O método utilizado para analisar os dados dos três estudos foi a análise temática de conteúdo. Resultados: Estudo 1) A maioria dos profissionais de saúde refere o Fisioterapeuta como elemento pertencente à equipa materno-infantil, remetendo as suas funções e importância na preparação para o nascimento, pós parto e cuidados à mãe e ao bebé; a grande maioria dos profissionais de saúde considera o Fisioterapeuta importante na área materno-infantil...

Coverage and adequacy of ferrous sulfate supplementation in the prevention of anemia among children treated at health centers of Florianopolis, Santa Catarina

Cembranel,Francieli; Corso,Arlete Catarina T.; Gonzalez-Chica,David Alejandro
Fonte: Sociedade de Pediatria de São Paulo Publicador: Sociedade de Pediatria de São Paulo
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/09/2013 EN
Relevância na Pesquisa
65.87%
OBJECTIVE To evaluate the National Program of Iron Supplementation (PNSF) coverage, the compliance with the directions for of using of this supplementation and the association with sociodemographic factors in children aged six to 18 months old and registered in 35 public health centers of Florinópolis (Southern Brazil). METHODS Cross-sectional study using secondary data obtained from the health information system of the Health Department of Florianópolis, Santa Catarina, Brazil (Infosaúde). Data on ferrous sulfate supplementation and sociodemographic variables were obtained of all children registered in PNSF in Florianópolis in 2010. STATA 11.0 software was used in the analyses. RESULTS The PNSF covered 6.3% (95%CI 5.9-6.7) of the children; the compliance with the directions regarding age at the onset of supplementation and its frequency was adequate only in 2.4% of the cases (95%CI 1.5-3.7). There was no association with the child's gender, maternal education level and ethnicity or the distance from home to the health center. CONCLUSIONS This study showed low coverage and inadequate compliance with the PNSF directions. Measures to improve this strategy are urgent.

Coping with changing conditions: alternative strategies for the delivery of maternal and child health and family planning services in Dhaka, Bangladesh

Routh,Subrata; Arifeen,Shams El; Jahan,Shamim Ara; Begum,Anwara; Thwin,Aye Aye; Baqui,Abdullah  Hel
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2001 EN
Relevância na Pesquisa
96.02%
The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour- intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services.