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Strengthening mental health system governance in six low- and middle-income countries in Africa and South Asia: challenges, needs and potential strategies

PETERSEN, Inge
et al
February 2017

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The aim of this study was to identify key governance issues that need to be addressed to facilitate the integration of mental health services into general health care in the six participating "Emerald" countries (Ethiopia, India, Nepal, Nigeria, South Africa, and Uganda).  The study adopted a descriptive qualitative approach, using framework analysis. Purposive sampling was used to recruit a range of key informants, to ensure views were elicited on all the governance issues within the expanded framework. Key informants across the six countries included policy makers at the national level in the Department/Ministry of Health; provincial coordinators and planners in primary health care and mental health; and district-level managers of primary and mental health care services. A total of 141 key informants were interviewed across the six countries. Data were transcribed (and where necessary, translated into English) and analysed thematically using framework analysis, first at the country level, then synthesised at a cross-country level.

Integration of childhood tuberculosis into maternal and child health, HIV and nutrition services: A case study from Uganda

VERKUIJL, Sabine
et al
September 2016

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"Country case studies were conducted in Uganda and Malawi to document and analyse experiences and perspectives on childhood TB integration into other programmes at country level and related health system requirements. The aim was to inform the broader thinking about integration of childhood TB services. The Uganda case study identified and described different approaches to integration and unpacked the integration process. The perspective on TB integration of different relevant health actors at national and district level are described. The case study used a health systems approach and focused on the community and primary levels of the health system, paying attention to factors related to children of different ages in a lifecycle approach. The methodology for the case study included document review, consultations with key health actors at national and district level, a facility visit and a participatory workshop at national level. An analytical framework approach was used to investigate the extent of integration of childhood TB interventions in multiple dimensions. An assessment tool for the case studies was developed, summarising the assessment questions by theme, combining a number of existing tools and frameworks on health care integration in general and childhood TB and iCCM benchmarks"

Integration of childhood TB into maternal and child health, HIV and nutrition services. A case study from Malawi.

VERKUIJL, Sabine
et al
September 2016

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"Country case studies were conducted in Uganda and Malawi in order to document and analyse experiences and perspectives on childhood TB integration into other programmes at country level and related health system requirements. The aim was to inform the broader thinking about integration of childhood TB services. The Malawi case study identified and described different approaches to integration and unpacked the integration process. The perspective on TB integration of different relevant health actors at national and district level are described. The case study used a health systems approach and focused on the community and primary levels of the health system, paying attention to factors related to children of different ages in a lifecycle approach. The method for the case study included document review, consultations with key health actors at national and district level, a facility visit and a participatory workshop at national level. An analytical framework approach was used to investigate the extent of integration of childhood TB interventions in multiple dimensions. An assessment tool for the case studies was developed, summarising the assessment questions by theme, combining a number of existing tools and frameworks on health care integration in general and childhood TB and benchmarks for integrated community case management (iCCM)"

HIV & AIDS "train the trainers" manual

AFRICA UNION OF THE BLIND (AFUB)
2010

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"This manual is for use by Trainers of Trainers. i.e. trainers of visually impaired Peer Educators. It has been developed to provide awareness and training on HIV&AIDS prevention, treatment, care and support and to equip blind and partially sighted participants with Peer Educations skills. It is hoped that blind and partially sighted participants will become effective Peer Educators in training other visually impaired persons in their communities"
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Anchoring awareness in the community : issuing from an learning-from-experience process on the project "Improvement of HIV/AIDS prevention and treatment in the cross-border regions of Djibouti, in Ethiopia and in Somaliland"

DE LAMARZELLE, Julie
October 2009

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This report provides feedback from a "learning-from-experience processes" in order to improve HIV/AIDS prevention and treatment around Djibouti, Ethiopia and Somalia regions. It aims for stakeholders and projects’ leaders to integrate the lessons learned on other awareness development projects so future implementation techniques can be improved
Lessons from experience : know-how analysis

Repositioning postnatal care in a high HIV environment : Swaziland

WARREN, Charlotte
et al
2008

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This report arose from recognition of the need to provide better care and follow up of mothers and infants in the postnatal period in order to improve maternal and neonatal outcomes in Swaziland. The objectives of the study were to determine if changes to the guidelines on postnatal care would result in improvements to provision of of maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum (PP) women, and improve the care and follow up of HIV-positive postpartum women and their infants. The study confirmed that the introduction of an improved postnatal package with revised timing and content provided key components of maternal, newborn, and HIV care, and increased the utilization of services among postpartum women and their infants. An assessment of the quality of care during client-provider interactions for all postpartum women demonstrated a fourfold increase in the proportion that included all aspects of care: maternal and newborn health, counseling for HIV, family planning, and improved provider-client relationships

Mainstreaming blindness issues into HIV & AIDS training programs : organisational guide

AFRICAN UNION OF THE BLIND (AFUB)
2007

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This comprehensive resource provides a set of criteria for mainstreaming the training of blind and visually impaired people on HIV & AIDS education. It is based on the meetings and workshops conducted at the Institutional Development Program (IDP) 4th Africa forum, with the aim of ensuring the inclusion and participation of blind and visually impaired individuals in HIV & AIDS education programmes. This ends with a set of tips for facilitators working in disabled peoples organisations and HIV & AIDS services and organisations

