Documents & Reports

It is in the context of Ghana’s persistently high number of maternal deaths that the Integrated Social Development Centre (ISODEC) is simulating two policy scenarios: (1) Training and deploying Skilled Birth Attendants (SBAs) at health centers in the five worst affected regions of Ghana by the year 2015 and (2) Training and deploying SBAs at district hospitals in the five worst affected regions of Ghana by the same year to find out if one or both will help Ghana achieve, or be close to achieving, the MDG 5 target of a maternal mortality rate of 185 per 100,000 live births by 2015.

Decentralization of family planning is a critical concern for policymakers as international family planning commitments and the expansion of decentralization reforms become more common. Building on the latest research, this paper presents a family planning and decentralization analytical framework that was developed by the USAID-funded Health Policy Project to help key stakeholders better understand family planning decentralization processes, identify potential challenges and opportunities, and guide decentralization reforms. [from abstract]

Health investments in Kenya have increased in the past two decades, resulting in the expansion of service delivery and improvements in the quality of health services. Although devolution in Kenya provides better opportunities for increasing access to high-quality healthcare services, if the transition is not well managed it may erode the gains made over the last decade, especially in maternal and child health. [from introduction]

India faces critical human resources shortages for key cadres such as doctors, specialists, nurses, and midwives. Other key challenges include suboptimal deployment of staff exacerbated by a skewed urban-rural distribution, gaps in certain specialties, and inefficient use of staff due to poor rationalization of tasks. Lack of comprehensive, reliable, and up-to-date data and an absence of commonly agreed definitions and analytical tools make the task of managing the health workforce more difficult.

In the last decade, evidence has emerged that user fees are regressive and undermine equitable access to essential health services, particularly for women and children. It is against this background that the government of Kenya took decisive action to remove user fees in dispensaries and health centers and to provide free maternal health services at all public health facilities in an effort to increase access to essential health services and reduce maternal mortality. [adopted from introduction]

The aim of this research was to contribute to a better understanding of health system governance and apply this knowledge to the Tanzanian health system. The insights gained should aid policy makers and other stakeholders to design
interventions that are appropriate for the local context to ensure a stronger health system which is able to attain its goals of improving the level and distribution of health, while responding to the population’s needs and protecting them from large, often catastrophic financial expenditures. [from introduction]

Community-based monitoring and planning (CBMP) of health services in Maharashtra state, India represents an innovative participatory approach to improving accountability and healthcare delivery. This paper examines the successes and challenges of this process, discussing lessons learned and the potential for generalizing such initiatives to other sectors and regions. Maharashtra’s experiment could inform ‘communitization’ of health services in diverse contexts, as an alternative to
privatization and as a means to enhancing the ‘publicness’ of health services. [from summary]

Fragile and Conflict Affected States present difficult contexts to achieve health system outcomes and are neglected in health systems research. This report presents key debates from the Consultation of the Collaboration for Applied Health Research and Delivery, Liverpool, June, 2014.

Social participation in health systems has been a consistent element of post-independence health policies in east and Southern African (ESA) countries and central to primary health care (PHC). The Regional Network for Equity in Health in east and southern Africa (EQUINET) 2007 Regional Equity analysis highlighted that social participation and power are key for equitable health systems, and for reclaiming and using resources for health. [from introduction]

This synthesis report is part of the Regional Network for Equity in Health (EQUINET) programme of work on Contributions of global health diplomacy to health systems in sub-Saharan Africa: Evidence and information to support capabilities for health diplomacy in east and southern Africa. The programme aims to identify factors that support the effectiveness of global health diplomacy (GHD) in addressing selected key challenges to health strengthening systems in eastern and southern Africa (ESA). [from introduction]

African community activists have long recognized the need to strengthen the voices of African advocates and civil
society working to improve health and wellbeing across the continent. With funding from the United States Agency for
International Development (USAID), PATH helped former tuberculosis (TB) patients from five African countries to
build on the previous efforts of their colleagues to create a strong core organization—the Africa Coalition on
Tuberculosis (ACT!)—and then expand ACT!

Health professional schools are important in that they produce health workers, the major input in the health system. Not only are labor costs a central part of the health budget, but the majority of all health system costs are determined by health worker variables. The practice behaviors and personal preferences of health workers will determine the communities in which they work and whether they practice primary or specialty care. In some countries, the amount of study and the magnitude of educational debt with which health workers graduate also significantly affect their practice behavior.

This document provides an overview of the HRH labour market in Sudan, highlighting the importance of a comprehensive approach to understanding the driving forces that affect the supply and demand for health workers, in order to provide a basis for developing effective HRH polices that can contribute to progress towards universal health coverage. [from abstract]

Indonesia is striving to achieve the Millennium Development Goal 4 target of less than 23 infant deaths per 1000 live births by 2015. In order to reach this target, a community case management (CCM) model, was introduced by the American funded Maternal and Child Health Integrated Program (MCHIP) and the Indonesian Ministry of Health (MoH) in 2011. Little is known about how CCM has been delivered and there is no research that examines the factors that contribute to the successful implementation of CCM in Indonesia.

