Global Health Action最新文献

{"title":"Do cash or digital payment modalities affect community health worker performance? - a case study of a remote refugee settlement in Western Uganda.","authors":"Michael T Wagaba, David Musoke, Charles Opio, Arthur Bagonza, Juliet Aweko, Hajarah Nakitende, Alex Mulyowa, Michael Ediau, Peter Waiswa, Elizabeth Ekirapa-Kiracho","doi":"10.1080/16549716.2024.2375867","DOIUrl":"10.1080/16549716.2024.2375867","url":null,"abstract":"<p><strong>Background: </strong>There is inadequate evidence about the influence of digital and cash payment modalities on the performance of Community Health Workers (CHWs) in underserved communities, such as refugee settlements.</p><p><strong>Objective: </strong>To compare the performance of CHWs when paid in cash or digitally in Kyaka II refugee settlement, Uganda.</p><p><strong>Methods: </strong>A comparative cross-sectional mixed methods design was used. Secondary data comprising 247 CHW reports during a six-month period of cash and digital payments were analyzed using Stata v14. Eleven focus group discussions, four in-depth interviews, and ten key informant interviews were conducted among the settlement stakeholders to explore perceptions of the payment methods. Qualitative data were analyzed thematically using Atlas.ti v9.</p><p><strong>Results: </strong>CHWs performed better when paid cash than digital payments (<i>t</i> = 5.28; df = 246; <i>p</i> < 0.001). During the cash payment period, at least secondary education (APR 1.71 CI: 1.14-2.58) and having a side occupation (APR 1.58; CI: 1.13-2.21) were positively associated with performance. For digital payments, being male (APR 0.58; CI: 0.34-0.98), serving longer than 9 years (APR 0.87; CI: 0.82-0.93), and being allocated more than 60 households per month (APR 0.31; CI: 0.19-0.52) were negatively associated with CHW performance. Qualitative data revealed that most stakeholders preferred cash due to inconsistent and delayed digital payments.</p><p><strong>Conclusion: </strong>CHWs preferred and performed better with cash payments because digital payments were associated with delays and payment shortfalls that demotivated them. Implementers should invest towards averting digital payment shortfalls in remote settings to enhance CHW motivation and performance.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2375867"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142037508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction.","authors":"","doi":"10.1080/16549716.2024.2390310","DOIUrl":"10.1080/16549716.2024.2390310","url":null,"abstract":"","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2390310"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Form and functioning: contextualising the start of the global financing facility policy processes in Burkina Faso.","authors":"Joël Arthur Kiendrébéogo, Orokia Sory, Issa Kaboré, Yamba Kafando, Meghan Bruce Kumar, Asha S George","doi":"10.1080/16549716.2024.2360702","DOIUrl":"10.1080/16549716.2024.2360702","url":null,"abstract":"<p><strong>Background: </strong>Burkina Faso joined the Global Financing Facility for Women, Children and Adolescents (GFF) in 2017 to address persistent gaps in funding for reproductive, maternal, newborn, child, and adolescent health and nutrition (RMNCAH-N). Few empirical papers deal with how global funding mechanisms, and specifically GFF, support resource mobilisation for health nationally.</p><p><strong>Objective: </strong>This study describes the policy processes of developing the GFF planning documents (the Investment Case and Project Appraisal Document) in Burkina Faso.</p><p><strong>Methods: </strong>We conducted an exploratory qualitative policy analysis. Data collection included document review (<i>N</i> = 74) and in-depth semi-structured interviews (<i>N</i> = 23). Data were analysed based on the components of the health policy triangle.</p><p><strong>Results: </strong>There was strong national political support to RMNCAH-N interventions, and the process of drawing up the investment case (IC) and the project appraisal document was inclusive and multi-sectoral. Despite high-level policy commitments, subsequent implementation of the World Bank project, including the GFF contribution, was perceived by respondents as challenging, even after the project restructuring process occurred. These challenges were due to ongoing policy fragmentation for RMNCAH-N, navigation of differing procedures and perspectives between stakeholders in the setting up of the work, overcoming misunderstandings about the nature of the GFF, and weak institutional anchoring of the IC. Insecurity and political instability also contributed to observed delays and difficulties in implementing the commitments agreed upon. To tackle these issues, transformational and distributive leaderships should be promoted and made effective.</p><p><strong>Conclusions: </strong>Few studies have examined national policy processes linked to the GFF or other global health initiatives. This kind of research is needed to better understand the range of challenges in aligning donor and national priorities encountered across diverse health systems contexts. This study may stimulate others to ensure that the GFF and other global health initiatives respond to local needs and policy environments for better implementation.