Modernization and development: impact on health care decision-making in Uganda

Uganda has faced numerous challenges over the past 50 years from overcoming political conflict and civil unrest, to rapid population growth, to combating the HIV epidemic and ever-growing health needs. Women in Uganda have had a major role to play in the health of families and communities. The researchers' purpose in this study, undertaken in rural Uganda, was to

• a) identify a people-centered definition of development,
• b) compare it to the process of modernization, and
• c) investigate how these processes have changed the role women play in decision-making, in areas directly and indirectly related to their health and that of their families.

Twenty-two men and women participated in focus group discussion and completed questionnaires. Based on our analysis of discussions it appears that both modernization and development have impacted health positively and negatively. Key themes distilled from interviews included that modernization has led to the breakdown of families; increased maternal ...

Briefing note: Policy dialogue: What it is and how it can contribute to evidence-informed decision-making

This briefing note brings together knowledge generated through the EU-Luxembourg-WHO Universal Health Coverage Partnership, which currently supports policy dialogue processes in 28 countries.

Good governance for health (part of Strategy 3 of the Framework on Integrated People-Centred Health Services) involves broad, continuous and consultative policy dialogue on crucial health sector issues amongst and between all relevant social, technical and political stakeholders. Yet there exists little guidance and analysis on what actually constitutes policy dialogue, how it can contribute to better policies, and what countries can concretely do to better engage in participatory dialogue processes. This Briefing note is a first attempt at making sense of the policy dialogue literature and experiences in using it in health and in low- and middle-income countries. It further examines the following questions:

- What is poilcy dialogue?

- How can the policy dialogue contribute to improving a policy and decision making process?

- What are the possible ...

Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care

Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this proyect was to develop and evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. 

Making it Easier: A Health Literacy Action Plan for Scotland

Making it Easier- a health literacy plan for Scotland 2017-25, builds on the current learning about health literacy and aims to remove and prevent barriers. Health literacy is the degree to ehich individuals have the capacity to obtain, process and understand basic health information and services needed to make appropiate health decisions

The new guidance aims to improve design and delivery of services founded on the following themes: 

- equal access

- shared decision-making

- people supported to live and die well on their own terms with the health conditions they have

How to assess and prepare health systems in low- and middle-income countries for integration of services—a systematic review

Despite growing support for integration of frontline services, a lack of information about the pre-conditions necessary to integrate such services hampers the ability of policy makers and implementers to assess how feasible or worthwhile integration may be, especially in low- and middle- income countries (LMICs). This article adopted a modified systematic review with aspects of realist review, including quantitative and qualitative studies that incorporated assessment of health system preparedness for capacity to implement integrated services. 

Multi-Criteria Decision Analysis of Integrated Care Webinar – SELFIE Project

Professionals are increasingly keen to assess the effects of integrated care initiatives and payers and policy makers are keen to ensure that they allocate scarce resources only to services that have proven value for money. When evaluating the added value of complex interventions such as integrated care initiatives, we need to adopt a broad, inclusive method of evaluation and a holistic, person-centered understanding of ‘value’. This is possible with Multi-Criteria Decision Analysis (MCDA). MCDA is a method to improve transparency of decision-making that makes the impact that multiple criteria have on a decision, and their relative importance explicit. It is particularly suited for interventions where multiple, sometimes conflicting, criteria play a role, and the viewpoints of multiple stakeholders about the importance of decision-criteria need to be taken into account. In this webinar prof.dr. Maureen Rutten-van Mölken of the Erasmus School of Health Policy and Management of the Erasmus ...

Evaluation of integrated care services in Catalonia: population-based and service-based real-life deployment protocols.

Comprehensive assessment of integrated care deployment constitutes a major challenge to ensure quality, sustainability and transferability of both healthcare policies and services in the transition toward a coordinated service delivery scenario. To this end, the manuscript articulates four different protocols aiming at assessing large-scale implementation of integrated care, which are being developed within the umbrella of the regional project Nextcare (2016-2019), undertaken to foster innovation in technologically-supported services for chronic multimorbid patients in Catalonia (ES) (7.5 M inhabitants). Whereas one of the assessment protocols is designed to evaluate population-based deployment of care coordination at regional level during the period 2011-2017, the other three are service-based protocols addressing: i) Home hospitalization; ii) Prehabilitation for major surgery; and, iii) Community-based interventions for frail elderly chronic patients. All three services have demonstrated efficacy and potential for health value generation.

