Presentation given by Professor Sophie Witter at the 5th Meeting of the Montreux Collaborative on Fiscal Space, Public Financial Management and Health Financing in November 2021
Philippines: Governing for Quality Improvement in the Context of UHCHFG Project
The Philippine Health Insurance Corporation, or PhilHealth, was created in 1995 to administer the National Health Insurance Program, which aims to provide financial access to health services to all Filipinos. In 1998, PhilHealth established the Sponsored Program to provide coverage for the poor. In 2004, the Philippines passed a law to mandate subsidized coverage of the indigent, and PhilHealth campaigned with the Local Government Units to enroll the poor in their jurisdiction, while the Department of Health invested in the local health service delivery and strengthened its regulatory function (Lagrada, 2009). In 2013, another law was passed requiring PhilHealth to extend the subsidy to the poor and near-poor and to mobilize sin tax revenue to finance the subsidies for these groups. In response to these legal mandates, PhilHealth has streamlined its enrollment processes and has used targeted outreach to rapidly poor and vulnerable groups with the aim of achieving UHC.
Can strategic purchasing of health services from the private sector drive val...Rebekah McKay-Smith
Can strategic purchasing of health services from the private sector drive value for money? Evidence from the Results Based Financing programme in Malawi
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
Presentation given by Professor Sophie Witter at the 5th Meeting of the Montreux Collaborative on Fiscal Space, Public Financial Management and Health Financing in November 2021
Philippines: Governing for Quality Improvement in the Context of UHCHFG Project
The Philippine Health Insurance Corporation, or PhilHealth, was created in 1995 to administer the National Health Insurance Program, which aims to provide financial access to health services to all Filipinos. In 1998, PhilHealth established the Sponsored Program to provide coverage for the poor. In 2004, the Philippines passed a law to mandate subsidized coverage of the indigent, and PhilHealth campaigned with the Local Government Units to enroll the poor in their jurisdiction, while the Department of Health invested in the local health service delivery and strengthened its regulatory function (Lagrada, 2009). In 2013, another law was passed requiring PhilHealth to extend the subsidy to the poor and near-poor and to mobilize sin tax revenue to finance the subsidies for these groups. In response to these legal mandates, PhilHealth has streamlined its enrollment processes and has used targeted outreach to rapidly poor and vulnerable groups with the aim of achieving UHC.
Can strategic purchasing of health services from the private sector drive val...Rebekah McKay-Smith
Can strategic purchasing of health services from the private sector drive value for money? Evidence from the Results Based Financing programme in Malawi
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
A presentation by Bruno Meessen, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014.
The high rates of non-communicable diseases combined with large expatriate populations leads GCC countries to use different strategies to control healthcare expenditure among which is the PPP solution. This presentation highlights the formula for PPP success based on international cases.
6 reasons fqhcs and chcs benefit from patient referral management softwareGaryRichards30
FQHCs and CHCs provide critical primary care services to tens of millions of people each year in this country. Their role in the front-line of healthcare makes them important entry points for patients entering the broader healthcare system. Let us see how these organizations use patient referral management systems to leverage their role as an important source of patient referrals and improve the care they can provide for their populations.
Something In my head for a while, Its probably a little dramatic.
Probably ripe for implementation in India.
The reference by no means are complete, prepared the ppt over an extended period, lost track of references or was too lazy to search for them.
Will me more than glad to add them(references) if provided.
Measuring to Manage Progress toward Universal Health CoverageBen Bellows
In spite of greater economic convergence globally, as low-income countries grow into middle-income country economies, intra-country inequalities – economic, social, and health status – risk being exacerbated. To expand access to high quality healthcare at low cost at point of care, guidance is needed to identify effective performance measures to gauge progress. Is is increasing access to the current healthcare package to new users, is it adding more or better healthcare for current beneficiaries, or is healthcare expansion to be understood as lower prices and greater protection from out-of-pocket spending on health services? Results are presented from a 2012 pilot of two equity measures that set out to determine whether either of the measures was more practical to implement at lower cost and easily understood by social protection program managers. Recommendations are made for integrating these measures into existing programs.
