Health Extension: Community-Based Healthcare and the Future of Cooperative Extension explores innovation in extension health programs, engaged scholarship promoting research-based information in communities, and the evaluation and documentation of community programs and their impacts. This volume provides land-grant and university-based colleagues up-to-date information on using the Cooperative Extension System (CES) for community engagement in healthcare while also familiarizing those outside CES and the academy with a roadmap for improvement. The contributions of a diverse array of scholars challenge the status quo in extension programs by characterizing the introspection, understanding, creativity, partnerships, and leadership that will be required to improve lives and communities in the twenty-first century. This perspective underscores the role of CES as foundational to the future of Health Extension and offers an alternative to approaches that utilize the CES as a model without the accompanying advantages of history, community embeddedness, and sustainability.

As a low-income country, Ethiopia has made impressive progress in improving health outcomes. This report examines how Ethiopia s Health Extension Program (HEP) has contributed to the country s move toward Univeral Health Coverage (UHC), and to shed light on how other countries may learn from Ethiopia s experiences of HEP when designing their own path to UHC. HEP is one of the government s UHC strategies introduced in a context of limited resources and low coverage of essential health services. The key aspects of the program include the capacity building and mobilization of more than 30, 000 Health Extension Workers (HEWs) targeting more than 12 million model families, and the mobilization of health development army ? to support the community-based health system. Using the HEP-UHC conceptual model and data from Demographic and Health Surveys, the study examines how the HEP has contributed to the country s move toward UHC. During the period that the HEP has been implemented, the country has experienced significant improvements in many dimensions: in terms of socioeconomic, psychological, behavioral, and biological dimensions of the beneficiaries; and in terms of the coverage of health care services. The study finds an accelerated rate of improvements among the rural, less-educated, and the poor population, which is leading to an overall reduction in equity gaps and improvements in the equity indicators including the concentration indices - that suggest a more equitable distribution of resources and health outcomes. The HEP in Ethiopia has demonstrated that an institutionalized community approach is effective in helping a country make progress toward UHC. The elements of success in the HEP include the emphasis on community mobilization which identifies community priorities, engages and empowers community members, and supports their ability to solve local problems. The other aspect of HEP is the emphasis on institutionalization of the activities, which addresses the sustainability of community programs through high level of political commitment, and effective coordination of national policies and leveraging of support from partners. These findings may offer useful lessons for other low income countries facing similar challenges in developing and implementing a sustainable UHC strategy.

Most accounts of health and healthcare in Africa are written by foreigners. African Health Leaders: Making Change and Claiming the Future redresses the balance. Written by Africans, who have themselves led improvements in their own countries, the book discusses the creativity, innovation and leadership that has been involved tackling everything from HIV/AIDs, to maternal, and child mortality and neglected tropical diseases. It celebrates their achievements and shows how, over three generations, African health leaders are creating a distinctively African vision of health and health systems. The book reveals how African Health Leaders are claiming the future - in Africa, but also by sharing their insights and knowledge globally and contributing fully to improving health throughout the world. It illustrates how African leadership can enable foreign agencies and individuals working in Africa to avoid all those misunderstandings and misinterpretations of culture and context which lead to wasted efforts and frustrated hopes. African Health Leaders challenges Africans to do more for themselves; build on success; tackle weak governance, corrupt systems and low expectations and claim the future. It sets out what Africa needs from the rest of the world in the spirit of global solidarity - not primarily in aid, but through investment, collaboration, partnership and co-development. It concludes with a vision for improvement based on three foundations: an understanding that 'health is made at home'; the determination to offer access to health services for everyone; and an insistence on the pursuit of quality.

The One Resource That Explains EVERY Provision of the Single Most Sweeping Piece of Legislation in 50 Years! CCH's Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact provides employers, legal, legislative, health, and insurance professionals with comprehensive explanation and analysis of every aspect of health care reform legislation. The information is crucial, current, and reliable and offers complete, clear and practical guidance on every provision. This is one of the most high-impact pieces of legislation passed in decades. Taken together, the laws are over 2,800 pages long. Many hundreds of changes are made to existing laws and– over 600 changes to the Social Security Act alone (which contains all of the Medicare and Medicaid law), including almost 50 newly added provisions. Other laws affected include the Employee Retirement Income and Security Act (ERISA), the Public Health Service Act, the Internal Revenue Code, and even the Fair Labor Standards Act, among others. Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact include contains almost 500 expert explanations telling you what all those law changes mean. Only Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact includes: An editorially enhanced version of the Patient Protection and Affordable Care Act that integrates in place changes made to it by the Reconciliation Act of 2010 and Title X amendments Text of the Joint Committee on Taxation report that provides background information on the revenue-related provisions of the laws Finding devices to help navigate between analysis and official text Caution notes The legislation contains the most significant health care changes in decades. Topics covered include the following: For employers: Enhanced employer responsibility Insurance market reforms Health insurance exchanges Individual responsibility mandate For health providers and beneficiaries: Expanded eligibility rules for Medicaid and the Children's Health Insurance Program Reimbursement changes for physicians and hospitals to focus on primary and preventive care Reimbursement changes for hospitals to increase coverage in rural areas Expansion of existing value-based purchasing and quality programs EXCLUSIVE ONLINE FEATURE! With your purchase of the book, you'll receive access to a special website that gives you access to SSA, ERISA, and IRC provisions amended by the Patient Protection and Affordable Care Act and the Reconciliation Act of 2010, as well as other valuable Health Care Reform information and resources. Full text of both Acts will also be provided on this exclusive website.

