Health services management and research

Professional knowledge aims at improving practice. It reduces uncertainty in decision-making, improves effectiveness in action and relevance in evaluation, stimulates reflexivity, and subjects practice to ethical standards.

 

We used empirical learning and action-research to test strategies designed

 

  • To improve medical professionalism with “non managed-care” techniques and enhance the symbolic motivation of health professionals in publicly-oriented health services

 

Unger JP, Vargas I & Vázquez ML. Non managed care techniques to improve clinical decision making. In: Unger JP, De Paepe P, Sen K, Soors W, editors. International health and aid policies; the need for alternatives. Cambridge: Cambridge University Press; 2010.


https://www.cambridge.org/core/books/international-health-and-aid-policies/improving-clinical-decision-making/3B12B65D301F3D527F841E7C0B203861

 

  • To secure access to essential generic drugs (in Senegal)

 

Unger JP, Mbaye AM & Diao M. Finances and Drugs at the Core of District Health Service Rehabilitation. A Case-Study in Senegal: the Kolda District. Health Pol Plan. 1990; 5,4:367-377


https://academic.oup.com/heapol/article-abstract/5/4/367/559361?redirectedFrom=fulltext

 

  • To improve access to first-line health services (in Ecuador)

 

De Paepe, P., Rojas, E., Abad, L., Van Dessel, P., & Unger, J. (2010). Improving access. In J. Unger, P. De Paepe, K. Sen, & W. Soors (Authors), International Health and Aid Policies: The Need for Alternatives (pp. 210-224). Cambridge: Cambridge University Press. doi:10.1017/CBO9780511902512.028


https://www.cambridge.org/core/books/international-health-and-aid-policies/improving-access/ACF072F50665DF7D273C02C25D7DD59C

 

  • To train and coach mid-level health managers (in Senegal)

 

Public Health Research and Training Unit of the ITM. The Training of District Medical Officers in the Organization of Health Services: a Methodology Tested in Senegal. Health Policy and Planning 1989; 4(2): 148-156.


https://academic.oup.com/heapol/article-abstract/4/2/148/642298?redirectedFrom=fulltext

 

  • To organize local health systems (in Senegal, Burkina Faso, and Niger)

 

Unger JP. PhD thesis: "Role of health districts and methodology of their development in Africa” 1991, Free University of Brussels, Faculty of Medicine (in French)


https://research.itg.be/nl/publications/rôle-des-districts-sanitaires-et-méthodologie-de-leur-développeme

 

  • To disseminate medical audits in health services, enhance medical reflectivity and care coordination across institutional divides (in Belgium) and derive improvements in service organization from clinical evaluation

 

Unger J.-P., Marchal B., Dugas S., Wuidar M. J., Burdet D., Leemans P. & Unger J. Interface flow process audit: using the patient's career as a tracer of quality of care and of system organisation. Int J Integr Care. 2004;4:1568-4156.


https://www.ijic.org/articles/10.5334/ijic.99/

 

  • To promote family medicine-like healthcare practice by paramedics (in LMICs)

 

Unger JP, Van Dormael M, Criel B, Van der Vennet J, & De Munck P. A plea for an initiative to strengthen family medicine in public healthcare services of developing countries. Int J Health Serv. 2002;32,4:799-815.


https://www.jstor.org/stable/pdf/45131247.pdf

 

  • To enhance the contribution of academic departments to the universal right to care (in Latin America and Belgium)

 

Unger, J., De Paepe, P., Sen, K., & Soors, W. (2010). Reorienting academic missions: How can public health departments and public health teaching in particular best support access to good quality comprehensive health care? In International Health and Aid Policies: The Need for Alternatives (pp. 240-246). Cambridge: Cambridge University Press. doi:10.1017/CBO9780511902512.030


https://www.cambridge.org/core/books/international-health-and-aid-policies/reorienting-academic-missions-how-can-public-health-departments-and-public-health-teaching-in-particular-best-support-access-to-good-quality-comprehensive-health-care/67AD124202D902C6D1F39513D46B294E 

 

  • To strengthen public services with mother and child programs (in Senegal)

 

  1. Unger J.-P. Can intensive campaigns dynamize front line health services ? The Evaluation of a Vaccination Campaign in Thiès Medical District, Senegal. Soc Sci Med 1991; 32(3): 249-259. Notice that this article also shows the importance of preventive medicine in public health

 

https://www.sciencedirect.com/science/article/abs/pii/027795369190101H

 

  • To improve the national drug distribution system (in Burkina Faso)

 

