National Policy

Policy Brief: Strengthening Vital Statistics Systems

The Policy Brief has looked into different systems that produce data on causes of death and laid out some options and potential strategies that countries might follow to rapidly and cost-effectively improve the cause of death information that these systems produce. This in turn would greatly benefit national health planning and increase critical knowledge about disease burden in the region as well as provide accurate information about how it is changing. [from introduction]

Initiatives Supporting Evidence Informed Health System Policymaking in Cameroon and Uganda: A Comparative Historical Case Study

There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health policymaking (EIHSP) in Cameroon and Uganda.

Enrolment of Older People in Social Health Protection Programs in West Africa – Does Social Exclusion Play a Part?

We explore whether social exclusion determines enrolment of older people in Senegal’s Plan Sesame and Ghana’s NHIS. Social exclusion affects older people’s uptake of social health protection (SHP) programs in both Senegal and Ghana. Reducing financial barriers is not enough to achieve universal coverage.Efforts to cover older people at risk of social exclusion should be increased. Sociocultural, political and economic dimensions should be considered while designing SHP schemes. [from abstract]

Back to Basics: Designing an Appropriate Health Financing System

In striving for Universal Health Coverage, Jo Kemp advocates for a well-rounded assessment of health financing options. [from resource]

Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada. Policy Synthesis and Recommendations

To prepare this report, an interprofessional research team conducted in-depth interviews with key informants and
undertook a wide-ranging survey of peer-reviewed and grey literature on the components of teamwork; effectiveness of teams; types of interventions; healthcare team dynamics; and the impact of government infrastructure, legislation,
and policy on teamwork in the Canadian healthcare system. [from summary]

Connecting Health Information Systems for Better Health: Leveraging Interoperability Standards to Link Patient, Provider, Payor, and Policymaker Data

This e-book is a reference guide for countries wanting to link their universal health coverage and eHealth information systems using a standards-based approach. It provides a set of actionable steps and links to resources to develop a national eHealth standards framework. [adapted from resource]

District Health Barometer 2013/14

The 2013/14 District Health Barometer (DHB) provides an overview of the delivery of primary health care (PHC) in the
public health sector across the provinces and districts in South Africa. The DHB is widely known for providing data to inform the development of District Health Plans and the National Department of Health’s Annual Performance Plan; as such, the publication has been used extensively for strategic planning and district monitoring.

National Health Insurance and South Africa’s Private Sector

As limited information has emanated from government as to the role of the private health sector in the National Health Insurance (NHI), this chapter directs the enquiry towards the private health sector in order to establish what it perceives as its role in a post-reform healthcare industry. [from abstract]

Universal Health Coverage in Emerging Economies: Findings on Health Care Utilization by Older Adults in China, Ghana, India, Mexico, the Russian Federation, and South Africa

The achievement of universal health coverage (UHC) in emerging economies is a high priority within the global community. This timely study uses standardized national population data collected from adults aged 50 and older in China, Ghana, India, Mexico, the Russian Federation, and South Africa. The objective is to describe health care utilization and measure association between inpatient and outpatient service use and patient characteristics in these six low- and middle-income countries. [from abstract]

Picking Up the Bill - Improving Health-Care Utilisation in the Democratic Republic of Congo Through User Fee Subsidisation: A Before and After Study

Our research brings mixed findings on the effectiveness of user fee subsidisation as a strategy to increase the utilisation of services. Future work should focus on feasibility issues associated with the removal or reduction of user fees and how to sustain its effects on utilisation in the longer term. [from abstract]

Investing in Health Systems for Universal Health Coverage in Africa

This study focused on the 47 Member States of the World Health Organization (WHO) African Region. The specific objectives were to prepare a synthesis on the situation of health systems’ components, to analyse the correlation between the interventions related to the health Millennium Development Goals (MDGs) and some health systems’ components and to provide overview of four major thrusts for progress towards universal health coverage (UHC). [from abstract]

How Much Will Health Coverage Cost? Future Health Spending Scenarios in Brazil, Chile, and Mexico

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.

