Integrating health care for mothers and children in refugee camps and at district leve

Hafeez, Assad; Riaz, Rubina; Shah, Samin Ullah; Pervaiz, Javed; Southall, D P

doi:10.1136/bmj.328.7443.834

Cited by 12 publications

(10 citation statements)

References 7 publications

(7 reference statements)

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“…Lainez and colleagues highlighted the issue of “competent care” in their study on the prevalence of respiratory symptoms in Afghanistan and found that there was a gap in diagnosis with 23.8% of patients with TB-suggestive symptoms going undiagnosed [ 37 ]. Another manifestation of the “competent care” sub-domain was necessary patient referrals [ 32 , 34 , 66 , 69 , 77 ]. For example, Elmusharaf et al found that outcomes were better for pregnant women in South Sudan where there was no facility available rather than when the woman accessed a non-functioning facility, and the absence of a health care provider was better than the presence of a non-competent provider [ 66 ].…”

Section: Resultsmentioning

confidence: 99%

“…In their study on perceptions and utilization of primary health care services in Iraq, Burnham and colleagues showed that high satisfaction corresponded with low expectations of the health system [ 39 ]. The patient’s perception of the low quality of care was a barrier to care uptake and retention in the health system [ 32 , 67 , 78 ]. A qualitative study by Hunter-Adams et al on the language barriers between South African health care providers and conflict-affected cross-boarder migrants suggested that providing interpretive services could increase the patient’s confidence in the system and potentially increase preventative care visits [ 67 ].…”

Section: Resultsmentioning

confidence: 99%

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Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

2021

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Background There is a growing concern that the quality of health systems in humanitarian crises and the care they provide has received little attention. To help better understand current practice and research on health system quality, this paper aimed to examine the evidence on the quality of health systems in humanitarian settings. Methods This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The context of interest was populations affected by humanitarian crisis in low- and middle- income countries (LMICs). We included studies where the intervention of interest, health services for populations affected by crisis, was provided by the formal health system. Our outcome of interest was the quality of the health system. We included primary research studies, from a combination of information sources, published in English between January 2000 and January 2019 using quantitative and qualitative methods. We used the High Quality Health Systems Framework to analyze the included studies by quality domain and sub-domain. Results We identified 2285 articles through our search, of which 163 were eligible for full-text review, and 55 articles were eligible for inclusion in our systematic review. Poor diagnosis, inadequate patient referrals, and inappropriate treatment of illness were commonly cited barriers to quality care. There was a strong focus placed on the foundations of a health system with emphasis on the workforce and tools, but a limited focus on the health impacts of health systems. The review also suggests some barriers to high quality health systems that are specific to humanitarian settings such as language barriers for refugees in their host country, discontinued care for migrant populations with chronic conditions, and fears around provider safety. Conclusion The review highlights a large gap in the measurement of quality both at the point of care and at the health system level. There is a need for further work particularly on health system measurement strategies, accountability mechanisms, and patient-centered approaches in humanitarian settings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

2021

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“…The programme has also integrated emergency care from the community through to the first referral and tertiary hospitals strengthening the "emergency chain of care" [28]. By working as partners, and including the Ministry of Health as the lead, the aim was for the programme to become an integral part of The Gambian public health system on which 95% of the population rely.…”

Section: Discussionmentioning

confidence: 99%

Strengthening the emergency healthcare system for mothers and children in The Gambia

Cole-Ceesay

Cherian²,

Sonko³

et al. 2010

Reprod Health

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A system to improve the management of emergencies during pregnancy, childbirth, infancy and childhood in a region of The Gambia (Brikama) with a population of approximately 250,000 has been developed.This was accomplished through formal partnership between the Gambian Ministry of Health, the World Health Organisation, Maternal Childhealth Advocacy International and the Advanced Life Support Group.Since October 2006, the hospital in Brikama has been renovated and equipped and more efficiently provided with emergency medicines. An emergency ambulance service now links the community with the hospital through a mobile telephone system. Health professionals from community to hospital have been trained in obstetric, neonatal and paediatric emergency management using skills' based education. The programme was evaluated in log books detailing individual resuscitations and by external assessment.The hospital now has constant water and electricity, a functioning operating theatre and emergency room; the maternity unit and children's wards have better emergency equipment and there is a more reliable supply of oxygen and emergency drugs, including misoprostol (for treating post partum haemorrhage) and magnesium sulphate (for severe pre-eclampsia). There is also a blood transfusion service.Countrywide, 217 doctors, nurses, and midwives have undergone accredited training in the provision of emergency maternal, newborn and child care, including for major trauma. 33 have received additional education through Generic Instructor Courses and 15 have reached full instructor status. 83 Traditional Birth Attendants and 48 Village Health Workers have been trained in the recognition and initial management of emergencies, including resuscitation of the newborn. Eleven and ten nurses underwent training in peri-operative nursing and anaesthetics respectively, to address the acute shortage required for emergency Caesarean section.Between May 2007 and March 2010, 109 patients, mostly pregnant mothers, were stabilised and transported to hospital by the new emergency ambulance service.293 resuscitation attempts were documented in personal logbooks.A sustainable system for better managing emergencies has been established and is helping to negate the main obstacle impeding progress: the country's lack of available trained medical and nursing staff. However, insufficient attention was paid to improving staff morale and accommodation representing significant failings of the programme.

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“…Problems with regard to a lack of integration between primary and secondary healthcare and poorly resourced and staffed hospitals have lead to very low uptake rates following referral. 49 The presence of user fees has also acted as a disincentive to the uptake of hospital care. 49 …”

Section: Integrated Management Of Childhood Illnessmentioning

confidence: 99%

Child health in Africa: 2005 a year of hope?

O’Hare

Venables²,

Southall³

2005

Archives of Disease in Childhood

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Integrating health care for mothers and children in refugee camps and at district leve

Cited by 12 publications

References 7 publications

Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

Quality in crisis: a systematic review of the quality of health systems in humanitarian settings

Strengthening the emergency healthcare system for mothers and children in The Gambia

Child health in Africa: 2005 a year of hope?

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