Lisa R Hirschhorn
Datos Biográficos
| ID | 152129 |
|---|---|
| NOMBRE | Lisa R Hirschhorn |
| NOMBRES | Lisa R |
| APELLIDO | Hirschhorn |
| FIRMA | HIRSCHHORN L R |
| AFILIACIONES | Northwestern University |
| ORCID | 0000-0002-4355-7437 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 54 |
| TOTAL DE CITAS | 5 |
| TOTAL COMO AUTOR | 54 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 2006 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2026 |
| ÍNDICE H | 1 |
Co‐Designing a Primary Healthcare Intervention to Improve Diabetes Care in Mendoza, Argentina
BACKGROUND: In low- and middle-income countries, primary healthcare (PHC) faces significant challenges in delivering effective care for chronic conditions, exacerbated by fragmented systems, resource limitations, and inequitable access. In Argentina, despite national strategies for non-communicable diseases, implementation varies due to decentralised governance, leading to gaps in care. Here, we describe the codesign process of a contextually rel…
Long Covid and its associations with burnout, anxiety, and depression among U. S. healthcare workers in the United States
Background Data on Long COVID and its associations with burnout, anxiety and depression among healthcare workers (HCW) in the United States (U. S.) is limited. Methods This study utilized cross-sectional data from the final survey conducted in July 2023, which was part of a longitudinal cohort study assessing COVID-19-related burnout and wellbeing among healthcare workers (HCWs) in a large tertiary academic healthcare system in the Chicago area. …
Design and implementation of a drug revolving fund for hypertension treatment in primary care setting of the Federal Capital Territory, Nigeria
BACKGROUND: Expanding treatment for hypertension requires ensuring access to affordable, high-quality blood pressure (BP) lowering medications. We describe the design, implementation and evaluation of a BP-lowering medication drug revolving fund (DRF) embedded in the Hypertension Treatment in Nigeria (HTN) Programme in 60 primary healthcare centres (PHCs) in the Federal Capital Territory, Nigeria. METHODS: We used the exploration, preparation, im…
The use of Childbirth Experience Questionnaire (CEQ) and Birth Satisfaction Scale-Revised (BSS-R) in comparing the experiences of mothers with and without HIV in Tanzania
INTRODUCTION: Mothers' experiences at birth and respectful maternal care are critical to achieving Sustainable Development Goal number 3 in Tanzania. However, little is known about the differences in perinatal experience quality between women with and without HIV. To address this gap, we compared mothers' experience at birth among women with and without HIV. METHODS: This cross-sectional study was conducted in four Reproductive and Child Health C…
Accessibility and quality of care for adults with hypertension in rural Burkina Faso
Providing quality healthcare is essential to reduce the future burden of cardiovascular disease. We assessed the quality of care for people with hypertension in Burkina Faso using the Institute of Medicine (IoM) Quality Domains of effectiveness, timeliness of access, patient-centredness and equitability of care. We performed an analysis of cross-sectional household survey data collected from a population-representative sample of 4000 adults ≥40 y…
Health and well-being of older adults in rural and urban Rwanda
Background: Ageing often leads to multimorbidity, frailty, and disability; these interconnected conditions significantly impact quality of life (QoL) and strain healthcare systems through increased dependency and care needs. Despite their importance for health system planning, they remain understudied in Rwanda's older population. Here we describe the epidemiology of these outcomes in Rwanda's ageing population. Methods: We conducted a cross-sect…
Generalized and Covid-19 related anxiety among Tanzanian adolescents with HIV and association with HIV outcomes during the Covid-19 pandemic
Low levels of generalized and COVID-19 related anxiety were reported among Tanzanian AWH. Scaling up integrated screening and management of GAD into HIV care for AWH could improve VLS among this population
Highlighting the Need for Representation of Black Women in PrEP Marketing and Educational Efforts
Women reported minimal representation and knowledge regarding PrEP, yet demonstrated high interest in learning more about PrEP and sharing that information with others. Black women must be featured prominently in mainstream PrEP advertisements and PrEP educational materials and included by providers in discussions about PrEP. Increasing funding and support for these efforts will be instrumental to promote PrEP uptake among Black women and to redu…
A Cross-Sectional Study of Sexual Health and Well-Being in Married or Cohabitating Middle-Aged and Older Adults in Nouna, Burkina Faso
