evidence-based blog of Filippo Dibari

Posts Tagged ‘care health services’

Stock-outs of essential health products in Mozambique – longitudinal analyses from 2011 to 2013

In Under-nutrition on April 19, 2014 at 4:52 pm

by Wagenaar BH, Gimbel S, Hoek R, Pfeiffer J, Michel C, Manuel JL, Cuembelo F, Quembo T, Afonso P, Gloyd S, Sherr K.

Trop Med Int Health. 2014 Apr 11

 

Abstract

Objectives

To assess the relationship between health system factors and facility-level EHP stock-outs in Mozambique.

Methods

Service provisions were assessed in 26 health facilities and 13 district warehouses in Sofala Province, Mozambique, from July to August in 2011–2013. Generalised estimating equations were used to model factors associated with facility-level availability of essential drugs, supplies and equipment.

Results

Stock-out rates for drugs ranged from 1.3% for oral rehydration solution to 20.5% for Depo-Provera and condoms, with a mean stock-out rate of 9.1%; mean stock-out rates were 15.4% for supplies and 4.1% for equipment. Stock-outs at the district level accounted for 27.1% (29/107) of facility-level drug stock-outs and 44.0% (37/84) of supply stock-outs. Each 10-km increase in the distance from district distribution warehouses was associated with a 31% (CI: 22–42%), 28% (CI: 17–40%) or 27% (CI: 7–50%) increase in rates of drug, supply or equipment stock-outs, respectively. The number of heath facility staff was consistently negatively associated with the occurrence of stock-outs.

Conclusions

Facility-level stock-outs of EHPs in Mozambique are common and appear to disproportionately affect those living far from district capitals and near facilities with few health staff. The majority of facility-level EHP stock-outs in Mozambique occur when stock exists at the district distribution centre. Innovative methods are urgently needed to improve EHP supply chains, requesting and ordering of drugs, facility and district communication, and forecasting of future EHP needs in Mozambique. Increased investments in public-sector human resources for health could potentially decrease the occurrence of EHP stock-outs.

Latest WHO release: “Essential Nutrition Actions: Improving maternal, newborn, infant and young child nutrition”

In Over-nutrition, Under-nutrition on June 12, 2013 at 4:51 pm

by WHO web page

Downloads:  Full document – pdf, 1.09Mb

Overview

Malnutrition in all its forms is closely linked, either directly or indirectly, to major causes of death and disability worldwide. The causes of malnutrition are directly related to inadequate dietary intake as well as disease, but indirectly to many factors, among others household food security, maternal and child care, health services and the environment. While most nutrition interventions are delivered through the health sector, non-health interventions can also be critical. Actions should target the different causes to reach sustainable change, which requires a multisectoral approach.

This document provides a compact of WHO guidance on nutrition interventions targeting the first 1,000 days of life. Focusing on this package of essential nutrition actions (ENA), policy-makers could reduce infant and child mortality, improve physical and mental growth and development, and improve productivity. Part I presents the interventions currently recommended by WHO, summarizes the rationale and the evidence, and describes the actions required to implement them. The document uses a life course approach, from pre-conception throughout the first 2 years of life. Part II provides an analysis of community-based interventions aimed at improving nutrition and indicates how effective interventions can be delivered in an integrated fashion. It shows how the ENAs described in the first part have been implemented in large-scale programmes in various settings, what the outcomes have been, and to examine the evidence for attribution of changes in nutritional outcomes to programme activities.

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