Case Studies in Telehealth AdoptionThe mission of The Comm.docxjasoninnes20
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro ...
Case Studies in Telehealth AdoptionThe mission of The Comm.docxcowinhelen
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro.
Case Studies in Telehealth AdoptionThe mission of The Comm.docxwendolynhalbert
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro ...
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
A presentation by Bruno Meessen, delivered during "Transforming Health Systems Through Results-Based Financing," an event held during the Third Global Symposium on Health Systems Research in Cape Town on September 30, 2014.
The high rates of non-communicable diseases combined with large expatriate populations leads GCC countries to use different strategies to control healthcare expenditure among which is the PPP solution. This presentation highlights the formula for PPP success based on international cases.
6 reasons fqhcs and chcs benefit from patient referral management softwareGaryRichards30
FQHCs and CHCs provide critical primary care services to tens of millions of people each year in this country. Their role in the front-line of healthcare makes them important entry points for patients entering the broader healthcare system. Let us see how these organizations use patient referral management systems to leverage their role as an important source of patient referrals and improve the care they can provide for their populations.
Something In my head for a while, Its probably a little dramatic.
Probably ripe for implementation in India.
The reference by no means are complete, prepared the ppt over an extended period, lost track of references or was too lazy to search for them.
Will me more than glad to add them(references) if provided.
Measuring to Manage Progress toward Universal Health CoverageBen Bellows
In spite of greater economic convergence globally, as low-income countries grow into middle-income country economies, intra-country inequalities – economic, social, and health status – risk being exacerbated. To expand access to high quality healthcare at low cost at point of care, guidance is needed to identify effective performance measures to gauge progress. Is is increasing access to the current healthcare package to new users, is it adding more or better healthcare for current beneficiaries, or is healthcare expansion to be understood as lower prices and greater protection from out-of-pocket spending on health services? Results are presented from a 2012 pilot of two equity measures that set out to determine whether either of the measures was more practical to implement at lower cost and easily understood by social protection program managers. Recommendations are made for integrating these measures into existing programs.
Case Studies in Telehealth AdoptionThe mission of The Comm.docxjasoninnes20
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro ...
Case Studies in Telehealth AdoptionThe mission of The Comm.docxcowinhelen
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro.
Case Studies in Telehealth AdoptionThe mission of The Comm.docxwendolynhalbert
Case Studies in Telehealth Adoption
The mission of The Commonwealth
Fund is to promote a high performance
health care system. The Fund carries
out this mandate by supporting
independent research on health care
issues and making grants to improve
health care practice and policy. Support
for this research was provided by
The Commonwealth Fund. The views
presented here are those of the author
and not necessarily those of The
Commonwealth Fund or its directors,
officers, or staff.
For more information about this study,
please contact:
Andrew Broderick, M.A., M.B.A.
Codirector, Center for Innovation
and Technology in Public Health
Public Health Institute
[email protected]
The Veterans Health Administration:
Taking Home Telehealth Services to
Scale Nationally
Andrew Broderick
ABSTRACT: Since the 1990s, the Veterans Health Administration (VHA) has used infor-
mation and communications technologies to provide high-quality, coordinated, and com-
prehensive primary and specialist care services to its veteran population. Within the VHA,
the Office of Telehealth Services offers veterans a program called Care Coordination/
Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care man-
agement and case management services to veterans with diabetes, congestive heart fail-
ure, hypertension, post-traumatic stress disorder, and other conditions. The program uses
remote monitoring devices in veterans’ homes to communicate health status and to cap-
ture and transmit biometric data that are monitored remotely by care coordinators. CCHT
has shown promising results: fewer bed days of care, reduced hospital admissions, and
high rates of patient satisfaction. This issue brief highlights factors critical to the VHA’s
success—like the organization’s leadership, culture, and existing information technology
infrastructure—as well as opportunities and challenges.