Sexual health and well-being is important for middle-aged and older adults, but knowledge is limited on prevalence and determinants in countries in Sub-Saharan Africa. We analyzed cross-sectional data collected in 2021 from married or cohabitating adults age ≥ 40 in Nouna, Burkina Faso. Sexual health and well-being were measured using the Sexual Relationships and Activities Questionnaire. Descriptive statistics and multivariable logistic models w…
Healthcare provider perspectives on barriers and facilitators to integration of cardiovascular disease-related care into HIV care and treatment clinics in urban Tanzania
Background: The increase in the dual burden of HIV and cardiovascular diseases (CVD), calls for the provision of integrated HIV/CVD care. This study aimed to explore barriers and facilitators to the integration of HIV/CVD care within HIV care and treatment clinics (CTCs) in urban, Tanzania. Methods: Between March and April 2023, we conducted 12 key informant interviews with healthcare providers at six HIV CTCs in urban, Tanzania. Guided by the Co…
Mitigating the impact of Covid-19 on primary healthcare interventions for the reduction of under-5 mortality in Bangladesh
The COVID-19 pandemic posed unprecedented challenges and threats to health systems, particularly affecting delivery of evidence-based interventions (EBIs) to reduce under-5 mortality (U5M) in resource-limited settings such as Bangladesh. We explored the level of disruption of these EBIs, strategies and contextual factors associated with preventing or mitigating service disruptions, and how previous efforts supported the work to maintain EBIs duri…
Identifying determinants of under-five child mortality in northern Togo
Background: Although global rates of under-five mortality have declined, many low- and middle-income countries (LMICs), including Togo, have not achieved sufficient progress. We aimed to identify the structural and intermediary determinants associated with under-five mortality in northern Togo. Methods: We collected population-representative cross-sectional household surveys adapted from the Demographic Household Survey (DHS) and Multiple Indicat…
Evidence of health system resilience in primary health care for preventing under-five mortality in Rwanda and Bangladesh
Background: The coronavirus disease 2019 (COVID-19) pandemic led to disruptions of health service delivery in many countries; some were more resilient in either limiting or rapidly responding to the disruption than others. We used mixed methods implementation research to understand factors and strategies associated with resiliency in Rwanda and Bangladesh, focussing on how evidence-based interventions targeting amenable under-five mortality that …
Factors influencing community-facility linkage for case management of possible serious bacterial infections among young infants in Kenya
Despite evidence showing the feasibility and acceptability of implementing the World Health Organization’s guidelines on managing possible serious bacterial infection (PSBI) in Kenya, the initial implementation revealed sub-optimal community-facility referrals and follow-up of PSBI cases. This study explores facilitators and barriers of community-facility linkages in implementing PSBI guidelines in Busia and Migori counties, Kenya. We used an exp…
Provider and facility readiness for age-friendly health services for older adults in primary health care centres in southwest, Nigeria
There is a growing focus on interventions at the health system level to promote healthy aging and provide age-friendly health services (AFHS) in low- and middle-income countries where populations are aging. This study aimed to determine the provider and facility readiness for AFHS. We developed and implemented surveys to collect PHC facility capacity and readiness to deliver AFHS and a KAP survey for facility healthcare workers based on guideline…
Patient reported experience measures on HIV viral load testing at public health facilities in Dar es Salaam, Tanzania
While viral load (VL) testing is critical to effective treatment of human immunodeficiency virus (HIV), little is known about patients’ experiences with, and barriers to VL-testing in the context of HIV infection. We assessed patient reported experience measures (PREMs) on VL-testing in public HIV clinics in Tanzania. In a cross-sectional convergent mixed method study, we collected information on VL test related PREMs, clinical and sociodemograph…
Nigeria healthcare worker Sars-CoV-2 serology study
Healthcare workers, both globally and in Nigeria, have an increased risk for SARS-CoV-2 infection compared with the general population due to higher risk contacts, including occupational exposures. In addition, primary healthcare workers represent an important group for estimating prior infection to SARS-CoV-2 because they work at the first point-of-contact for most patients yet have not been included in prior COVID-19 seroepidemiology research i…
Health service readiness to provide care for HIV and cardiovascular disease risk factors in low- and middle-income countries
