Protocol-driven primary care and community linkages to improve population health in rural Zambia: the Better Health Outcomes through Mentoring and ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2013-05

AUTHORS

Jeffrey SA Stringer, Angela Chisembele-Taylor, Carla J Chibwesha, Harmony F Chi, Helen Ayles, Handson Manda, Wendy Mazimba, Linnaea Schuttner, Ntazana Sindano, Frank B Williams, Namwinga Chintu, Roma Chilengi

ABSTRACT

INTRODUCTION: Zambia's under-resourced public health system will not be able to deliver on its health-related Millennium Development Goals without a substantial acceleration in mortality reduction. Reducing mortality will depend not only upon increasing access to health care but also upon improving the quality of care that is delivered. Our project proposes to improve the quality of clinical care and to improve utilization of that care, through a targeted quality improvement (QI) intervention delivered at the facility and community level. DESCRIPTION OF IMPLEMENTATION: The project is being carried out 42 primary health care facilities that serve a largely rural population of more than 450,000 in Zambia's Lusaka Province. We have deployed six QI teams to implement consensus clinical protocols, forms, and systems at each site. The QI teams define new clinical quality expectations and provide tools needed to deliver on those expectations. They also monitor the care that is provided and mentor facility staff to improve care quality. We also engage community health workers to actively refer and follow up patients. EVALUATION DESIGN: Project implementation occurs over a period of four years in a stepped expansion to six randomly selected new facilities every three months. Three annual household surveys will determine population estimates of age-standardized mortality and under-5 mortality in each community before, during, and after implementation. Surveys will also provide measures of childhood vaccine coverage, pregnancy care utilization, and general adult health. Health facility surveys will assess coverage of primary health interventions and measures of health system effectiveness. DISCUSSION: The patient-provider interaction is an important interface where the community and the health system meet. Our project aims to reduce population mortality by substantially improving this interaction. Our success will hinge upon the ability of mentoring and continuous QI to improve clinical service delivery. It will also be critical that once the quality of services improves, increasing proportions of the population will recognize their value and begin to utilize them. More... »

PAGES

s7

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/1472-6963-13-s2-s7

DOI

http://dx.doi.org/10.1186/1472-6963-13-s2-s7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1050981974

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23819614


Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
Incoming Citations Browse incoming citations for this publication using opencitations.net

JSON-LD is the canonical representation for SciGraph data.

TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

[
  {
    "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
    "about": [
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1117", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Public Health and Health Services", 
        "type": "DefinedTerm"
      }, 
      {
        "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
        "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
        "name": "Medical and Health Sciences", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Adolescent", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Adult", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Clinical Protocols", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Delivery of Health Care, Integrated", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Goals", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Humans", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Mentors", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Middle Aged", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Mortality", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Outcome Assessment (Health Care)", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Population Surveillance", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Primary Health Care", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Quality Improvement", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Rural Health Services", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Young Adult", 
        "type": "DefinedTerm"
      }, 
      {
        "inDefinedTermSet": "https://www.nlm.nih.gov/mesh/", 
        "name": "Zambia", 
        "type": "DefinedTerm"
      }
    ], 
    "author": [
      {
        "affiliation": {
          "alternateName": "University of North Carolina at Chapel Hill", 
          "id": "https://www.grid.ac/institutes/grid.10698.36", 
          "name": [
            "Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Stringer", 
        "givenName": "Jeffrey SA", 
        "id": "sg:person.015313027357.83", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015313027357.83"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chisembele-Taylor", 
        "givenName": "Angela", 
        "id": "sg:person.0760147720.67", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0760147720.67"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chibwesha", 
        "givenName": "Carla J", 
        "id": "sg:person.0600120510.03", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0600120510.03"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Development Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chi", 
        "givenName": "Harmony F", 
        "id": "sg:person.0720212645.66", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0720212645.66"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "name": [
            "ZAMBART PROJECT, Zambia AIDS Related Tuberculosis Project, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Ayles", 
        "givenName": "Helen", 
        "id": "sg:person.0702777076.09", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0702777076.09"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Manda", 
        "givenName": "Handson", 
        "id": "sg:person.01034441245.04", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01034441245.04"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Mazimba", 
        "givenName": "Wendy", 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Schuttner", 
        "givenName": "Linnaea", 
        "id": "sg:person.01076710710.78", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01076710710.78"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Sindano", 
        "givenName": "Ntazana", 
        "id": "sg:person.01145024110.11", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01145024110.11"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "University of Alabama at Birmingham", 
          "id": "https://www.grid.ac/institutes/grid.265892.2", 
          "name": [
            "School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Williams", 
        "givenName": "Frank B", 
        "id": "sg:person.0734342571.28", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0734342571.28"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chintu", 
        "givenName": "Namwinga", 
        "id": "sg:person.01244123704.92", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01244123704.92"
        ], 
        "type": "Person"
      }, 
      {
        "affiliation": {
          "alternateName": "Centre for Infectious Disease Research in Zambia", 
          "id": "https://www.grid.ac/institutes/grid.418015.9", 
          "name": [
            "Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia"
          ], 
          "type": "Organization"
        }, 
        "familyName": "Chilengi", 
        "givenName": "Roma", 
        "id": "sg:person.01250043704.13", 
        "sameAs": [
          "https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01250043704.13"
        ], 
        "type": "Person"
      }
    ], 
    "citation": [
      {
        "id": "https://doi.org/10.1016/j.ajog.2007.03.031", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1002927953"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/j.1365-3156.2011.02776.x", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1003713511"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1472-6963-10-272", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1011519316", 
          "https://doi.org/10.1186/1472-6963-10-272"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.298.16.1888", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1011573896"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1478-4491-8-19", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1011800031", 
          "https://doi.org/10.1186/1478-4491-8-19"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1093/ije/28.2.319", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1014718753"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1478-4491-7-55", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1020857820", 
          "https://doi.org/10.1186/1478-4491-7-55"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1478-7954-9-40", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1027833876", 
