Demography by Catherine G Schenck-Yglesias
Medair Lebanon Technical Report, produced with the support of Global Affairs Canada and Swiss Solidarity, 2017
This statistical report is based on a household survey conducted by Medair Lebanon between Decemb... more This statistical report is based on a household survey conducted by Medair Lebanon between December 10th and 16th, 2016. This is the second annual KPC Survey, the first of which was conducted in mid-December 2015. Different households were sampled from the same geographic area each year. In 2016, Medair enumerators completed interviews of 754 Syrian refugee and vulnerable Lebanese women of reproductive age caring for children under five years of age residing within four target districts within the Bekaa governorate of Lebanon. The three strata compared in this report are Syrian refugees living in informal settlements (IS), Syrian refugees living outside IS, and vulnerable Lebanese, all of whom live outside IS.
Social Science & Medicine, Nov 22, 2006
Surveys have attempted to measure married women's decision-making power by asking women who has a... more Surveys have attempted to measure married women's decision-making power by asking women who has a say and/or final say in a number of household decisions. In several studies where the same questions were posed to husbands, considerable discrepancies in reports were found. This paper assesses husband and wife reports of decision-making on four matters (whether or not to buy household items; what to do if a child becomes ill; whether or not to buy medicine for a family member who is ill; what to do if a pregnant women becomes very ill) and the relationship of these reports to three recent health behaviors (having an emergency plan during pregnancy; delivering in a health facility; having a postpartum checkup within 4 weeks). A sample of 1000 women in 53 communities in three departments of western Guatemala was selected using a stratified random sampling approach. A standard household questionnaire was used to identify the respondents as well as to obtain data on household characteristics. Husbands of interviewed women were interviewed in every other household giving information on 546 couples for this analysis. Women and men's questionnaires were similar and were designed to obtain information on the respondent's knowledge, attitudes and behaviors regarding maternal health. Consistent with other research, results show that relative to their husbands' report, wives tend to under-report their household decision-making power. In couples with both partners educated and in couples in which women work for pay, both partners were significantly more likely to report that both of them participate in the final decisions than was the case in couples without education or in which the wife did not work for pay. Women's reports of their decision-making power was significantly related to the household having a plan for what to do in case of a maternal emergency, but was not associated with place of childbirth or with having a postpartum checkup, while husband's reports of the wife's decision-making power was negatively associated with the likelihood of having the last birth in a health facility.
Informatics by Catherine G Schenck-Yglesias
A Pre-Symposium Tutorial Presented by the AMIA Public Health Informatics Working Group, 2012
This presentation describes the potential clinical benefits of sharing health and human services ... more This presentation describes the potential clinical benefits of sharing health and human services data, and discusses the related informatics issues including unique health identifiers and data sharing agreements.
Proceedings from a multidisciplinary UNAIDS Workshop, May 15, 2007
A three-day Workshop was held in Geneva, Switzerland 15th-17th May 2006, which was
attended by a ... more A three-day Workshop was held in Geneva, Switzerland 15th-17th May 2006, which was
attended by a multidisciplinary group of health professionals and community members,
including people living with HIV. The Workshop’s aim was to develop draft guidelines on
protecting the confidentiality and security of HIV information, and to produce a plan to field test them within countries. It involved plenary sessions and small and large group work.
USAID Bureau for Global Health Technical Report, produced by Jhpiego, Sep 2002
In October 1999, JHPIEGO established a TALC at the Health Sciences Library of the Universidad May... more In October 1999, JHPIEGO established a TALC at the Health Sciences Library of the Universidad Mayor de San Andrés in La Paz, Bolivia. JHPIEGO trained library staff and faculty to conduct Internet searches and to use basic software applications. Library staff members were also trained in maintenance of the network and hardware. During the first year, there were more than 5,300 faculty and student TALC user sessions recorded, and a successful cost-recovery system garnered US $3,600.
This report documents a March 2001 evaluation of over 300 students, faculty and library staff to determine the effectiveness of the TALC at the UMSA Health Sciences Library, and to examine to what extent the availability of information and communication technology was ensuring access to updated reproductive health information. The evaluation showed that the TALC succeeded in increasing professional and academic access to up-to-date reproductive health information, opening up the online world for UMSA faculty and students, and promoting South-to-
South collaboration in a variety of ways.
Morbidity and Mortality Weekly Report, Jul 27, 2001
In 1988, CDC published Guidelines for Evaluating Surveillance Systems (1) to promote the best use... more In 1988, CDC published Guidelines for Evaluating Surveillance Systems (1) to promote the best use of public health resources through the development of efficient and effective public health surveillance systems. CDC's Guidelines for Evaluating Surveillance Systems are being updated to address the need for a) the integration of surveillance and health information systems, b) the establishment of data standards, c) the electronic exchange of health data, and d) changes in the objectives of public health surveillance to facilitate the response of public health to emerging health threats (e.g., new diseases). For example, CDC, with the collaboration of state and local health departments, is implementing the National Electronic Disease Surveillance System (NEDSS) to better manage and enhance the large number of current surveillance systems and allow the public health community to respond more quickly to public health threats (e.g., outbreaks of emerging infectious diseases and bioterrorism) (2). When NEDSS is completed, it will electronically integrate and link together several types of surveillance systems with the use of standard data formats; a communications infrastructure built on principles of public health informatics; and agreements on data access, sharing, and confidentiality. In addition, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates that the United States adopt national uniform standards for electronic transactions related to health insurance enrollment and eligibility, health-care encounters, and health insurance claims; for identifiers for health-care providers, payers and individuals, as well as code sets and classification systems used in these transactions; and for security of these transactions (3). The electronic exchange of health data inherently involves the protection of patient privacy.