Cardiovascular disease risk factors (CVDRF), in particular diabetes and hypertension, are chronic conditions which carry a substantial disease burden in Low- and Middle-Income Countries. Unlike HIV, they were neglected in the Millenium Development Goals along with the health services required to manage them. To inform the level of health service readiness that could be achieved with increased attention, we compared readiness for CVDRF with that f…
Ending the HIV Epidemic
The rapid implementation of molecular HIV surveillance (MHS) has resulted in significant challenges for local health departments to develop real-time cluster detection and response (CDR) interventions for priority populations impacted by HIV. This study is among the first to explore professionals' strategies to implement MHS and develop CDR interventions in real-world public health settings. Methods: Semi-structured qualitative interviews were co…
Older persons experiences of healthcare in rural Burkina Faso
Ensuring responsive healthcare which meets patient expectations and generates trust is important to increase rates of access and retention. This need is important for aging populations where non-communicable diseases (NCDs) are a growing cause of morbidity and mortality. We performed a cross-sectional household survey including socio-demographic; morbidities; and patient-reported health system utilization, responsiveness, and quality outcomes in …
Impact of the Liberian National Community Health Assistant Program on childhood illness care in Grand Bassa County, Liberia
Liberia launched its National Community Health Assistant Program in 2016, which seeks to ensure that all people living 5 kilometers or farther from a health facility have access to trained, supplied, supervised, and paid community health workers (CHWs). This study aims to evaluate the impact of the national program following implementation in Grand Bassa County in 2018 using data from population-based surveys that included information on 1291 ill…
Pre-Exposure Prophylaxis (PrEP) Initiation and Retention Among Young Kenyan Women
HIV Pre-exposure Prophylaxis Use and Persistence among Black Ciswomen
Does decentralization of health systems translate into decentralization of authority? A decision space analysis of Ugandan healthcare facilities
Since the 1990s, following similar reforms to its general politico-administrative systems, Uganda has decentralized its public healthcare system by shifting decision-making power away from its central Ministry of Health and towards more distal administrative levels. Previous research has used decision space—the decision-making autonomy demonstrated by entities in an administrative hierarchy—to measure overall health system decentralization. This …
Facilitators and barriers to HIV pre-exposure prophylaxis (PrEP) uptake through a community-based intervention strategy among adolescent girls and young women in Seme Sub-County, Kisumu, Kenya
Overall, the community roll-out of PrEP within the DREAMS Initiative was successful due to a number of key facilitating factors, which ultimately led to successful PrEP implementation, increased PrEP initiation and enhanced persistence among adolescent girls and young women. The identified barriers should be addressed so that a larger scale-up of PrEP roll-out is possible in the future
The Case adherence index
The Center for Adherence Support Evaluation (CASE) Adherence Index, a simple composite measure of self-reported antiretroviral therapy (ART) adherence, was compared to a standard three-day self-reported adherence measure among participants in a longitudinal, prospective cross-site evaluation of 12 adherence programs throughout the United States. The CASE Adherence Index, consisting of three unique adherence questions developed for the cross-site …
Gender differences in quality of HIV care in Ryan White Care Act-funded clinics
The Impact of a Quality Improvement Program on Systems, Processes, and Structures in Medical Clinics
OBJECTIVE: We sought to assess whether participation in a quality-improvement collaborative changed care processes, systems, and organization of outpatient human immunodeficiency virus (HIV) clinics. METHODS: We surveyed clinicians, medical directors, and HIV program administrators before and after an 18-month quality improvement collaborative at 54 intervention and 37 control clinics providing HIV care. Surveys assessed clinic structures, proces…
The quality of care received by HIV patients without a primary provider
The goal of this study was to compare the quality of care received by HIV patients who report that their primary HIV care provider is a physician, a nurse practitioner (NP) or a physician assistant (PA) to that of patients who cannot identify a primary HIV provider. We used data from patients who participated in the HIV Cost and Services Utilization Study (HCSUS), a study of a probability sample of non-institutionalized HIV-infected individuals i…
Reported care quality in federal Ryan White HIV/Aids Program supported networks of HIV/Aids care
