Rethinking assumptions about delivery of healthcare: implications for universal health coverage

Das, Jishnu; Woskie, Liana; Rajbhandari, Ruma; Abbasi, Kamran; Jha, Ashish K.

doi:10.1136/bmj.k1716

Cited by 87 publications

(74 citation statements)

References 33 publications

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“…Global collaboration is also essential, including efforts by WHO and other leading global health organisations to develop standardised, evidence based tools and resources that support the implementation of effective, safe, and patient centred primary healthcare 5. With these resources, countries will be able to evaluate progress using internationally comparable datasets that generate robust knowledge about what works, what does not, and why.…”

Section: Integration Collaborationmentioning

confidence: 99%

Primary healthcare is cornerstone of universal health coverage

Binagwaho

Ghebreyesus

2019

BMJ

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Section: Integration Collaborationmentioning

confidence: 99%

Primary healthcare is cornerstone of universal health coverage

Binagwaho

Ghebreyesus

2019

BMJ

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“…Quality healthcare is safe, effective, patient-centered, timely, efficient, and equitable. Optimal resources and clinical skills are clearly necessary to deliver quality care, but are not enough by themselves [1]. Approaches to ensure that patients receive high quality care can be divided into two general categories: quality assurance (QA) and quality improvement (QI).…”

Section: E D I T O R I a L E D I T O R I A L E D I T O R I A L E D I mentioning

confidence: 99%

Delivering Quality Healthcare in India: Beginning of Improvement Journey

Deorari

Livesley

2018

Indian Pediatr

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“…This is especially true for patients with multiple chronic conditions, who often struggle to receive care for comorbid diseases without numerous, fragmented encounters [9]. Health workforce shortages and an emphasis on physician-provided care have contributed to significant access, coverage, and quality deficits [10,11].…”

Section: Introductionmentioning

confidence: 99%

An integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study

Schwarz¹,

Dhungana

Kumar

et al. 2020

Trials

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Background: In Nepal, the burden of noncommunicable, chronic diseases is rapidly rising, and disproportionately affecting low and middle-income countries. Integrated interventions are essential in strengthening primary care systems and addressing the burden of multiple comorbidities. A growing body of literature supports the involvement of frontline providers, namely mid-level practitioners and community health workers, in chronic care management. Important operational questions remain, however, around the digital, training, and supervisory structures to support the implementation of effective, affordable, and equitable chronic care management programs. Methods: A 12-month, population-level, type 2 hybrid effectiveness-implementation study will be conducted in rural Nepal to evaluate an integrated noncommunicable disease care management intervention within Nepal's new municipal governance structure. The intervention will leverage the government's planned roll-out of the World Health Organization's Package of Essential Noncommunicable Disease Interventions (WHO-PEN) program in four municipalities in Nepal, with a study population of 80,000. The intervention will leverage both the WHO-PEN and its cardiovascular disease-specific technical guidelines (HEARTS), and will include three evidence-based components: noncommunicable disease care provision using mid-level practitioners and community health workers; digital clinical decision support tools to ensure delivery of evidence-based care; and training and digitally supported supervision of mid-level practitioners to provide motivational interviewing for modifiable risk factor optimization, with a focus on medication adherence, and tobacco and alcohol use. The study will evaluate effectiveness using a pre-post design with stepped implementation. The primary outcomes will be disease-specific, "at-goal" metrics of chronic care management; secondary outcomes will include alcohol and tobacco consumption levels.

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Rethinking assumptions about delivery of healthcare: implications for universal health coverage

Abstract: Simply providing more resources for universal coverage is not enough to improve health, argue Jishnu Das and colleagues. We also need to ensure good quality of care

Cited by 87 publications

References 33 publications

Primary healthcare is cornerstone of universal health coverage

Primary healthcare is cornerstone of universal health coverage

Delivering Quality Healthcare in India: Beginning of Improvement Journey

An integrated intervention for chronic care management in rural Nepal: protocol of a type 2 hybrid effectiveness-implementation study

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