Based on CDC's Framework for Program Evaluation in Public Health (4), research and discussion of concerns related to public health surveillance systems, and comments received from the public health community, this report provides updated guidelines for evaluating public health surveillance systems.
RBM by Catherine G Schenck-Yglesias
AMIA 2010 Symposium Proceedings, 2010
Jhpiego and Voxiva, Inc. will present the Results Information System for Excellence, RISE, launch... more Jhpiego and Voxiva, Inc. will present the Results Information System for Excellence, RISE, launched in the third quarter of calendar 2010 as Jhpiego's first such enterprise-level system.
Jhpiego is an international non-profit health organization affiliated with The Johns Hopkins University. In operation for over 35 years, Jhpiego improves the quality of services provided to vulnerable populations in developing countries, scaling up evidence-based health innovations; we monitor performance according to standard as well as the outcomes and impacts of improved performance.
Voxiva is a global leader in interactive mobile health (mHealth), providing a range of interactive health information services that: (a) support and engage people in managing their health and living healthier lives, and (b) help health delivery systems work more effectively.
The Voxiva technology platform supports Jhpiego business process improvement not only in standardizing indicator data collection, storage, and analysis, but in the systematic review of data completeness and traceability, all using streamlined business intelligence (BI) tools. While demonstrating RISE features, we will discuss how this enabling technology is supporting Jhpiego in scaling up results-based program management and monitoring.
M&E by Catherine G Schenck-Yglesias
USAID Technical Report produced by MEASURE/Evaluation, 2006
The objective of this document is to illustrate and compare the current status of facilities in t... more The objective of this document is to illustrate and compare the current status of facilities in three countries for which data are available, using information derived from the core indicators to create a set of facility profiles. Also illustrated is the calculation of a composite index that combines results obtained from the individual indicators into an overall summary measure of facility-based service conditions in a given country. It is hoped that this application of core indicators results in the form of facility profiles will stimulate further discussion and refinement of the core indicators and the summary indices.
The ultimate aim is to facilitate the adoption of standard procedures that can produce consistent and internationally comparable information to inform the planning of health system investments and health programs, and to assess their impact. We believe that the use of standardized and internationally comparable information to produce facility profiles will allow donors and countries to understand better how conditions for facility-based services differ among countries, and can provide a context for interpreting status and needs.
USAID Maternal & Neonatal Health Program Technical Report, produced by Jhpiego and the Johns Hopkins Center for Communication Programs, 2004
Empowering individuals and communities to recognize and respond to obstetrical emergencies is a c... more Empowering individuals and communities to recognize and respond to obstetrical emergencies is a concrete goal of the Guatemalan Ministry of Health and Public Assistance (MOH) and of the Maternal and Neonatal Health (MNH) Program. The MNH Program promotes the use of skilled
maternal and newborn care, family and community involvement in this care, and supportive government policies to sustain these efforts. This report presents the results of these Program efforts. The MNH Program in Guatemala employed research methods to formally evaluate the
impact of the behavior change intervention (BCI) component. Routine health and management information systems were used to construct Safe Motherhood process indicators to monitor the essential maternal and neonatal care (EMNC) service delivery component. Program documents were used to monitor the policy component. The methods and results of each are presented in this impact report, adding to the evidence base on the effectiveness of strengthening community mobilization and service delivery efforts to improve maternal and neonatal survival in the developing world.
The maternal mortality ratio in Guatemala fell from an estimated 219 maternal deaths per 100,000 live births in 1989 to 153 in 2000, but it still remains one of the highest in Latin America. The major causes of maternal mortality in Guatemala are preventable: hemorrhage (53%), followed by infection (14%) and hypertension (12%). In the western part of the country, between 69% and 80% of women give birth at home, where complications can lead to death if the family and community are
not prepared to act appropriately to respond to the emergency condition. The 2000 Reproductive Age Mortality Study (RAMOS) in Guatemala found that maternal deaths generally occurred within 24 hours of the resolution of the pregnancy.1 More than half died at home, and four out of 10 died in a healthcare facility. Sixty percent of those mothers who died had been attended at the time of childbirth by a traditional birth attendant (TBA) or a family member or gave birth alone. Thirty percent of those women who died had been attended by a trained healthcare provider.
To address Guatemala’s maternal survival problems, the Guatemalan MOH received technical assistance from the MNH Program to improve essential maternal services and mobilize individuals and communities to respond to obstetric emergencies in an appropriate and timely manner. The United States Agency for International Development (USAID) supports the MNH Program through its Guatemala-Central American Program. The timeframe for MNH Program implementation in Guatemala was 1999–2004.
