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At least 469 records · Page 26Linked to original sources
PubMed2002

The rhetoric of sector-wide approaches for health development.

The past decade has witnessed an increasing concerns over the effectiveness of project-based development assistance and the promotion of sector-wide approaches (SWAps) to health as a means to increase donor collaboration, consolidate local management of resources and undertake the policy and systems reform necessary to achieve a greater impact on health issues. The concept has gained the support of both the World Bank and the World Health Organisation. as well as key bilateral donors, and dominates current initiatives in development assistance for health. This paper examines the proposal of SWAps as rhetoric, and seeks to understand how that rhetoric functions, despite the variable application of its constituent elements and the range of contexts in which it operates.

Community Health Planning↗
PubMed1998

Surviving change: one district health board's experience.

This qualitative evaluation examines critical steps the Moose Jaw-Thunder Creek District Health Board initiated to address health reform; in particular, the adoption of a governance philosophy, restructuring of services, development of a comprehensive planning process, and implementation of a communication strategy. The outcome has been a yearly health plan that maintains quality health services; provides opportunities for service growth, client-centred health delivery and increased accountability through defined outcomes; and ensures that the Board ends the year with a balanced budget.

Community Health Planning↗
PubMed1992

Alberta's Acute Care Funding Project.

Alberta initiated the Acute Care Funding Project (ACFP) in 1988, a new hospital funding system that institutes case mix budgeting adjustments to the global budget so that hospitals can be treated more equitably. The initiative is a significant departure in principle from the former method of funding. The ACFP is summarized and critiqued, and focuses on the inpatient side of the picture. The various elements of the project are discussed, such as the hospital performance index, the hospital performance measure, the Refined Diagnostic Related Group, case weights, typical and outlier cases, and the costing mechanisms. Since its implementation, the ACFP has undergone substantial changes; these are discussed, as well as some of the problems that still need to be addressed. Overall, the system offers incentives to reduce length of stay and to increase the efficiency with which inpatient care is provided.

Alberta↗
PubMed2002

Buying healthcare quality with grants and donations.

We find that grants and contracts increase California healthcare clinics' average costs, but donations do not. We interpret these results as meaning that grants and contracts change the nature of the product while donations are used to increase output without changing the product. One possible scenario is that grants and contracts are targeted money used to enhance quality. A theoretical analysis shows that quality is enhanced more if grants and contracts are used to reward quality rather than as seed money to create quality. The empirical evidence, however, is that grantors are motivated by the second reason.

California↗
PubMed1998

Financially independent primary health care drug supply system in Cameroun.

The drug supply system in the North-west Province of Cameroun differs from 'simple' health financing projects in three important respects. Firstly, the system does not promote drug sales for cofinancing purposes but aims at supporting the prescribers to provide better medical care, and patients' access to the most essential drugs at fair prices. Secondly, the project guarantees equal prices and services throughout the Province regardless of distance from the central warehouse and sales at a given location. Thirdly, along with the revolving fund-financed drug supply system, a community-based legal framework has been established. Built-in management alert mechanisms helped the project resist common causes of collapse such as uneconomic behaviour and political interference. The drug supply system has gained full independence from subsidies and external authorities. Its strong community participation promotes good governance.

Cameroon↗
PubMed2002

Strengthening primary health care: building the capacity of rural communities to access health funding.

Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities.

Budgets↗
PubMedDate not supplied

A win-win model for an academic nursing center: community partnership faculty practice.

A number of schools of nursing have established community nursing centers to provide faculty practice sites, student learning experiences, and a service to the community, most often to a poor underserved population. The current literature concludes that these centers provide a quality clinical service and improve access to health care, and they also provide an avenue for research, training, and faculty practice. Acquiring necessary financial support and the ability to achieve financial independence appear to be the most common difficulties for these centers. Most of the current literature includes an examination of issues relating to funding. The model presented in this article focuses on organizational variables that include both the center and its placement in relationship to other functions and programs in the school and a broadening of the meaning of fiscal responsibility to include an awareness of the broad spectrum of benefits that the community nursing center brings to the entire school. Efforts to coordinate and integrate the needs and functions of several groups are described. Establishing goals and priorities that simultaneously meet the needs of all or most of these groups has been an important outcome. The activities of the center have become an integral part of the everyday life of the school. Achieving financial independence and being fiscally aware and responsible is not the same thing.

Community Health Centers↗
PubMedDate not supplied

The Health Action Fund: a community-based approach to enhancing health.

This article is based on a program that was developed by the Center for Healthy Communities (CHC), a community-academic partnership in Dayton, Ohio, that continues to act as a force for change in health professions' education and health delivery, stressing the philosophy of "doing with" instead of "doing for" or "doing to." The Health Action Fund is a grassroots health communications and social marketing program that targets community groups who are involved often in health promotion activities developed by large agencies. However, rather than taking the traditional approach to health promotion and prevention where program development and implementation is left to professionals, a different approach was taken that encourages members of neighborhoods, a community group, or a church to identify a problem and then develop a way to address that problem for their group. The program focuses on neighbors helping neighbors where communities take the lead in health promotion and prevention activities. We discuss in detail the project's innovation, challenges and how they have been addressed, qualitative and quantitative improvements made to the program, and how the program serves as a model for other communities.

Community Participation↗
PubMed2004

The Medical Specialist Outreach Assistance Programme in South Australia at 2 years.

OBJECTIVE: To describe the progress and achievements of the psychiatric services developed by the Medical Specialist Outreach Assistance Programme in South Australia over the last 2 years. There is a particular focus on services provided to the remote areas of the far northern region of South Australia. CONCLUSION: During this period there has been an expansion of visiting psychiatric services to South Australia's rural and remote communities. In particular, child and Indigenous services have improved considerably. These have been important developments and it is hoped that funding and services will continue after the June 2004 conclusion of the Medical Specialist Outreach Assistance Programme.

Adult↗
PubMed2006

A survey of publicly funded aged psychiatry services in Australia and New Zealand.

OBJECTIVE: To map the size and distribution of publicly funded aged psychiatry (psychogeriatric) services in Australia and New Zealand in 2003. METHOD: Services were tracked exhaustively through personal, professional and academic contacts, electronic searches and word-of-mouth. Directors or managers of services were asked to complete a brief questionnaire concerning their locality, services, staff profile and patient contacts. RESULTS: Services varied widely with respect to their numbers, size and community outreach. Victoria was the only Australian state to provide specialist, multidisciplinary aged psychiatry teams with community, acute inpatient and residential arms in all its major cities. New South Wales, the state with the largest aged population, performed relatively poorly on most indicators. New Zealand performed relatively well despite its small size and widely dispersed population. CONCLUSIONS: Publicly funded aged mental health services are effective and reach frail, multiply disabled old people who cannot access private psychiatrists and are often overlooked by services for younger adults. At the time of our survey, such services were distributed in Australia in a highly inequitable fashion.

Aged↗
PubMed2002

Factors influencing decisions regarding influenza vaccination and treatment: a survey of healthcare workers.

Surveys conducted in our healthcare facility evaluated factors associated with acceptance of influenza vaccination and opinions regarding influenza prevention and treatment and willingness to pay. Avoiding lost work and low risk were primary reasons for vaccine recipients and non-recipients, respectively. One-third of vaccine recipients would refuse vaccination if asked to pay at least $10.

Adolescent↗