          "https://doi.org/10.1186/1478-7954-9-40"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1111/j.1467-985x.2009.00624_4.x", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1031230731"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1472-6963-9-5", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1039016560", 
          "https://doi.org/10.1186/1472-6963-9-5"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1478-4505-7-14", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1040836289", 
          "https://doi.org/10.1186/1478-4505-7-14"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1475-2875-10-273", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1041111121", 
          "https://doi.org/10.1186/1475-2875-10-273"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1471-2288-6-54", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1043348979", 
          "https://doi.org/10.1186/1471-2288-6-54"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1186/1475-2875-10-372", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1045312907", 
          "https://doi.org/10.1186/1475-2875-10-372"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1001/jama.296.7.782", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1052189815"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "sg:pub.10.1057/jphp.2011.4", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1052763752", 
          "https://doi.org/10.1057/jphp.2011.4"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1080/13576280600937911", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1058384112"
        ], 
        "type": "CreativeWork"
      }, 
      {
        "id": "https://doi.org/10.1590/s1726-46342011000200022", 
        "sameAs": [
          "https://app.dimensions.ai/details/publication/pub.1068112530"
        ], 
        "type": "CreativeWork"
      }
    ], 
    "datePublished": "2013-05", 
    "datePublishedReg": "2013-05-01", 
    "description": "INTRODUCTION: Zambia's under-resourced public health system will not be able to deliver on its health-related Millennium Development Goals without a substantial acceleration in mortality reduction. Reducing mortality will depend not only upon increasing access to health care but also upon improving the quality of care that is delivered. Our project proposes to improve the quality of clinical care and to improve utilization of that care, through a targeted quality improvement (QI) intervention delivered at the facility and community level.\nDESCRIPTION OF IMPLEMENTATION: The project is being carried out 42 primary health care facilities that serve a largely rural population of more than 450,000 in Zambia's Lusaka Province. We have deployed six QI teams to implement consensus clinical protocols, forms, and systems at each site. The QI teams define new clinical quality expectations and provide tools needed to deliver on those expectations. They also monitor the care that is provided and mentor facility staff to improve care quality. We also engage community health workers to actively refer and follow up patients.\nEVALUATION DESIGN: Project implementation occurs over a period of four years in a stepped expansion to six randomly selected new facilities every three months. Three annual household surveys will determine population estimates of age-standardized mortality and under-5 mortality in each community before, during, and after implementation. Surveys will also provide measures of childhood vaccine coverage, pregnancy care utilization, and general adult health. Health facility surveys will assess coverage of primary health interventions and measures of health system effectiveness.\nDISCUSSION: The patient-provider interaction is an important interface where the community and the health system meet. Our project aims to reduce population mortality by substantially improving this interaction. Our success will hinge upon the ability of mentoring and continuous QI to improve clinical service delivery. It will also be critical that once the quality of services improves, increasing proportions of the population will recognize their value and begin to utilize them.", 
    "genre": "research_article", 
    "id": "sg:pub.10.1186/1472-6963-13-s2-s7", 
    "inLanguage": [
      "en"
    ], 
    "isAccessibleForFree": true, 
    "isPartOf": [
      {
        "id": "sg:journal.1327417", 
        "issn": [
          "1472-6963"
        ], 
        "name": "BMC Health Services Research", 
        "type": "Periodical"
      }, 
      {
        "issueNumber": "Suppl 2", 
        "type": "PublicationIssue"
      }, 
      {
        "type": "PublicationVolume", 
        "volumeNumber": "13"
      }
    ], 
    "name": "Protocol-driven primary care and community linkages to improve population health in rural Zambia: the Better Health Outcomes through Mentoring and Assessment (BHOMA) project", 
    "pagination": "s7", 
    "productId": [
      {
        "name": "readcube_id", 
        "type": "PropertyValue", 
        "value": [
          "f2dc11c3337a17e2213e72dbf747eb335cd9bc1c05823a49a4091b9a43713d3d"
        ]
      }, 
      {
        "name": "pubmed_id", 
        "type": "PropertyValue", 
        "value": [
          "23819614"
        ]
      }, 
      {
        "name": "nlm_unique_id", 
        "type": "PropertyValue", 
        "value": [
          "101088677"
        ]
      }, 
      {
        "name": "doi", 
        "type": "PropertyValue", 
        "value": [
          "10.1186/1472-6963-13-s2-s7"
        ]
      }, 
      {
        "name": "dimensions_id", 
        "type": "PropertyValue", 
        "value": [
          "pub.1050981974"
        ]
      }
    ], 
    "sameAs": [
      "https://doi.org/10.1186/1472-6963-13-s2-s7", 
      "https://app.dimensions.ai/details/publication/pub.1050981974"
    ], 
    "sdDataset": "articles", 
    "sdDatePublished": "2019-04-10T15:02", 
    "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
    "sdPublisher": {
      "name": "Springer Nature - SN SciGraph project", 
      "type": "Organization"
    }, 
    "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000001_0000000264/records_8663_00000516.jsonl", 
    "type": "ScholarlyArticle", 
    "url": "http://link.springer.com/10.1186%2F1472-6963-13-S2-S7"
  }
]
 

