Health Sector Reform

Older persons report poor health status and greater need for healthcare. However, there is limited research on older persons’ healthcare disparities in Uganda. Therefore, this paper aimed at investigating factors associated with older persons’ healthcare access in Uganda, using a nationally representative sample. [from abstract]

No study to date has focused on how the decisions made, or not made, in the post-conflict
period can affect the longer term pattern of attraction, retention, distribution and
performance of health workers, and thus ultimately the performance of the sector. [from abstract]

Despite numerous persistent challenges – including low quality of care, continuing inequalities and the substantial impact of the HIV/AIDS pandemic – Mozambique provides important lessons to other countries aiming to scale up health provision rapidly in a post-conflict setting. These particularly include the importance of focusing on distance and education as barriers to access, using innovative and low-cost human-resource policies to scale up health personnel quickly, and of moving towards more coordinated systems of aid disbursement. [from abstract]

In the Dominican Republic, the Ministry of Health is improving to access to high-quality health services by focusing on the health workforce and, in particular, the systems used to manage these valuable human resources. One important outcome has been the discovery of a large number of people on the payroll who were no longer working. The money saved by cleaning the payroll is being reinvested into the health sector. [from resource]

As Latin American countries seek to expand the coverage and benefits provided by their health systems under a global drive for universal health coverage (UHC), decisions taken today – whether by government or individuals – will have an impact tomorrow on public spending requirements. To understand the implications of these decisions and define needed policy reforms, this paper calculates long-term projections for public spending on health in three countries, analyzing different scenarios related to population, risk factors, labor market participation, and technological growth.

Performance-Based Financing (PBF) has been advanced as a solution to contribute to improving the performance of health systems in developing countries. This is the case in Benin. This study aims to analyse how two PBF approaches, piloted in Benin, behave during implementation and what effects they produce, through investigating how local stakeholders perceive the introduction of PBF, how they adapt the different approaches during implementation, and the behavioural interactions induced by PBF. [from abstract]

Unfortunately, with its current estimated population of 150 million and estimated total of 23,640 health facilities operated via a three – tiered governance structure, Nigeria is still ranked by World Health Organization at 187th position in its health system among 191 member states. This article reviewed related relevant literature which revealed that, for more than two decades ago, African countries including Nigeria have been plunged into economic crisis which seriously affected a large portion of their populations and raised social and political tensions.

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]

Indonesia is one of the countries in the world which has a decentralized model of government. The decentralization in the form of regional autonomy aims to improve the public welfare through public services. The services, especially the health service depends much on the wide area and also the geographical condition of the regional. Thus, it is necessary to do an analysis of systems towards the health service from the catchment area perspectives to solve the present and future problems. [adapted from abstract]

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.

Lauded for getting specific health issues onto national and international agendas and for their potential to improve value for money and outcomes, public-private global health initiatives (GHIs) have come to dominate global health governance. Yet, they have also been criticised for their negative impact on country health systems. In response, disease-specific GHIs have, somewhat paradoxically, appropriated the aim of health system strengthening (HSS).

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]

Performance-based incentives (PBIs) aim to counteract weak providers’ performance in health systems of many developing countries by providing rewards that are directly linked to better health outcomes for mothers and their newborns. This paper analyzes and synthesizes the available evidence from published studies on the impact of supply-side PBIs on the quantity and quality of health services for mothers and newborns. This paper reviews evidence from published and grey literature that spans PBI for public-sector facilities, PBI in social insurance reforms, and PBI in NGO contracting.

