Background: Malaria is a disease of public health concern, which causes significant mortality and morbidity in the tropics, particularly in Africa. Ghana as a country has been implementing a combination of preventive ...Background: Malaria is a disease of public health concern, which causes significant mortality and morbidity in the tropics, particularly in Africa. Ghana as a country has been implementing a combination of preventive and curative interventions as outlined in the Strategic Plan for Malaria Control in Ghana, 2014-2020. Additionally, Ghana subscribes to sub-regional and global initiatives such as the test, treat and track (T3) initiative which seeks to ensure that every suspected malaria case is tested, every case tested positive is treated with the recommended quality-assured antimalarial medicine, and every case treated with antimalarial is followed up to ensure complete parasite clearance. However, the implementation of this policy is a challenge, hence the need to study provider adherence to the testing, treating, and tracking. Materials and method: The study is cross-sectional in nature and data for this research was collected from consulting room registers, patients’ folders, the District Health Information Management System and a structured questionnaire designed to interview healthcare providers. The data was exported into Stata for cleaning and analysis. The results of the study were presented in the form of statistical charts and tables. Results: The study revealed that generally, provider adherence to the T3 policy was encouraging in the Binduri district, and a high level of testing (100%) of suspected malaria cases eliminated the practice of presumptive treatment. However, tracking of patients (68.2%) was not as high as testing and treatment which was revealed by the number asked to return for a review during the folder review. Conclusion: Significant progress in clinicians’ adherence to policy on malaria case management (T3) in the Binduri District. Continued training and facilitative supervision are essential to sustain gains and close existing gaps in clinicians’ adherence to malaria case management policy.展开更多
Background:Payment methods are known to influence maternal care delivery in health systems.Ghana suspended a piloted capitation provider payment system after nearly five years of implementation.This study aimed to exa...Background:Payment methods are known to influence maternal care delivery in health systems.Ghana suspended a piloted capitation provider payment system after nearly five years of implementation.This study aimed to examine the effects of Ghana’s capitation policy on maternal health care provision as part of lesson learning and bridging this critical literature gap.Methods:We used secondary data in the District Health Information Management System-2 and an interrupted time series design to assess changes in level and trend in the provision of ANC4_(+)(visits of pregnant women making at least the fourth antenatal care attendance per month),HB36(number of hemoglobin tests conducted for pregnant women who are at the 36th week of gestation)and vaginal delivery in capitated facilities-CHPS(Community-based Health Planning and Services)facilities and hospitals.Results:The results show that the capitation policy withdrawal was associated with a statistically significant trend increase in the provision of ANC4+in hospitals(coefficient 70.99 p<0.001)but no effect in CHPS facilities.Also,the policy withdrawal resulted in contrasting effects in hospitals and CHPS in the trend of provision of Hb36;a statistically significant decline was observed in CHPS(coefficient−7.01,p<0.05)while that of hospitals showed a statistically significant trend increase(coefficient 32.87,p<0.001).Finally,the policy withdrawal did not affect trends of vaginal delivery rates in both CHPS and hospitals.Conclusions:The capitation policy in Ghana appeared to have had a differential effect on the provision of maternal services in both CHPS and hospitals;repressing maternal care provision in hospitals and promoting adherence to anemia testing at term for pregnant women in CHPS facilities.Policy makers and stakeholders should consider the possible detrimental effects on maternal care provision and quality in the design and implementation of per capita primary care systems as they can potentially impact the achievement of SDG 3.展开更多
文摘Background: Malaria is a disease of public health concern, which causes significant mortality and morbidity in the tropics, particularly in Africa. Ghana as a country has been implementing a combination of preventive and curative interventions as outlined in the Strategic Plan for Malaria Control in Ghana, 2014-2020. Additionally, Ghana subscribes to sub-regional and global initiatives such as the test, treat and track (T3) initiative which seeks to ensure that every suspected malaria case is tested, every case tested positive is treated with the recommended quality-assured antimalarial medicine, and every case treated with antimalarial is followed up to ensure complete parasite clearance. However, the implementation of this policy is a challenge, hence the need to study provider adherence to the testing, treating, and tracking. Materials and method: The study is cross-sectional in nature and data for this research was collected from consulting room registers, patients’ folders, the District Health Information Management System and a structured questionnaire designed to interview healthcare providers. The data was exported into Stata for cleaning and analysis. The results of the study were presented in the form of statistical charts and tables. Results: The study revealed that generally, provider adherence to the T3 policy was encouraging in the Binduri district, and a high level of testing (100%) of suspected malaria cases eliminated the practice of presumptive treatment. However, tracking of patients (68.2%) was not as high as testing and treatment which was revealed by the number asked to return for a review during the folder review. Conclusion: Significant progress in clinicians’ adherence to policy on malaria case management (T3) in the Binduri District. Continued training and facilitative supervision are essential to sustain gains and close existing gaps in clinicians’ adherence to malaria case management policy.
文摘Background:Payment methods are known to influence maternal care delivery in health systems.Ghana suspended a piloted capitation provider payment system after nearly five years of implementation.This study aimed to examine the effects of Ghana’s capitation policy on maternal health care provision as part of lesson learning and bridging this critical literature gap.Methods:We used secondary data in the District Health Information Management System-2 and an interrupted time series design to assess changes in level and trend in the provision of ANC4_(+)(visits of pregnant women making at least the fourth antenatal care attendance per month),HB36(number of hemoglobin tests conducted for pregnant women who are at the 36th week of gestation)and vaginal delivery in capitated facilities-CHPS(Community-based Health Planning and Services)facilities and hospitals.Results:The results show that the capitation policy withdrawal was associated with a statistically significant trend increase in the provision of ANC4+in hospitals(coefficient 70.99 p<0.001)but no effect in CHPS facilities.Also,the policy withdrawal resulted in contrasting effects in hospitals and CHPS in the trend of provision of Hb36;a statistically significant decline was observed in CHPS(coefficient−7.01,p<0.05)while that of hospitals showed a statistically significant trend increase(coefficient 32.87,p<0.001).Finally,the policy withdrawal did not affect trends of vaginal delivery rates in both CHPS and hospitals.Conclusions:The capitation policy in Ghana appeared to have had a differential effect on the provision of maternal services in both CHPS and hospitals;repressing maternal care provision in hospitals and promoting adherence to anemia testing at term for pregnant women in CHPS facilities.Policy makers and stakeholders should consider the possible detrimental effects on maternal care provision and quality in the design and implementation of per capita primary care systems as they can potentially impact the achievement of SDG 3.
