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Hospital volume and operative mortality in the modern era

One of the gaps in the current Muteu’s Health Sector Strategic Plan is an evaluation. As one of the conditions for its financial and technical support to the Muteu Ministry of Health, the Australia Government has requested that the next plan for Muteu should include an evaluation plan clearly outlining how it will assess the success of its next plan. Based on your review of the Muteu health sector strategic plan, suggest a blueprint of an evaluation plan that the Muteu’s Health sector can adopt in its new plan based on the priorities, overall goal, objectives and strategies which you identified in your initial review. Your task as an external consultant; Drawing on the initial review of the Muteu health sector plan from your first assignment, develop an evaluation plan on behalf of the Muteu government addressing the following evaluation requirements; A clear logic frame that presents the relationship of the proposed priority needs for the next plan, planning context, the inputs, outputs, outcomes, impact (long-term outcomes) and performance indicators. Drawing on three key priority areas which you identified in your first assignment, what should be the focus of the evaluation in order to generate useful information for assessing the success of the Muteu’s next health plan? What evaluation type (s) and design (s) will be appropriate? What evaluation questions need to be answered and type of data need to be collected? What methods of data collection will be appropriate? Who needs to be involved as key stakeholders for the evaluation process and why? Who will be the main users of the evaluation results? How will the findings be disseminated to the relevant users? List resources which will be required for the evaluation. Indicate an estimated timeframe for the evaluation. A suggested outline for the assignment The basic outline and your assignment MUST address all the sections as outlined here. Feel free to restructure the presentation of your final write-up to allow for creativity and uniqueness in approaching this assignment as long as you address the key sections. Title page: This should include the title of the evaluation plan, author with credentials, to whom the proposal is addressed, and date. Executive summary: provide a brief summary of; the evaluation focus and purpose; the type of evaluation, evaluation design, types of data to be collected, data collection methods; estimated time frame for conducting the evaluation; resources required for the evaluation; and users of the evaluation results. Background information: Talk to the fact that as a consultant you reviewed the Muetu’s Health Sector Plan and based on your chosen planning framework, discuss the areas that need to be improved and rationale for improvement i.e. give examples of where there is need for more information to understand the health issues or establish baseline for future reference at the evaluation stage. Evaluation focus: based on the key priority areas which you identified in your initial review of the Muteu’s Health Sector Plan, discuss the focus or scope of the evaluation and the evaluation questions that will be appropriate for generating information relevant for evaluating the success of the Muteu’s Health Sector Plan Methodology: Based on your logic frame, describe the type of the proposed evaluation and design of your evaluation; identify types of data that will be collected to answer the evaluation questions, sources and data collection methods. A table or tables will be useful here accompanied by text to explain the table or tables. Timeframe and estimated resources: present an estimated time frame and resources required for the evaluation. Stakeholders: who will be involved in conducting the evaluation and who are the intended users. Remember to apply stakeholder analysis principles here. Dissemination of findings: how will the findings be disseminated? Conclusion: is this evaluation worth? Give a final punch arguing why this evaluation needs to happen and what will be the implications if Muteu Government does not evaluate its next plan. You will need to think about the relevance of evaluation for the health sector and tailor that to the Muteu scenario. As a requirement for any academic writing, you are required to reference your analysis and arguments accurately and appropriately in this assignment. In addition, academic writing rules for numbering, spelling, punctuation and grammar MUST be observed. Note that the word limit excludes, tables, figures and references.

Principles of Health Planning and Evaluation Assessment2– An evaluation plan

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Assignment 2 has a word limit of 3000 words and it is worth 30%. For submission date, see the unit outline.

One of the gaps in the currentMuteu’sHealth Sector StrategicPlan is an evaluation. As one of the conditions for its financial and technical support to theMuteuMinistry of Health, the Australia Government has requested that the next plan for Muteushould include an evaluation plan clearly outlining how it will assess the success of its next plan. Based on your review of theMuteuhealth sector strategic plan, suggest a blueprint of an evaluation plan that theMuteu’sHealth sector can adopt in its new plan based on the priorities, overall goal, objectives and strategieswhich you identified in your initial review.