Unger JP & Yada A. Should Medication be Distributed in Africa by Health Services and/or pharmacies? A Preliminary Evaluation of the Boulgou project in Burkina Faso. Health Pol Plan 1993;8,3:240-246.


https://academic.oup.com/heapol/article-abstract/8/3/240/596261?redirectedFrom=fulltext

 


  • To use semi-quantitative epidemiological information to control diseases (in African local health systems)

 

Unger JP & Dujardin B. Epidemiology's contribution to health service management and planning in developing countries. Bulletin of WHO. 1992; 70,4:487-497


https://apps.who.int/iris/bitstream/handle/10665/51584/bulletin_1992_70%284%29_487-497.pdf?sequence=1&isAllowed=y

 

  • To control malaria (in Mali)

 

Unger JP, d'Alessandro U, De Paepe P, & Green A. Can malaria be controlled where basic health services are not used? Tropical Med Int Health. 2006; 11,3: 314-322.


http://bmj.bmjjournals.com/cgi/eletters/328/7448/1129#60538.

 

  • To stimulate GPs’ practice of family therapy (in LMICs)

 

Quinet A et al. Family Therapy in Developing Countries Primary Care. J Fam Med Dis Prev 2015;1:006


https://clinmedjournals.org/articles/jfmdp/jfmdp-1-006.pdf

 

  • To improve social assistance in medical practice (in Belgium)

 

Unger JP, Shelmerdine S, van der Veer C, & Roland M (2016) How can GPs Best Handle Social Determinants in Practice? Application in the Brussels Environment. J Fam Med Dis Prev. 2016 ;2:025 ;2, 1


http://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-2-025.php?jid=jfmdp 

 

  • To improve care coordination (in Latin America)

 

Vázquez ML, Vargas I, Unger JP, et al. Evaluating the effectiveness of care integration strategies in different healthcare systems in Latin America: the EQUITY-LA II quasi experimental study protocol. BMJ Open. 2015;5:e007037. doi:10.1136/bmjopen-2014- 007037


https://bmjopen.bmj.com/content/bmjopen/5/7/e007037.full.pdf

 

  • To control physicians’ and health professionals’ burnout

 

Unger JP. Physicians' Burnout (and That of Psychologists, Nurses, Magistrates, Researchers, and Professors) For a Control Program. Int J Health Serv. 2020;50(1):73-81. doi:10.1177/0020731419883525


https://journals.sagepub.com/doi/full/10.1177/0020731419883525

 

  • To improve clinical services with public health programs

 

J.-P. Unger. How could disease specific programs strengthen health systems delivering comprehensive health care? Strategic and technical guidelines. European Commission, DG DEV, 30 Sept 2008, Brussels

 

  • To get hospitals to strengthen regional healthcare services and professionals that sent patients to them

 

Unger J.-P. Les responsabilités systémiques des hôpitaux à finalité publique. Hospitals.be 2005, 1: 27-34.


 

  • To improve care coordination between healthcare tiers and introduce reflective thinking in health services

 

Unger J.-P. Les systèmes locaux de santé. Santé Conjuguée Oct 2004, 30: 29-32.


https://www.maisonmedicale.org/Sommaire-no30-La-recherche-action.html  (in French) 

 

  • To disseminate bio-psychosocial care in first line health services (in Ecuador)

 

Unger J. P., Van Dormael M., Criel B., Van der Vennet J., De Munck P. A plea for an initiative to strengthen family medicine in public health care services of developing countries. Int J Health Serv. 2002; 32(4): 799-815


https://www.jstor.org/stable/45131247?seq=1#metadata_info_tab_contents

 

  • To stimulate interdisciplinary teamwork with appropriate management of hospitals, health centres and in general, health services organization



Unger J.-P., Macq J., Bredo F., Boelaert M.Through Mintzberg's glasses: a fresh look at the organization of ministries of health. Bull WHO2000; 78(8): 1005-1014.

Unger, J. P., Macq, J., Bredo, F. & Boelaert, M. (‎2000)‎. Through Mintzberg's glasses: a fresh look at the organization of ministries of health.. Bulletin of the World Health Organization, 78 (‎8)‎, 1005 - 1014. World Health Organization.


https://apps.who.int/iris/handle/10665/268199


What are the desirable, heuristic particularities of research in professional, medical practice, and what distinguishes this research from scientific research?

 

Unger, JP., Morales, I. & De Paepe, P. Medical heuristics and action-research: professionalism versus science. BMC Health Serv Res 20, 1071 (2020). https://doi.org/10.1186/s12913-020-05888-x


https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05888-x