Policy

This article presents a South African case study of an intervention to address conflict in roles and responsibilities between multiple actors supporting service delivery at the local level, and explores the broader insights this experience generates about the nature of local health system governance. [from abstract]

Formalized task shifting structures have been used to rapidly scale up antiretroviral service delivery to underserved populations in several countries, and may be a promising mechanism for accomplishing universal health coverage. However, studies evaluating the quality of service delivery through task shifting have largely ignored the patient perspective, focusing on health outcomes and acceptability to health care providers and regulatory bodies, despite studies worldwide that have shown the significance of patient satisfaction as an indicator of quality.

This booklet communicates fundamental concepts about the importance of health inequality monitoring, using text, figures, maps and videos. This report illustrates four general principles pertaining to health inequalities are highlighted: health inequalities are widespread; health inequality is multidimensional; benchmarking puts changes in inequality in context; and, health inequalities inform policy. [Adapted from introduction]

Despite the development of national community-based health worker (CBHW) programmes in several low- and middle-income countries, their integration into health systems has not been optimal. Studies have been conducted to investigate the factors influencing the integration processes, but systematic reviews to provide a more comprehensive understanding are lacking. [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]

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]

The development of Human Resources for Health (HRH) is one of the keys to achieving The Millennium Development Goals (MDG). Providing and ensuring the best health care service in every region of Indonesia has long been a major concern. Several challenges faced by HRH development are a shortage of professionals, uneven distribution of professionals between regions, a variety of settings (urban and rural), and management of the health workforce under a
decentralization system. This paper aims to assess the HRH progress made toward achieving the health-related MDGs.

During the past decade, donor funding for health interventions in Kenya and other African countries has risen sharply. Focused on high-profile diseases such as HIV/AIDS, these funds create islands of intervention in a sea of under-resourced public health services. This paper draws on ethnographic research conducted in HIV clinics and in a public hospital to examine how health workers experience and reflect upon the juxtaposition of ‘global’ medicine with ‘local’ medicine. We show that health workers face an uneven playing field.

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]

As countries strive toward universal health coverage, mobile wireless technologies—mHealth tools—in support of enumeration, registration, unique identification, and maintenance of health records will facilitate improved health system performance. Electronic forms and registry systems will enable routine monitoring of the coverage of essential interventions for individuals within relevant target populations. A cascading model is presented for prioritizing and operationalizing the role of integrated mHealth strategies.

The Global Outbreak Alert and Response Network (GOARN) was established in 2000 as a network of technical institutions, research institutes, universities, international health organisations and technical networks willing to contribute and participate in internationally coordinated responses to infectious disease outbreaks. It reflected a recognition of the need to strengthen and coordinate rapid mobilisation of experts in responding to international outbreaks and to overcome the sometimes chaotic and fragmented operations characterising previous responses. [from abstract]

Medicines are a major driver of quality, safety, equity, and cost of care in low and middle-income country health systems. Universal health coverage implementers must explicitly address appropriate use of medicines to realize the health benefits of medicines, avoid wasting scarce resources, and sustain the financial viability of universal health coverage schemes. [from abstract]

Health systems interventions, such as capacity-building of health workers, are implemented across districts in order to improve performance of healthcare organisations. However, such interventions often work in some settings and not in others. Local health systems could be visualised as complex adaptive systems that respond variously to inputs of capacity building interventions, depending on their local conditions and several individual, institutional, and environmental factors.

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).

Patient’s satisfaction is one indicator of healthcare quality. Few studies have examined the inpatient experiences in resource-scarce environments in sub-Saharan Africa. This paper examines patient’s satisfaction on the public medical wards at a Kenyan referral hospital, we performed a cross-sectional survey focused on patient’s satisfaction with medical information and their relationship with staffing and hospital routine. Ratings of communication with providers, efforts to protect privacy, information about costs, food, and hospital environment were also elicited. [adapted from abstract]

There is growing evidence that providing increased voice to vulnerable or disenfranchised populations is important to improving health equity. In this paper we will examine the engagement of Aboriginal community members and community controlled organisations in local governance reforms associated with the Aboriginal Health National Partnership Agreements (AHNPA) in Australia and its impact on the uptake of health assessments. [from abstract]

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]

Universal health coverage (UHC) is the means to provide accessible and appropriate health services to all citizens without financial hardships. India, an emerging economy with demographic window of opportunity has been facing dual burden of diseases in midst of multiple transitions. Health situation in the country despite quantum improvements in recent past has enormous challenges with urban-rural and interstate differentials. Successful national programs exists, but lack ability to provide and sustain UHC.[from abstract]

One of the main goals of Human Resource Management (HRM) is to increase the performance of organizations. However, few studies have explicitly addressed the multidimensional character of performance and linked HR practices to various outcome dimensions. This study therefore adds to the literature by relating HR practices to three outcome dimensions: financial, organizational and employee (HR) outcomes. Furthermore, we will analyze how HR practices influence these outcome dimensions, focusing on the mediating role of job satisfaction. [from abstract]

This report describes the proceedings and main outcomes of the Third Global Forum on Human Resources for Health in Recife, Brazil, from 10 to 13 November 2013.

Participation is a key policy concept in global health, and relates to the ability of stakeholders to engage with and shape health policy at four intersecting levels: Local, national, regional and global. Such engagement remains the key normative aim behind debates about furthering more equitable health diplomacy and has, as a result, been increasingly integrated into the agenda of global agencies, including the Global Fund to Fight AIDS, TB and Malaria and the World Bank. [from executive summary]

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]

Health policies impact on nursing profession and health care. Nurses’ involvement in health policy development ensures that health care is safe, of a high quality, accessible and affordable. Numerous factors influence nurse leaders’ ability to be politically active in influencing health policy development. These factors can be facilitators or barriers to their participation. There is scant research evidence from Eastern African region that draws
attention to this topic. This paper reports part of the larger study. [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]

To examine linkages between family planning and health and development outcomes, the CSIS Global Health Policy Center led a delegation to Ethiopia in February 2014.

In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work.

WHO policy brief that includes recommended policy and program actions for expanding access to Family Planning.

In 2005, India embarked on the National Rural Health Mission, an extraordinary effort to strengthen the health systems. However, coverage of priority interventions remains insufficient, and the content and quality of existing interventions are suboptimum.

Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance.