Can a standards-based approach improve access to and quality of primary health care? Findings from an end-of-project evaluation in Ghana

Maly, Christina; Boadu, Richard Okyere; Rosado, Carina; Lailari, Aliza; Vikpeh-Lartey, Bernard; Allen, Chantelle

doi:10.1371/journal.pone.0216589

Cited by 2 publications

(1 citation statement)

References 32 publications

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“…52,53 Benchmarking Myriad approaches exist for measuring clinical competence and quality of care that are tied to continuous improvement efforts, from professional certification requiring continuing medical education, to coaching, clinical mentoring, supportive supervision, standardsbased assessment, and practice drills. 2,54,55 Regular drills both refresh clinical skills and strengthen teamwork, as has been shown in South Africa. 56 Another example, a nurse mentoring program in Karnataka, India, exemplifies the potential of regular supervision and clinical mentorship.…”

Section: Clinical Guidance Documentation and Reviewmentioning

confidence: 89%

Developing a Common Understanding of Networks of Care through a Scoping Study

Carmone

Kalaris

Leydon

et al. 2020

Health Systems & Reform

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The phrase "Networks of Care" seems familiar but remains poorly defined. A health system that exemplifies effective Networks of Care (NOC) purposefully and effectively interconnects service delivery touch points within a catchment area to fill critical service gaps and create continuity in patient care. To more fully elaborate the concept of Networks of Care, we conducted a multimethod scoping study that included a literature review, stakeholder interviews, and descriptive case studies from five low-and middle-income countries. Our extended definition of a Network of Care features four overlapping and interdependent domains of activity at multiple levels of health systems, characterized by: 1) Agreement and Enabling Environment, 2) Operational Standards, 3) Quality, Efficiency and Responsibility, and 4) Learning and Adaptation. There are a series of key interrelated themes within each domain. Creating a common understanding of what characterizes and fosters an effective Network of Care can drive the evolution and strengthening of national health programs, especially those incorporating universal health coverage and promoting comprehensive care and integrated services. An understanding of the Networks of Care model can help guide efforts to move health service delivery toward goals that can benefit a diversity of stakeholders, including a variety of health system actors, such as health care workers, users of health systems, and the wider community at large. It can also contribute to improving poor health outcomes and reducing waste originating from fragmented services and lack of access.

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Section: Clinical Guidance Documentation and Reviewmentioning

confidence: 89%

Developing a Common Understanding of Networks of Care through a Scoping Study

Carmone

Kalaris

Leydon

et al. 2020

Health Systems & Reform

View full text Add to dashboard Cite

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Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why

Elsey,

Abboah-Offei,

Vidyasagaran

et al. 2023

Front. Public Health

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BackgroundDespite renewed emphasis on strengthening primary health care globally, the sector remains under-resourced across sub–Saharan Africa. Community-based Health Planning and Services (CHPS) has been the foundation of Ghana's primary care system for over two decades using a combination of community-based health nurses, volunteers and community engagement to deliver universal access to basic curative care, health promotion and prevention. This review aimed to understand the impacts and implementation lessons of the CHPS programme.MethodsWe conducted a mixed-methods review in line with PRISMA guidance using a results-based convergent design where quantitative and qualitative findings are synthesized separately, then brought together in a final synthesis. Embase, Medline, PsycINFO, Scopus, and Web of Science were searched using pre-defined search terms. We included all primary studies of any design and used the RE-AIM framework to organize and present the findings to understand the different impacts and implementation lessons of the CHPS programme.ResultsN = 58 out of n = 117 full text studies retrieved met the inclusion criteria, of which n = 28 were quantitative, n = 27 were qualitative studies and n = 3 were mixed methods. The geographical spread of studies highlighted uneven distribution, with the majority conducted in the Upper East Region. The CHPS programme is built on a significant body of evidence and has been found effective in reducing under-5 mortality, particularly for the poorest and least educated, increasing use and acceptance of family planning and reduction in fertility. The presence of a CHPS zone in addition to a health facility resulted in increased odds of skilled birth attendant care by 56%. Factors influencing effective implementation included trust, community engagement and motivation of community nurses through salaries, career progression, training and respect. Particular challenges to implementation were found in remote rural and urban contexts.ConclusionsThe clear specification of CHPS combined with a conducive national policy environment has aided scale-up. Strengthened health financing strategies, review of service provision to prepare and respond to pandemics, prevalence of non-communicable diseases and adaptation to changing community contexts, particularly urbanization, are required for successful delivery and future scale-up of CHPS.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214006, identifier: CRD42020214006.

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Can a standards-based approach improve access to and quality of primary health care? Findings from an end-of-project evaluation in Ghana

Cited by 2 publications

References 32 publications

Developing a Common Understanding of Networks of Care through a Scoping Study

Developing a Common Understanding of Networks of Care through a Scoping Study

Implementation of the Community-based Health Planning and Services (CHPS) in rural and urban Ghana: a history and systematic review of what works, for whom and why

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