Your task as an external consultant;

Drawing on the initial review of theMuteuhealth sector plan from your first assignment, develop an evaluation plan on behalf of theMuteugovernment addressing the following evaluation requirements;

  • A clear logic frame that presents the relationship of the proposed priority needs for the next plan, planning context, the inputs, outputs, outcomes, impact (long-term outcomes) and performance indicators.
  • Drawing on three key priority areas which you identified in your first assignment, what should be the focus of the evaluation in order to generate useful information for assessing the success of theMuteu’snext health plan?
  • What evaluation type (s) and design (s) will be appropriate?
  • What evaluation questions need to be answered and type of data need to be collected?
  • What methods of data collection will be appropriate?
  • Who needs to be involved as key stakeholdersfor the evaluation process and why?
  • Who will be the main users of the evaluation results?
  • How will the findings be disseminated to the relevant users?
  • List resources which will be required for the evaluation.
  • Indicate an estimated timeframe for the evaluation.

A suggested outline for the assignment

The basic outline and your assignment MUST address all the sections as outlined here. Feel free to restructure the presentation of your final write-up to allow for creativity and uniqueness in approaching this assignment as long as you address the key sections.

  1. Title page:This should include the title of the evaluation plan, author with credentials, to whom the proposal is addressed, and date.
  2. Executive summary:provide a brief summary of; the evaluation focus and purpose; the type of evaluation, evaluation design, types of data to be collected, data collection methods; estimated time frame for conducting the evaluation; resources required for the evaluation; and users of the evaluation results.
  3. Background information: Talk to the fact that as a consultant you reviewed theMuetu’sHealth Sector Plan and based on your chosen planning framework, discussthe areas that need to be improved and rationale for improvement i.e. give examples of where there is need for more information to understandthe health issues or establish baseline for future referenceat the evaluation stage.
  4. Evaluation focus: based on the key priority areas which you identified in your initial review of theMuteu’sHealth Sector Plan, discuss the focus or scope of the evaluation and the evaluation questions that will be appropriate for generating information relevant for evaluating the success of theMuteu’sHealth Sector Plan
  5. Methodology:Based on your logic frame, describe the type of the proposed evaluation and design of your evaluation;identifytypes of data that will be collected to answer the evaluation questions, sources and data collection methods. A table or tables will be useful here accompanied by text to explain the table or tables.
  6. Timeframe and estimated resources:present an estimated time frame and resources required for the evaluation.
  7. Stakeholders:who will be involved in conducting the evaluation andwho are the intended users. Remember to apply stakeholder analysis principles here.
  8. Dissemination of findings:how will the findings be disseminated?
  9. Conclusion:is this evaluation worth? Give a final punch arguing why this evaluation needs to happen and what will be the implications if Muteu Government does not evaluate its next plan. You will need to think about the relevance of evaluation for the health sector and tailor that to theMuteuscenario.

As a requirement for any academic writing, you are required to reference your analysis and arguments accurately and appropriately in this assignment. In addition, academic writing rules for numbering, spelling, punctuation and grammar MUST be observed.

Note that the word limit excludes, tables, figures and references.

Introduction 4

SWOT Analysis of Muteu’s HSSP Context 5

Strengths. 5

Weaknesses. 4

Opportunities. 6

Threats. 7

Three Contextual Factors and how they will Impact the Country’s Health Care System/Plan 9

Strong Government Support/Involvement 8

The Economic Condition. 9

Socio-Cultural Realities. 9

The 3 Key Priority Population Health Issues/Needs that Should be Addressed in the Next Plan 11

Communicable and Preventable Diseases and Ailments. 10

Access to Health Care. 11

Preventable (Neonatal, Infant and Child) Mortalities. 11

Using RCA to Analyze the 3 Key Priority Population Health Issues and Needs 12

The Desired Overall Goal of Muteu’s Next HSSP based on the RCA Model 14

The Use of Flip Method 16

Stakeholder Analysis Matrix for Muteuan HSSP Stakeholders that the Ministry of Health should Engage 17