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2360702"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11198144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual intelligence: a scoping review on the gateway to mental health.","authors":"Cristina Teixeira Pinto, Lúcia Guedes, Sara Pinto, Rui Nunes","doi":"10.1080/16549716.2024.2362310","DOIUrl":"10.1080/16549716.2024.2362310","url":null,"abstract":"<p><p>Spiritual Intelligence (SI) is an independent concept from spirituality, a unifying and integrative intelligence that can be trained and developed, allowing people to make use of spirituality to enhance daily interaction and problem solving in a sort of spirituality into action. To comprehensively map and analyze current knowledge on SI and understand its impact on mental health and human interactions, we conducted a scoping review following the Joanna Briggs Institute methodology, searching for 'spiritual intelligence' across PubMedCentral, Scopus, WebOfScience, and PsycInfo. Quantitative studies using validated SI instruments and reproducible methodologies, published up to 1 January 2022, were included. Selected references were independently assessed by two reviewers, with any disagreements resolved by a third reviewer. Data were extracted using a data extraction tool previously developed and piloted. From this search, a total of 69 manuscripts from 67 studies were included. Most studies (<i>n</i> = 48) were conducted in educational (<i>n</i> = 29) and healthcare (<i>n</i> = 19) settings, with the Spiritual Intelligence Self Report Inventory (SISRI-24) emerging as the predominant instrument for assessing SI (<i>n</i> = 39). Analysis revealed several notable correlations with SI: resilience (<i>n</i> = 7), general, mental, and spiritual health (<i>n</i> = 6), emotional intelligence (<i>n</i> = 5), and favorable social behaviors and communication strategies (<i>n</i> = 5). Conversely, negative correlations were observed with burnout and stress (<i>n</i> = 5), as well as depression and anxiety (<i>n</i> = 5). These findings prompt a discussion regarding the integration of the SI concept into a revised definition of health by the World Health Organization and underscore the significance of SI training as a preventative health measure.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2362310"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11195480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, risk factors and health-seeking behavior of menstrual disorders among women in India: a review of two-decade evidence.","authors":"Puja Das, Suresh Jungari","doi":"10.1080/16549716.2024.2433331","DOIUrl":"10.1080/16549716.2024.2433331","url":null,"abstract":"<p><strong>Background: </strong>Menstrual health is critical for women of reproductive age. It is also evident that menstrual disorders have contributed to the increasing burden of non-communicable diseases.</p><p><strong>Objective: </strong>To our knowledge, no literature review explicitly addresses the prevalence, risk factors, and health-seeking behaviour of menstrual disorders in India. Therefore, the current study aims to synthesize the available scientific evidence on the prevalence and risk factors of menstrual disorders in India over the last two decades.</p><p><strong>Methods: </strong>We followed PRISMA guidelines to conduct the review. We used Google Scholar, PubMed, JSTOR, Scopus, and Sci Direct search engines to find eligible research studies and extracted data from 2000 to 2022. We also conducted quality appraisals of included studies in the review.</p><p><strong>Results: </strong>Results show that the prevalence of any menstrual disorders ranges from 3% to 87%. Among all menstrual disorders, Dysmenorrhea was reported to be high (46% to 76%) among women, followed by premenstrual symptoms (PMS) (40% to 71%), while PCOS (3% to 14.14%) was less. The study further found that irregular lifestyle, obesity, inadequate diet, age at marriage, family history, smoking, and place of residence factors is associated with menstrual disorders in India. As far as health-seeking for menstrual disorders is concerned, one-third of women sought treatment for menstrual disorders.</p><p><strong>Conclusion: </strong>The present study has revealed that most women reported high rates of Dysmenorrhea, while Polycystic Ovary Syndrome (PCOS) is less prevalent. The study findings suggest that health-seeking behaviour is the most important factor in reducing menstrual disorders, which has long-term effects of increasing other comorbidities.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2433331"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 pandemic on type 2 diabetes care and factors associated with care disruption in Kenya and Tanzania.","authors":"Richard E Sanya, Caroline H Karugu, Peter Binyaruka, Shukri F Mohamed, Lyagamula Kisia, Peter Kibe, Irene Mashasi, Grace Mhalu, Christopher Bunn, Manuela Deidda, Frances S Mair, Eleanor Grieve, Cindy M Gray, Sally Mtenga, Gershim Asiki","doi":"10.1080/16549716.2024.2345970","DOIUrl":"10.1080/16549716.2024.2345970","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic affected healthcare delivery globally, impacting care access and delivery of essential services.</p><p><strong>Objectives: </strong>We investigated the pandemic's impact on care for patients with type 2 diabetes and factors associated with care disruption in Kenya and Tanzania.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among adults diagnosed with diabetes pre-COVID-19. Data were collected in February-April 2022 reflecting experiences at two time-points, three months before and the three months most affected by the COVID-19 pandemic. A questionnaire captured data on blood glucose testing, changes in medication prescription and access, and healthcare provider access.