Cargando…

Bottlenecks to child health service delivery – how can Health System Performance Assessment help?

Health System Performance Assessment (HSPA) is an established tool that can help identify issues with the way health systems work to achieve their intended goals, improve transparency and account-ability, and provide stimulus for reform. However, HSPA frameworks tend to be adult-centric and therefor...

Descripción completa

Detalles Bibliográficos
Autores principales: Shuftan, N, Rajan, D
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593960/
http://dx.doi.org/10.1093/eurpub/ckac129.332
_version_ 1784815293115138048
author Shuftan, N
Rajan, D
author_facet Shuftan, N
Rajan, D
author_sort Shuftan, N
collection PubMed
description Health System Performance Assessment (HSPA) is an established tool that can help identify issues with the way health systems work to achieve their intended goals, improve transparency and account-ability, and provide stimulus for reform. However, HSPA frameworks tend to be adult-centric and therefore not generally sensitive to child health challenges. Using a new HSPA framework for Universal Health Coverage, we show how child health tracer conditions can be used to pinpoint system under-performance and flag major bottlenecks impeding service delivery overall. Based on the HSPA framework, health system bottlenecks can be traced backwards to explore possible origins (areas to be targeted for improvement) or forwards to understand potential implications for the achievement of health system goals. The following qualitative and quantitative data are used to highlight major bottlenecks to child health service delivery: eight health system-focused child health assessments which show that one of the main bottlenecks is weak primary care coverage of sexual, reproductive, maternal, newborn, child, and adolescent health services, leading to parents bypassing PHC in favour of hospitals; results from WHO missions (e.g. in Romania and Tajikistan) showing that paediatric patients were often admitted to hospitals for treatment, even for conditions that could be safely managed in the outpatient setting; quantitative data on responsiveness, user experience, client satisfaction and people-centredness from publicly available datasets and national datasets obtained in collaboration with WHO Country Offices for national level data, to contextualize the aforementioned findings.
format Online
Article
Text
id pubmed-9593960
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Oxford University Press
record_format MEDLINE/PubMed
spelling pubmed-95939602022-11-22 Bottlenecks to child health service delivery – how can Health System Performance Assessment help? Shuftan, N Rajan, D Eur J Public Health Parallel Programme Health System Performance Assessment (HSPA) is an established tool that can help identify issues with the way health systems work to achieve their intended goals, improve transparency and account-ability, and provide stimulus for reform. However, HSPA frameworks tend to be adult-centric and therefore not generally sensitive to child health challenges. Using a new HSPA framework for Universal Health Coverage, we show how child health tracer conditions can be used to pinpoint system under-performance and flag major bottlenecks impeding service delivery overall. Based on the HSPA framework, health system bottlenecks can be traced backwards to explore possible origins (areas to be targeted for improvement) or forwards to understand potential implications for the achievement of health system goals. The following qualitative and quantitative data are used to highlight major bottlenecks to child health service delivery: eight health system-focused child health assessments which show that one of the main bottlenecks is weak primary care coverage of sexual, reproductive, maternal, newborn, child, and adolescent health services, leading to parents bypassing PHC in favour of hospitals; results from WHO missions (e.g. in Romania and Tajikistan) showing that paediatric patients were often admitted to hospitals for treatment, even for conditions that could be safely managed in the outpatient setting; quantitative data on responsiveness, user experience, client satisfaction and people-centredness from publicly available datasets and national datasets obtained in collaboration with WHO Country Offices for national level data, to contextualize the aforementioned findings. Oxford University Press 2022-10-25 /pmc/articles/PMC9593960/ http://dx.doi.org/10.1093/eurpub/ckac129.332 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of the European Public Health Association. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Parallel Programme
Shuftan, N
Rajan, D
Bottlenecks to child health service delivery – how can Health System Performance Assessment help?
title Bottlenecks to child health service delivery – how can Health System Performance Assessment help?
title_full Bottlenecks to child health service delivery – how can Health System Performance Assessment help?
title_fullStr Bottlenecks to child health service delivery – how can Health System Performance Assessment help?
title_full_unstemmed Bottlenecks to child health service delivery – how can Health System Performance Assessment help?
title_short Bottlenecks to child health service delivery – how can Health System Performance Assessment help?
title_sort bottlenecks to child health service delivery – how can health system performance assessment help?
topic Parallel Programme
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9593960/
http://dx.doi.org/10.1093/eurpub/ckac129.332
work_keys_str_mv AT shuftann bottleneckstochildhealthservicedeliveryhowcanhealthsystemperformanceassessmenthelp
AT rajand bottleneckstochildhealthservicedeliveryhowcanhealthsystemperformanceassessmenthelp