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Research Pillars

Research Study Spotlight

Summary

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.

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Purpose

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.

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Results

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.

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Takeaways

The operationalization of the CDVC framework is an effective approach to drive continuous quality improvement.

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Summary

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.

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Purpose

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.

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Results

We found that the proportion of women receiving care and treatment from Community Health Workers increased from 2015 to 2020, and that there was an increase in coverage and utilization of key health services, such as prenatal and postnatal care.

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Takeaways

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.

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Summary

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 is expanding to four additional districts in northern Togo.

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Purpose

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.

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Takeaways

The Integrated Primary Care Program expansion has been successfully launched in three of the four districts, despite the current challenges due to the COVID-19 pandemic. The final launch is planned for summer 2021.

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Summary

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.

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Purpose

This study aims to examine changes in maternal and under-five healthcare utilization in 15 public sector health centers in the Bassar district in northern Togo. In addition, we will explore factors influencing healthcare utilization through interviews with health center staff, Community Heath Workers, and patients.

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Status

This project has received funding from Northwestern University and is in progress with preliminary results anticipated in late 2021.

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Summary

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.

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Purpose

The purpose of this study is to: 1) find out how, when, and why CHWs use the mHealth tool; 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.

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Status

This project has received funding from the University of Iowa and data collection is ongoing.

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