A5010065974- Global Maternal and Child Health
- Healthcare Systems and Reforms
- Child Nutrition and Water Access
- Healthcare Policy and Management
- COVID-19 epidemiological studies
- Vaccine Coverage and Hesitancy
- Global Public Health Policies and Epidemiology
- Global Health Care Issues
- HIV/AIDS Impact and Responses
- Migration, Health and Trauma
- Global Health and Surgery
- HIV, Drug Use, Sexual Risk
- COVID-19 Clinical Research Studies
- HIV/AIDS Research and Interventions
- Primary Care and Health Outcomes
- SARS-CoV-2 and COVID-19 Research
- Viral Infections and Outbreaks Research
- Healthcare Quality and Management
- Urban Transport and Accessibility
- Health Policy Implementation Science
- Health Systems, Economic Evaluations, Quality of Life
- Data-Driven Disease Surveillance
- Immune responses and vaccinations
- Urban and Freight Transport Logistics
- Medical Coding and Health Information
Harvard University
2018-2024
Harvard Global Health Institute
2019-2024
PIVOT
2020-2023
Centre National de la Recherche Appliquée au Developpement Rural
2020-2023
Pivot
2020-2023
Institute for Community Health
2018-2020
Cambridge Health Alliance
2018-2020
University of Maryland Medical System
2019
University of Maryland, Baltimore
2019
Johns Hopkins University
2015-2018
Nationally, health in Rwanda has been improving since 2000, with considerable improvement 2005. Despite improvements, rural areas continue to lag behind urban sectors regard key outcomes. Partners In Health (PIH) supporting the Ministry of (MOH) two districts Since 2009, MOH and PIH have spearheaded a systems strengthening (HSS) intervention these as part Population Implementation Training (PHIT) Partnership. The partnership is guided by belief that HSS interventions should be comprehensive,...
As the US wrestles with immigration policy and caring for an aging population, data on immigrants' role as health care long-term workers can inform both debates. Previous studies have examined direct (nursing, home health, personal aides) but not that of immigrants hired by private households or nonmedical facilities such senior housing to assist elderly disabled people unauthorized in providing these services. Using nationally representative data, we found 2017 accounted 18.2 percent 23.5...
Routine health data can guide systems improvements, but poor quality of these hinders use. To address concerns about in Malawi, the Ministry Health and National Statistical Office conducted a assessment (DQA) July 2016 to identify systems-level factors that could be improved.We used 2-stage stratified random sampling methods select centers hospitals under auspices, included those managed by faith-based entities, for this DQA. Dispensaries, village clinics, police military facilities,...
Although Rwanda's health system underwent major reforms and improvements after the 1994 Genocide, population in southeast lagged behind other areas. In 2005, Partners Health Rwandan Ministry of began a strengthening intervention this region. We evaluate potential impacts on maternal child indicators.Combining results from 2005 2010 Demographic Surveys with those supplemental survey, we compared changes output indicators outcomes between as reported by women living area pooled all rural areas...
Geographic distance is a critical barrier to healthcare access, particularly for rural communities with poor transportation infrastructure who rely on non-motorized transportation. There broad consensus the importance of community health workers (CHWs) reduce effects geographic isolation access. Due lack fine-scale spatial data and individual patient records, little known about precise CHWs removing barriers at this level system. Relying high-quality, crowd-sourced dataset that includes all...
Despite widespread adoption of community health (CH) systems, there are evidence gaps to support global best practice in remote settings where access care is limited and workers (CHWs) may be the only available providers. The nongovernmental organization Pivot partnered with Ministry Public Health (MoPH) pilot a new enhanced (ECH) model rural Madagascar, one CHW provided at stationary CH site while additional CHWs via proactive household visits. program included professionalization workforce...
Adapting health systems for climate change can lessen the negative impact of on human health. Even when not targeting climate-health links explicitly, broad system strengthening interventions (HSSi's) ensure that workforce, infrastructure, and networks are robust enough to respond recover from climate-driven shocks. We explored ability an HSSi in a rural district southeastern Madagascar serve as adaptation response cyclone Batsirai 2022. The provides support programs infrastructure while...
Integrated into the work in health systems strengthening (HSS) is a growing focus on importance of ensuring quality services delivered and which support them. Understanding how to define measure different key World Health Organization building blocks critical providing information needed address gaps identify models for replication. We describe approaches defining improving across five country programs funded through Doris Duke Charitable Foundation African Initiative. While each program has...
In October 2018, the Trump administration published a proposed rule change that would increase chance of an immigrant being deemed "public charge" and thereby denied legal permanent residency or entry to United States. The changes are expected cause many parents disenroll their families from safety-net programs, in large part because fear confusion about rule, even among whom does not technically apply.To simulate potential harms by estimating number, medical conditions, care needs children...