OVERVIEW
Since the 1990s, information and communications technologies—including tele-
health—have been at the core of the Veterans Health Administration’s (VHA’s)
successful system-level transformation toward providing continuous, coordinated,
and comprehensive primary and specialist care services. The VHA’s leadership
and culture; underlying health information technology infrastructure; and strong
commitment to standardized work processes, policies, and training have all con-
tributed to the home telehealth program’s success in meeting the chronic care
needs of a population of aging veterans and reducing their use of institutional
care and its associated costs. The home teleheath model also encourages patient
activation, self-management, and helps in the early detection of complications.
To learn more about new publications
when they become available, visit the
Fund's website and register to receive
Fund email alerts.
Commonwealth Fund pub. 1657
Vol. 4
January 2013
www.commonwealthfund.org
www.commonwealthfund.org
mailto:[email pro ...
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
2. Outline:
0. Executive Summary
1. What is DFF and how does it work?
2. The evidence on DFF
3. Effects of DFF on health systems, mitigation of COVID-19, and on
HIV, TB, and Malaria Services
4. Possible next steps
2
3. Executive Summary
• Direct Facility Financing (DFF) is the direct provision of government and/or external funds to a
health facility (HF) to meet operating costs. The HF has substantial autonomy in how funds are
used.
• DFF works best when accompanied by strengthened supervision and community engagement
• The evidence supporting DFF is very strong, including 3 large randomized trials in Africa
• DFF increases use of curative services & immunization coverage. It improves drug availability,
outreach, waste management, quality of care, etc. This can be accomplished for $1-1.50 per capita
per year. With little additional effort it can improve performance around the 3 diseases.
• DFF can help to maintain access to care during COVID-19 by providing funds to buy PPE,
conduct outreach, do behaviour change, reduce user fees, and fund things we don’t even know yet
will be important.
• The GF is well positioned to implement DFF during COVID-19, by using existing LFAs,
community engagement, and ongoing work on improving supervision.
• To scale up DFF need to determine: a) how it will be funded? b) financial management protocols;
and; c) which countries should be prioritized
3
4. Direct Facility Financing (DFF) provides funds to the health workers
delivering the services at the front lines
1
Definition
Structure
• Direct Facility Financing (DFF) is the direct provision of government or
external funds to a health facility to meet operating costs
• Funds are sent electronically to the bank account of the PHC or through
“mobile money”. The use of cash is eliminated
• Management has autonomy over the use of funds to: (i) buy drugs, test kits,
reagents, PPE, from accredited wholesalers; (ii) conduct outreach; (iii) make
repairs or capital improvements, etc.;
• Facility has to follow guidelines set by the Government for fund management
and how funds can be used.
Support
4
• DFF works best when it is accompanied by strengthened supervision and
community engagement in health facility management
• DFF can provide good results at an investment of roughly $1 to $1.50 per capita
per year
5. The example of Tanzania demonstrates the difference between
centralized and decentralized financing, and the potential impact
1
5
• DFF in Tanzania started with Development partners through
basket funding then extended to public funds
• Shift from providing physical inputs to direct provision of
operating budget and increased facility autonomy and
accountability
• Locus of control of financing shifted from local government to
health facility
• All health facilities are now independent and able to manage
day-to-day activities
• Health clinics now have bank accounts and codes in PFM
system
• Supported by systems to allow managerial autonomy
o Facility Accounting System (FFARS) and Epicor
o PlanRep for planning and budgeting
o Many other systems made interoperable at facility level
including DHIS, HR etc.
• Accountability enhanced through new Health Councils which
include community oversight over PHC
6. Advantages of DFF:
• Provides flexible funding to health workers so they can alleviate constraints
they’re facing,
• Increases the availability of PPE and other effective interventions (like soap and
water, disinfectant, and fans to improve ventilation);
• Engage in communications efforts and outreach activities to increase the
demand for services;
• Improves the availability of essential drugs;
• Reduces user charges;
• Ensures availability of water, electricity, and connectivity;
• Improves health care waste management;
• Simpler to implement than performance-based financing (PBF)
6
7. 3 RCTS across Africa have shown positive impact of DFF
2
Cameroon
4 Arm
RCT
Zambia
3 Arm
RCT
• 5 year project, covering a population of over 3 million and
implemented in 26 districts
• Over 400 health facilities - ; household and facility surveys.