This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability. Licensing, price controls, and other traditional approaches to the regulation of markets for health products and services have played an important role, but they have been of questionable effectiveness in ensuring safety and efficacy at the point of the user in LMICs. [from abstract]

The purpose of this paper was to critically review the various initiatives that the government of Kenya has over the years initiated
towards enhancement of universal coverage in terms of policy reforms including health care financing. [from abstract]

The [National Health Service] is confronted by radically changing demographic pressures and hugely increasing demands. Alongside these is the need to build public confidence after several high-profile scandals, to increase productivity and to promote innovation in health and social care. This all comes as public sector financial cuts are implemented on a large scale. How can health care organisations respond effectively to these challenges? [from introduction]

Human Resource for Health production was started in Nepal in a limited way some eighty years ago and picked up a
somewhat faster pace from the 1950s as per the requirements at that time. The establishment of the Institute of Medicine
led to some diversification but it was only after 1990 that there has been a much larger involvement of the private sector
in the production of Human Resources for Health. Although a number of categories have been listed in this article, the
position of doctors, dentists and nurses has been dealt with in more detail. [from abstract]

Building on the experience in several countries, this course draws on practices and analyses to provide participants with an understanding of factors bearing on the success of private sector health education and training.

This technical highlight provides a brief overview of Pathfinder’s experience implementing the Kenyan Community Strategy through the USAID-funded APHIAplus (AIDS, Population, and Health Integrated Assistance Plus) Nairobi-Coast project (2011-2014). [from abstract]

Reflecting on service delivery in northern, rural or remote Canada, Dr. Roger Strasser (Dean of the Northern Ontario School of Medicine) and Erin Leith (Director, Collaboration for Innovation and Improvement, Canadian Foundation of Healthcare Improvement) discuss the significant momentum generated by the Canadian Recruit and Retain Conference and the influence and impact this will have on healthcare in these often under-served regions. [from introduction]

This study helps government and donors to understand how local government and service delivery work and to assess whether the return of local councils is likely to improve their functioning. [from introduction]

This paper examines three groups of innovative ideas have been institutionalized in African countries to improve maternal health: policy, institutional and experimental innovations. [adapted from abstract]

External challenges to health systems have received little attention in recent years, including the increase of prices for petroleum-based products. Health systems are significant consumers of fossil fuels in the form of petroleum-based medical supplies; transportation of goods, personnel and patients; and fuel for lighting, heating, cooling and medical equipment. Long-term increases in petroleum prices in the global market will have potentially devastating effects on health sectors who already struggle to deliver services to remote parts of their catchment areas. [adapted from abstract]

It has been more than 20 years since the 1988 Constitution formally established the Brazilian Unified Health System (Sistema Único de Saúde, SUS), which established health as a fundamental right and duty of the state and started a process of fundamentally transforming Brazil’s health system. The report assesses whether the SUS reforms have transformed the health system as envisaged more than 20 years ago and whether the reforms have led to improved outcomes with regard to access to services, financial protection, and health status. [adapted from introduction]

This paper presents a framework for assessing the interactions between performance-based financing (meaning performance-based incentives are earned by service providers) and health systems, focusing on low and middle income countries in order to develop a framework for monitoring and evaluating health system reforms in general. [adapted from author]

This article examines and documents the experiences facing the implementation of decentralization of health services from the perspective of national and district officials, including inadequate funding, untimely disbursement of funds from the central government, insufficient and unqualified personnel, lack of community participation in planning and political interference. [adapted from author]

Enacting appropriate changes in both regulation and education of nurses requires engagement of national regulatory bodies, and key stakeholders such as government chief nursing officers, professional associations, and educators. The purpose of this research is to describe the perspectives and engagement of these stakeholders in advancing critical regulatory and educational reform in east, central, and southern Africa. [adapted from abstract]

This review documents the ways in which primary health care, specifically human resources in primary health care, has been evaluated in low- and middle income countries with a focus given to countries that have undergone health sector reforms similar to Vietnam. [adapted from author]

The purpose of this study was to investigate the performance of health workers after decentralisation of the health services in Uganda in order to identify and suggest possible areas for improvement. [from abstract]

The case study outlines a program of nursing reform in Egypt to correct shortages and improve nursing quality by restructuring nursing education.