Joseph Naimoli - Academia.edu (original) (raw)

Papers by Joseph Naimoli

BMC Health Services Research, 2011

Background: There is widespread agreement on the need for scaling up in the health sector to achi... more Background: There is widespread agreement on the need for scaling up in the health sector to achieve the Millennium Development Goals (MDGs). But many countries are not on track to reach the MDG targets. The dominant approach used by global health initiatives promotes uniform interventions and targets, assuming that specific technical interventions tested in one country can be replicated across countries to rapidly expand coverage. Yet countries scale up health services and progress against the MDGs at very different rates. Global health initiatives need to take advantage of what has been learned about scaling up. Methods: A systematic literature review was conducted to identify conceptual models for scaling up health in developing countries, with the articles assessed according to the practical concerns of how to scale up, including the planning, monitoring and implementation approaches.

Recent developments at the World Bank provide an opportunity for development partners with simila... more Recent developments at the World Bank provide an opportunity for development partners with similar interests to work together to better understand how results-based financing schemes work and whether they are effective. The World Bank's Health Results Innovation Trust Fund is a multi-donor fund that supports eight competitively selected countries to design, implement, monitor, and evaluate health results-based financing (HRBF) mechanisms with the potential to accelerate progress toward the achievement of national health goals, especially those related to reducing child malnutrition, child mortality, and maternal mortality (MDGs 1c, 4 and 5, respectively). The Government of Norway is the first donor to contribute to the Fund, with an NOK 586 million grant (US$95 million) for the period 2008-2012.

This report is intended to help shape the Africa Region&#x27;s engagement in this key pub... more This report is intended to help shape the Africa Region&#x27;s engagement in this key public health intervention. The major findings both validate conventional wisdom on immunization and challenge the development community to think outside the box. According to the study ...

Bulletin of the World Health Organisation

Evaluation is an essential management tool for the improvement of public health programmes or pro... more Evaluation is an essential management tool for the improvement of public health programmes or projects. As malaria morbidity and mortality continue to increase in most countries in Africa, international agencies and malaria control programme managers have identified the strengthening of programme evaluation as an important strategy for improving the efficiency and effectiveness of malaria control programmes.

Human Resources for Health, 2015

Background: There is robust evidence that community health workers (CHWs) in low-and middle-incom... more Background: There is robust evidence that community health workers (CHWs) in low-and middle-income (LMIC) countries can improve their clients' health and well-being. The evidence on proven strategies to enhance and sustain CHW performance at scale, however, is limited. Nevertheless, CHW stakeholders need guidance and new ideas, which can emerge from the recognition that CHWs function at the intersection of two dynamic, overlapping systemsthe formal health system and the community. Although each typically supports CHWs, their support is not necessarily strategic, collaborative or coordinated.

Global Health: Science and Practice, 2014

International Quarterly of Community Health Education, 1993

A project in Togo, West Africa, demonstrated that motivated and skilled district health teams can... more A project in Togo, West Africa, demonstrated that motivated and skilled district health teams can increase community involvement in promoting positive health behavior. Village health committees, village volunteers, health workers, itinerant health agents, and school teachers collaborated with district health personnel in village-wide efforts to increase the use of health services targeted to children under five years of age. The project also demonstrated that in areas where health services are accessible, high levels of service utilization can be achieved by villages through a combination of strategies that rely on person-to-person and group methods of communication. Village-level educational programs, which included theater, storytelling, patient education at health facilities, and child-to-child activities in schools contributed to improvements in immunization coverage levels in children twelve to twenty-three months of age after less than one year following the educational intervention. The major factors responsible for the success of the project are summarized, and issues related to project replication and diffusion are discussed.

International Quarterly of Community Health Education, 2006

Evaluation is a necessary component of all training, including workshops. Evaluation can provide ... more Evaluation is a necessary component of all training, including workshops. Evaluation can provide information about the teaching and learning that occur during a workshop and document the extent to which long-term objectives were achieved after a workshop. Multiple methods for evaluating the process and outcomes of a regional workshop on Program Planning and Management for Malaria Control were developed and implemented by an evaluation team composed of African program managers and technical assistance partners, all of whom served as workshop trainers. Among the five methods used to assess the process of workshop implementation and participant satisfaction, a questionnaire administered at the close of the two-week workshop was found least useful in improving the training. Much more useful were the results of daily trainers' meetings and of two qualitative evaluation methods: large group feedback sessions and focused group discussions. Among the three methods used to evaluate the workshop outcomes, a review of the quality of the pre- and post-workshop national malaria control program plans by a panel of experts was found to be the most useful in providing information about the extent to which learning objectives were achieved. The involvement of trainers in evaluation activities permitted immediate action based on results. Our experience suggests that during brief workshops, evaluation should not compete with training activities for time and resources but must be considered an essential part of the curriculum. Effective and efficient workshop evaluation will require advance planning by trainers, support and training in evaluation methods for all members of the evaluation team, and advance consideration of how evaluation results will be summarized and translated into action.