Download the RDF metadata as:  json-ld nt turtle xml License info

HOW TO GET THIS DATA PROGRAMMATICALLY:

JSON-LD is a popular format for linked data which is fully compatible with JSON.

curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1186/1472-6963-13-s2-s7'

N-Triples is a line-based linked data format ideal for batch operations.

curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1186/1472-6963-13-s2-s7'

Turtle is a human-readable linked data format.

curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1186/1472-6963-13-s2-s7'

RDF/XML is a standard XML format for linked data.

curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1186/1472-6963-13-s2-s7'


 

This table displays all metadata directly associated to this object as RDF triples.

281 TRIPLES      21 PREDICATES      63 URIs      37 LITERALS      25 BLANK NODES

Subject Predicate Object
1 sg:pub.10.1186/1472-6963-13-s2-s7 schema:about N067a052df8c34af88c2fb21dd19914fc
2 N40f722427473420e81ef0986b9acb42b
3 N5a560f1f09af4a50be0d63d12040b09d
4 N5e4d4a04cdce40718e8242825890610f
5 N70abc1b53ea249f2868f09de55586187
6 Na1c7eef0985d4aa89457be5dd95a026b
7 Naabca937b6e14a1d8044f5e15ad66fe6
8 Nab005199d71a4bec8602756ac8b4bb07
9 Nb5688876525b4d39a7cf16072a236590
10 Nb5e595ebeec943a695265b52538d6b6a
11 Nbf6f3ba715754fbf80da6310cca67855
12 Nd6a64f129ca54e3eb9d80a0b1503600f
13 Nea89f26a4d394147be28794729a0a89f
14 Nf3a77dfd74b94ff7ba2874a0abac57af
15 Nf7344b974cb54ead87a2112ff0d97f06
16 Nfa683962c8bc4142b6ee195cdf42e0a9
17 anzsrc-for:11
18 anzsrc-for:1117
19 schema:author N4e406e8aeaf0438aa79607350f3032ab
20 schema:citation sg:pub.10.1057/jphp.2011.4
21 sg:pub.10.1186/1471-2288-6-54
22 sg:pub.10.1186/1472-6963-10-272
23 sg:pub.10.1186/1472-6963-9-5
24 sg:pub.10.1186/1475-2875-10-273
25 sg:pub.10.1186/1475-2875-10-372
26 sg:pub.10.1186/1478-4491-7-55
27 sg:pub.10.1186/1478-4491-8-19
28 sg:pub.10.1186/1478-4505-7-14
29 sg:pub.10.1186/1478-7954-9-40
30 https://doi.org/10.1001/jama.296.7.782
31 https://doi.org/10.1001/jama.298.16.1888
32 https://doi.org/10.1016/j.ajog.2007.03.031
33 https://doi.org/10.1080/13576280600937911
34 https://doi.org/10.1093/ije/28.2.319
35 https://doi.org/10.1111/j.1365-3156.2011.02776.x
36 https://doi.org/10.1111/j.1467-985x.2009.00624_4.x
37 https://doi.org/10.1590/s1726-46342011000200022
38 schema:datePublished 2013-05
39 schema:datePublishedReg 2013-05-01
40 schema:description INTRODUCTION: Zambia's under-resourced public health system will not be able to deliver on its health-related Millennium Development Goals without a substantial acceleration in mortality reduction. Reducing mortality will depend not only upon increasing access to health care but also upon improving the quality of care that is delivered. Our project proposes to improve the quality of clinical care and to improve utilization of that care, through a targeted quality improvement (QI) intervention delivered at the facility and community level. DESCRIPTION OF IMPLEMENTATION: The project is being carried out 42 primary health care facilities that serve a largely rural population of more than 450,000 in Zambia's Lusaka Province. We have deployed six QI teams to implement consensus clinical protocols, forms, and systems at each site. The QI teams define new clinical quality expectations and provide tools needed to deliver on those expectations. They also monitor the care that is provided and mentor facility staff to improve care quality. We also engage community health workers to actively refer and follow up patients. EVALUATION DESIGN: Project implementation occurs over a period of four years in a stepped expansion to six randomly selected new facilities every three months. Three annual household surveys will determine population estimates of age-standardized mortality and under-5 mortality in each community before, during, and after implementation. Surveys will also provide measures of childhood vaccine coverage, pregnancy care utilization, and general adult health. Health facility surveys will assess coverage of primary health interventions and measures of health system effectiveness. DISCUSSION: The patient-provider interaction is an important interface where the community and the health system meet. Our project aims to reduce population mortality by substantially improving this interaction. Our success will hinge upon the ability of mentoring and continuous QI to improve clinical service delivery. It will also be critical that once the quality of services improves, increasing proportions of the population will recognize their value and begin to utilize them.