Relevance of the Stakeholders. 18

Conclusion and Recommendations 18

References.……………………………………………………………………………………………………………………….19

INTRODUCTION

Muteu Health Sector Strategic Plan (HSSP) for 2011 to 2016 is an important document because it offers a clue as to how the country of Muteu is planning to address the health phenomenon within its borders. The review of HSSP is important in the sense that it helps the reader to appreciate the rationale driving the Muteu’s national health policy plans. The review of HSSP also helps the reviewer or the audience to appreciate the causes and the underlying causes and the short-term effect and the long-term effect of HSSP. The review of HSSP is also important because it can help the audience to appreciate the strengths and weaknesses of the country’s health plan based on the measures proposed by the country’s ministry of health and the other stakeholders involved. HSSP is also important to Australia because the Australian Government is a major stakeholder in Muteu’s health sector. In this regard, the Australian Government stands to gain from the review of HSSP because the review will help it make rational decisions regarding its support to Muteu. More importantly, the Australian Government will gain an important insight into the way in which its support might help the Muteu government better the health prospects of its people.

This HSSP review will be comprehensive and will really on a number of models and analytical tools. First and foremost, the review will begin with a SWOT analysis of the HSSP. Then, the author will use the root cause analysis (RCA) tool to analyze the HSSP case study. RCA explores the one of the most useful approaches that health care planners can use in the planning of their health programs. SWOT analysis is also a crucial tool for analyzing the various components and contexts of a country’s health care system. This report will contain several headings and subheadings depending on the author’s need for clarity and to be persuasive. There will be a conclusion, references and appendix at the end of this report. Above all, the report will contain a table of contents to ease the audiences’ experience when reading the report.SWOT ANALYSIS OF MUTEU’S HSSP CONTEXT Strengths

The war on STI’s (sexually transmitted infections) especially HIV/AIDs and other communicable diseases: Muteu has enhanced the funding and strategies that have been helping prevent and cure communicable diseases like STIs and TB. Muteu’ TB treatment rate is 86% which is higher than the WHO’s target of 85%. The prevention of and treatment of TB is important because TB is known to increase a high chance of co-infection with STI’s and other disease (Mesfin, Hailemariam, Biadglign & Kibret, 2014; Mihret et al. 2014; Venturini et al. 2014). As such, Muteu’s policy towards TB will generally prevent an increase in HIV and TB prevalence in the nation.

Effective maternal and neonatal health: The country has enjoyed a tremendous reduction in the rate of maternal mortality from 984/100,000 in 2004 to 675/100,000 in 2010. This change has been brought about by the increased number or Muteu women delivering in health facilities and hospitals up to 73% in 2010 from 57.2% in 2004. Apparently, post-partum hemorrhage and sepsis are the main causes of death in many of the maternal mortality instances across Muteu. The good news is that the maternal health-related MDG targets can be reached if there is adequate investment in the health sector because funding is a major issue in Muteu.Weaknesses

High rate of malnutrition: The rate of malnutrition is still high in the country thereby affecting many young children especially those below five years. About 47% of the children below 5 years of age are stunted and about “20% severely stunted.” The country cannot improve the health and well-being of the children if malnutrition is a big issue. This is because any malnourished person or child has a weak immunes system and his or her body cannot fight common ailments and diseases like common cold or malaria when it strikes.

Ineffective war on acute diarrhea: Diarrhea affects 17.5 of the Muteuans with 38 percent of the cases among the children who are between 6 months and one year. Diarrhea is high in areas that lack clean drinking water and experience poor sanitation. This means that the country cannot overcome diarrhea without overcoming the problem of lack of sanitation and the lack of clean drinking water. More so, the sanitation problem is reflective of the fact that the country is at risk of cholera, dysentery and other waterborne diseases.

Lack of adequate funding: Underfunded health sector often offer substandard health care services because it leads to fewer, overcrowded, and underfunded hospitals and clinics (Reames et al. 2014). The government’s funding of the health care sector is less than the target of 15% of the national budget. In real sense, even with a budget of 15% of the country’s national budget, Muteu’s health care will still be underfunded to deliver the much-needed health care services because many of the country’s citizens are too poor to afford health insurance or to afford healthy lifestyles. For instance, Muteu is experiencing high instances of maternal health problems and maternal mortality rates because there are fewer health facilities in the rural parts of Muteu.

Slow progress in family planning: the country has recorded a slow growth in the use of contraceptives. Muteu government data shows that the use of contraceptive among the 15-49-year-olds is 55% which is lower than the MDG target of 65% in 2010. The data also showed that about 73% of the women wanted to practice birth control but they had no access to contraceptives.