• 4 arm design: 1) PBF: Additional funding linked to
performance using balanced scorecard and external
verification: 2) DFF: Additional funding with management
autonomy; 3) Supervision: Additional monitoring and
supervision from district level; 4) Control: The control group
where nothing changed
• 4 year project involving 4.5 million population across
33 districts across 9 provinces, more than 500 health
facilities
• Districts were randomized to 3 arms: 1) PBF; 2) DFF;
3) control
Nigeria
3 arm
RCT
• 3 year study period in 52 districts, 1,389 health facilities,
covering 9.5 million people
• Districts were randomized to 2 arms: 1) PBF; 2) DFF; (control
districts non-randomized
• DFF facilities received half (about $1.50 per capita per year)
of what PBF facilities earned
• PBF and DFF perform significantly better than
Supervision and Control
• There is little difference between DFF and PBF in terms
of performance
• Both are very cost-effective interventions, but DFF is
considerably less complex and expensive,
• PBF and DFF performed significantly better than
Control
• Little difference between DFF and PBF
• Evidence showed increased management autonomy in
both DFF and PBF
• Significant improvement in key indicators for DFF which
performs as well as PBF and better than control
• Improved supervision and community engagement were
key.
• In Nigeria where there has been limited progress PBF and
DFF were effective on a large scale.
Findings
Description
Source: Looking into the Performance-based Financing Blackbox: Evidence from an impact evaluation in the health sector in Cameroon: Damien de Walque et al, World Bank, Policy Research Working paper 8162; The effect of direct
facility financing, autonomy, community engagement, supervision, and performance based payment in strengthening PHC: a large-scale quasi-experimental trial in Nigeria, E. Kandpal et al., WB 2018
8. In Nigeria, DFF was more effective in increasing use of
services than the control group
0 10 20 30 40 50 60 70 80
Control
DFF
Under 5 consultations per month
Baseline Change from Baseline
-5 5 15 25 35 45 55
Control
DFF
Penta3 Vaccination Coverage
2
9. In Nigeria DFF improved quality of care & drug availability much more
than the control group
9
3.9
41.7
0 10 20 30 40 50 60 70 80 90
Control
DFF
% of essential drugs in stock
Baseline Change from Baseline
-5.8
19.1
-10 0 10 20 30 40 50 60 70 80
Control
DFF
% of HFs conducting outreach
4
35.4
0 10 20 30 40 50 60 70 80 90 100
Control
DFF
% of HFs with proper waste disposal system
2
10. Effects of DFF (vs. Control) on Post-natal Care (PNC) and
Skilled Birth Attendance (SBA) in Zambia
10
19.6
1.6
19.6
6.1
0 10 20 30 40 50 60 70 80 90
DFF
Control
DFF
Control
SBA
PNC
baseline Endline-Baseline
2
12. DFF can help to transform supply chains by taking advantage of
existing private sector capacity
3
• Some element of competition between CMS and private wholesales creates healthier
market and improves the availability of essential drugs.
• DFF would allow PHC facilities to order commodities from other suppliers on pre-
qualified list. TA provided to these private providers and to CMS to enhance their capacity
• Kenya and Tanzania showed decentralized financing leads to improved performance
of central medical stores; counties in Kenya and health centers in Tanzania could now
go elsewhere.
• RCTs in Cameroon, Nigeria, and Zambia shows improved availability of essential
commodities in DFF and PBF arm leading to increased usage of health facilities
13. DFF can address the 3 challenges to health worker morale - helps to
maintain essential health services during COVID-19
3
Unpaid / reduced
salaries
Lack of “Agency”
and Autonomy
Limited access to
PPE and other
commodities
Threat from COVID-19 DFF Solution
• If governments face fiscal
challenges, salaries may be paid
late or in reduced amounts
• Health workers often feel they lack
authority to make decisions that
affect their working conditions
• Health workers do not have access
to PPE and other things required to
protect themselves and their
patients.
