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Health systems bottlenecks and evidence-based district health planning : Experiences from the district health system in UgandaHenriksson, Dorcus Kiwanuka January 2017 (has links)
In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children. This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children. Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports. District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of district-specific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of district-specific evidence. Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.
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Assessment of community health volunteers' knowledge regarding infant and young child feeding in Tewor District, Grand Cape Mount County, LiberiaDemissie, Shiferaw Dechasa 12 March 2013 (has links)
The objectives of the study were to determine infant and young child feeding (IYCF)
knowledge of Household Health Promoters (HHPs) and examine its relationship with
demographic characteristics. Quantitative, non-experimental descriptive design was
used. Seventy-one randomly selected HHPs participated in the study. A structured
questionnaire was used to collect the data. The results showed that the mean IYCF
knowledge score was 77.8% (N=71). The knowledge of the respondents was not
uniform across the components of IYCF which ranged between 19.72% for duration of
breastfeeding to 100% for colostrums feeding. None of the socio-demographic
characteristic was significantly associated to the mean knowledge score. The study
identified that refresher training should be provided to the HHPs on IYCF with emphasis
on the aspects of IYCF with scores below the mean / Health Studies
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Assessment of community health volunteers' knowledge regarding infant and young child feeding in Tewor District, Grand Cape Mount County, LiberiaDemissie, Shiferaw Dechasa 12 March 2013 (has links)
The objectives of the study were to determine infant and young child feeding (IYCF)
knowledge of Household Health Promoters (HHPs) and examine its relationship with
demographic characteristics. Quantitative, non-experimental descriptive design was
used. Seventy-one randomly selected HHPs participated in the study. A structured
questionnaire was used to collect the data. The results showed that the mean IYCF
knowledge score was 77.8% (N=71). The knowledge of the respondents was not
uniform across the components of IYCF which ranged between 19.72% for duration of
breastfeeding to 100% for colostrums feeding. None of the socio-demographic
characteristic was significantly associated to the mean knowledge score. The study
identified that refresher training should be provided to the HHPs on IYCF with emphasis
on the aspects of IYCF with scores below the mean / Health Studies
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