This study was funded by the United States Agency for International Development (USAID)
The private sector in health care is growing in most low- and middle-income countries. Private providers now deliver more out-patient services than public in many of these countries. Global health achievements require the collaboration of... more
The private sector in health care is growing in most low- and middle-income countries. Private providers now deliver more out-patient services than public in many of these countries. Global health achievements require the collaboration of the private sector. Governments must learn how to address new health systems issues arising out of this fact. Public-private partnerships are of increasing importance. An international conference on the role of the private sector in health system development, held in Jinan, China in September 2006, provided further evidence of the significant role that the private sector plays in low- and middle-income countries (see www.psp.ki.se for full report). Participants called for the establishment of a network of scholars and policy makers interested in issues related to the role of the private sector in health care delivery and public health. At iHEA the rationale for creating such a network as a platform for the exchange of policy-oriented evidence and r...
The present study aimed to explore the inter-relationships among maternal death, household economic status after the event, and potential influencing factors. We conducted a prospective cohort study of households that had experienced... more
The present study aimed to explore the inter-relationships among maternal death, household economic status after the event, and potential influencing factors. We conducted a prospective cohort study of households that had experienced maternal death (n = 195) and those that experienced childbirth without maternal death (n = 384) in rural China. All the households were interviewed after the event occurred and were followed up 12 months later. Structural equation modeling was used to test the relationship model, utilizing income and expenditure per capita in the following year after the event as the main outcome variables, maternal death as the predictor, and direct costs, the amount of money offset by positive and negative coping strategies, whether the husband remarried, and whether the newborn was alive as the mediators. In the following year after the event, the path analysis revealed a direct effect from maternal death to lower income per capita (standardized coefficient = -0.43, ...
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This study evaluates the effect of a nurse training program in family planning counseling skills on the quality of service delivery at the clinic level, as well as its impact on client compliance with prearranged appointments. The study... more
This study evaluates the effect of a nurse training program in family planning counseling skills on the quality of service delivery at the clinic level, as well as its impact on client compliance with prearranged appointments. The study used a quasi-experimental design to compare certified nurses who received six weeks of family planning technical training with certified nurses who, in addition to the technical training course, received a three-day course in counseling skills. Data were collected through client exit interviews, expert observation, and inspection of medical record abstracts. Trained nurses performed better than their untrained counterparts in the quality-of-care areas investigated--interpersonal relations, information giving, counseling, and mechanisms for encouraging continuity. The likelihood that clients will attend follow-up visits was also found to improve when they were attended by trained professionals. Short-term counseling training can significantly improve the quality of care provided by family planning workers, as well as client compliance with follow-up appointments.
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Research Interests: Economics, Death, China, Multidisciplinary, Humans, and 6 moreFemale, Economic Impact, Mothers, PLoS one, Questionnaires, and Rural Area
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The quality of abortion in Turkey's public sector hospitals is investigated using multiple research methods including observations of actual procedures, interviews with medical staff and clients, and an inventory of materials and... more
The quality of abortion in Turkey's public sector hospitals is investigated using multiple research methods including observations of actual procedures, interviews with medical staff and clients, and an inventory of materials and equipment. The results suggest that women who obtain abortions in public sector hospitals have a higher abortion rate than the general population. They are likely to receive a vacuum aspiration with minimal pain control medication. Clinical infection control procedures are insufficient, as are interpersonal communication practices including counseling on reproductive health issues and providing factual information. Links with family planning services are strong and the majority of abortion patients who desire family planning receive a contraceptive method, either through direct provision of postabortion contraceptives or referral.
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Strengthening management capacity and meeting the need for Reproductive and Child Health (RCH) services is a major challenge for the national RCH programme in India. Central and state governments are working through multiple options to... more
Strengthening management capacity and meeting the need for Reproductive and Child Health (RCH) services is a major challenge for the national RCH programme in India. Central and state governments are working through multiple options to meet this challenge, responding to the complexity of issues in RCH which cut across social, cultural and economic factors, as well as reflecting the immense geographical barriers to access for remote and rural populations. Other barriers are also being addressed, including lessening financial burdens and creating Public - Private Partnerships (PPP) to expand access. For example, the NRHM has been initiated with particular focus on rural population. However, there are a number constraints faced by departments of health in implementing these initiatives. In this paper we focus on one key area: the development of management capacity for working with the private sector. A synthesis of the learning from three case studies of public-private partnerships in ...