Dan Schwarz

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Over the last decade, extensive scientific and policy innovations have begun to reduce the "quality chasm"--the gulf between best practices and actual implementation that exists in resource-rich medical settings. While limited data exist, this chasm is likely to be equally acute and deadly in resource-limited areas. While health systems have begun to be(More)
INTRODUCTION Despite decades of experience with community health workers (CHWs) in a wide variety of global health projects, there is no established conceptual framework that structures how implementers and researchers can understand, study and improve their respective programs based on lessons learned by other CHW programs. OBJECTIVE To apply an(More)
PROBLEM In hospitals in rural, resource-limited settings, there is an acute need for simple, practical strategies to improve healthcare quality. SETTING A district hospital in remote western Nepal. KEY MEASURES FOR IMPROVEMENT To provide a mechanism for systems-level reflection so that staff can identify targets for quality improvement in healthcare(More)
Dear Sir: Pandey and others reported the first case of visceral leish-maniasis (VL) in the Far Western Hills region of Nepal. 1 At our hospital in the Achham district, which neighbors the Doti district described in the Pandey and others report, we recently had a case of VL in a 17-year-old woman who presented with advanced disease. We transferred her to a(More)
BACKGROUND Nepal's Female Community Health Volunteer (FCHV) program has been described as an exemplary public-sector community health worker program. However, despite its merits, the program still struggles to provide high-quality, accessible services nation-wide. Both in Nepal and globally, best practices for community health worker program implementation(More)
BACKGROUND Zimbabwe underwent a socioeconomic crisis and resultant increase in food insecurity in 2008-9. The impact of the crisis on Tuberculosis (TB) incidence is unknown. METHODS Prospective databases from two mission hospitals, which were geographically widely separated, and remained open during the crisis, were reviewed. RESULTS At the Howard(More)
BACKGROUND Surveillance systems are increasingly relying upon community-based or crowd-sourced data to complement traditional facilities-based data sources. Data collected by community health workers during the routine course of care could combine the early warning power of community-based data collection with the predictability and diagnostic regularity of(More)
Household indoor air pollution from open-fire cookstoves remains a public health and environmental hazard which impacts negatively on people's right to health. Technologically improved cookstoves designed to reduce air pollution have demonstrated their efficacy in laboratory studies. Despite the tremendous need for such stoves, in the field they have often(More)
Acknowledgements: The authors would like to express our appreciation to the entire staff of Possible in Achham who dedicate themselves to providing excellent healthcare to the patients of Achham; to Dr. Borgny Ween at Oslo and Akershus University College of Applied Sciences for her valuable assistance in preparing this manuscript, for her contributions to(More)