The study, impact assessment of health care management and health care delivery profile will build up from previous work and is expected to serve as a future building block that advances the conceptualization and practical understanding of how to evaluate the competence of health care management and delivery in Gabon.
Throughout Gabon, there is a growing consensus about the nature and importance of health care management and delivery competence a necessary component to accessible, responsive, and high-quality health care (Gerardi, 2004). Nevertheless, the pursuit of competence in health care management and delivery institutions is somehow constrained partly by the health industries’ deficiency of systematic procedures and instruments for assessing competence in relation to health care status.
The health care management and delivery will be gauged on its presence, quality level as well as its contribution to good health and health care of the entire population of Gabon.
The particular aims of the research are to develop an analytic framework for accessing the impact of health care management and health care delivery in the health care delivery organizations, point out specific indicators that can be used in connection to the framework as well as assessing the importance, feasibility and practical implication of the framework and its indicators.
The health status indicators in Gabon will mainly be focused on the quality of provision of primary health care, general mortality rates for both adults and children, and the effects of health care management and delivery on the average life expectancy of the people of Gabon (MSH, 1991).
The Problem of the Statement
To study the impact of health care management and health care delivery in Gabon, the research team will apply various methods to reach these objectives. The research team will solicit inputs from individuals with wide expertise on issues related to health care management and delivery.
These individuals will share information, insights as well as opinions throughout the research period on an ongoing basis through meetings and written commentaries. The research team will also receive inputs from a wide range of key informants in the private and public sector who have knowledge on health care management and health care delivery in Gabon.
Further, the research will also include inputs from workshops with the public in different zones. Finally, the research team will make visits to best practice settings in the health care delivery institutions that have been recognized by the public for their creative and innovation in health care delivery. Visits will be made to both public and private health care facilities.
The sites to be visited should be varied in size, population served, auspices as well as history and scope of health care management and delivery competence activities. These visits will offer opportunities to get experience-based practical views about the impact of health care management and health care delivery in Gabon.
The research intends to use an interactive process in developing the research findings. Initially, there will be a preliminary assessment of guidelines and an initial set of indicators’ need to be developed in the literature review.
This will be followed closely by refining the preliminary framework, set of indicators and related assumptions. This will be done by considering the feedback from the key informants, input from the professionals in the health care industry as well as findings from site visits. Finally, the framework and indicators resulting from this refinement will further be revised based on the wide range of inputs from the experts as well as various persons contacted during the site visits. The final report of the findings of the research will be compiled and presented for analysis and evaluation.
For this research purposes, the health care management and delivery will be referred to as behaviors, policies, and attitudes that combine in a system among professionals and/or agency in agency in facilitating the above to work effectively in improving the health status of the Gabonese. To develop tools to access the impact in the context of health care, the research team is to concentrate on the organizational level only.
The organizational structure in health management and delivery is an integral part of systematic patient-centered and has the momentum to improve the access to care, quality of care as well as health outcomes (MSH, 1991).
The organization normally serves as the driving force in the development and maintenance of individual health care provider competence by providing the managers, policies and systems that support the experiences they encounter. Moreover, organizational culture affects the service delivery and also serves as a mechanism for maintaining quality health care delivery.
Historical Perspective of Health Care Management and Delivery
Research and other studies have indicated that late neo-natal deaths are attributed to perinatally related experiences. The survival of infants at 24-27 weeks gestation depends on the effectiveness of maternal and/or prenatal care (Weir, et al, 1993). Although Gabon’s expenditure on health care provision is higher, infant survival rates are low relative to other developing countries.
Lower child maternal rates in Gabon can be avoided by improving the policy of health care delivery mainly by focusing on process issues. Recent studies show that prenatal maternal rates in Gabon are approximately 82 per every 1,000 total births and there is a gradual increase in rate over time (Weir, et al, 1993).
Prenatal deaths are mostly caused by asphyxia, immaturity, and macerated stillbirth. The prevalence of low birth weight babies, multiple pregnancies, and admitted patients are some of the major reasons for high mortality rates, particularly in Gabon.
To reduce the current high prenatal maternal rates in Gabon, public education on danger signs of prolonged labor and regular training of health professionals as well as improving neo-dental facilities are very important. Recent studies on global prenatal mortality figures show that between 6 and 7 million prenatal deaths occur for every 132 million births per year (MSH, 1991).
It also shows that the dominant causes of those prenatal deaths were mainly caused by poor maternal health, early childbearing and most importantly, lack of appropriate and quality health delivery. Although technology has provided medical service providers with life-saving practices, almost ⅓ of mothers have no access to services during pregnancy and also do not have access to services for childbirth.
Infectious diseases such as pneumonia, influenza, malaria as well as tuberculosis are the main causes of mortality in the 20th century in Gabon (Gerardi, 2004). In the same vein recently measles, cholera as well as intestinal infections are continually and regularly causing mortality in Gabon and many other parts of the world.
There has been a substantial reduction of prevalence and impact of the above-mentioned diseases due to current improved control of the environment, personal hygiene, medical facilities, proper management of human waste as well as dispensation including proper vaccination.