Community Score Cards were used in 10 health facilities in Malawi to improve maternal and newborn health. The process brought together communities, health workers, and local government to identify challenges and mutually generate solutions. Evidence showed improvements in key indicators like the relationship between health providers and communities. Challenges included managing emotions, constrained resources, and limited participation. Overall, the Community Score Card approach improved communication and increased demand for health services.
Speaking at the 2015 CCIH Annual Conference, Regan Deming, MPH, Monitoring and Evaluation Technical Officer for the General Board of Global Ministries of the United Methodist Church examines how UMC's Imagine NO Malaria program increased access to malaria interventions in Zimbabwe by working with the Ministry of Health to engage community volunteers.
HIV+ logbook tracks HIV + mother-baby pairs from pregnancy to 18 months post-partum
HIV- logbook tracks HIV- women through pregnancy for retesting at three months
Speaking at the 2015 CCIH Annual Conference, Regan Deming, MPH, Monitoring and Evaluation Technical Officer for the General Board of Global Ministries of the United Methodist Church examines how UMC's Imagine NO Malaria program increased access to malaria interventions in Zimbabwe by working with the Ministry of Health to engage community volunteers.
HIV+ logbook tracks HIV + mother-baby pairs from pregnancy to 18 months post-partum
HIV- logbook tracks HIV- women through pregnancy for retesting at three months
Impact of voucher system on access to maternal and child health services in E...Jeff Knezovich
John Bua of Makerere University presents on a voucher scheme in Eastern Uganda to transport pregnant women to the care facility at iHEA 2011 in Toronto, Canada.
Well Care Health Plans, Inc.
Presentation to Georgia House Children's Mental Health Study Committee
October 20, 2015
Dauda Griffin, MD
Behavioral Health Medical Director
Remedios Roderiguez, Senior Director
Behavioral Health Operations
Increasing Access to Institutional Deliveries Using Demand and Supply Side In...IDS
This presentation was given by Elizabeth Ekirapa-Kiracho of Makerere University School of Public health to XII Ascon, Dhaka, February 2009. The author is a member of the Future Health Systems Research Programme Consortium (www.futurehealthsystems.org).
Ricardo Colon of the AIDS Activities Coordinating Office provided this overview of AACO's Client Services Unit to the HIV Integrated Planning Council on May 10, 2018. It includes information on the medical case management program and top needs identified at client intake.
Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Presentation from Francene McCartin; Acting Director, Community & Individual Support
DHS
DHS plans to meet the changing needs of people with disabilities who are ageing
Forum held on Thursday 17 June 2010.
Further information visit www.field.org.au
MaryJane Lewitt, PhD, APRN, CNM, FACNM
Nurse-Midwifery Program Director
Emory University Nell Hodgson Woodruff School of Nursing
Presentation to the Georgia Senate Women's Adequate Healthcare Study Committee
November 9, 2015
Decentralization in Health Care – is there evidence for it?
Guest lecture at School of Public Health, National University of Kyiv-Mohyla Academy
by Axel Hoffmann, PhD
Swiss Tropical and Public Health Institute
Impact of voucher system on access to maternal and child health services in E...Jeff Knezovich
John Bua of Makerere University presents on a voucher scheme in Eastern Uganda to transport pregnant women to the care facility at iHEA 2011 in Toronto, Canada.
Well Care Health Plans, Inc.
Presentation to Georgia House Children's Mental Health Study Committee
October 20, 2015
Dauda Griffin, MD
Behavioral Health Medical Director
Remedios Roderiguez, Senior Director
Behavioral Health Operations
Increasing Access to Institutional Deliveries Using Demand and Supply Side In...IDS
This presentation was given by Elizabeth Ekirapa-Kiracho of Makerere University School of Public health to XII Ascon, Dhaka, February 2009. The author is a member of the Future Health Systems Research Programme Consortium (www.futurehealthsystems.org).
Ricardo Colon of the AIDS Activities Coordinating Office provided this overview of AACO's Client Services Unit to the HIV Integrated Planning Council on May 10, 2018. It includes information on the medical case management program and top needs identified at client intake.
Making Seven Day Services a reality, pop up uni, 2 pm, 3 september 2015NHS England
Expo is the most significant annual health and social care event in the calendar, uniting more NHS and care leaders, commissioners, clinicians, voluntary sector partners, innovators and media than any other health and care event.
Expo 15 returned to Manchester and was hosted once again by NHS England. Around 5000 people a day from health and care, the voluntary sector, local government, and industry joined together at Manchester Central Convention Centre for two packed days of speakers, workshops, exhibitions and professional development.
This year, Expo was more relevant and engaging than ever before, happening within the first 100 days of the new Government, and almost 12 months after the publication of the NHS Five Year Forward View. It was also a great opportunity to check on and learn from the progress of Greater Manchester as the area prepares to take over a £6 billion devolved health and social care budget, pledging to integrate hospital, community, primary and social care and vastly improve health and well-being.