41 schema:genre research_article
42 schema:inLanguage en
43 schema:isAccessibleForFree true
44 schema:isPartOf N3c541186547d448d9ce21f377a1d3b84
45 Ncc44e888b29b484898bca6c9f84d66db
46 sg:journal.1327417
47 schema:name Protocol-driven primary care and community linkages to improve population health in rural Zambia: the Better Health Outcomes through Mentoring and Assessment (BHOMA) project
48 schema:pagination s7
49 schema:productId N1502d59accc54045bb8a6178910e1585
50 N26595beae87c4a65b7941d4829e1bb79
51 Na2d74ef57b5445098395f832dcfa94d4
52 Nb5833865e8844e32ba93e6af58181315
53 Nb8ec5aa2a83c46e48e9adc21a6116ccb
54 schema:sameAs https://app.dimensions.ai/details/publication/pub.1050981974
55 https://doi.org/10.1186/1472-6963-13-s2-s7
56 schema:sdDatePublished 2019-04-10T15:02
57 schema:sdLicense https://scigraph.springernature.com/explorer/license/
58 schema:sdPublisher N978641cb5ae14507a6999dcf7f36a820
59 schema:url http://link.springer.com/10.1186%2F1472-6963-13-S2-S7
60 sgo:license sg:explorer/license/
61 sgo:sdDataset articles
62 rdf:type schema:ScholarlyArticle
63 N067a052df8c34af88c2fb21dd19914fc schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
64 schema:name Quality Improvement
65 rdf:type schema:DefinedTerm
66 N1502d59accc54045bb8a6178910e1585 schema:name dimensions_id
67 schema:value pub.1050981974
68 rdf:type schema:PropertyValue
69 N163be2af44a94760943eacc3b7c58d61 rdf:first N24a1377eb232494c886895412757c386
70 rdf:rest N88d20ad47d684c71a2089343be26d2a9
71 N24a1377eb232494c886895412757c386 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
72 schema:familyName Mazimba
73 schema:givenName Wendy
74 rdf:type schema:Person
75 N26595beae87c4a65b7941d4829e1bb79 schema:name pubmed_id
76 schema:value 23819614
77 rdf:type schema:PropertyValue
78 N30afdaa5251d4176b126d9926fa37462 rdf:first sg:person.0720212645.66
79 rdf:rest N55163f0b02774e94a1c9f7f0fb981777
80 N3c1ecb10954244839252128ae67f659e rdf:first sg:person.01034441245.04
81 rdf:rest N163be2af44a94760943eacc3b7c58d61
82 N3c541186547d448d9ce21f377a1d3b84 schema:volumeNumber 13
83 rdf:type schema:PublicationVolume
84 N40f722427473420e81ef0986b9acb42b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
85 schema:name Rural Health Services
86 rdf:type schema:DefinedTerm
87 N4e406e8aeaf0438aa79607350f3032ab rdf:first sg:person.015313027357.83
88 rdf:rest Nfdc25dc8b5ed4e64a98b3c457ff39aa4
89 N55163f0b02774e94a1c9f7f0fb981777 rdf:first sg:person.0702777076.09
90 rdf:rest N3c1ecb10954244839252128ae67f659e
91 N5a560f1f09af4a50be0d63d12040b09d schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
92 schema:name Middle Aged
93 rdf:type schema:DefinedTerm
94 N5e4d4a04cdce40718e8242825890610f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
95 schema:name Outcome Assessment (Health Care)
96 rdf:type schema:DefinedTerm
97 N61dad68e54e2465fafc59e1b426d669c schema:name ZAMBART PROJECT, Zambia AIDS Related Tuberculosis Project, Lusaka, Zambia
98 rdf:type schema:Organization
99 N70abc1b53ea249f2868f09de55586187 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
100 schema:name Humans
101 rdf:type schema:DefinedTerm
102 N88d20ad47d684c71a2089343be26d2a9 rdf:first sg:person.01076710710.78
103 rdf:rest Ne5b55b938aea44a1b85406c322a7dd85
104 N9490253279ba4dc28c7c09a2eaf5842c rdf:first sg:person.0600120510.03
105 rdf:rest N30afdaa5251d4176b126d9926fa37462
106 N978641cb5ae14507a6999dcf7f36a820 schema:name Springer Nature - SN SciGraph project
107 rdf:type schema:Organization
108 Na1c7eef0985d4aa89457be5dd95a026b schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
109 schema:name Clinical Protocols
110 rdf:type schema:DefinedTerm
111 Na2d74ef57b5445098395f832dcfa94d4 schema:name doi
112 schema:value 10.1186/1472-6963-13-s2-s7
113 rdf:type schema:PropertyValue
114 Naabca937b6e14a1d8044f5e15ad66fe6 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
115 schema:name Mentors
116 rdf:type schema:DefinedTerm
117 Nab005199d71a4bec8602756ac8b4bb07 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
118 schema:name Adolescent
119 rdf:type schema:DefinedTerm
120 Nb5688876525b4d39a7cf16072a236590 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
121 schema:name Zambia
122 rdf:type schema:DefinedTerm
123 Nb5833865e8844e32ba93e6af58181315 schema:name nlm_unique_id
124 schema:value 101088677
125 rdf:type schema:PropertyValue