The MNH Program’s global strategic objective is to promote maternal and neonatal survival in low resource settings by increasing the use of appropriate maternal and neonatal health and nutrition interventions. The goal of the MNH Program in Guatemala is to increase the adoption of practices and use of services that are key for maternal and neonatal survival by:
- Establishing a network of high-quality, accredited essential maternal and neonatal care (EMNC)
- Increasing appropriate use of accredited community and institutional services
- Strengthening policies and norms implemented to sustain an adequate provision of EMNC
services
HR for Health by Catherine G Schenck-Yglesias
WHO/World Bank/USAID Handbook on Monitoring and Evaluation of Human Resources for Health, 2009
The global health literature demonstrates that health-care service coverage and quality are direc... more The global health literature demonstrates that health-care service coverage and quality are directly correlated with health worker numbers and performance. For instance, the World Health Organization (WHO) has presented evidence showing that coverage of selected primary health-care services, including maternal, newborn and child health interventions, tend to rise with higher national health workforce densities (1). Using the Millennium Development Goals as the benchmark, WHO reports that countries with the highest shortfalls in numbers of physicians, nurses and midwives are the ones most at risk of not meeting coverage targets. The African region-home to only 3% of the estimated 59.2 million health workers in the world but having 24% of the global burden of disease-is the area hardest hit by health worker shortfalls and imbalances worldwide (1). Securing improvements in the size and quality of the health workforce is important for achieving regional and country-specific Millennium Development Goals in health. Overcoming human resources for health (HRH) shortages and imbalances requires strengthening education and training programmes for health workers, improving health sector working conditions (including staff salaries and benefits) and forging cooperation and collaboration in health workforce management within and across countries. Evidence-based monitoring of health workforce dynamics is important for ensuring that policy and programmatic inputs lead to the expected outcomes. Often, a lack of comprehensive, timely and reliable data on HRH results in poor knowledge of workforce status and curtails development of evidence-based policies among national and international stakeholders. Several factors have contributed to the weak information and evidence base on the health workforce in many low-and middle-income countries. These include lack of a common framework from which to understand HRH issues; poor data availability and quality; imprecise definitions and classifications of certain health worker categories ; weak technical capacity to conduct in-country workforce analysis; lack of appropriate measurement tools; and underinvestment in national health information systems (1-3). In particular, lack of standardized approaches to HRH assessment limits the potential for comparative analysis over time and across countries to better understand how different situations, policies and interventions impact the performance of human resources and health systems and, ultimately, population health outcomes. Health facility assessments (HFAs), the focus of this chapter, are tools for gathering data that are a potentially important source of information for health workforce monitoring. A number of countries already conduct such assessments, and demand for them is increasing. Health facilities refer to service delivery points in the formal health sector, including hospitals, health centres, dispensaries and health posts. HFA protocols capture real-time information (i.e. at the moment of the assessment) on a key component of the overall health system: facility-based service delivery. Depending on the nature of the data collection instruments, HFAs can provide detailed information on health workforce availability, distribution, qualifications, skills mix, training and performance. This information can be used to determine, for example, how existing staffing patterns relate to desired or planned staffing levels, how well staff members' qualifications match their assigned scope of work and the nature and extent of geographical or other staffing imbalances. HFAs can also provide insight into the broader health labour market context, including management practices and other features of the work environment (for example infrastructure and availability of medical supplies and equipment), and how these variables affect health worker supply and performance. In short, HFAs can inform workforce policy by telling us what is happening on the ground, in the real world of service delivery. The main objective of this chapter is to describe the current and potential usefulness of HFAs as a source of 7
USAID/Ghana Technical Report produced by Quality Health Partners, May 2005
The main objective of the assessment was to evaluate the human resources management (HRM) capacit... more The main objective of the assessment was to evaluate the human resources management (HRM) capacity of the Ministry of Health and Ghana Health Service (GHS) in terms of systems effectiveness and efficiency, identifying strengths and highlighting areas in need of improvement.
The specific objectives were to:
- Review current HRM policies, plans and procedures.
- Assess HR data management systems, including personnel filing systems.
- Assess staff performance management capacity and systems.
- Assess the roles and responsibilities of stakeholders in the HRM systems and their impact on the efficiency and effectiveness of the management systems.
- Assess pre-service and in-service training systems including policies, plans and procedures for managing intake and outcomes, and assess the linkages between pre-service and in-service training.
- Assess the role of women in the GHS and their opportunities for job advancement.
- Provide recommendations for streamlining and strengthening HRM systems in the GHS.
USAID Bureau for Global Health Technical Report, produced by Jhpiego, 2004
The Malawi Fourth National Health Plan states that the achievement of an “adequate and equitable ... more The Malawi Fourth National Health Plan states that the achievement of an “adequate and equitable distribution of appropriately trained and effective staff to provide planned health services in Malawi” is a national goal. Deployment and training policies and plans grounded in and monitored and evaluated according to reliable health human resource data would provide a guide for Malawi’s health sector leaders as they attempt to realize this desired outcome.
WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, JHPIEGO reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.
