ASSESSING THE QUALITY OF REPRODUCTIVE HEALTH SERVICES ppt

... management of the service facility as one component of the quality of care5" QUALITY IN THE CONTEXT OF REPRODUCTIVE HEALTH SERVICES The WHO definition of reproductive health extends ... level of satisfaction with the service, to complement the views of the providers of care. A CONCEPTUAL FRAMEWORK FOR ASSESSING QUALITY IN REPRODUCTIVE HEALTH SERVICES Stages of the Health ... REPRODUTIVE HEALTH SERVICES A CONCEPTUAL FRAMEWORK FOR ASSESSING QUALITY IN REPRODUCTIVE HEALTH SERVICES Stages of the Health Care Continuum The Components of Quality PUTTING THE FRAMEWORK...

... Access and Quality (MAQ) Initiative to illuminate key issues about the quality of reproductive health care foryoung adults. The quality of care framework ismultidimensional and depends on the priori-ties ... people oftenseek information about reproductive health from their peers and the media, rather thanfrom teachers, health professionals, or parents.They are also more likely to obtain services from ... Χαρε7Address the Full Range of Young People’s Reproductive Health Care Needs Health care facilities need be aware of andaddress the full spectrum of young people’s reproductive health care needs....

... 1Systematicscreeningisatechniqueforidentifyingandmeetingunmetclientneedfor health care services. Providersuseastandardizedinstrument,generallyachecklistorset of questionstodeterminewhetheraclientneeds services otherthan the oneforwhichshecame—suchas reproductive health services, immunization,orother services. Providersthenofferadditional services during the samevisitormakeanappointmentorreferralfor services thatcannotbeprovidedimmediately(Foreit2006,onlineatwww.popcouncil.org/pdfs/frontiers/pbriefs/Sys_Scrn_brf.pdf). ... Mutilation/Cutting Gender Integration of Services Sustainability of Services Utilization of Research Findings Youth Reproductive Health The complete reports referenced in these papers are available ... FRONTIERSLegacyDocumentsFinancialSustainability of RH Services DetermineCostsEarlytoEnhanceSustainabilityAsexternalsupportforinnovativeinterventionscontinuestodecline,programmanagersneedtoconsiderlong‐termusefulnessandsustainability of anyneworrevisedinterventionsbeingpilot‐tested;thereislittlepointintestinginterventionsthatarenotaffordable.Somestrategiesprogramscanusetoassesscost of testingandexpanding reproductive health projects,aswellasways of assessing potentialincome‐generatingstrategies,follow.Considercosts of implementingandscalingupinterventionsfromearliestplanningstages.Implementinginterventionsandinstitutionalizingeffectivepracticesinvolvecosts—includinglabor,capitol,materials,technicalassistance,andopportunitycosts—all of whichneedtobebornebygovernment,NGOs,donors,orserviceusers.Thus,whendesigningapilotproject,plannersshouldattempttoestimatecosts of institutionalizingandscalingupinterventionsbeforeembarkingonimplementation.Suchplanningcanhelptoavoidpilotingunsustainableinterventions.Thiscanbedonebyidentifyingandcostingresourcerequirementsaccordingto the threemainphases of apilot–test:planning;introduction of intervention;andongoingservicedelivery(Janowitzetal.2007).Thisreducescomplexity of costingbybreakingprojectimplementationdownintocomponentpartsandfocusingoncostsassociatedwitheachphase.Scaling‐upcostscanthenbeestimatedon the basis of the secondtwophases,whicharelikelytorepresentcosts of expandingintonewsites(introduction of intervention)andsustaining services onaroutinebasis(ongoingservicedelivery).Calculatefirst‐phaseandscale‐upcostsseparately.Costs of routinelyimplementingscaled‐upinterventionsarenotsimplemultipliers of costs of pilotprojects,butusuallyarelowerthan the pilotprojectonaper‐sitebasisbecause of economies of scale,streamlining of activitiesandsubstitution of lower‐costresources(Boatengetal.2006;Birungietal.2008).Numerousfactorsaffect the cost of scalingupasuccessfulpilotinterventiontomultipleservicedeliverypoints(SDPs)—includingnumberandsize of SDPs,whoprovidesresourcesandatwhatprices,andchangesininterventionalteringcostcalculationsinscale‐up.Modeling the scale‐up of apilotprojecttoimproveFPclient‐providerinteractionsinEgyptianclinicsshowscostperclinicforimplementationwoulddropsignificantlyfrompilottoscale‐up,inpartbecausemanyplanningmeetingsandpreparatoryactivities—about25percent of cost of the pilotproject—canbereduced,orcancoveralargernumber of clinics.Economies of scalealsoreducecost of otheractivities,suchastraining,becauselargernumbers of providerscanbetrainedtogether.Forexample,modelingscale‐upfrom24to567clinicsreducesprojectedcosts of planningfrom$1,018perclinicto$40perclinicbecauselittleadditionalworkisneededtoplanfor567comparedwith24clinics.Bycontrast,supervisioncostsmightnotchangeafterscale‐upascontinualsupervisionisusuallynecessarytoensurecorrectimplementation of intervention(Janowitzetal.2007).FRONTIERSLegacyDocumentsFinancialSustainability of RH Services Useexistinginstitutionstopilot‐testactivitiesthatcouldbescaledup.InKenyaandSenegal,multisectoralapproachesforimprovingyouth reproductive health wereintroducedthroughpublic‐sectorministriesbecauseexistingstructuresaresustainableandalreadyreach the vastpopulationmajority.Stafffromthreeministriesineachcountryplannedandimplementedinterventions;communityleadersandexistingyouthorganizationsparticipatedinplanningandplayedmajorrolesinoutreachandeducation.Thisapproachnotonlycontainedcostspilot‐testingdonorsthroughenormousresourcecontributions of ministrystafftime,infrastructureandfacilities,butalsoenabledexpansionandscale‐upcoststobeinstitutionalizedwithinannualbudgetsandministryworkplans(Joyceetal.2008).CapacityBuildingtoHelpNGOsAchieveFinancialSustainabilityItisdifficulttofindtrainedprofessionalsinnongovernmentalorganizations(NGOs)withexperiencecollectingandanalyzinginformationonservicedeliverycosts.Moreover,few health NGOspossessessentialbusinessskillsincosting,break‐evenanalysisandmarketresearch,skillsnecessaryforplanningandevaluatinginterventionstocontrolcostsandincreaseincome.FRONTIERSpartner,Family Health International,implemented the “FinancialSustainabilityCapacityBuildingInitiative”(FSCBI)from1999to2008tobuildskillsineconomicanalysistohelpNGOsimprovesustainability.StaffandmanagersfromparticipatingNGOsinAfrica,Asia,andLatinAmericaattendedweek‐longregionalworkshopscombiningtrainingoneconomicanalyseswithresearchproposaldevelopment(Box2);thosewhoseproposalswereacceptedreceivedfinancialandtechnicalassistancetoconductcapacitybuildingandresearch(Bratt,Janowitz,Homan,andForeit2008).Box...

