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  1. Book ; Online: Effects of performance incentives for community health worker cooperatives in Rwanda

    Shapira, Gil / Condo, Jeanine / Humuza, James / Kalisa, Ina / Mugeni, Cathy / Nkunda, Denis / Walldorf, Jeanette

    (Policy research working paper ; 8059)

    2017  

    Author's details Gil Shapira, Ina Kalisa, Jeanine Condo, James Humuza, Cathy Mugeni, Denis Nkunda, Jeanette Walldorf
    Series title Policy research working paper ; 8059
    Language English
    Size 1 Online-Ressource (circa 34 Seiten), Illustrationen
    Publisher World Bank Group, Development Research Group, Human Development and Public Services Team
    Publishing place Washington, D.C
    Document type Book ; Online
    Database ECONomics Information System

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  2. Article ; Online: Going beyond incentivizing formal health providers: Evidence from the Rwanda Community Performance-Based Financing program.

    Shapira, Gil / Kalisa, Ina / Condo, Jeanine / Humuza, James / Mugeni, Cathy / Nkunda, Denis / Walldorf, Jeanette

    Health economics

    2018  Volume 27, Issue 12, Page(s) 2087–2106

    Abstract: Pay-for-performance programs are introduced in an increasing number of low- and middle-income countries with the goal of reducing maternal and child mortality and morbidity through increased health service utilization and quality. Although most programs ... ...

    Abstract Pay-for-performance programs are introduced in an increasing number of low- and middle-income countries with the goal of reducing maternal and child mortality and morbidity through increased health service utilization and quality. Although most programs incentivize formal health providers, some constraints to utilization might be better alleviated by incentivizing other actors in the health care system. This paper presents results from a randomized controlled trial set to evaluate the effects of two incentive schemes that were introduced on top of Rwanda's national Performance-Based Financing program at the health facility level. One scheme rewarded community health worker cooperatives for the utilization of five services by their communities. The second scheme provided in-kind transfers to users of three services. The analysis finds no impact of the cooperative performance payments on coverage of the targeted services, behaviors of community health workers, or outcomes at the cooperative level. Although health centers experienced frequent stock outs of the gifts, the demand-side intervention significantly increased timely antenatal care by 9.3 percentage points and timely postnatal care by 8.6 percentage points. This study shows that demand-side incentives can increase service utilization also when provided in addition to a supply-side pay-for-performance scheme.
    MeSH term(s) Community Health Workers ; Delivery of Health Care/economics ; Developing Countries ; Female ; Humans ; Maternal Health Services/statistics & numerical data ; Pregnancy ; Prenatal Care/methods ; Reimbursement, Incentive/statistics & numerical data ; Rwanda
    Language English
    Publishing date 2018-08-29
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1135838-5
    ISSN 1099-1050 ; 1057-9230
    ISSN (online) 1099-1050
    ISSN 1057-9230
    DOI 10.1002/hec.3822
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  3. Article ; Online: Balancing workload, motivation and job satisfaction in Rwanda: assessing the effect of adding family planning service provision to community health worker duties.

    Chin-Quee, Dawn / Mugeni, Cathy / Nkunda, Denis / Uwizeye, Marie Rose / Stockton, Laurie L / Wesson, Jennifer

    Reproductive health

    2016  Volume 13, Page(s) 2

    Abstract: Background: Task shifting from higher cadre providers to CHWs has been widely adopted to address healthcare provider shortages, but the addition of any service can potentially add to an already considerable workload for CHWs. Objective measures of ... ...

    Abstract Background: Task shifting from higher cadre providers to CHWs has been widely adopted to address healthcare provider shortages, but the addition of any service can potentially add to an already considerable workload for CHWs. Objective measures of workload alone, such as work-related time and travel may not reflect howCHWs actually perceive and react to their circumstances. This study combined perception and objectivemeasures of workload to examine their effect on quality of services, worker performance, and job and clientsatisfaction.
    Methods: Three hundred eighty-three CHWs from control and intervention districts, where the intervention group was trained to provide contraceptive resupply, completed diaries of work-related activities for one month. Interviews were also conducted with a subset of CHWs and their clients.
    Results: CHW diaries did not reveal significant differences between intervention and control groups in time spent on service provision or travel. Over 90% of CHWs reported workload manageability, job satisfaction, and motivation to perform their jobs. Clients were highly satisfied with CHW services and most stated preference for future services from CHWs.
    Conclusion: The study demonstrated that adding resupply of hormonal contraceptives to CHWs' tasks would not place undue burden on them. Accordingly, the initiative was scaled up in all 30 districts in the country.
    MeSH term(s) Adult ; Attitude of Health Personnel ; Community Health Workers/education ; Community Health Workers/psychology ; Contraceptive Agents, Female/administration & dosage ; Contraceptives, Oral, Hormonal/administration & dosage ; Cross-Sectional Studies ; Drug Implants/administration & dosage ; Family Planning Services/education ; Family Planning Services/manpower ; Female ; Humans ; Inservice Training ; Job Satisfaction ; Longitudinal Studies ; Male ; Motivation ; Patient Satisfaction ; Pilot Projects ; Professional Role/psychology ; Quality of Health Care ; Rwanda ; Stress, Psychological/etiology ; Stress, Psychological/prevention & control ; Work Performance ; Workload/psychology
    Chemical Substances Contraceptive Agents, Female ; Contraceptives, Oral, Hormonal ; Drug Implants
    Language English
    Publishing date 2016-01-06
    Publishing country England
    Document type Journal Article ; Multicenter Study
    ISSN 1742-4755
    ISSN (online) 1742-4755
    DOI 10.1186/s12978-015-0110-z
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  4. Article ; Online: Lowering hospital walls to achieve health equity.

