Gregory D Karelas

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BACKGROUND Knowledge of care practices among clinicians who annually treat <20 human immunodeficiency virus (HIV)-positive patients with antiretroviral therapy (ART) is insufficient, despite their number, which is likely to increase given shifting healthcare policies. We analyze the practices, distribution and quality of care provided by low-volume(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)
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)
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)
This paper proposes social marketing as a tool to build individual self-esteem and thus prevent the uptake of activities that pose risk to health. Evidence supporting this approach can be drawn from pioneer social marketing campaigns of the last 30 years that successfully addressed the prevention, treatment and stigmatization of skin cancer and leprosy with(More)
INTRODUCTION There are well-established protocols and procedures for the majority of common surgical diseases, yet surgical services remain largely inaccessible for much of the world's rural poor. Data on the process and outcome of surgical care expansion, however, are very limited, and the roll-out process of rural surgical implementation in particular has(More)
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