This report is the result of a number of technical assistance site visits to Malawi between February 2001 and December 2002, in addition to the review of several reports and consultant documents focused on human resources and training monitoring systems in the Malawian health sector. The report divides human resources for health (HRH) data into two categories: demand and supply. Demand data tell a health sector leader how many personnel in each cadre in each type of facility, and in which geographical areas, are needed. Supply data tell the decision-makers how many personnel there are presently or will be available. Demand sources reviewed in the present assessment include the current establishment and functional review of HRH in Malawi, and the World Health Organization (WHO) Human Resource for Health computer model, used by JHPIEGO and Keele University in 2003 in Malawi to project HRH demand. The review of supply data revealed that 10 parallel data sources on HRH are in place covering Malawi MOHP personnel, while one streamlined data source was in place at the Christian Health Association of Malawi.
Training data sources from preservice institutions and family planning/reproductive health (FP/RH) inservice programs were also reviewed as part of this assessment.
FP/RH by Catherine G Schenck-Yglesias
USAID Bureau for Global Health Technical Report, produced by Jhpiego, Mar 2004
Using the training needs projection methods in the Spectrum Policy Modeling System software modul... more Using the training needs projection methods in the Spectrum Policy Modeling System software module ProTrain™, JHPIEGO collaborated with the Malawi Ministry of Health and Population (MOHP) Reproductive Health Unit (RHU) to estimate numbers of Family Planning/Reproductive Health (FP/RH) service providers who are needed to reach total fertility rate (TFR) and contraceptive prevalence goals for Malawi from 2001–2007.
ProTrain™ allows the user to project the available versus required number of trained and competent family planning (FP) service providers of several FP methods, in various sectors of a national health system, given expected client demand and expected training outputs.
In creating these FP human resource projections, JHPIEGO was building upon work done at the FP/RH Projections Update Workshop in Malawi in March 2003 by the Malawi MOHP Reproductive Health Unit. Those demographic and FP projections form the foundation for the current human resources (HR) study. A conservative demography/family planning model was used, which assumed that the decline in TFR between 2001 and 2015 would be at the same rate as the decline measured between the two Malawi Demographic and Health Surveys (DHSs) in 1992 and 2000. This is a slower rate of decline, reaching 5.64 by the year 2015 instead of the population policy goal of 4.5 by 2015. The demography/family planning model was based on constrained rather than adequate resources to meet the TFR goal. The FP
projection contains estimates of current and anticipated future percentages of eligible women receiving their contraceptive services from different sources within Malawi: public and private sector, Christian Health Association of Malawi (CHAM), Banja La Mtsogolo (a local nongovernmental organization), and community-based distribution agents (CBDAs).
In order to construct the training projection model, JHPIEGO gathered data on several aspects of the preservice and inservice training that produces FP providers, and on FP service delivery in Malawi, from various data sources. The data sources included national human resource and training plans, and interviews with personnel at the Malawi MOHP Human Resources Management and Development (HRMD) and Planning Unit offices, the MOHP Reproductive Health Unit, the Nurses and Midwives Council of Malawi, and at several of the preservice institutions.
Results showed that current FP/RH training outputs would result in adequate to surplus numbers of injectables providers. However, there would not be sufficient providers of Norplant® implants and female sterilization in Malawi over the period 2001–2007. Introducing additional preservice training alone would bring the numbers of female sterilization providers up to meet the projected needs, but additional preservice education and inservice training would be needed to produce sufficient Norplant providers. The demand for condoms and pills will also surpass the
number of providers of these methods in the projection period from 2001 to 2007, although introducing more training was not modeled in the current set of projections.
USAID Bureau for Global Health Technical Report, produced by Jhpiego, 2004
A postabortion care (PAC) needs assessment undertaken in 2000 by the Malawi Ministry of Health an... more A postabortion care (PAC) needs assessment undertaken in 2000 by the Malawi Ministry of Health and Population Reproductive Health Unit, JHPIEGO, and EngenderHealth showed that systemic improvements were needed to improve comprehensive PAC services for women throughout the country. Previous study data had already shown that nearly a third of maternal deaths were due to complications of abortion, and the needs assessment confirmed deficiencies in the level of care available at the time for these patients at Malawi hospitals.
In 2001, the Ministry of Health and Population (MOHP) in Malawi and JHPIEGO, through the United States Agency for International Development (USAID) Training in Reproductive Health (TRH) award, began to implement a project to introduce comprehensive PAC services on a broad scale to Malawi. The program components included: (1) advocacy and policy development, (2) PAC training, (3) provision of materials and equipment, (4) organization of services, (5) expansion of PAC services, and (6) supervision, in order to increase the availability, quality, and use of comprehensive PAC services throughout Malawi.
This report presents the methodology and results of a process evaluation conducted by the MOHP RHU, JHPIEGO, and EngenderHealth in October 2002 to assess progress in achieving Malawi’s National PAC program goals at the initial 14 implementation hospitals. This evaluation was anticipated at the outset of the program and was considered part of the MOHP’s ongoing monitoring and quality assurance efforts.
Talks by Catherine G Schenck-Yglesias
• Public health informatics (PHI) was defined at the beginning of the century, as "the systematic... more • Public health informatics (PHI) was defined at the beginning of the century, as "the systematic application of information and computer science and technology to public health practice, research, and learning."