Since 1991, the US Government has funded medical and support services for people living with HIV and AIDS (PLWHA) through the Ryan White HIV/AIDS Program. The Ryan White Program supports networks of care which include medical care providers and support services for PLWHA in 51 Eligible Metropolitan Areas (EMAs). In the 2000 reauthorization of the Ryan White Program, quality management programs were required for all sites receiving funding. To fac…
From scaling up to sustainability in HIV
BACKGROUND: In 30 years of experience in responding to the HIV epidemic, critical decisions and program characteristics for successful scale-up have been studied. Now leaders face a new challenge: sustaining large-scale HIV prevention programs. Implementers, funders, and the communities served need to assess what strategies and practices of scaling up are also relevant for sustaining delivery at scale. METHODS: We reviewed white and gray literatu…
Utilizing community health worker data for program management and evaluation
Toward utilization of data for program management and evaluation
BACKGROUND: Health data can be useful for effective service delivery, decision making, and evaluating existing programs in order to maintain high quality of healthcare. Studies have shown variability in data quality from national health management information systems (HMISs) in sub-Saharan Africa which threatens utility of these data as a tool to improve health systems. The purpose of this study is to assess the quality of Rwanda's HMIS data over…
Patient satisfaction with HIV/Aids care at private clinics in Dar es Salaam, Tanzania
Health system responsiveness (HSR) measures quality of care from the patient's perspective, an important component of ensuring adherence to medication and care among HIV patients. We examined HSR in private clinics serving HIV patients in Dar es Salaam, Tanzania. We surveyed 640 patients, 18 or older receiving care at one of 10 participating clinics, examining socioeconomic factors, HIV regimen, and self-reported experience with access and care a…
Are social support and HIV coping strategies associated with lower depression in adults on antiretroviral treatment? Evidence from rural KwaZulu-Natal, South Africa
We assess depression rates and investigate whether depression among HIV-infected adults receiving antiretroviral treatment (ART) is associated with social support and HIV coping strategies in rural South Africa (SA). The study took place in a decentralised public-sector ART programme in a poor, rural area of KwaZulu-Natal, SA, with high-HIV prevalence and high-ART coverage. The 12-item General Health Questionnaire (GHQ12), validated in this setti…
Interdisciplinary HIV care in a changing healthcare environment in the USA
HIV remains a complex disease that requires comprehensive, coordinated care to ensure optimal outcomes. In the USA, interdisciplinary models of care have developed over time to optimize treatment outcomes. These models may be increasingly important in an era of healthcare reform in the USA. A qualitative study of nine clinical sites funded by the Ryan White HIV/AIDS Program (RWHAP), the federally funded "safety net" program for uninsured and unde…
Improving district facility readiness
BACKGROUND: While health systems strengthening (HSS) interventions are recommended by global health policy experts to improve population health in resource-limited settings, few examples exist of evaluations of HSS interventions conducted at the district level. In 2009, a partnership between Partners In Health (PIH), a non-governmental organization, and the Rwandan Ministry of Health (RMOH) was provided funds to implement and evaluate a district-…
Race to the Top
BackgroundPerformance-based financing (PBF) has demonstrated a range of successes and failures in improving health outcomes across low- and middle-income countries. Evidence indicates that the success of PBF depends, in large part, on the model selected, in relation to a variety of contextual factors.ObjectivePartners In Health∣Inshuti Mu Buzima aimed to evaluate health outcomes associated with a novel capacity-building model of PBF at health cen…
Closing the delivery gaps in pediatric HIV care in Togo, West Africa
Providing quality care for all children living with HIV/AIDS remains a global challenge and requires the development of new healthcare delivery strategies. The care delivery value chain (CDVC) is a framework that maps activities required to provide effective and responsive care for a patient with a particular disease across the continuum of care. By mapping activities along a value chain, the CDVC enables managers to better allocate resources, im…
Preparedness of HIV care and treatment clinics for the management of concomitant non–communicable diseases
A number of gaps were identified in this sample of HIV clinics that currently limit the ability of Tanzanian healthcare workers to diagnose and manage NCD in the context of HIV care. Integrated NCD and HIV care may be successfully achieved in these settings with basic measures incorporated into existing infrastructures at minimal added expense, i.e., improving access to basic functioning equipment, introducing standardized treatment guidelines, a…
