We carry out research to be able to better evaluate and understand the strengths and gaps along the care continuum, in order to ensure that all women and children are reached with the services they need. Integrate Health has partnered with the Albert Einstein College of Medicine in New York to conduct rigorous, pragmatic implementation research that improves delivery of care.
UNDERSTANDING OUR IMPACT
Our approach is pragmatic, assessing the impact of an intervention while simultaneously driving continuous improvement. We use implementation science methods to understand not only if an intervention works, but also how and why it works or does not.
BUILDING A LEARNING ORGANIZATION
We are committed to providing high-quality care to our patients by striving to be a learning health organization embedding knowledge translation in the delivery of health services. Our research questions are designed to identify gaps in service delivery and provide actionable feedback for continuous program improvement.
ADVANCING RESEARCH IN TOGO
Francophone countries in sub-Saharan Africa often receive less health research funding and support than English-speaking countries. We are committed to collaborating with and supporting the research careers of our Togolese colleagues, ensuring that their expertise is increasingly included in the global health discourse.
CLOSING THE EVIDENCE AND PROGRAM GAP
We are reimagining how community health can be delivered by blending implementation science and the expertise of communities. The Community Health Systems Lab is accelerating heath equity in the Bronx by engaging the local community, organizations, government and frontline workers to guide implementation strategy, research questions, and evaluation design and contribute to lessons learned for health systems globally.
Research Study Spotlight
Using the care delivery value chain (CDVC) framework, 28 specific gaps in service delivery were identified and integrated into a strategic quality improvement plan specific to existing HIV/AIDS services in northern Togo.
The purpose of this paper is to describe the authors’ experience operationalizing the care delivery value chain (CDVC) as a management and continuous quality improvement approach to strengthen HIV/AIDS services provided in northern Togo through addressing gaps across a care continuum.
The CDVC framework proved to be valuable in: 1) facilitating the first comprehensive mapping of HIV/AIDS services in the Kara region of Togo; 2) enabling the identification of gaps or insufficiencies in the currently available services across the full continuum of care; and 3) catalyzing the creation of a strategic quality improvement plan based on identified gaps.
The operationalization of the CDVC framework is an effective approach to drive continuous quality improvement.
Millions of children die annually from preventable or treatable conditions in low- and middle-income settings. Approaches that focus on improving access and quality of evidence-based practices have contributed to declines in some but not all settings.
The purpose of this study was to determine whether our Integrated Primary Care Program was effective in expanding health coverage, improving care quality, and reducing child mortality in the Kozah district in northern Togo. When we launched the Integrated Primary Care Program in 2015, the Kozah district had high rates of child mortality, 51.1 per 1000 live births. The Integrated Primary Care Program seeks to reduce child mortality through a bundle of evidence-based interventions.
Findings from the study suggest that Integrate Health’s Integrated Primary Care Program contributed to a 30% decline in under-five mortality over a five-year period (from 51.1 per 1000 live births in 2015 to 35.8 in 2020). In addition, improvements in care access and quality were observed, including increases in the proportion of women who reported Community Health Worker (CHW) home visits (49.3% to 58.7%), treatment by CHWs (24.1% to 45.7%), and increases in prenatal care (37.5% to 50.1%).
Community-based approaches to healthcare delivery, coupled with public sector health system-strengthening in strong collaboration with government partners, are the path forward to reducing neonatal and child mortality in low-income countries.
Following the success of the Integrated Primary Care Program in the Kozah district, and in collaboration with the Ministry of Health in Togo, Integrate Health has expanded to four additional districts in northern Togo.
This study aims to evaluate the effectiveness and implementation of the expansion of the Integrated Primary Care Program in 21 public sector health facilities located throughout four districts in northern Togo serving more than 200,000 people from 2018-2022.
The Integrated Primary Care Program expansion has been successfully launched in all four districts, despite the challenges due to the COVID-19 pandemic. Final data collection will occur throughout 2022 to assess the impact of the expansion.
There is growing concern about the possible indirect impact of the COVID-19 pandemic on the health of vulnerable communities due to resulting changes in healthcare utilization, in particular maternal and child health. Early estimates of the indirect effect of the COVID-19 predict that disruptions in routine healthcare could reverse the significant gains made over the past two decades in reducing maternal and under-five mortality.
This study aims to examine changes in maternal and under-five healthcare utilization in 18 public sector health centers in the Bassar district in northern Togo. In addition, we are exploring factors influencing healthcare utilization through interviews with health center staff, Community Health Workers, and patients.
This project, funding by Northwestern University, has completed all data collection and analysis is ongoing.
Digital health interventions are increasingly common in global health; however, many are implemented without rigorous evaluation. To be effective, mHealth solutions must be implemented in ways that lead to long-term, sustainable use.
The purpose of this study is to: 1) find out how, when, and why CHWs use mHealth tools; 2) understand patients’ perspectives of CHWs using an mHealth tool to inform their care; and 3) develop an evaluation survey to be used in future efforts to expand use of the tool.
This project, funded by the University of Iowa, has completed data collection and analysis. Preliminary results have been disseminated to the team using the mHealth tool with actionable recommendations for improved implementation.
Read More about Our Research
See our full library of research papers and publications.