... envisioned in the Programme of action. Olsen and Zeckhauser (1966) were the first to check whether there exist in the practice of the NATO some form of ‘exploitation’ by the small countries of the large ... and can therefore not neglect the efforts of others if they want to achieve goals that are in line with the agenda set by the participants of the Cairo conference. They are dependent on others ... assume for the sake of the argument that all decisions are made by the national government (often the ministry of foreign affairs). The maximization problem of the government can then be represented...

... cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels. The results of this assessment will guide the management in the setting of ... in the market, limit ability to collect revenues from these services. Therefore these services will remain dependent upon donor or other third party financing. The cost analysis of these services ... PMTCT services, the cost of production needs to be reduced and/or revenues from these or other services need to increase. Discussion: The provision of RH services is not sustainable under the...

... years”12 Assessing the quality of investment advice in the retail banking sector Section 2 – Key causes of poor adviceabout these failings as the majority of the mystery shops based upon the short, ... remuneration with the customer The adviser went through the contents of the firm’s ‘Keyfacts about our services and costs’ document with the customer at the beginning of their first meeting. The adviser ... concerns with the quality of advice in the other quarter.In 11% of mystery shops we felt the advice was unsuitable for the customer and in a further 15% the adviser did not gather enough information...

... travelled, the cost of services and the attitudes of providers. The brief also discusses tools for measuring quality of care and improvements in quality of care. The authors recommend a list of quality ... definitions of quality of care in the context of reproductive health. The brief focuses on a client-centred approach to improving quality of care, where the needs and perspectives of patients ... Health Services Research examines the relationship between the quality of family planning services and the use of intrauterine devices (IUDs) in Egypt. There is general agreement that the quality...

... stand-alone STI services are uncom-mon, training of primary health care nurses insyndromic management of STIs in MCH/FP services was the primary focus of much of the early work on the interface ... always bear in mind their dualresponsibility to provide optimal care to the motherand reduce the likelihood of MTCT of HIV. ‘ The core goal of all medical therapy is to bring the patient’s viral ... forproviding reproductive health services. Integrating HIV services within programmesproviding other sexual and reproductive health services is anticipated to offer cost savingsthrough sharing of staff,...

... (USAID) under the terms of Cooperative Agreement No. HRN-A-00-98-00012-00. The contents are the responsibility of the FRONTIERS Program and do not necessarily reflect the views of USAID or the United ... Based on the findings of the pilot study, Adolescent Health was established as a priority and a strategic goal in Senegal’s reproductive health agenda. As part of the repositioning of family ... districts. e. Adolescent Reproductive Health was included in the Norms and Guidelines in Reproductive Health during the revision process conducted by the Ministry of Health in December 2004....

... adjusted for the effect of the health of the population the GP serves. To illustrate ideas, we model child health as a function of family characteristics, Xi, and the true quality of the GP ... measure of the health and SES of the younger female population of the practice. Most of these measures are taken early during pregnancy and refer to the health, housing and SES of the mother prior ... of the practice and the number of night visits, but not of other measures of practice quality. 21 The population health measures derived from the health of the ALSPAC mothers were significantly...