Community-Based Accompaniment and the Impact of Distance for HIV Patients Newly Initiated on Antiretroviral Therapy
High-quality health systems in the Sustainable Development Goals era
and respecting all workers to deliver the best care possible. Fourth, governments and civil society should ignite demand for quality in the population to empower people to hold systems accountable and actively seek high-quality care. Additional targeted actions in areas such as health financing, management, district-level learning, and others can complement these efforts. What works in one setting might not work elsewhere, and improvement efforts…
Causes of death and predictors of childhood mortality in Rwanda
In the context of rapidly declining childhood mortality in Rwanda and increased access to health care, we found a large proportion of remaining deaths occur at home, with home deliveries still representing a significant risk factor for neonatal death. The major causes of death at a population level remain largely avoidable communicable diseases. Household characteristics associated with death included well-established socioeconomic and care-seeki…
Availability of Safe Childbirth Supplies in 284 Facilities in Uttar Pradesh, India
Objectives Vital to implementation of the World Health Organization (WHO) Safe Childbirth Checklist (SCC), designed to improve delivery of 28 essential birth practices (EBPs), is the availability of safe birth supplies: 22 EBPs on the SCC require one or more supplies. Mapping availability of these supplies can determine the scope of shortages and need for supply chain strengthening. Methods A cross-sectional survey on the availability of function…
Learning from Exemplars in Global Health
To minimise these negative indirect effects, countries will need to consider all domains of health systems, including demand, supply, resources and social determinants. To this end, learning from countries that have improved health outcomes amid other crises could provide helpful strategies. Some of the strategies used by these positive outlier countries include clear national leadership, datadriven targeting, community-focused health services an…
A framework for identifying and learning from countries that demonstrated exemplary performance in improving health outcomes and systems
This paper introduces a framework for conducting and disseminating mixed methods research on positive outlier countries that successfully improved their health outcomes and systems. We provide guidance on identifying exemplar countries, assembling multidisciplinary teams, collecting and synthesising pre-existing evidence, undertaking qualitative and quantitative analyses, and preparing dissemination products for various target audiences. Through …
Implementing sustainable primary healthcare reforms
As the world strives to achieve universal health coverage by 2030, countries must build robust healthcare systems founded on strong primary healthcare (PHC). In order to strengthen PHC, country governments need actionable guidance about how to implement health reform. Costa Rica is an example of a country that has taken concrete steps towards successfully improving PHC over the last two decades. In the 1990s, Costa Rica implemented three key refo…
Does adherence to evidence-based practices during childbirth prevent perinatal mortality? A post-hoc analysis of 3,274 births in Uttar Pradesh, India
BACKGROUND: Evidence-based practices that reduce childbirth-related morbidity and mortality are core processes to quality of care. In the BetterBirth trial, a matched-pair, cluster-randomised controlled trial of a coaching-based implementation of the WHO Safe Childbirth Checklist (SCC) in Uttar Pradesh, India, we observed a significant increase in adherence to practices, but no reduction in perinatal mortality. METHODS: Within the BetterBirth tri…
Level of confidence in and endorsement of the health system among internet users in 12 low-income and middle-income countries
Confidence and endorsement of the health system were low across 12 LMICs. This may hinder efforts to gain support for universal health coverage. Positive patient experience was strongly associated with confidence in and endorsement of the health system
Implementing an integrated community based health systems strengthening approach to improve HIV survival in Northern Togo
To disseminate lessons learned from the implementation experience of a public-private sector partnership, we describe a comprehensive HIV/AIDS program including 5-year survival outcomes for individuals who initiated antiretroviral therapy (ART) treatment in Togo from 2010 to 2015. A retrospective case study analysis was conducted from a cohort of patients receiving ART at an HIV/AIDS care clinic in Kara Region, Togo. Kaplan-Meier curves with Log …
Medicine (45 obras) · Nursing (30 obras) · Global Maternal and Child Health (26 obras) · Health care (25 obras) · Environmental health (23 obras) · Family medicine (23 obras) · Public health (21 obras) · HIV/AIDS Research and Interventions (20 obras) · Business (19 obras) · Population (16 obras)