In:
PLOS Global Public Health, Public Library of Science (PLoS), Vol. 2, No. 11 ( 2022-11-16), p. e0000985-
Abstract:
In 2014 the Kingdom of Lesotho, in conjunction with Partners In Health, launched a National Health Reform with three components: 1) improved supply-side inputs based on disease burden in the catchment area of each of 70 public primary care clinics, 2) decentralization of health managerial capacity to the district level, and 3) demand-side interventions including paid village health workers. We assessed changes in the quarterly average of quality metrics from pre-National Health Reform in 2013 to 2017, which included number of women attending their first antenatal care visit, number of post-natal care visits attended, number of children fully immunized at one year of age, number of HIV tests performed, number of HIV infection cases diagnosed, and the availability of essential health commodities. The number of health centers adequately equipped to provide a facility-based delivery increased from 3% to 95% with an associated increase in facility-based deliveries from 2% to 33%. The number of women attending their first antenatal and postnatal care visits rose from 1,877 to 2,729, and 1,908 to 2,241, respectively. The number of children fully immunized at one year of life increased from 191 to 294. The number of HIV tests performed increased from 5,163 to 12,210, with the proportion of patients living with HIV lost to follow-up falling from 27% to 22%. By the end of the observation period, the availability of essential health commodities increased to 90% or above. Four years after implementation of the National Health Reform, we observed increases in antenatal and post-natal care, and facility-based deliveries, as well as child immunization, and HIV testing and retention in care. Improved access to and utilization of primary care services are important steps toward improving health outcomes, but additional longitudinal follow-up of the reform districts will be needed.
Type of Medium:
Online Resource
ISSN:
2767-3375
DOI:
10.1371/journal.pgph.0000985
DOI:
10.1371/journal.pgph.0000985.g001
DOI:
10.1371/journal.pgph.0000985.g002
DOI:
10.1371/journal.pgph.0000985.g003
DOI:
10.1371/journal.pgph.0000985.g004
DOI:
10.1371/journal.pgph.0000985.t001
DOI:
10.1371/journal.pgph.0000985.s001
DOI:
10.1371/journal.pgph.0000985.s002
DOI:
10.1371/journal.pgph.0000985.s003
DOI:
10.1371/journal.pgph.0000985.s004
DOI:
10.1371/journal.pgph.0000985.s005
DOI:
10.1371/journal.pgph.0000985.s006
DOI:
10.1371/journal.pgph.0000985.s007
DOI:
10.1371/journal.pgph.0000985.s008
DOI:
10.1371/journal.pgph.0000985.r001
DOI:
10.1371/journal.pgph.0000985.r002
DOI:
10.1371/journal.pgph.0000985.r003
DOI:
10.1371/journal.pgph.0000985.r004
DOI:
10.1371/journal.pgph.0000985.r005
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
3101394-6
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