Human resources for health, 2014

There has been a resurgence of interest in national Community Health Worker (CHW) programs in low... more There has been a resurgence of interest in national Community Health Worker (CHW) programs in low- and middle-income countries (LMICs). A lack of strong research evidence persists, however, about the most efficient and effective strategies to ensure optimal, sustained performance of CHWs at scale. To facilitate learning and research to address this knowledge gap, the authors developed a generic CHW logic model that proposes a theoretical causal pathway to improved performance. The logic model draws upon available research and expert knowledge on CHWs in LMICs. Construction of the model entailed a multi-stage, inductive, two-year process. It began with the planning and implementation of a structured review of the existing research on community and health system support for enhanced CHW performance. It continued with a facilitated discussion of review findings with experts during a two-day consultation. The process culminated with the authors' review of consultation-generated docu...

Patient Education and Counseling, 1996

This paper describes the design and implementation of a health worker training program in diarrhe... more This paper describes the design and implementation of a health worker training program in diarrhea case management and its effect on patient education in health facilities in the Central African Republic (C.A.R.). In 1989, a facility-based assessment of health worker practices in managing diarrheal disease in children under 5 years of age documented serious deficiencies in patient education as performed by health workers. Based on these results, the Ministry of Health (MOH) designed an inservice training program that promoted education as an integral component of curative care. The training program was implemented in all five health regions of the country. An evaluation of the training's impact on the delivery of patient education indicated dramatic increases in the number of messages health workers communicated to mothers. This experience demonstrated that the patient education practices of health workers can be improved through inservice training that integrates the teaching of clinical and communication skills. Additional study in C.A.R. is needed to (1) further improve the quality of patient education for diarrhea and other childhood communicable diseases, (2) determine the impact of patient education on the care provided by mothers in the home following a clinic visit, and (3) assess how operational research can be conducted within the limitations of inservice training programs and routine clinical operations.

Patient Education and Counseling, 1992

International Journal for Quality in Health Care, 2005

Objective. To evaluate an intervention to promote health workers' use of the World Health Organiz... more Objective. To evaluate an intervention to promote health workers' use of the World Health Organization's Integrated Management of Childhood Illness clinical guidelines and to identify other factors influencing quality of care received by Moroccan children.

The International journal of health planning and management

Despite a burgeoning literature on global health partnerships (GHPs), there have been few studies... more Despite a burgeoning literature on global health partnerships (GHPs), there have been few studies of how GHPs, particularly those trying to build a bridge between horizontal and vertical modes of delivering essential health services, operate at global and country levels. This paper will help address this knowledge gap by describing and analyzing the GAVI Alliance's early experience with health systems strengthening (HSS) to improve immunization coverage and other maternal-child health outcomes. To date, the strengths of HSS reside in its potential to optimize GAVI's overall investment in immunization, efforts to harmonize with other initiatives, willingness to acknowledge risk and identify mitigation strategies, engagement of diverse stakeholders, responsiveness to country needs, and effective management of an ambitious grant-making enterprise. The challenges have been forging a common vision and approach, governance, balancing pressure to move money with incremental learn...

Health Policy and Planning, 2008

The question of why some immunization programmes in sub-Saharan Africa are more successful than o... more The question of why some immunization programmes in sub-Saharan Africa are more successful than others is an intriguing one, but not one that is frequently raised or investigated. Borrowing techniques from both performance benchmarking and positive deviance inquiry, we explored this question in six countries. We first set out to define for a systematic sample of countries the key constructs commonly associated with improving immunization coverage, using an inductive, 'insider' point of view. We then explored their utility in generating hypotheses about coverage differences across countries through a preliminary application of the measures of these constructs to the countries in this sample. Our findings suggest that there are different paths to success, and that not only what countries do, but how they execute their programmes, seem to make a difference in coverage outcomes. In some cases, extramural, contextual factors may also help to explain these differences. We discuss several hypotheses generated by our study, identify methodological limitations, and recommend improvements to the methods we used. Similar formative studies are needed to validate our preliminary hypotheses, to generate new ones, and to raise our level of confidence in the early policy implications that we see emerging from our preliminary work in this area. Eventually, testing of the hypotheses generated by this and other formative studies could generate a robust theory of why some programmes are more successful than others, a phenomenon likely to be relevant to other child and maternal health programmes in sub-Saharan Africa.

Health Education & Behavior, 1991

... In each village focus group interviews were conducted with approximately 12 mothers to discus... more ... In each village focus group interviews were conducted with approximately 12 mothers to discuss their beliefs and knowledge, social and cultural norms and practices, and experiences with health services that hinder or promote the acceptability of childhood immunization. ...

This report is intended to help shape the Africa Region's engagement in this key public heal... more This report is intended to help shape the Africa Region's engagement in this key public health intervention. The major findings both validate conventional wisdom on immunization and challenge the development community to think outside the box. According to the study ...