More information is available online: www.expo.nhs.uk
Presentation from Francene McCartin; Acting Director, Community & Individual Support
DHS
DHS plans to meet the changing needs of people with disabilities who are ageing
Forum held on Thursday 17 June 2010.
Further information visit www.field.org.au
MaryJane Lewitt, PhD, APRN, CNM, FACNM
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Emory University Nell Hodgson Woodruff School of Nursing
Presentation to the Georgia Senate Women's Adequate Healthcare Study Committee
November 9, 2015
Decentralization in Health Care – is there evidence for it?
Guest lecture at School of Public Health, National University of Kyiv-Mohyla Academy
by Axel Hoffmann, PhD
Swiss Tropical and Public Health Institute
Setting a Path for Improved Health Outcomes RBFRBFHealth
Learning is a critical part of the HRITF RBF portfolio, with all programs benefiting from an embedded impact evaluation and in some cases, complemented by qualitative research components such as process evaluation studies. The presentation discusses the following topics:
1. Using RBF at the community-level to address demand side barriers
This presentation elaborates on the early evidence and the rationale for using RBF at the community level. It will share lessons learned from the implementation of community RBF at country level.
2. Using RBF to Strengthen Quality of Care: Early Lessons
This presentation discusses the broader policy implications of using RBF to strengthen the quality of care. It will explore how Measuring and Paying for the Quality of Care has been operationalized and will highlight the experience of Nigeria. Lastly, it will focus on measuring and Analyzing the Quality of Care from the Impact Evaluation perspective.
as part of the IFPRI-Egypt Seminar Series- funded by the United States Agency for International Development (USAID) project called “Evaluating Impact and Building Capacity” (EIBC) that is implemented by IFPRI.
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Primary Health Care Strategy:
Key Directions for the Information Environment. Case study report and composite success model.
Steve Creed & Philip Gander
Slides from the workshop 'A modern vision of integrated care and support' led by Dr Martin McShane, Dr Damian Riley (NHS England) and David Pearson (ADASS) - NHS Medical Leaders Conference 2014. - See more at: http://www.icase.org.uk/pg/cv_content/content/view/98680#sthash.45Xs2o9r.dpuf
Similar to Evidence of Social Accountability_Thumbiko Misiska_5.7.14 (20)
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
Title: Sense of Taste
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 structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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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
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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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.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
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2. Presentation Outline
1) Background on project utilizing the
Community Score Card (CSC) in Malawi
2) CSC Evaluation
3) Community Score Card Process
4) Evidence of Impact to date
5) Challenges
3. What we want to achieve?
Why are women still dying in childbirth?
What is needed?
4. Maternal Health Alliance Project
Intervention: Community Score Card
(CSC)
Goal: develop & test broadly applicable
approaches to improve family planning
and maternal health implementation
and outcomes.
Maternal Health Alliance Project
(2011-2015) Supported by Sall Family
Foundation
Location: Ntcheu
district, Malawi
social
accountability
approach
innovated by CARE
in 2002
6. Evaluation Components
Component Target population Sample size
Women’s survey
(& medical chart
review)
Women who have given
birth within the last year
1950 total:
-650 treatment
-650 comparison
-650 spillover areas in
treatment
Health worker
survey
All health workers in
treatment and
comparison catchment
areas
~327 (all health workers in
treatment and control)
7. Theory of Change
Accountable, effective,
responsive service
providers & policy
makers
Women & community
members empowered
Maternalandnewbornmortality
Health
behaviors
Health service
coverage, quality
& equity
Negotiated space
expanded & inclusive
and effective
Community
Score Card
8. Intervention: Community Score Card
A social accountability approach that brings together community
members, service providers, and local government to
identify service access, utilization and provision challenges,
and to mutually generate solutions,
and work in partnership to implement and track the effectiveness of
those solutions in an ongoing process of improvement
Underlying Rights Based
Principles
Participation and inclusion
of voice
Accountability and
transparency
Equity
Shared responsibility
9. PHASE II: Conducting the Score
Card with the Community
PHASE IV: Interface Meeting and Action Planning
PHASE I: PLANNING AND PREPARATION
PHASE III: Conducting the
Score Card with Service
Providers
Repeatcycle
PHASE V: Action Plan Implementation and M&E
Catchment Community
Health providers
Local gov’t &
decision makers
MethodologyIndicator Score Sample Reasons for Score
1- Referral system – availability of transportation for
pregnant women from health center to hospital
45 Ambulance is rarely available in cases of
emergency Providers make clients use
public transport
2- Availability of transport from the community to the
health facility
20 Long distance to health facility Sometimes
women delay doing to the facility during
delivery
3- Availability of resources (i.e. drugs, supplies, space) 50 HIV test kits stock outs occur regularly