126 Nb5e595ebeec943a695265b52538d6b6a schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
127 schema:name Primary Health Care
128 rdf:type schema:DefinedTerm
129 Nb8ec5aa2a83c46e48e9adc21a6116ccb schema:name readcube_id
130 schema:value f2dc11c3337a17e2213e72dbf747eb335cd9bc1c05823a49a4091b9a43713d3d
131 rdf:type schema:PropertyValue
132 Nbf6f3ba715754fbf80da6310cca67855 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
133 schema:name Goals
134 rdf:type schema:DefinedTerm
135 Nc1dfd5b894f24b3896e72076f1d9bb4c rdf:first sg:person.01244123704.92
136 rdf:rest Ne52ab5c13fcd4bfaaa5f672df9055ea6
137 Ncc44e888b29b484898bca6c9f84d66db schema:issueNumber Suppl 2
138 rdf:type schema:PublicationIssue
139 Nd6a64f129ca54e3eb9d80a0b1503600f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
140 schema:name Mortality
141 rdf:type schema:DefinedTerm
142 Ne161a2e1036a4d9bad944bc10402850e rdf:first sg:person.0734342571.28
143 rdf:rest Nc1dfd5b894f24b3896e72076f1d9bb4c
144 Ne52ab5c13fcd4bfaaa5f672df9055ea6 rdf:first sg:person.01250043704.13
145 rdf:rest rdf:nil
146 Ne5b55b938aea44a1b85406c322a7dd85 rdf:first sg:person.01145024110.11
147 rdf:rest Ne161a2e1036a4d9bad944bc10402850e
148 Nea89f26a4d394147be28794729a0a89f schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
149 schema:name Young Adult
150 rdf:type schema:DefinedTerm
151 Nf3a77dfd74b94ff7ba2874a0abac57af schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
152 schema:name Delivery of Health Care, Integrated
153 rdf:type schema:DefinedTerm
154 Nf7344b974cb54ead87a2112ff0d97f06 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
155 schema:name Adult
156 rdf:type schema:DefinedTerm
157 Nfa683962c8bc4142b6ee195cdf42e0a9 schema:inDefinedTermSet https://www.nlm.nih.gov/mesh/
158 schema:name Population Surveillance
159 rdf:type schema:DefinedTerm
160 Nfdc25dc8b5ed4e64a98b3c457ff39aa4 rdf:first sg:person.0760147720.67
161 rdf:rest N9490253279ba4dc28c7c09a2eaf5842c
162 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
163 schema:name Medical and Health Sciences
164 rdf:type schema:DefinedTerm
165 anzsrc-for:1117 schema:inDefinedTermSet anzsrc-for:
166 schema:name Public Health and Health Services
167 rdf:type schema:DefinedTerm
168 sg:journal.1327417 schema:issn 1472-6963
169 schema:name BMC Health Services Research
170 rdf:type schema:Periodical
171 sg:person.01034441245.04 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
172 schema:familyName Manda
173 schema:givenName Handson
174 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01034441245.04
175 rdf:type schema:Person
176 sg:person.01076710710.78 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
177 schema:familyName Schuttner
178 schema:givenName Linnaea
179 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01076710710.78
180 rdf:type schema:Person
181 sg:person.01145024110.11 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
182 schema:familyName Sindano
183 schema:givenName Ntazana
184 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01145024110.11
185 rdf:type schema:Person
186 sg:person.01244123704.92 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
187 schema:familyName Chintu
188 schema:givenName Namwinga
189 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01244123704.92
190 rdf:type schema:Person
191 sg:person.01250043704.13 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
192 schema:familyName Chilengi
193 schema:givenName Roma
194 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.01250043704.13
195 rdf:type schema:Person
196 sg:person.015313027357.83 schema:affiliation https://www.grid.ac/institutes/grid.10698.36
197 schema:familyName Stringer
198 schema:givenName Jeffrey SA
199 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.015313027357.83
200 rdf:type schema:Person
201 sg:person.0600120510.03 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
202 schema:familyName Chibwesha
203 schema:givenName Carla J
204 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0600120510.03
205 rdf:type schema:Person
206 sg:person.0702777076.09 schema:affiliation N61dad68e54e2465fafc59e1b426d669c
207 schema:familyName Ayles
208 schema:givenName Helen
209 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0702777076.09
210 rdf:type schema:Person
211 sg:person.0720212645.66 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
212 schema:familyName Chi
213 schema:givenName Harmony F
214 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0720212645.66