Inadequate medical supplies: Muteu experiences a serious problem of shortages related to medical supplies. Inefficient procurement, under-developed logistical information systems and under-funded health care system are some of the underlying causes of the problem. Planning is integral to the provision of high-quality care to the taxpayers (Brinkman-Stoppelenburg, Rietjens & van der Heide, 2014). However, there seems to be inadequate planning with regard to creation of efficient funding and overall management of the health care sector.

Inadequate HR for the sector: The country faces an acute shortage of workers thereby making it hard for the people of this country to be served effectively. Understaffing of hospitals and clinics lowers the quality of care services offered in any country and vice versa (Shamian, Kerr, Laschinger & Thomson, 2016). Research has also shown the existence of a positive correlation between staffing quantity and quality and the quality of health care provided in any society (Aiken et al. 2014; Backhaus, Verbeek, van Rossum, Capezuti & Hamers, 2014; Carayon et al. 2014). In 2010, the country had 8,369 health workers and supporting staff, which was a 53% increase from 5343 workers in 2004. During the same period (2004-2010) the number of trained nurses only rose by 22 percent per year. There are a lot of vacancies with regard to positions such as physicians, clinical officers, laboratory technicians, pharmacy technicians, and environmental health professionals/officers. The data showed that only 30% of the clinicians were available, nurses (50%).Opportunities

Seek more funding from the international community: The country’s health sector will thrive with additional funding from outside the country. Muteu is one of the poorest countries in the world. The nation’s GDP per capita was $313 in 2008. This means that there is a need for the country to seek funding from external sources. The external funding will help the country to hire more health care workers, train more nurses and other health care professionals, buy medicines and other health care equipments and products like condoms and contraceptives.

Volunteer program for health care workers: The country can increase its health care work force by encouraging local and international health care professionals to volunteer in Muteu. There are so many students in the international colleges and retired health care workers who are willing to work for free in poor countries like Muteu. Perhaps, Muteu can collaborate with other nations and NGOs to secure health care professionals.

Grow the economy: the country needs to grow the economy to stimulate the health and wellbeing of its people. Economic growth will result in more taxes to the government andThreats

Weak governance structure: The Muteu government’s ineffective leadership will be a major threat to the prospects of the country’s health care. For example, Muteu government has been reluctant to appoint the right people to work as quality assurance managers.

The slow growth of the global economy: Muteu’s health sector depends on the tranquility and stability of the global economy. However, the international economy is currently in on a shaky ground as the decline in the oil price and the effect of 2008 financial crisis.

The growing population: Muteu’s growing economy will definitely create many problems to the country’s health care sector. The country’s population rose from 8 million in 1987 to about 14.4 million in 2011 and it is expected to grow much further beyond 2018.THREE CONTEXTUAL FACTORS AND HOW THEY IMPACT THE COUNTRY’S HEALTHCARE SYSTEM/PLAN Strong Government Support/Involvement

The role of the government is important because it means that there will be the right legal and structural mechanisms to ensure that the HSSP succeeds. The government’s support to any HHS is important because, usually, there are no other organizations more legally powerful than the central, regional or state governments. The government’s support is also essential and important for any health sector to succeed because health care is one of the state or government’s functions (Pulvirenti, McMillan & Lawn, 2014). The Muteu constitution gives the government the central duty of both primary and secondary health care and to support the country’s health care improvements and agenda to its people. The government is also involved in many other things that affect the lives and well-being of the Muteuan people. For example, it is upon the government to ensure that the country’s economy is stable and thriving in order to create a scenario where people can afford healthy lifestyles and medication. Therefore, the current government’s support and active involvement in the Muteu health sector is important for the long-term and short-term success.

Muteu government will help the other stakeholders in the country’s health sector to get the much needed external and internal support. This is because diplomacy, security and health policies re the functions of any government. At the moment, Muteu government is signatory to many regional and international treaties. The country is signatory to the Millennium Development Goals (MDGs) that helped the country to focus on vital health indicators like infant and maternal mortality and family planning. MDGs are some of the international commitments that have enabled the country to understand the need to better the health status of its people. The country is also a member of the WHO (The World Health Organization) and a signatory to the “Ouagadougou Declaration on Health Care (PHC) and Health Systems in Africa” among other organizations. One can anticipate a scenario where the government will sign many international treaties and conventions that will make it possible to ensure a global fight against diseases. This also means that the country can benefit from technical and financial support from organization like UNICEF or international community.