Papers by Catherine G Schenck-Yglesias
Using the training needs projection methods in the Spectrum Policy Modeling System software modul... more Using the training needs projection methods in the Spectrum Policy Modeling System software module ProTrain JHPIEGO collaborated with the Malawi Ministry of Health and Population (MOHP) Reproductive Health Unit (RHU) to estimate numbers of Family Planning/Reproductive Health (FP/RH) service providers who are needed to reach total fertility rate (TFR) and contraceptive prevalence goals for Malawi from 2001-2007. ProTrain allows the user to project the available versus required number of trained and competent family planning (FP) service providers of several FP methods in various sectors of a national health system given expected client demand and expected training outputs. In creating these FP human resource projections JHPIEGO was building upon work done at the FP/RH Projections Update Workshop in Malawi in March 2003 by the Malawi MOHP Reproductive Health Unit. Those demographic and FP projections form the foundation for the current human resources (HR) study. A conservative demogr...
PsycEXTRA Dataset
The purpose of evaluating public health surveillance systems is to ensure that problems of public... more The purpose of evaluating public health surveillance systems is to ensure that problems of public health importance are being monitored efficiently and effectively. CDC's Guidelines for Evaluating Surveillance Systems are being updated to address the need for a) the integration of surveillance and health information systems, b) the establishment of data standards, c) the electronic exchange of health data, and d) changes in the objectives of public health surveillance to facilitate the response of public health to emerging health threats (e.g., new diseases). This report provides updated guidelines for evaluating surveillance systems based on CDC's Framework for Program Evaluation in Public Health, research and discussion of concerns related to public health surveillance systems, and comments received from the public health community. The guidelines in this report describe many tasks and related activities that can be applied to public health surveillance systems.
Jhpiego and Voxiva, Inc. will present the Results Information System for Excellence, RISE, launch... more Jhpiego and Voxiva, Inc. will present the Results Information System for Excellence, RISE, launched in the third quarter of calendar 2010 as Jhpiego's first such enterprise-level system. Jhpiego is an international non-profit health organization affiliated with The Johns Hopkins University. In operation for over 35 years, Jhpiego improves the quality of services provided to vulnerable populations in developing countries, scaling up evidence-based health innovations; we monitor performance according to standard as well as the outcomes and impacts of improved performance. Voxiva is a global leader in interactive mobile health (mHealth), providing a range of interactive health information services that: (a) support and engage people in managing their health and living healthier lives, and (b) help health delivery systems work more effectively. The Voxiva technology platform supports Jhpiego business process improvement not only in standardizing indicator data collection, storage, and analysis, but in the systematic review of data completeness and traceability, all using streamlined business intelligence (BI) tools. While demonstrating RISE features, we will discuss how this enabling technology is supporting Jhpiego in scaling up results-based program management and monitoring.
TRADEMARKS: All brand and product names are trademarks or registered trademarks of their respecti... more TRADEMARKS: All brand and product names are trademarks or registered trademarks of their respective companies.
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Demography by Catherine G Schenck-Yglesias
Informatics by Catherine G Schenck-Yglesias
attended by a multidisciplinary group of health professionals and community members,
including people living with HIV. The Workshop’s aim was to develop draft guidelines on
protecting the confidentiality and security of HIV information, and to produce a plan to field test them within countries. It involved plenary sessions and small and large group work.
This report documents a March 2001 evaluation of over 300 students, faculty and library staff to determine the effectiveness of the TALC at the UMSA Health Sciences Library, and to examine to what extent the availability of information and communication technology was ensuring access to updated reproductive health information. The evaluation showed that the TALC succeeded in increasing professional and academic access to up-to-date reproductive health information, opening up the online world for UMSA faculty and students, and promoting South-to-
South collaboration in a variety of ways.
Based on CDC's Framework for Program Evaluation in Public Health (4), research and discussion of concerns related to public health surveillance systems, and comments received from the public health community, this report provides updated guidelines for evaluating public health surveillance systems.
RBM by Catherine G Schenck-Yglesias
Jhpiego is an international non-profit health organization affiliated with The Johns Hopkins University. In operation for over 35 years, Jhpiego improves the quality of services provided to vulnerable populations in developing countries, scaling up evidence-based health innovations; we monitor performance according to standard as well as the outcomes and impacts of improved performance.
Voxiva is a global leader in interactive mobile health (mHealth), providing a range of interactive health information services that: (a) support and engage people in managing their health and living healthier lives, and (b) help health delivery systems work more effectively.
The Voxiva technology platform supports Jhpiego business process improvement not only in standardizing indicator data collection, storage, and analysis, but in the systematic review of data completeness and traceability, all using streamlined business intelligence (BI) tools. While demonstrating RISE features, we will discuss how this enabling technology is supporting Jhpiego in scaling up results-based program management and monitoring.
M&E by Catherine G Schenck-Yglesias
The ultimate aim is to facilitate the adoption of standard procedures that can produce consistent and internationally comparable information to inform the planning of health system investments and health programs, and to assess their impact. We believe that the use of standardized and internationally comparable information to produce facility profiles will allow donors and countries to understand better how conditions for facility-based services differ among countries, and can provide a context for interpreting status and needs.
maternal and newborn care, family and community involvement in this care, and supportive government policies to sustain these efforts. This report presents the results of these Program efforts. The MNH Program in Guatemala employed research methods to formally evaluate the
impact of the behavior change intervention (BCI) component. Routine health and management information systems were used to construct Safe Motherhood process indicators to monitor the essential maternal and neonatal care (EMNC) service delivery component. Program documents were used to monitor the policy component. The methods and results of each are presented in this impact report, adding to the evidence base on the effectiveness of strengthening community mobilization and service delivery efforts to improve maternal and neonatal survival in the developing world.