Perry, James F. Phillips, Meike Schleiff, Melissa Sherry, Rita Thapa, Kebede Worku

Within modern medicine, a pressing concern looms; the care and well-being of our aging population. As the number of elderly individuals seeking medical attention continues to rise, healthcare professionals, particularly internists and family medicine specialists, find themselves faced with unique challenges in the diagnosis and management of geriatric patients. The specialized field of geriatrics demands a comprehensive understanding of the intricacies involved in providing top-tier care to the elderly. Without this expertise, there is a risk of suboptimal healthcare outcomes, diminished quality of life, and increased mortality rates. Difficulties and Challenges in Geriatric Health Management offers profound insights and practical strategies to address the unique challenges geriatric patients present. Covering essential topics such as palliative care, pulmonary health, renal function, neurological disorders, endocrine conditions, and orthopedic concerns, this book equips scholars with the tools they need to deliver exemplary care to the elderly. With Difficulties and Challenges in Geriatric Health Management in hand, healthcare professionals can confidently navigate the intricate landscape of geriatric healthcare, ultimately contributing to a brighter and healthier future for our aging population.

This book provides a unique assessment of the Nigerian healthcare system's different professions. It begins by examining the fundamentals of health professions to contextualize the issues explored in the book in more detail. It goes on to present the hierarchy of occupations, professionalization, and the evolutionary path and socialization milestones that occupations attempting to attain true professions' status and power transcend. It also analyses the differences between professional autonomy, direct access, and independent practice. The latter parts identify Nigeria's primary healthcare professions and vocational careers and discuss their central roles, each discipline's specialty; including the biography of 35 notable pioneer Nigerian healthcare professionals during the 19th and early 20th centuries. The book concludes by analyzing the causes and adverse impacts of interprofessional conflict and industrial action within the Nigerian healthcare system and proposes the interdisciplinary team concept as a panacea for both conundrums.

This paper, based on quantitative surveys at the level of primary health care facilities, health care personnel, and households in their vicinity, aims at understanding the performance of primary health care providers in four states in Nigeria. As possible ways to improve performance, the paper concludes that clearly defining lines of responsibility, implementing performance-based financing of local governments and providers, and collecting, analyzing, and sharing information are some options that can help realign incentives and improve accountability in the service delivery chain and service provision. This working paper was produced as part of the World Bank s Africa Region Health Systems for Outcomes (HSO) Program. The Program, funded by the World Bank, the Government of Norway, the Government of the United Kingdom, and the Global Alliance for Vaccines and Immunization (GAVI), focuses on strengthening health systems in Africa to reach the poor and achieve tangible results related to Health, Nutrition, and Population. The main pillars and focus of the program center on knowledge and capacity building related to Human Resources for Health, Health Financing, Pharma-ceuticals, Governance and Service Delivery, and Infrastructure and ICT.

Remote areas are often characterized by lower welfare outcomes due to economic disadvantages and higher transaction costs for trade. But their worse situation may also be linked to worse public service delivery. Relying on large household surveys in rural Ethiopia, we explore this by assessing the association of two measures of remoteness – (1) the distance of villages and primary service centers to district capitals and (2) the distance of households to service centers (the last mile) – with public service delivery in agriculture and health sectors. In the agriculture sector, we document statistically significant and economically meaningful associations between exposure to agriculture extension and the two measures of remoteness. For health extension, only the last mile matters. These differences between the two sectors could be due to the fact that more remote villages tend to have fewer agriculture extension workers who also put in fewer hours than their peers in more connected areas. This does not apply in the health sector. These findings provide valuable inputs for policymakers aiming to improve inclusiveness in poor rural areas.