Consultation on the Handbook on Social Participation for UHC for civil society

UHC2030, WHO and the UHC Partnership have launched a consultation for civil society to provide substantial feedback on the contents of the Handbook on Social Participation for UHC. The ‘Handbook on Social Participation for UHC’ will provide specific best practice guidance to policymakers on how to effectively and meaningfully engage with populations, civil society and communities for policy- and decision-making.

The Handbook is in an advanced stage of development and your views would be useful to shape the final document. Currently, you can comment on the overview of five of the chapters through a survey until February 2020.

See more information about the handbook and an overview presentation.

Determinants of enrollment decision in the community-based health insurance, North West Ethiopia: a case-control study

Health security is increasingly being recognized as an integral part of poverty reduction effort. Many lower and middle-income countries (LMICs) have not been able to fulfill equitable healthcare needs of their citizens.
The aim of this study was to identify the determinants for enrollment decision in the community-based health insurance program among informal economic sector-engaged societies, North West Ethiopia.

Are Clients Satisfied with Integrated Care? Enhancing Client Feedback on Discharge from a Domiciliary Based Multidisciplinary Integrated Care Service

The Integrated Care Programme for Older People has supported the development of integrated care services at pioneer sites in Ireland, each developed to meet local needs. Patient Reported Experience Measures (PREMs) have been used to evaluate user experience in intermediate care in the United Kingdom. This project aimed to evaluate client experience of a domiciliary based, multidisciplinary, integrated care service.

Telemedicine for housebound older persons during the Covid-19 pandemic

Hollander and Brendan highlighted the benefit to decision-making that may be drawn from the use of automated screening algorithms in prioritizing patient care to better allocate resources during the Coronavirus disease 2019 (Covid-19) pandemic.  A strategy to screen older community dwellers at risk for home confinement-related adverse consequences must, therefore, be adopted based on an efficient and effective forward triage framework. In older community dwellers, assessing frailty is a definite cornerstone of triage, as it provides insight into the degree of vulnerability in their health status and their risk for adverse consequences. 

The Centre of Excellence on Longevity of McGill University (Quebec, Canada) designed, in late March 2020, a short assessment known as “Evaluation SOcio-GERiatrique” (ESOGER) for Montreal’s housebound community-dwelling older adults. It acts as the first step in connecting older community dwellers who are housebound during the ...

Patient Empowerment: An introduction. Patient Empowerment Mini-Series with CEmPaC

Global Competency and Outcomes Framework for Universal Health Coverage

The goal of this Global Competency and Outcomes Framework for UHC is to advance improvements in health and progress towards UHC through aligning health worker education approaches with population health needs and health system demands. More specifically, the primary objective of this document is to provide guidance for the specification of pre-service and in-service competency-based education outcomes for health workers, which in turn inform the development of relevant curricula, learning activities and assessment approaches. Its main target audience is health workforce educators, but it can be of relevance also for licensing and regulatory authorities and health service and facility managers. With this framework, WHO sets out its recommended approach to competency-based health worker education outcomes; in so doing, it also provides conceptual and terminological clarity.

The Global Competency and Outcomes Framework for Universal Health Coverage identifies the health worker competencies towards the achievement of UHC organized within six domains: people-centredness ...

Decision-Making Dilemmas within Integrated Care Service Networks: A Systematic Literature Review

The diverse nature of people’s care needs requires collaboration between different organisations and sectors. One way of achieving such collaboration is through integrated care service networks. Decision-making is considered an important aspect of network governance and key to achieve further integration of care services. As integrated care scholars only implicitly seem to touch upon the issue of decision-making, we aimed to identify multiple decision-making dilemmas.