Protocol-driven primary care and community linkages to improve population health in rural Zambia: the Better Health Outcomes through Mentoring and Assessment (BHOMA) project

摘要: 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 depend only upon increasing access care but also improving the quality of that is delivered. Our project proposes improve clinical and utilization care, through targeted improvement (QI) intervention delivered at facility community level. The being carried out 42 primary facilities serve largely rural population more than 450,000 Lusaka Province. We have deployed six QI teams implement consensus protocols, forms, systems each site. define new expectations provide tools needed those expectations. They monitor provided mentor staff quality. engage workers actively refer follow up patients. Project implementation occurs over period four years stepped expansion randomly selected every three months. Three annual household surveys determine estimates age-standardized under-5 before, during, after implementation. Surveys measures childhood vaccine coverage, pregnancy utilization, general adult health. Health assess coverage interventions effectiveness. patient-provider interaction an important interface where meet. aims reduce by substantially this interaction. success hinge ability mentoring continuous service delivery. It critical once services improves, proportions recognize their value begin utilize them.