The maternal mortality ratio in Guatemala fell from an estimated 219 maternal deaths per 100,000 live births in 1989 to 153 in 2000, but it still remains one of the highest in Latin America. The major causes of maternal mortality in Guatemala are preventable: hemorrhage (53%), followed by infection (14%) and hypertension (12%). In the western part of the country, between 69% and 80% of women give birth at home, where complications can lead to death if the family and community are
not prepared to act appropriately to respond to the emergency condition. The 2000 Reproductive Age Mortality Study (RAMOS) in Guatemala found that maternal deaths generally occurred within 24 hours of the resolution of the pregnancy.1 More than half died at home, and four out of 10 died in a healthcare facility. Sixty percent of those mothers who died had been attended at the time of childbirth by a traditional birth attendant (TBA) or a family member or gave birth alone. Thirty percent of those women who died had been attended by a trained healthcare provider.
To address Guatemala’s maternal survival problems, the Guatemalan MOH received technical assistance from the MNH Program to improve essential maternal services and mobilize individuals and communities to respond to obstetric emergencies in an appropriate and timely manner. The United States Agency for International Development (USAID) supports the MNH Program through its Guatemala-Central American Program. The timeframe for MNH Program implementation in Guatemala was 1999–2004.
The MNH Program’s global strategic objective is to promote maternal and neonatal survival in low resource settings by increasing the use of appropriate maternal and neonatal health and nutrition interventions. The goal of the MNH Program in Guatemala is to increase the adoption of practices and use of services that are key for maternal and neonatal survival by:
- Establishing a network of high-quality, accredited essential maternal and neonatal care (EMNC)
- Increasing appropriate use of accredited community and institutional services
- Strengthening policies and norms implemented to sustain an adequate provision of EMNC
services
HR for Health by Catherine G Schenck-Yglesias
The specific objectives were to:
- Review current HRM policies, plans and procedures.
- Assess HR data management systems, including personnel filing systems.
- Assess staff performance management capacity and systems.
- Assess the roles and responsibilities of stakeholders in the HRM systems and their impact on the efficiency and effectiveness of the management systems.
- Assess pre-service and in-service training systems including policies, plans and procedures for managing intake and outcomes, and assess the linkages between pre-service and in-service training.
- Assess the role of women in the GHS and their opportunities for job advancement.
- Provide recommendations for streamlining and strengthening HRM systems in the GHS.
WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, JHPIEGO reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.
This report is the result of a number of technical assistance site visits to Malawi between February 2001 and December 2002, in addition to the review of several reports and consultant documents focused on human resources and training monitoring systems in the Malawian health sector. The report divides human resources for health (HRH) data into two categories: demand and supply. Demand data tell a health sector leader how many personnel in each cadre in each type of facility, and in which geographical areas, are needed. Supply data tell the decision-makers how many personnel there are presently or will be available. Demand sources reviewed in the present assessment include the current establishment and functional review of HRH in Malawi, and the World Health Organization (WHO) Human Resource for Health computer model, used by JHPIEGO and Keele University in 2003 in Malawi to project HRH demand. The review of supply data revealed that 10 parallel data sources on HRH are in place covering Malawi MOHP personnel, while one streamlined data source was in place at the Christian Health Association of Malawi.
Training data sources from preservice institutions and family planning/reproductive health (FP/RH) inservice programs were also reviewed as part of this assessment.
FP/RH by Catherine G Schenck-Yglesias
ProTrain™ allows the user to project the available versus required number of trained and competent family planning (FP) service providers of several FP methods, in various sectors of a national health system, given expected client demand and expected training outputs.
In creating these FP human resource projections, JHPIEGO was building upon work done at the FP/RH Projections Update Workshop in Malawi in March 2003 by the Malawi MOHP Reproductive Health Unit. Those demographic and FP projections form the foundation for the current human resources (HR) study. A conservative demography/family planning model was used, which assumed that the decline in TFR between 2001 and 2015 would be at the same rate as the decline measured between the two Malawi Demographic and Health Surveys (DHSs) in 1992 and 2000. This is a slower rate of decline, reaching 5.64 by the year 2015 instead of the population policy goal of 4.5 by 2015. The demography/family planning model was based on constrained rather than adequate resources to meet the TFR goal. The FP
projection contains estimates of current and anticipated future percentages of eligible women receiving their contraceptive services from different sources within Malawi: public and private sector, Christian Health Association of Malawi (CHAM), Banja La Mtsogolo (a local nongovernmental organization), and community-based distribution agents (CBDAs).
In order to construct the training projection model, JHPIEGO gathered data on several aspects of the preservice and inservice training that produces FP providers, and on FP service delivery in Malawi, from various data sources. The data sources included national human resource and training plans, and interviews with personnel at the Malawi MOHP Human Resources Management and Development (HRMD) and Planning Unit offices, the MOHP Reproductive Health Unit, the Nurses and Midwives Council of Malawi, and at several of the preservice institutions.