</p><p><strong>Results: </strong>We recruited 1000 participants (500/country). Diabetes care was disrupted in both countries, with 34.8% and 32.8% of the participants reporting change in place and frequency of testing in Kenya, respectively. In Tanzania, 12.4% and 17.8% reported changes in location and frequency of glucose testing, respectively. The number of health facility visits declined, 14.4% (<i>p</i> < 0.001) in Kenya and 5.6% (<i>p</i> = 0.001) in Tanzania. In Kenya, there was a higher likelihood of severe care disruption among insured patients (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI][1.05-2.34]; <i>p</i> = 0.029) and a lower likelihood among patients residing in rural areas (aOR, 0.35[95%CI, 0.22-0.58]; <i>p</i> < 0.001). Tanzania had a lower likelihood of severe disruption among insured patients (aOR, 0.51[95%CI, 0.33-0.79]; <i>p</i> = 0.003) but higher likelihood among patients with low economic status (aOR, 1.81[95%CI, 1.14-2.88]; <i>p</i> = 0.011).</p><p><strong>Conclusions: </strong>COVID-19 disrupted diabetes care more in Kenya than Tanzania. Health systems and emergency preparedness should be strengthened to ensure continuity of service provision for patients with diabetes.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2345970"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distances to emergency departments and non-urgent utilization of medical services: a systematic review.","authors":"Uma Kelekar, Debasree Das Gupta, Nicole Theis-Mahon, Emily Fashingbauer, Boyen Huang","doi":"10.1080/16549716.2024.2353994","DOIUrl":"10.1080/16549716.2024.2353994","url":null,"abstract":"<p><strong>Background: </strong>The use of Emergency Departments (EDs) for non-urgent medical conditions is a global public health concern.</p><p><strong>Objectives: </strong>A systematic review, guided by a registered protocol (PROSPERO: CRD42023398674), was conducted to interpret the association between distance as a measure of healthcare access and the utilization of EDs for non-urgent care in high- and middle-income countries.</p><p><strong>Methods: </strong>The search was conducted on 22 August 2023 across five databases using controlled vocabulary and natural language keywords. Eligibility criteria included studies that examined non-urgent care, and featured concepts of emergency departments, non-urgent health services and distance, reported in English. Articles and abstracts where patients were transported by ambulance/paramedic services, referred/transferred from another hospital to an ED, or those that measured distance to an ED from another health facility were excluded. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework informed the quality of evidence.</p><p><strong>Results: </strong>Fifteen articles met the inclusion criteria. All studies demonstrated satisfactory quality with regard to study design, conduct, analysis and presentation of results. Eight (53.3%) of the studies (1 paediatric, 4 all ages/adult, 3 ecological) found a moderate level of evidence of an inverse association between distance and ED visit volume or utilization for non-urgent medical conditions, while the remaining studies reported very low or low evidence.</p><p><strong>Conclusions: </strong>Half of the studies reported non-urgent ED use to be associated with shortest distance traveled or transportation time. This finding bears implications for healthcare policies aiming to reduce ED use for non-urgent care.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2353994"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of mobile phones to collect data on COVID-19: phone access and participation rates, in Rakai, Uganda.","authors":"Robert Ssekubugu, Anthony Ndyanabo, Fredrick Makumbi, Anna Mia Ekström, Laura Beres, Grace Nalwoga Kigozi, Hadijja Nakawooya, Joseph Ssekasanvu, Maria J Wawer, Fred Nalugoda, Nelson Sewankambo, Victor Ssempijja, Betty Nantume, David Serwadda, Godfrey Kigozi, Ronald H Gray, Larry W Chang, M Kate Grabowski, Helena Nordenstedt, Joseph Kagaayi","doi":"10.1080/16549716.2024.2419160","DOIUrl":"10.1080/16549716.2024.2419160","url":null,"abstract":"<p><p>During the COVID-19 pandemic lockdown, we deployed a rapid, mobile phone-based survey to assess access and participation rates when using mobile phones to collect data on COVID-19 in Rakai, south-central Uganda. We sampled prior Rakai Community Cohort Study (RCCS) participants based on HIV status using mobile phone contacts. We administered a 30-minute phone-based interview to consenting participants to assess their knowledge about different aspects of COVID-19 and their access to care. Our analysis compares the mobile phone survey participation rates with historic participation rates in regular RCCS face-to-face interviews. We supplemented phone survey data with demographic, behavioral, and HIV status data from prior face-to-face RCCS surveys. Phone access in Round 19 of the RCCS was found to be 90.2%, with lower access among older people, and people living with HIV. When including only individuals who participated in the previous RCCS survey round, participation in the face-to-face survey (81.9%) was higher than participation in our phone survey (74.8%, <i>p</i> < .001). Survey participation was higher among people living with HIV compared to HIV-negative individuals (84.0% vs 81.4%, <i>p</i> < .001) in the face-to-face survey, but in the phone survey the reverse was found, with participation rates being higher among HIV-negative individuals compared to people living with HIV (78.0% vs 71.6%, <i>p</i> < .001). It was possible to collect data from an existing population cohort during the lockdown using phones. Phone access was high. Overall participation rates were somewhat lower in the phone survey, notably in people living with HIV, compared to the face-to-face survey.