Effective Coverage: A Metric for Monitoring Universal Health Coverage

A major challenge in monitoring universal health coverage (UHC) is identifying an indicator that can adequately capture the multiple components underlying the UHC initiative. Effective coverage, which unites individual and intervention characteristics into a single metric, offers a direct and flexible means to measure health system performance at different levels. We view effective coverage as a relevant and actionable metric for tracking progress towards achieving UHC.

Global Governance for Health

The authors address the issue of governance in health from a critical standpoint, taking globalization as the core focus. They discuss the issue of governance in health based on the trend of stimulating world production/consumption in accordance with the interests of developed countries. [from abstract]

The Production, Distribution, and Performance of Physicians, Nurses, and Midwives in Indonesia: An Update

Indonesia launched the national health insurance program - Jaminan Kesehatan National (JKN) - on January 1, 2014, and aims to achieve universal health coverage (UHC) by 2019. Achieving UHC means not only increasing the number of people covered but also expanding the benefits package and ensuring financial protection. Although the JKN benefits package is comprehensive, a key challenge related to the capacity to deliver the promised services is ensuring the availability, distribution, and quality of human resources for health (HRH). [from abstract]

Universal Health Coverage for Inclusive and Sustainable Development: Lessons from Japan

This report brings together 10 in-depth studies on different aspects of Japan’s UHC [Universal Healthcare Coverage] experience, using a common framework for analysis focused on the political economy of UHC reform, and the policies and strategies for addressing challenges in health financing and human resources for health. Japan’s commitment to UHC played a key role in the country’s economic recovery after World War second, and helped ensure that the benefits of economic growth were shared equitably across the population. [from abstract]

Making the Post-MDG Global Health Goals Relevant for Highly Inequitable Societies: Findings From A Consultation with Marginalized Populations in Guatemala

Achieving health goals in a context of deep-rooted inequality and marginalization requires going beyond the simple expansion of health services and working with developing trusting relationships between health service providers and community members. Involving community members in decision-making processes that shape policies will contribute to a
larger process of community empowerment and democratization. [from abstract]

Health Financing in the Republic of Gabon

This is a review of the health financing situation in the Republic of Gabon. The book reviews the situation in the country under the lens of the principles of health financing: revenue mobilization for health, risk pooling, and purchasing services. [from abstract]

Universal Health Coverage for Inclusive and Sustainable Development: A Synthesis of 11 Country Case Studies

The goals of Universal Health Coverage (UHC) are to ensure that all people can access quality health services, to safeguard all people from public health risks, and to protect all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. [from resource]

Exploring the Nature of Governance At The Level of Implementation For Health System Strengthening: The DIALHS Experience

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]

Patient Satisfaction with Task Shifting of Antiretroviral Services in Ethiopia: Implications for Universal Health Coverage

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.

Integrating National Community-Based Health Worker Programmes into Health Systems: A Systematic Review Identifying Lessons Learned From Low-and Middle-Income Countries

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]

Assessing the Quality of Primary Healthcare Services in Kenya: Evidence from the PETS-PLUS Survey 2012

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]

Health Systems Governance in Tanzania: Impact on Service Delivery in the Public Sector

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]

Human Resource Development for Health in Indonesia: Challenges of Achieving the Millennium Development Goals

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.

In the Shadowlands of Global Health: Observations from Health Workers in Kenya In The Shadowlands of Global Health: Observations From Health Workers in Kenya

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.

Strengthening Health Centre Committees as a Vehicle for Social Participation in Health in East and Southern Africa

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]

Prioritizing Integrated mHealth Strategies for Universal Health Coverage

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.

Quality Use of Medicines within Universal Health Coverage: Challenges and Opportunities

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]

Does More Equitable Governance Lead to More Equitable Health Care? A Case Study Based on the Implementation of Health Reform in Aboriginal Health Australia

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]