Clients told to buy medication which should
be free
4- Availability and accessibility of health services
(MNH, FP, PMTCT)
80 Most service are available FP long acting
term methods provided rarely No MNH
services provided in community
5- Availability and accessibility to information 80 The messages are only available at the
health facility not in the community
6- Level of male involvement in MNH, FP, PMTCT 50 Few men accompany their wives to
antenatal care Most men refuse HIV test
7-Level of youth involvement in reproductive health
issues
10 There are no youth clubs so most youth
have little information on family planning,
MNH or youth friendly services
8-Reception of clients at the facility 40 Some health workers have good attitudes
and respect clients Some women are
shouted at during delivery
9- Relationship between providers and communities 40 There is no health advisory committee or
village health committee Meetings
between health providers and clients is rare
10. Example Actions Resulting from CSC Process…
May 13, 2014
10
-Train community health workers on
MNH issues
-Train Community Action Groups
-Reflection session with district gov’t
partners
-Follow-up on action plan implementation,
keep diary, review health facility data
12. Improvements in Score Card Indicators
(ex. Relationship between providers and communities)
Indicator Score
Dec 2012
Score
Jun 2013
Score
Dec 2013
1- Referral system
2- Availability of transport from the
community to the HF
3- Availability of resources (i.e. drugs,
supplies, space)
4- Availability and accessibility of health
services
5- Availability and accessibility to
information
6- Level of male involvement in MNH, FP,
PMTCT
7-Level of youth involvement in
reproductive health issues
8-Reception of clients at the facility
9- Relationship between providers and
communities
Mochocho
Chiwfiri
Yesaya
Kasinje
Health Facility
13. Improved relationship and communication between service
users and providers increased demand for services
0
10
20
30
40
50
60
70
80
90
Health Workrs Mchocho Chifwiri Yesaya
Relationship between users and providers
12-Dec
Relationship between users and providers
13-Jun
Relationship between users and providers
13-Dec
14. The challenges and complexities of using CSC?
• Potential to be destructive if not properly handled-managing
emotions vs building relationships
• Constrained resource environment (human and material)
failing to meet the generated demand
• Culture of protecting domains of power/influence especially
among power holders – resistant to creation of spaces for
negotiation
• Limited policy influencing due to following the small evidence
base- only one of the 28 districts covered
• Chiefs/committees being gatekeepers on who participates in
the CSC
15. For more information
contact:
Michael Rewald
CARE Malawi Country Director
mrewald@co.care.org
Thumbiko Msiska
MHAP Project Manager
thumbiko.msiska@co.care.org
Editor's Notes
-the practice around what to deliver in MNH is well established is well established, but despite this evidence approx. 800 women die everyday from pregnancy and childbirth amounting to 287,000 maternal deaths a year. In Malawi, a women’s lifetime risk in of maternal death is 1 in 36 (MMR is 460 in 100,000 live births) (WHO - http://www.who.int/gho/maternal_health/countries/en/index.html#M)-PMTCT. The transmission of HIV from an HIV-positive mother to her child during pregnancy, labour, delivery or breastfeeding is called mother-to-child transmission. Yearly there are 430,000 new pediatric HIV cases a year do to MTCT. In the absence of any interventions transmission rates range up to 45%. This rate can be reduced to levels below 5% with effective interventions.In addition, HIV contributes to 42,000 maternal deaths yearly & in Malawi is responsible for 29% of all maternal deaths. Number of maternal (2009 http: //apps. who.int/iris /bitstream/10665 /75341/1/9789241504270_eng.pdf) & (http://www.who.int/hiv/topics/mtct/en/) & -Family planning- Use of modern methods of family planning will prevent more than a third of maternal deaths and ten per cent of child deaths. Worldwide 222M women have an umet need for contraceptives. In Malawi, 26% of women who want to use contraceptives cannot get them. This translates into an unacceptably high number of unintended pregnancies with all the risks that comes with it. ((TFR) in Malawi is 5.7, quarter of teens have begun childbearing).
Ntcheu district – 471,589 population with 23,579 expected births annually Cluster – randomized control evaluation10 intervention clusters 20 intervention GVHs selected using probability proportional to size (PPS). These will participate in the intervention and baseline. (Pop = 58,164) 20 spillover GVHs selected using (PPS). These will only participate in the baseline. (Pop = 69,450)10 control clusters 20 control GVHs selected using (PPS). These will only participate in the baseline (Pop = 68,241)
The CSC consists of 5 phases: I- Planning and preparation, II- Conducting the Score Card with the community, III- Conducting the Score Card with service providers, IV- Interface meeting and action planning, and V- Action plan-The CSC is done between a service user unit and service provider unit – in our case between the health center and catchment area-CSC process is not a one off process but done repeatedly every 6 months
Created space for engagement between the service providers and usersEnhanced communities knowledge and demand for entitlements in a subtle manner- starting from the analysis of issues hindering delivery and accessibility of services. Enhanced the culture of accountability among providers in a negotiated mannerEnhance collective responsibility to address barriers to delivery and utilization of quality service.