<h3>Background:</h3> Medical scribes are a clinical innovation increasingly being used in primary care. The impact of care remain unclear. We aimed to examine the medical on productivity, time spent facing patient during visit, and comfort with <h3>Methods:</h3> conducted prospective observational pre-post study 5 family internal medicine-pediatrics physicians their patients at an urban safety net health clinic. accompanied providers examination room documented encounter. After initial...
Poor geographic access can persist even when affordable and well-functioning health systems are in place, limiting efforts for universal coverage (UHC). It is unclear how to balance support facilities community workers UHC national strategies. The goal of this study was evaluate a system strengthening (HSS) intervention aimed towards affected the primary care rural district Madagascar. For this, we collected fokontany residence (lowest administrative unit) from nearly 300 000 outpatient...
Health care is most effective when a patient's basic primary needs are met as close to home possible, with advanced accessible needed. In Ifanadiana District, Madagascar, collaboration between the Ministry of Public (MoPH) and PIVOT, non-governmental organization (NGO), fosters Networks Care (NOC) support high-quality, patient-centered care. The district's health system has three levels care: community, center, district hospital; regional hospital available for tertiary services. We explore...
There are many outstanding questions about how to control the global COVID-19 pandemic. The information void has been especially stark in World Health Organization Africa Region, which low per capita reported cases, testing rates, access therapeutic drugs, and longest wait for vaccines. As with all disease, central challenge responding is that it requires integrating complex health systems incorporate prevention, testing, front line care, reliable data inform policies their implementation...
While health systems strengthening (HSS) interventions are recommended by global policy experts to improve population in resource-limited settings, few examples exist of evaluations HSS conducted at the district level. In 2009, a partnership between Partners Health (PIH), non-governmental organization, and Rwandan Ministry (RMOH) was provided funds implement evaluate district-level intervention two rural districts Rwanda.The limited 14 centers for targeted support 2010; six others received...
Large scale evaluations in several settings have demonstrated that lay community health workers can be trained to provide quality case management of childhood illnesses. In 2010, Mozambique introduced the integrated (iCCM) strategy reach children remote areas with care provided through Agentes Polivalentes Elementares (APEs). We assessed contribution program improved care-seeking and appropriate treatment febrile illness Nampula Province.We used a post-test quasi-experimental design three...
To reach global immunisation goals, national programmes need to balance routine at health facilities with vaccination campaigns and other outreach activities (eg, weeks), which boost coverage particular times help reduce geographical inequalities. However, where is weak, an over-reliance on may lead heterogeneous coverage. Here, we assessed the impact of a system strengthening (HSS) intervention relative contribution goals in rural Madagascar.We obtained data from centres Ifanadiana district...
Introduction Despite renewed commitment to universal health coverage and system strengthening (HSS) improve access primary care, there is insufficient evidence guide their design implementation. To address this, we conducted an impact evaluation of ongoing HSS initiative in rural Madagascar, combining data from a longitudinal cohort centres. Methods We carried out district representative household survey at the start intervention 2014 over 1500 households Ifanadiana district, follow-up...
ABSTRACT Community health programs are gaining relevance within national systems and becoming inherently more complex. To ensure that community lead to equitable geographic access care, the WHO recommends adapting target population workload of workers (CHWs) according local context size communities they serve. Geographic optimization could be particularly beneficial for those activities require CHWs visit households door-to-door last mile delivery care. The goal this study was demonstrate...
Abstract Objective We demonstrate a replicable model health district for Madagascar. The governments of many low-income countries have adopted policies that follow international standards, and yet there are four hundred million people without basic access to primary care. Closing this global delivery gap is typically framed as an issue scale-up, accomplished primarily through integrating donor funds with broad-based system strengthening (HSS) efforts. However, no established process by which...
As US policy makers tackle immigration reform, knowing whether immigrants are a burden on the nation’s health care system can inform debate. Previous studies have indicated that contribute more to Medicare than they receive in benefits but not examined roughly 50 percent of with private coverage provide similar subsidy or even drain resources. Using nationally representative data, we found accounted for 12.6 premiums paid insurers 2014, only 9.1 insurer expenditures. Immigrants’ annual...
Abstract Data on population health are vital to evidence-based decision making but rarely adequately localized or updated in continuous time. They also suffer from low ascertainment rates, particularly rural areas where barriers healthcare can cause infrequent touch points with the system. Here, we demonstrate a novel statistical method estimate incidence of endemic diseases at community level passive surveillance data collected primary centers. The zero-corrected, gravity-model (ZERO-G)...