DFF was successfully used in Sierra Leone during Ebola,
enabling PHC facilities to buy handwashing equipment and motivating staff to work
• DFF funds can be used to tide health workers over
until normal salary payments resume. Health facility
management can use the resources flexibly.
• DFF provides frontline health workers with the
resources and autonomy needed to make effective
decisions about their working environment
• PHCs can use DFF to buy PPE locally. They will know
how much they need and when.
• Immediately increases access to commodities,
including soap, towels, disinfectant etc. Allows PHCs to
improve water supply where needed.
• Strong evidence suggests DFF can decrease stock-
outs quickly
Threat to retention
13
14. DFF can be used directly to improve delivery of HIV, TB, and Malaria
(HTM) Services in the following ways:
3
Set Minimum
Conditions
Focus on
poorly
performing
areas
• DFF payments would only be made to HF’s that meet selected minimum
conditions for delivering HTM services, e.g. 1) regular and timely HMIS
reporting; 2) Abolish user fees for HTM services.
• Focus on areas where HTM performance is poor. Where there are other
sources of financing, GF DFF funds could be concentrated on areas where HTM
performance is low or has declined (possibly as a result of COVID-19).
Strengthen
Supervision
14
• Supervision systems can be reinforced to increase the quality and quantity of
HTM services that the HF delivers. (The RSSH Team is deeply involved in
improving supervision, including through the SDI SI).
Community
Oversight
• Increase community involvement in the management of the health facility by
having community representatives sit of the “management committee” and being
co-signatories of the facility’s bank account.
15. Addressing Public Financial Management (PFM) Challenges in
Deploying DFF
1. Experience thus far is that DFF funds are used more transparently than centralized funding.
2. Ernst & Young audit in Nigeria showed that PBF and DFF funds at health facility level were used
appropriately
3. Policies that would support strong PFM:
1. No use of cash by health facilities (electronic transfer or cheques)
2. Proper book-keeping and clear guidance on what can and can NOT be funded
4. GF is well positioned to monitor DFF through existing structures, including:
1. Local Fund Agents - random audit of facilities receiving funds
2. Community monitoring - assures greater accountability in how funds are used
3. Supervision System - Use strengthened supervision system to ensure procedures
4
15
16. Use of Mobile Money & Electronic Transfer
16
Africa is fastest growing region
for mobile money
> 400 million registered mobile
money accounts
> 60% of adult population have
mobile money accounts
> 130 mobile money providers
“Mobile money for cash transfers is common practice.
Yet, it remains vastly underused to deliver funds to
frontline service providers in health”
17. • ACT-A health system
connector financing
stream
• Reprogramming GF and
GAVI funds
• C19RM funds
• WB phase II COVID
loans: supply side
conditional cash transfer
• Reprogramming COVID-
19 WB loans
First step is to identify funding for DFF and support for PFM
technical assistance, for which COVID-19 is a catalyst
Potential sources of funding Technical assistance on expanding PFM linked to DFF
4
• World Bank PFM Global practice focus on health
• Health expanded activities/funding
• USAID
• PFM workstream new HF project
• Gates
• PFM workstream
• P4H/GIZ/KfW
• PFM/DFF workstream
• GFA fiscal intermediary in Laos for KfW, WB,
Gavi, and GF
18. • Tanzania: USAID/Norad/GF
• PNG: WB and ADB
• Cameroon: GFF HRITF
• Zambia: GFF HRITF pilot
• CIV: SFHA, GFF HRITF pilot
• Laos: (SFHA, Hansa project)
• Nigeria: Selected states
• Togo
Implement DFF in “quick win” countries, and then expand
Suggested DFF quick win 1st wave
Opportunity for rapidly expanding
DFF
4
• Many countries have prior
experience with DFF e.g.
Indonesia, Malaysia, India, and
OECD countries
• All WB/GFF/DFID/Norad HRITF
PBF projects should already have
DFF like structure (around 35
projects in est. 30 countries)
18