Third Global Symposium on Health Systems Research

The theme of the symposium this year was the science and practice of people-centred health systems, chosen to enable participants to address current and critical concerns of relevance across countries in all parts of the world. Researchers, policy-makers, funders, implementers and other stakeholders, from all regions and all socio-economic levels, worked together on the challenge of how to make health systems more responsive to the needs of individuals, families and communities.

See below for the USAID ASSIST Staff involvement at the Symposium. Details and downloads of each presentation are provided below.

USAID ASSIST staff presentations:

Name

Type of presentation

Title

ASSIST Project  Satellite Session

Re-energizing the human resources for health (HRH) agenda for a post-2015 world: Priorities for HRH research

Astou Coly

Poster

Reasons for Discontinued Clinic Attendance: Perspectives from ART Patients in Cote d'Ivoire 

Herbert Kisamba

Poster

Improving access to essential medicines at health facilities through active engagement of district leadership & experience from Uganda

Joseph Kundy Poster

Better HIV care - why does health worker engagement matter? A cross-sectional mixed methods study of health worker performance and engagement in Tanzania

Martin Muhire Oral presentation

Experiences of how patients are involved in tracking fellow patients back to HIV chronic care at a Health Centre III in Uganda

Ram Shrestha

Oral presentation

Strengthening the community system to increase access to people-centered care: A qualitative study of an improvement activity in Ethiopia 

Tamar Chitashvili

Poster

Addressing rational use of medication in pediatric patients with respiratory tract infections (RTI) through improvement collaborative in Georgia

Tana Wuliji

Oral presentation - Overview

Oral presentation - Logic Model

Enhancing Patient-Centered Care: Translating Knowledge into Action for CHW Performance

Presentation Details:

Re-energizing the human resources for health (HRH) agenda for a post-2015 world: Priorities for HRH research

Brief Description: There’s no health without a health workforce yet health workforce shortages are expected to rise to over 12 million by 2030. The USAID ASSIST Project together with other key partners facilitated rapid consultations with diverse range of stakeholders to get input into a new health workforce strategy coordinated by Global Health Workforce Alliance, and co-chaired by USAID and the International Confederation of Midwives. The USAID ASSIST Project co-chairs Working Group 7 which focuses on health worker productivity and performance and the role of standards, quality improvement and regulation.  The consultation is now public and all stakeholders are invited to contribute here: http://www.who.int/workforcealliance/media/news/2014/consultation_globstrat_hrh/en/

Learn more about this session on the Global Symposium Website

Enhancing Patient-Centered Care: Translating Knowledge into Action for CHW Performance

Brief Description: With investments in community health worker programs reaching unprecedented levels, how do we know if we are improving the performance of community health workers if we don’t measure it and we don’t understand it?  On Tuesday the Diana Frymus, USAID and Tana Wuliji, USAID ASSIST Project presented a logic model of community health worker performance that brings together the best known evidence and expertise to facilitate research, evaluation and real time learning and planning.

Learn more about this session on the Global Symposium Website

Better HIV care - why does health worker engagement matter? A cross-sectional mixed methods study of health worker performance and engagement in Tanzania 

Brief Description: This mixed methods study examined the engagement of health workers providing HIV services and explored the relationship between engagement and performance in providing HIV services.  Survey and facility performance data were collected from 1330 health workers and 183 health facilities across six regions of Tanzania. Qualitative data were collected through 50 semi-structured interviews

Key Findings: 

  • Four characteristics of an engaged health worker were identified: change agent, accountable, job satisfaction, and being client-centered
  • Engagement matters, particularly in complex tasks that necessitate multiple processes, multiple actors, and problem solving across multiple levels of care.  The study found that health facilities with health workers with below average levels of engagement had three times the proportion of HIV clients that were lost to follow-up (35%) and higher proportion of children born to HIV-infected mothers started on cotrimoxazole (76% vs 44%). No relationship was found between health worker engagement and other performance indicators for more simple tasks.
  • No influence was found of the perceived adequacy of resources on engagement.  Two factors were found to influence engagement, perceived support and relationship with their immediate supervisor and the adequacy of their own competencies to perform.  

Strengthening the community system to increase access to people-centered care: A qualitative study of an improvement activity in Ethiopia

Brief Description: Working with the Federal Ministry of Health in the Oromia Region, the Project supported a CHW collaborative in Illu and Tole districts (18 kebeles) that sought to leverage existing community groups to identify pregnant women, link them to ANC, and refer them to the health facility for HIV testing.  The approach strengthened linkages between communities and health system to support and improve the outreach and performance of Health Extension Workers (HEWs). In September 2012, a qualitative evaluation of the intervention examined perceived effect of improvement teams. Three kebeles were selected, 17 semi-structured interviews were conducted. Interviews were audio-recorded and iterative thematic analyses performed. 

Key Findings: 

  • Between November 2011 and September 2012, in nine health posts, the number of pregnant women tested for HIV rose from 36 to 191.  When the improvement activities began in October 2011, the proportion of pregnant women being identified by community QI team members who had actually received ANC at the health post was 72%.  By June 2012, this ratio had increased to 86%, and the number of pregnant women identified had almost doubled.
  • After working with community groups, HEWs felt that their reach had increased. One HEW said, “There is no member of a household who cannot be reached now. Each improvement team knows who is pregnant, who is lactating, who has a latrine, who sleeps under a bednet.” 
Date: 
Tuesday, September 30, 2014 - 16:15 to Friday, October 3, 2014 - 16:15
Location: 
Cape Town, South Africa
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