215 rdf:type schema:Person
216 sg:person.0734342571.28 schema:affiliation https://www.grid.ac/institutes/grid.265892.2
217 schema:familyName Williams
218 schema:givenName Frank B
219 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0734342571.28
220 rdf:type schema:Person
221 sg:person.0760147720.67 schema:affiliation https://www.grid.ac/institutes/grid.418015.9
222 schema:familyName Chisembele-Taylor
223 schema:givenName Angela
224 schema:sameAs https://app.dimensions.ai/discover/publication?and_facet_researcher=ur.0760147720.67
225 rdf:type schema:Person
226 sg:pub.10.1057/jphp.2011.4 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052763752
227 https://doi.org/10.1057/jphp.2011.4
228 rdf:type schema:CreativeWork
229 sg:pub.10.1186/1471-2288-6-54 schema:sameAs https://app.dimensions.ai/details/publication/pub.1043348979
230 https://doi.org/10.1186/1471-2288-6-54
231 rdf:type schema:CreativeWork
232 sg:pub.10.1186/1472-6963-10-272 schema:sameAs https://app.dimensions.ai/details/publication/pub.1011519316
233 https://doi.org/10.1186/1472-6963-10-272
234 rdf:type schema:CreativeWork
235 sg:pub.10.1186/1472-6963-9-5 schema:sameAs https://app.dimensions.ai/details/publication/pub.1039016560
236 https://doi.org/10.1186/1472-6963-9-5
237 rdf:type schema:CreativeWork
238 sg:pub.10.1186/1475-2875-10-273 schema:sameAs https://app.dimensions.ai/details/publication/pub.1041111121
239 https://doi.org/10.1186/1475-2875-10-273
240 rdf:type schema:CreativeWork
241 sg:pub.10.1186/1475-2875-10-372 schema:sameAs https://app.dimensions.ai/details/publication/pub.1045312907
242 https://doi.org/10.1186/1475-2875-10-372
243 rdf:type schema:CreativeWork
244 sg:pub.10.1186/1478-4491-7-55 schema:sameAs https://app.dimensions.ai/details/publication/pub.1020857820
245 https://doi.org/10.1186/1478-4491-7-55
246 rdf:type schema:CreativeWork
247 sg:pub.10.1186/1478-4491-8-19 schema:sameAs https://app.dimensions.ai/details/publication/pub.1011800031
248 https://doi.org/10.1186/1478-4491-8-19
249 rdf:type schema:CreativeWork
250 sg:pub.10.1186/1478-4505-7-14 schema:sameAs https://app.dimensions.ai/details/publication/pub.1040836289
251 https://doi.org/10.1186/1478-4505-7-14
252 rdf:type schema:CreativeWork
253 sg:pub.10.1186/1478-7954-9-40 schema:sameAs https://app.dimensions.ai/details/publication/pub.1027833876
254 https://doi.org/10.1186/1478-7954-9-40
255 rdf:type schema:CreativeWork
256 https://doi.org/10.1001/jama.296.7.782 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052189815
257 rdf:type schema:CreativeWork
258 https://doi.org/10.1001/jama.298.16.1888 schema:sameAs https://app.dimensions.ai/details/publication/pub.1011573896
259 rdf:type schema:CreativeWork
260 https://doi.org/10.1016/j.ajog.2007.03.031 schema:sameAs https://app.dimensions.ai/details/publication/pub.1002927953
261 rdf:type schema:CreativeWork
262 https://doi.org/10.1080/13576280600937911 schema:sameAs https://app.dimensions.ai/details/publication/pub.1058384112
263 rdf:type schema:CreativeWork
264 https://doi.org/10.1093/ije/28.2.319 schema:sameAs https://app.dimensions.ai/details/publication/pub.1014718753
265 rdf:type schema:CreativeWork
266 https://doi.org/10.1111/j.1365-3156.2011.02776.x schema:sameAs https://app.dimensions.ai/details/publication/pub.1003713511
267 rdf:type schema:CreativeWork
268 https://doi.org/10.1111/j.1467-985x.2009.00624_4.x schema:sameAs https://app.dimensions.ai/details/publication/pub.1031230731
269 rdf:type schema:CreativeWork
270 https://doi.org/10.1590/s1726-46342011000200022 schema:sameAs https://app.dimensions.ai/details/publication/pub.1068112530
271 rdf:type schema:CreativeWork
272 https://www.grid.ac/institutes/grid.10698.36 schema:alternateName University of North Carolina at Chapel Hill
273 schema:name Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, NC, USA
274 rdf:type schema:Organization
275 https://www.grid.ac/institutes/grid.265892.2 schema:alternateName University of Alabama at Birmingham
276 schema:name School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
277 rdf:type schema:Organization
278 https://www.grid.ac/institutes/grid.418015.9 schema:alternateName Centre for Infectious Disease Research in Zambia
279 schema:name Development Department, Centre for Infectious Disease Research, Lusaka, Zambia
280 Primary Care and Health Systems Department, Centre for Infectious Disease Research, Lusaka, Zambia
281 rdf:type schema:Organization
 




Preview window. Press ESC to close (or click here)


...