    Matheson, Anna / Bourke, Chris / Verhoeven, Alison / Khan, M Imran / Nkunda, Denis / Dahar, Zaib / Ellison-Loschmann, Lis

    BMJ (Clinical research ed.)

    2018  Volume 362, Page(s) k3597

    MeSH term(s) Australia/epidemiology ; Australia/ethnology ; Female ; Health Equity/statistics & numerical data ; Health Equity/trends ; Health Services Accessibility/statistics & numerical data ; Health Services Accessibility/trends ; Hospitals/standards ; Hospitals/statistics & numerical data ; Humans ; Leadership ; Life Expectancy/ethnology ; New Zealand/epidemiology ; Pakistan/epidemiology ; Primary Health Care/economics ; Primary Health Care/standards ; Rwanda/epidemiology
    Language English
    Publishing date 2018-09-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1362901-3
    ISSN 1756-1833 ; 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    ISSN (online) 1756-1833
    ISSN 0959-8154 ; 0959-8146 ; 0959-8138 ; 0959-535X ; 1759-2151
    DOI 10.1136/bmj.k3597
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  5. Article ; Online: Rwanda 20 years on: investing in life.

    Binagwaho, Agnes / Farmer, Paul E / Nsanzimana, Sabin / Karema, Corine / Gasana, Michel / de Dieu Ngirabega, Jean / Ngabo, Fidele / Wagner, Claire M / Nutt, Cameron T / Nyatanyi, Thierry / Gatera, Maurice / Kayiteshonga, Yvonne / Mugeni, Cathy / Mugwaneza, Placidie / Shema, Joseph / Uwaliraye, Parfait / Gaju, Erick / Muhimpundu, Marie Aimee / Dushime, Theophile /
    Senyana, Florent / Mazarati, Jean Baptiste / Gaju, Celsa Muzayire / Tuyisenge, Lisine / Mutabazi, Vincent / Kyamanywa, Patrick / Rusanganwa, Vincent / Nyemazi, Jean Pierre / Umutoni, Agathe / Kankindi, Ida / Ntizimira, Christian / Ruton, Hinda / Mugume, Nathan / Nkunda, Denis / Ndenga, Espérance / Mubiligi, Joel M / Kakoma, Jean Baptiste / Karita, Etienne / Sekabaraga, Claude / Rusingiza, Emmanuel / Rich, Michael L / Mukherjee, Joia S / Rhatigan, Joseph / Cancedda, Corrado / Bertrand-Farmer, Didi / Bukhman, Gene / Stulac, Sara N / Tapela, Neo M / van der Hoof Holstein, Cassia / Shulman, Lawrence N / Habinshuti, Antoinette / Bonds, Matthew H / Wilkes, Michael S / Lu, Chunling / Smith-Fawzi, Mary C / Swain, JaBaris D / Murphy, Michael P / Ricks, Alan / Kerry, Vanessa B / Bush, Barbara P / Siegler, Richard W / Stern, Cori S / Sliney, Anne / Nuthulaganti, Tej / Karangwa, Injonge / Pegurri, Elisabetta / Dahl, Ophelia / Drobac, Peter C

    Lancet (London, England)

    2014  Volume 384, Issue 9940, Page(s) 371–375

    Abstract: Two decades ago, the genocide against the Tutsis in Rwanda led to the deaths of 1 million people, and the displacement of millions more. Injury and trauma were followed by the effects of a devastated health system and economy. In the years that followed, ...

    Abstract Two decades ago, the genocide against the Tutsis in Rwanda led to the deaths of 1 million people, and the displacement of millions more. Injury and trauma were followed by the effects of a devastated health system and economy. In the years that followed, a new course set by a new government set into motion equity-oriented national policies focusing on social cohesion and people-centred development. Premature mortality rates have fallen precipitously in recent years, and life expectancy has doubled since the mid-1990s. Here we reflect on the lessons learned in rebuilding Rwanda's health sector during the past two decades, as the country now prepares itself to take on new challenges in health-care delivery.
    MeSH term(s) Child ; Child Mortality ; Delivery of Health Care/organization & administration ; Genocide ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/therapy ; Health Policy ; Humans ; Rwanda/epidemiology ; Tuberculosis, Pulmonary/mortality ; Warfare
    Language English
    Publishing date 2014-04-04
    Publishing country England
    Document type Journal Article
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(14)60574-2
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    In stock of ZB MED Cologne/Königswinter

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