However, ineffective government in Muteu is a liability to the current and the future health care realities in the country. The government of Muteu has been reluctant to ensure that there is adequate and timely funding to its health sector. The government has also failed to enhance efficiency in the procurement and related logistics. Therefore, the government needs to improve its handling of the health sector both materially and non-material ways.The Economic Condition

The local and international economy will influence the success or failure Muteu’s health care sector. The country has a small and under-developed economy in which the country’s GDP stands at $340 in per capita income as of 2011. The small and under-developed economy will undermine the Muteuans capacity to afford healthy food, clean drinking water and better education. Poverty or economic underdevelopment means that the government of Muteu does not and cannot afford the resources and technology and resources needed to provide and support health care services for its people. Unless the country works to reduce the level of poverty level across, the current health problems will be hard to overcome.Socio-Cultural Realities

Muteuan social and cultural realities affect and will continue to affect the country’s health and well-being in the future. Muteuan cultural policies and realities tend to encourage gender disparity that has resulted in higher level of illiteracy among women than me. The social realities have also contributed to higher instances of illiteracy in the country even though there is free primary education in 1994. The reality is that 70% of the students who enroll in the first grade drop out of school either because of poverty, ignorance of the importance of education and cultural values that promote child marriages. Indeed, child marriage and child labour are some of the main reasons why many children drop out of school. In any country where poverty is high, the cultural and social realities encourage vicious cycle of poverty to prevail and this undermine the health and well-being of the citizens in that country. Therefore, there is need for a concerted effort to root out the cultural and social challenges that keep Muteuan children out of school.THE 3 KEY PRIORITY HEALTH ISSUES/NEEDS THAT NEEDS TO BE ADDRESSED IN THE NEXT PLAN Communicable and Preventable Diseases and Ailments

The next HSSP should put emphasis on preventive medicine. Preventive medicine is any applied medical strategy that is designed to ensure the health and prosperity of the citizens by preventative approach to causes of ill health (Cooper, 2012). In the 2011-2016 HSSP, it was evident that HIV prevalence between 15-24 age groups was 12%; only 88% of the 1-year-olds have been immunized; only 35% of expectant women were on ART, and that access to safe water and improved toilets is 79.7% and 46%. Therefore, it is incumbent that the new HSSP should focus on preventive medicine to overcome preventable diseases and conditions such as HIV/AIDS and diarrhea because many of the health problems prevalent in Muteu are preventable. The focus on the preventive medicine should be based on the understanding that prevention of any health care problem is more effective and cheaper than any measure taken to cure it.Access to Health Care

The new HSSP should focus on how to ensure that the people of Muteu have access to quality health care. Many Muteuans suffer ill-health or die from complications that are preventable in all sense. Many Muteuans live in squalid conditions in towns and majority of the citizens live in remote rural villages. At the moment, the country’s “neonatal mortality health (NMR)” is 33 deaths in every “1000 live births.” However, Muteu rural areas have much higher NMR that is estimated at 34/1000 while the urban centers have NMR of 30/1000. NMR is higher in “male children (38/1000)” relative to female babies (30/1,000). Only 69% of the Muteu mothers receive tetanus jab or vaccine after birth despite the fact tetanus is one of the cheapest vaccines in the world. There is a need for the new HSSP to address the issue of access to health care services in the country.Preventable (Neonatal, Infant and Child) Mortalities

The new HSSP needs to focus on how to reduce neonatal, infant and child mortality rates. Data from the 2011-2016 HSSP has shown that the rate of death for children below five years was 112/1,000, neonatal mortality (31/1,000) and infant mortality (61/1,000). Thus, there is a need to ensure that the country has effective strategy or policy to combat neonatal, infant and child mortalities to reduce it to more acceptable rates.