This paper presents the results of two field experiments on local accountability in primary health care in Uganda. Efforts to stimulate beneficiary control, coupled with the provision of report cards on staff performance, resulted in significant improvements in health care delivery and health outcomes in both the short and the longer run. Efforts to stimulate beneficiary control without providing information on performance had no impact on quality of care or health outcomes.

The health systems of most countries in the region are characterized by the provision of services through both public and private providers, often in parallel or in competition with each other. This has raised the option for governments to purchase services from the private sector, to address gaps in services particularly for the poor and underserved. This policy brief reviews the evidence base of government purchasing primary care services from the private sector.

Health and well-being services, in common with many public services, cannot be delivered by a single organisation and require co-ordination across several organisations in a locality. There is some evidence, mostly from other sectors, that middle managers play pivotal roles in this co-ordination by developing networks of relationships with colleagues in other organisations. These networks of relationships, established over time, provide contexts in which managers can, collectively, create the knowledge needed to address the challenges they encounter.

Using online discussion forums can have a positive impact on psychological well-being through development of shared group identity and validation of thoughts, feelings and experiences. This may be particularly beneficial to people with complex regional pain syndrome (CRPS), who often become socially isolated, lack mobility and face threats to their sense of identity. We set up a peer-support online forum to identify the nature of support provided and to explore its development over time.

The leaflet, “Components of a Strong Health Information System” briefly explains the six key components that help countries develop their own health information systems in a way that empowers all those who contribute to and benefit from health information. The six key components include three categories of inputs, processes and outputs of HIS reform. [from introduction]
Companion piece to http://www.hrhresourcecenter.org/node/5925

The JAHR 2013 report assesses progress in implementing the tasks laid out in the Five-year health plan 2011–2015, as well as results of implementing the Five-year plan targets and Millennium Development Goals (MDGs). At the same time the report contains an in-depth analysis on “Universal health care coverage”. [from introduction]

The HMN Framework explains why and how countries can build stronger systems to gather, manage, analyse and distribute health information. The Framework describes the elements that help to make a system effective, how they can be evaluated, and the principles that empower countries to build and strengthen their systems according to an agreed standard. [from introduction]
Companion piece to http://www.hrhresourcecenter.org/node/5927

Special and emergency hiring programs entail the use of processes and mechanisms that are outside of the primary, nationally institutionalized human resource frameworks. Specifically, we sought to assess whether these approaches avert some of the challenges that undercut optimal deployment, long-term retention, and the rational assignment of transfers. Do efforts outside of the “regular” system bypass the P&T challenges of the “normal” system? Why? [from introduction]

Burkina Faso faces a daunting family planning (FP) challenge. While the use of any modern contraceptive method
more than tripled between 1993 and 2006, the unmet need for FP remains high, at 31.1% among married women. Long-acting methods (IUDs and implants)and permanent methods (female sterilization and vasectomy) are the most effective
of all FP methods. However, use of long-acting and permanent methods of contraception (LA/PMs) in Burkina Faso remains
low, at 13% of the overall method mix. [adapted from source]

One challenge that community health workers face when they provide hormonal contraceptives to new clients is ruling out pregnancy. A randomized controlled trial in Madagascar found that offering the health workers pregnancy tests to distribute for free increases their number of new contraceptive clients. [from introduction]

In 2012, Pathfinder conducted a study to explore whether CHWs who are intended to promote family planning as part of an integrated package of services do communicate with beneficiaries about family planning, and what actions women take based on these messages. The study also explored whether CHWs are reaching the poor, marginalized and vulnerable, and examined the costs of implementing the CHW component of the SCIP project. [from executive summary]

Health care is labor intensive and managers strive to identify a mix of staff that can safely deliver a range of services using available resources. In many developing countries,primary-level workers, auxiliary staff, and community health workers (CHWs) are being trained to assume roles and perform functions traditionally reserved for mid- or high-level cadres of health workers as a means of optimizing the number and capacity of available providers.

This guidebook is intended to complement the many excellent health literacy resources that already exist and are emerging every day, and to help organizations of any size use them to become health literate health care organizations. Health literate health care organizations “make it easier for people to navigate, understand, and use information and services to take care of their health. [from introductions]

This report documents the efforts and contributions made by USAID through the Innovations in Family Planning Services (IFPS) Project towards capacity building and strengthening of public and private institutions in the health sector
in India. The report highlights the support rendered at the national level and in three Indian states: Uttar
Pradesh, Uttarakhand, and Jharkhand. [from introduction]

The official report for the 9th International Conference on ICT for Development, Education & Training, which took place from May 28 to 30, 2014 in Kampala, Uganda. [adapted from publisher]

The study was conducted to better understand the roles and functions of the health workforce responsible for managing patient transitions to and from hospitals and nursing homes in New York’s downstate region to reduce the number of readmissions and to improve care transitions. [adapted from introduction]