Results showed that current FP/RH training outputs would result in adequate to surplus numbers of injectables providers. However, there would not be sufficient providers of Norplant® implants and female sterilization in Malawi over the period 2001–2007. Introducing additional preservice training alone would bring the numbers of female sterilization providers up to meet the projected needs, but additional preservice education and inservice training would be needed to produce sufficient Norplant providers. The demand for condoms and pills will also surpass the
number of providers of these methods in the projection period from 2001 to 2007, although introducing more training was not modeled in the current set of projections.
In 2001, the Ministry of Health and Population (MOHP) in Malawi and JHPIEGO, through the United States Agency for International Development (USAID) Training in Reproductive Health (TRH) award, began to implement a project to introduce comprehensive PAC services on a broad scale to Malawi. The program components included: (1) advocacy and policy development, (2) PAC training, (3) provision of materials and equipment, (4) organization of services, (5) expansion of PAC services, and (6) supervision, in order to increase the availability, quality, and use of comprehensive PAC services throughout Malawi.
This report presents the methodology and results of a process evaluation conducted by the MOHP RHU, JHPIEGO, and EngenderHealth in October 2002 to assess progress in achieving Malawi’s National PAC program goals at the initial 14 implementation hospitals. This evaluation was anticipated at the outset of the program and was considered part of the MOHP’s ongoing monitoring and quality assurance efforts.
Talks by Catherine G Schenck-Yglesias
Papers by Catherine G Schenck-Yglesias
attended by a multidisciplinary group of health professionals and community members,
including people living with HIV. The Workshop’s aim was to develop draft guidelines on
protecting the confidentiality and security of HIV information, and to produce a plan to field test them within countries. It involved plenary sessions and small and large group work.
This report documents a March 2001 evaluation of over 300 students, faculty and library staff to determine the effectiveness of the TALC at the UMSA Health Sciences Library, and to examine to what extent the availability of information and communication technology was ensuring access to updated reproductive health information. The evaluation showed that the TALC succeeded in increasing professional and academic access to up-to-date reproductive health information, opening up the online world for UMSA faculty and students, and promoting South-to-
South collaboration in a variety of ways.
Based on CDC's Framework for Program Evaluation in Public Health (4), research and discussion of concerns related to public health surveillance systems, and comments received from the public health community, this report provides updated guidelines for evaluating public health surveillance systems.
Jhpiego is an international non-profit health organization affiliated with The Johns Hopkins University. In operation for over 35 years, Jhpiego improves the quality of services provided to vulnerable populations in developing countries, scaling up evidence-based health innovations; we monitor performance according to standard as well as the outcomes and impacts of improved performance.
Voxiva is a global leader in interactive mobile health (mHealth), providing a range of interactive health information services that: (a) support and engage people in managing their health and living healthier lives, and (b) help health delivery systems work more effectively.
The Voxiva technology platform supports Jhpiego business process improvement not only in standardizing indicator data collection, storage, and analysis, but in the systematic review of data completeness and traceability, all using streamlined business intelligence (BI) tools. While demonstrating RISE features, we will discuss how this enabling technology is supporting Jhpiego in scaling up results-based program management and monitoring.
The ultimate aim is to facilitate the adoption of standard procedures that can produce consistent and internationally comparable information to inform the planning of health system investments and health programs, and to assess their impact. We believe that the use of standardized and internationally comparable information to produce facility profiles will allow donors and countries to understand better how conditions for facility-based services differ among countries, and can provide a context for interpreting status and needs.
maternal and newborn care, family and community involvement in this care, and supportive government policies to sustain these efforts. This report presents the results of these Program efforts. The MNH Program in Guatemala employed research methods to formally evaluate the
impact of the behavior change intervention (BCI) component. Routine health and management information systems were used to construct Safe Motherhood process indicators to monitor the essential maternal and neonatal care (EMNC) service delivery component. Program documents were used to monitor the policy component. The methods and results of each are presented in this impact report, adding to the evidence base on the effectiveness of strengthening community mobilization and service delivery efforts to improve maternal and neonatal survival in the developing world.
The maternal mortality ratio in Guatemala fell from an estimated 219 maternal deaths per 100,000 live births in 1989 to 153 in 2000, but it still remains one of the highest in Latin America. The major causes of maternal mortality in Guatemala are preventable: hemorrhage (53%), followed by infection (14%) and hypertension (12%). In the western part of the country, between 69% and 80% of women give birth at home, where complications can lead to death if the family and community are
not prepared to act appropriately to respond to the emergency condition. The 2000 Reproductive Age Mortality Study (RAMOS) in Guatemala found that maternal deaths generally occurred within 24 hours of the resolution of the pregnancy.1 More than half died at home, and four out of 10 died in a healthcare facility. Sixty percent of those mothers who died had been attended at the time of childbirth by a traditional birth attendant (TBA) or a family member or gave birth alone. Thirty percent of those women who died had been attended by a trained healthcare provider.