'Reverse integration' in leprosy : lessons from Mkar, Nigeria

IYOR, Fidelis T
2006

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[Author's abstract] : Integration of leprosy control into general health services (GHS) has gained much wider acceptance. Integration policies and efforts have usually been directed towards taking leprosy services to general health services. 'Reverse integration' means bringing other health care services into existing leprosy services. This paper discusses the process of reverse integration in a missionary hospital in Nigeria with the attendant advantages. These include; accessibility of specialised services; affordability of specialised services; extended application of expert knowledge and skills; reduction in cost of training workers for leprosy work; integration of persons affected by leprosy; comprehensive health care for leprosy patients; additional sources of funds; effective utilisation of personnel and facilities; springboard for other programmes; and interest of government functionaries and philanthropists. Reverse integration will help to showcase the contribution of leprosy programmes to general health services

Community-based health financing and child health

MAKINEN, Marty
PARTNERS FOR HEALTH REFORMPLUS (PHRplus)
et al
2006

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This brief reports on the effects that membership in community-based health financing schemes has on the use of health services when a member is ill or injured and, specifically, on priority child health services (immunisations, vitamin A supplementation, treatment of diarrhoeal disease, and prevention and treatment of malaria). The results come from household surveys performed by the Partners for Health Reformplus project (PHRplus) in the three West African countries of Ghana, Mali, and Senegal in 2004

Best practices in scaling up case study : Uganda, using a simple survey method for evidence-based decision making at the district level

NSABAGASANI, Xavier
et al
2006

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This document provides a case study of the Uganda Program for Human and Holistic Development (UPHOLD), and its use of the Lot Quality Assurance Sampling (LQAS) survey method. LQAS is used to collect district and sub-district data. This document highlights its importance, the country context before LQAS, the methodology behind it, results, steps in the scale-up process, best practice, lessons learned and challenges. The Ugandan government is currently considering expanding use of the LQAS into every district

Opportunities for Africa's newborns : practical data, policy and programmatic support for newborn care in Africa

LAWN, Joy
KERBER, Kate
2006

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The African region has the highest rates of neonatal mortality in the world, and has shown the slowest progress so far in reducing neonatal deaths. New policies, however, seem to provide opportunities to accelerate progress for maternal, newborn and child health. Section 1 presents an overview of neonatal deaths, and lives that could be saved in Africa in order to guide policy and programme priority setting. Section 2 explores the the continuum of care through pre-pregnancy, pregnancy, childbirth and the postnatal period, highlighting current gaps in coverage of care and opportunities to address these gaps at all levels - family and community care, outreach services, and primary and referral care facilities. Section 3 contains an overview of the current situation for 9 key programmes related to newborn health. Section 4 discusses lessons learned and existing gaps between new policies and their implementation. Section 5, finally, contains a summary of relevant data for decision making for 46 countries in sub-Saharan Africa regarding maternal, newborn and child health status and policy. This accessible and comprehensive tool will be of use to policy makers, health and community workers and programme managers

Are disabled peoples’ voices from both south and north being heard in the development process?|A comparative analysis between the situation in South Africa, Zimbabwe, United Kingdom and Northern Europe

DUBE, A K
CHAROWA, Gladys
May 2005

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This study reveals that there are major differences between the South and the North regarding issues involving persons with disabilities. It shows that the North provides devices for disabled persons and maintains high standards in disability; whereas countries in the South have weak acts of parliament, in addition to the fact that much of the South does not have social security benefits

Health care access of the very poor in Kenya

SOHANI, Salim B
2005

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This paper reviews a model of health care delivery for the poorest, developed in Kenya. "It illustrates that a pro-poor health system can be developed if the true representatives of the poorest are enabled to participate in health care delivery, and good governance and proper systems are established...With the active involvement of the community in a mutually supportive manner, the utilisation of services and access to basic health care for the poorest can be improved"

Quality assurance resource pack for voluntary counselling and testing service providers

LIVERPOOL VCT (LVCT)
CARE KENYA
2003

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This resource pack is a helpful tool aimed at services, organisations and health professionals involved in the voluntary counselling and testing (VCT) centres in Kenya. VCT services offer HIV testing to asymptomatic individuals, and pre- and post-testing counselling. Compliance with quality requirements in the provision of the service is crucial to the achievement of the objectives. The National Guidelines for VCT set minimum standards for the registration and accreditation of sites and the Liverpool School of Tropical Medicine has devised a comprehensive quality assurance system to accompany the upscaling of the VCT programme, with an emphasis on individual and community involvement. This resource outlines the lessons learned in the implementation of quality assurance in VCT, and includes useful training materials and tools such as self-assessment and service supervision survey forms for the monitoring and evaluation of service delivery quality

South African health review 2002

Health Systems Trust (HST)
2003

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This is a comprehensive, authoritative and independent review of the South African health system. It is published annually and the theme of this year's edition is the restructuring of the health care system: progress to date. It is made up of 21 chapters grouped into four themes: framework for transformation, human resources, priority programmes and support systems. The review acts as a barometer for assessing the transformation processes and their impact on provision of equitable health care to all in South Africa

South African health review 2001

HEALTH SYSTEMS TRUST (HST)
March 2002

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This is a comprehensive, authoritative and independent review of the South African health system. It is published annually and this year's edition is is made up of 17 chapters grouped into four themes: listening to voices, equity, information for health, accountability and transformation. The review acts as a barometer for assessing the transformation processes and their impact on provision of equitable health care to all in South Africa

Current issues in sector-wide approaches for health development : Uganda case study

BROWN, Adrienne
2000

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This brief document reports on the broad achievements and constraints faced in the health sector in Uganda. Poverty-reduction funds are being channelled into primary care, and improved management of public funds is helping the situation. However, capacity beyond the Ministry of Health is limited, and decentralization, with unclear policy links in the regions, is a challenge. There is some evidence of success in using funding strategies to reorient services to primary care and prevention

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