|
Service delivery model
|
| Community-based approaches, task-shifting |
Goa, India (mental health)24
Thailand (diabetes and hypertension screening)28
Indonesia, North India (basic package of care)53 112
Pakistan (maternal and reproductive health)50
|
Proximity of health facility Focus on cost-effective essential services (eg, maternal and child health) Community-based practitioners operate within an integrated team, supported by health system
|
| Integration of vertical programmes |
Maharashtra, India (HIV prevention)52
Orissa, India (leprosy)113
Pakistan (blindness prevention)60
Philippines (diabetes prevention and care)114
Vietnam (mental health)61
|
Sensitisation of staff Improved co-ordination across programmes Advocacy with key political and administrative stakeholders Adequate resourcing: staff and programme funds Use of treatment guidelines
|
|
Health promotion and
patient
management tools
|
| Population-based screening |
|
Universal (Bhutan) or targeted (high-risk groups >40 years, Indonesia) more cost-effective than opportunistic screening Follow-up treatment follows PEN guidelines
|
| Electronic decision-support tools |
|
|
|
PHC financing
|
| Contracting service through non-state providers |
|
‘Competition’ between providers may motivate performance Better organisation and management capacity, in part due to autonomy/independence Better systems and capacity to absorb and use budget Better infrastructure, equipment, medicines supply More staff Good community links Govt capacity for effective contract management Trust between contract managers and providers Regular supervisory visits Bonus system linked to coverage Link to higher-level facilities (also NGO run)
|
| Gatekeeping |
|
|