To address Guatemala’s maternal survival problems, the Guatemalan MOH received technical assistance from the MNH Program to improve essential maternal services and mobilize individuals and communities to respond to obstetric emergencies in an appropriate and timely manner. The United States Agency for International Development (USAID) supports the MNH Program through its Guatemala-Central American Program. The timeframe for MNH Program implementation in Guatemala was 1999–2004.
The MNH Program’s global strategic objective is to promote maternal and neonatal survival in low resource settings by increasing the use of appropriate maternal and neonatal health and nutrition interventions. The goal of the MNH Program in Guatemala is to increase the adoption of practices and use of services that are key for maternal and neonatal survival by:
- Establishing a network of high-quality, accredited essential maternal and neonatal care (EMNC)
- Increasing appropriate use of accredited community and institutional services
- Strengthening policies and norms implemented to sustain an adequate provision of EMNC
services
The specific objectives were to:
- Review current HRM policies, plans and procedures.
- Assess HR data management systems, including personnel filing systems.
- Assess staff performance management capacity and systems.
- Assess the roles and responsibilities of stakeholders in the HRM systems and their impact on the efficiency and effectiveness of the management systems.
- Assess pre-service and in-service training systems including policies, plans and procedures for managing intake and outcomes, and assess the linkages between pre-service and in-service training.
- Assess the role of women in the GHS and their opportunities for job advancement.
- Provide recommendations for streamlining and strengthening HRM systems in the GHS.
WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, JHPIEGO reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.
This report is the result of a number of technical assistance site visits to Malawi between February 2001 and December 2002, in addition to the review of several reports and consultant documents focused on human resources and training monitoring systems in the Malawian health sector. The report divides human resources for health (HRH) data into two categories: demand and supply. Demand data tell a health sector leader how many personnel in each cadre in each type of facility, and in which geographical areas, are needed. Supply data tell the decision-makers how many personnel there are presently or will be available. Demand sources reviewed in the present assessment include the current establishment and functional review of HRH in Malawi, and the World Health Organization (WHO) Human Resource for Health computer model, used by JHPIEGO and Keele University in 2003 in Malawi to project HRH demand. The review of supply data revealed that 10 parallel data sources on HRH are in place covering Malawi MOHP personnel, while one streamlined data source was in place at the Christian Health Association of Malawi.
Training data sources from preservice institutions and family planning/reproductive health (FP/RH) inservice programs were also reviewed as part of this assessment.
ProTrain™ allows the user to project the available versus required number of trained and competent family planning (FP) service providers of several FP methods, in various sectors of a national health system, given expected client demand and expected training outputs.
In creating these FP human resource projections, JHPIEGO was building upon work done at the FP/RH Projections Update Workshop in Malawi in March 2003 by the Malawi MOHP Reproductive Health Unit. Those demographic and FP projections form the foundation for the current human resources (HR) study. A conservative demography/family planning model was used, which assumed that the decline in TFR between 2001 and 2015 would be at the same rate as the decline measured between the two Malawi Demographic and Health Surveys (DHSs) in 1992 and 2000. This is a slower rate of decline, reaching 5.64 by the year 2015 instead of the population policy goal of 4.5 by 2015. The demography/family planning model was based on constrained rather than adequate resources to meet the TFR goal. The FP
projection contains estimates of current and anticipated future percentages of eligible women receiving their contraceptive services from different sources within Malawi: public and private sector, Christian Health Association of Malawi (CHAM), Banja La Mtsogolo (a local nongovernmental organization), and community-based distribution agents (CBDAs).
In order to construct the training projection model, JHPIEGO gathered data on several aspects of the preservice and inservice training that produces FP providers, and on FP service delivery in Malawi, from various data sources. The data sources included national human resource and training plans, and interviews with personnel at the Malawi MOHP Human Resources Management and Development (HRMD) and Planning Unit offices, the MOHP Reproductive Health Unit, the Nurses and Midwives Council of Malawi, and at several of the preservice institutions.
Results showed that current FP/RH training outputs would result in adequate to surplus numbers of injectables providers. However, there would not be sufficient providers of Norplant® implants and female sterilization in Malawi over the period 2001–2007. Introducing additional preservice training alone would bring the numbers of female sterilization providers up to meet the projected needs, but additional preservice education and inservice training would be needed to produce sufficient Norplant providers. The demand for condoms and pills will also surpass the
number of providers of these methods in the projection period from 2001 to 2007, although introducing more training was not modeled in the current set of projections.
In 2001, the Ministry of Health and Population (MOHP) in Malawi and JHPIEGO, through the United States Agency for International Development (USAID) Training in Reproductive Health (TRH) award, began to implement a project to introduce comprehensive PAC services on a broad scale to Malawi. The program components included: (1) advocacy and policy development, (2) PAC training, (3) provision of materials and equipment, (4) organization of services, (5) expansion of PAC services, and (6) supervision, in order to increase the availability, quality, and use of comprehensive PAC services throughout Malawi.
This report presents the methodology and results of a process evaluation conducted by the MOHP RHU, JHPIEGO, and EngenderHealth in October 2002 to assess progress in achieving Malawi’s National PAC program goals at the initial 14 implementation hospitals. This evaluation was anticipated at the outset of the program and was considered part of the MOHP’s ongoing monitoring and quality assurance efforts.