Putting Systems And Complexity Sciences Into Practice Sharing The Experience

Putting Systems and Complexity Sciences Into Practice

This idea-packed resource takes systems and complexity sciences out of blue-sky territory and into the concrete world of contemporary healthcare practice. Beginning with a new reframing of health and illness, its chapters redesign traditional disease-centered models of care into modern, health-centered—and patient-centered—health service systems. The approaches shown here combine innovation and common sense to recognize and attend to patients’ needs across areas including health education and training, information accessibility, health service organization and delivery, and disease in individual context. The variety of solutions applied to this wide spectrum of issues shows the suitability of systems, complexity, and adaptive thinking to the ongoing objectives of making health services more responsive, effective, and equitable. Highlights of the coverage: Healthy smoker: an oxymoron? Maybe, but it is more complicated than that Transforming monitoring and improving care with variability-derived clinical decision support Linking Gulf War illness to genome instability, somatic evolution, and complex adaptive systems Complexity of knowledge in primary care: understanding the discipline’s requisite knowledge: a bibliometric study New ways of knowing and researching: integrating complexity into a translational health sciences program Understanding the emergency department ecosystem using agent-based modelling Putting Systems and Complexity Sciences into Practice is an inspiring idea book that sill interest health policymakers, health financiers, organizational leaders, healthcare administrators, clinicians, researchers, students, and interested lay readers.

Putting Systems and Complexity Sciences Into Practice Sharing the Experience

Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program

Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.