Using RCA to Analyze the 3 Key Priority Population Health Issues and Needs

Definition of the ProblemDataPlausible causesRoot CausesRecommendations
Communicable and preventable diseases and ailmentsThere are many preventable communicable diseases like HIV, malaria, and acute diarrhea.HIV/AIDS prevalence among 15-24-year-olds (12%), malaria (6 million cases annually) and 17% cases of acute diarrheaHIV = infection with HIV.Malaria = Anopheles mosquito bites.Diarrhea = consumption of contaminated water and food.Ignorance.Poverty.Illiteracy.Improve access to condoms, sex education and other STI prevention mechanisms.Improve the supply and access to and the use of mosquito nets as the core malaria prevention strategy.Enhance access to clean drinking water and improvement of sanitation (clean toilets).
Access to Health CareThere are fewer hospitals and less affordable care for Muteuans.Only 9% of the women complete the 4 antenatal care visits.Fewer health facilities and hospitals.Ignorance.Poverty.Under-developed economy.High level of illiteracy.The government and other stakeholders in the country’s health care system need to improve public education on the importance of hospital visits for expectant women, vaccinations and other necessary health checks.
Preventable (neonatal, infant and child) mortalitiesMany mothers die soon after giving birth. Young children (under five years) die.Only 9% of the women complete the 4 antenatal care visits.NMR is 33/1000, death of children under 5 years of age (112/1000) and infant mortality (61/1000)Malnutrition.Diarrhea.Other diseases like malaria.Negligence.Poverty.Ignorance.Cultural practices/belief.The government and other stakeholders need to improve access to education, address abject poverty and

The Desired Overall Goal of Muteu’s Next HSSP based on the RCA Model

The overall goal of Muteu’s next HSSP should be to improve the affordability and accessibility to high-quality health care for the country’s residence. The “SMART (specific, measurable, achievable, relevant, and time-based)” model can be used to test the suitability of this goal (Glynn et al. 2014)

Specific

This objective is specific in the sense that the objective is to ensure that Muteuans have got access to affordable and accessible health care. This means that the new HSSP should attempt to ensure that there are adequate, fully equipped and staffed health care facilities and hospitals across the county.

Measurable

The new HSSP architects should be able to measure the outcome/success of the next HSSP because this objective is measurable. To measure this objective, the team will require data for comparison purposes based on the costs of and access to health care before and after the new HSSP comes into effect.

Relevant

This objective is relevant to Muteu’s case because it designed to improve the country’s health care. Many Muteuans are poor and cannot afford or access health care because they stay far away from health care facilities and hospitals or they ignorant about the importance of Western medicine.

Time-Bound

The objective should be achieved during the period in which the project is implemented, that is, five years.The Use of Flip Method

StrategiesSMART Objectives
Increase the quantity and quality of health HRImprove access to clean drinking water and how to enhance sanitationImprove the use of HIV prevention methods
Strategy #1.Strive to increase the number of slots for health professionals in the Muteuan universities and colleges.Teach the citizens on the dangers of defecating in the bushes and the health implications on having clean pit latrines or toilets.Launch national-wide sex education program to empower young and old Metuans on the best way to prevent and manage HIV/AIDS.
Strategy #2Improve incentives that will reduce brain drain and staff turnover in the country’s health sector.Advocate for and assist in the construction of toilets and latrines in the slum areas/densely populated poor villages and urban centers.Increase free HIV testing and counseling centers across the nation to enable the public to know their HIV status for effective or timely medication. Early detection of the HIV in the bloodstream followed by effective counseling of the victim is regarded as the best way to positive living and helps prevent the spread of the virus (Cohen et al. 2012; Moyer, 2013).
Strategy #3Encourage the government to hire more health care staffers to fill the vacancies. The inadequacy health care staff will be solved by the employment of additional health care HR.Advocate for improved access to clean tap water, wells and springs using simple water treatment options like boiling and the use of chlorination tablets.Help in the fight against stigma. HIV is always associated with evil and immorality and this has a negative effect on the war against it (Ramjee & Daniels, 2013; Ugarte et al. 2013). Eradication of stigma against HIV and its victims will be a win for the new HSSP.