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2419160"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children's exposure to unhealthy food advertising on Philippine television: content analysis of marketing strategies and temporal patterns.","authors":"Elaine Q Borazon, Ma Rica Magracia, Gild Rick Ong, Bridget Kelly Gillott, Sally Mackay, Boyd Swinburn, Tilakavati Karupaiah","doi":"10.1080/16549716.2024.2427445","DOIUrl":"10.1080/16549716.2024.2427445","url":null,"abstract":"<p><strong>Background: </strong>This study conducted an exploratory content analysis of TV food advertisements on the top three most popular channels for Filipino children aged two to 17 during school and non-school days.</p><p><strong>Methods: </strong>Data were collected by manually recording of aired advertisements from 16 non-school days (July to September 2020) and 16 school days (January to April 2021). Descriptive and inferential statistical analyses were used to assess children's rates of exposure to food advertisements (mean ± SD of advertisements aired per channel per hour), the healthiness of promoted foods (as permitted (healthier) or not permitted (unhealthy) according to nutrient profiling models from the World Health Organization), and persuasive techniques used in food advertisements, including promotional characters and premium offers.</p><p><strong>Results: </strong>The results show that the rates of exposure to food advertisements were higher during school days (14.6 ± 14.8) than on non-school days (11.9 ± 12.0) (<i>p</i> < 0.01). Both periods yield a similarly higher proportion of non-permitted food advertisements (e.g. 9.3 ± 9.7 ads/channel/hour for school days and 8.3 ± 8.5 ads/channel/hour for non-school days) than permitted ones. More non-permitted food advertisements during children's peak viewing times were observed than non-peak viewing times (e.g. 11.8 ± 10. vs. 8.3 ± 9.2 ads/channel/hour for school days). Non-permitted food advertisements employed persuasive techniques more frequently, accounting for 64-91% of all food ads during peak viewing times.</p><p><strong>Conclusion: </strong>Children are exposed to a large volume of television advertisements for foods that should not be permitted to be marketed to children based on authoritative nutrient criteria.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2427445"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How interventions to maintain services during the COVID-19 pandemic strengthened systems for delivery of maternal and child health services: a case-study of Wakiso District, Uganda.","authors":"Steven Ndugwa Kabwama, Rhoda K Wanyenze, Neda Razaz, John M Ssenkusu, Tobias Alfvén, Helena Lindgren","doi":"10.1080/16549716.2024.2314345","DOIUrl":"10.1080/16549716.2024.2314345","url":null,"abstract":"<p><strong>Background: </strong>Health systems are resilient if they absorb, adapt, and transform in response to shocks. Although absorptive and adaptive capacities have been demonstrated during the COVID-19 response, little has been documented about their transformability and strengthened service delivery systems. We aimed to describe improvements in maternal and child health service delivery as a result of investments during the COVID-19 response.</p><p><strong>Methods: </strong>This was a descriptive case study conducted in Wakiso District in central Uganda. It included 21 nurses and midwives as key informants and 32 mothers in three focus group discussions. Data were collected using an interview guide following the Systems Engineering Initiative for Patient Safety theoretical framework for service delivery.</p><p><strong>Results: </strong>Maternal and child health service delivery during the pandemic involved service provision without changes, service delivery with temporary changes and outcomes, and service delivery that resulted into sustained changes and outcomes. Temporary changes included patient schedule adjustments, community service delivery and negative outcomes such as increased workload and stigma against health workers. Sustained changes that strengthened service delivery included new infrastructure and supplies such as ambulances and equipment, new roles involving infection prevention and control, increased role of community health workers and outcomes such as improved workplace safety and teamwork.</p><p><strong>Conclusions: </strong>In spite of the negative impact the COVID-19 pandemic had on health systems, it created the impetus to invest in system improvements. Investments such as new facility infrastructure and emergency medical services were leveraged to improve maternal and child health services delivery. The inter-departmental collaboration during the response to the COVID-19 pandemic resulted into an improved intra-hospital environment for other service delivery. However, there is a need to evaluate lessons beyond health facilities and whether these learnings are deliberately integrated into service delivery. Future responses should also address the psychological and physical impacts suffered by health workers to maintain service delivery.</p>","PeriodicalId":49197,"journal":{"name":"Global Health Action","volume":"17 1","pages":"2314345"},"PeriodicalIF":2.2,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10883101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139913889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}