Stakeholder Analysis Matrix for Muteuan HSSP Stakeholders that the Ministry of Health Should Engage

High
IMPORTANCELow
College and school headsSocial media campaigners and bloggersChurch leadersWHOMinistries in charge of water and sanitationHealth insurance companies.Muteu Ministry of Finance
BanksEnvironmental conservationistsMuslim leadersFood and Agricultural Organization (FAO)Science communityMinistries of health from the developed countriesNGOs
Village leaders.Project management consultantsOther religious leadersFarmersBusiness leadersImmigration departmentHealth professionals
MenKey development partnersPolitical party leadersUNICEFNeighboring governments.Ministry of agriculture.Muteu parliament
WomenMuteuan college students.Village elitesThe World BankAmbassadorsMuteuan law enforcementMuteu courts
Low INFLUENCE High

RELEVANCE OF STAKEHOLDERS

Each of the above stakeholders has a unique role and potential contribution to the new HSSP. The inclusion of the above is informed by the fact that health is complex aspect because it shapes and gets influenced by economy, agricultural practices, education standards, and cultural/institutional frameworks. Thus, these stakeholders should all have a say or participate in the implementation of the new HSSP.

CONCLUSION AND RECOMMENDATIONS

In conclusion, the 2011-2016 Muteu HSSP has many positive and negative aspects that should considered in the next HSSP. The positive aspects of the previous HSSP are the fact there was commitment to address the comprehensive issue of health, the need to increase funding from 12.4% of the national budget to about 15% and the overall desire to reduce illnesses and deaths due to preventable illnesses and conditions. The other positive aspects of the 2011-2016 HSSP include the fact that Muteu’s economy is small and under-developed thereby making it hard for the government and its people to support and achieve better health care outcome. The new HSSP approach should be participatory in nature to ensure that those affected by it are actively involved in most of the HSSP’s activities. Perhaps, the Muteuan ministry of health should be more proactive and innovative and realistic implementing the principles of the new HSSP. The innovativeness could include engaging or consulting the key stakeholders to ensure that they not only buy the ideas, but also, support the initiative materially and morally.

REFERENCES

Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., … & McHugh, M. D. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet383(9931), 1824-1830.

Backhaus, R., Verbeek, H., van Rossum, E., Capezuti, E., & Hamers, J. P. (2014). Nurse staffing impact on quality of care in nursing homes: a systematic review of longitudinal studies. Journal of the American Medical Directors Association15(6), 383-393.

Brinkman-Stoppelenburg, A., Rietjens, J. A., & van der Heide, A. (2014). The effects of advance care planning on end-of-life care: a systematic review. Palliative medicine28(8), 1000-1025.

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied ergonomics45(1), 14-25.

Cohen, M. S., Dye, C., Fraser, C., Miller, W. C., Powers, K. A., & Williams, B. G. (2012). HIV treatment as prevention: debate and commentary—will early infection compromise treatment-as-prevention strategies? PLoS Medicine9(7), e1001232.

Cooper, K. H. (2012). Overcoming hypertension: Dr. Kenneth H. Cooper’s preventive medicine program. New York: Bantam Books

Glynn, L. G., Hayes, P. S., Casey, M., Glynn, F., Alvarez-Iglesias, A., Newell, J., … & Murphy, A. W. (2014). Effectiveness of a smartphone application to promote physical activity in primary care: the SMART MOVE randomised controlled trial. Br J Gen Pract64(624), e384-e391.

Houben, C. H., Spruit, M. A., Groenen, M. T., Wouters, E. F., & Janssen, D. J. (2014). Efficacy of advance care planning: a systematic review and meta-analysis. Journal of the American Medical Directors Association15(7), 477-489.

Mesfin, Y. M., Hailemariam, D., Biadglign, S., & Kibret, K. T. (2014). Association between HIV/AIDS and multi-drug resistance tuberculosis: a systematic review and meta-analysis. PloS One9(1), e82235.

Mihret, A., Abebe, M., Bekele, Y., Aseffa, A., Walzl, G., & Howe, R. (2014). Impact of HIV co-infection on plasma level of cytokines and chemokines of pulmonary tuberculosis patients. BMC Infectious Diseases14(1), 125.

Moyer, V. A. (2013). Screening for HIV: US preventive services task force recommendation statement. Annals of Internal Medicine159(1), 51-60.

Pulvirenti, M., McMillan, J., & Lawn, S. (2014). Empowerment, patient centred care and self-management. Health Expectations17(3), 303-310.

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