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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]

Female Community Health Volunteers (FCHVs) are considered service providers for major health problems at the community level in Nepal. However, few studies have been conducted about the roles of FCHVs from the users’perspective. This study sought to examine the current status of FCHV service utilization and identify the determinants of caregivers’utilization of FCHVs’health services in the mid-western region of Nepal. [from abstract]

Despite the growing interest in the private health sector in low- and middle-income countries, little is known about physicians working outside the public sector. The paper’s objective is to contribute to the understanding of such physicians, ultimately informing the policies regulating the medical profession in low- and middle-income countries. [adapted from abstract]

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.

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.

Worldwide there are different systems for providing pharmacy services. Most countries have some element of state assistance,either for all patients or selected groups such as children, and some private provisions. Medicines are financed either through cost sharing or full private. The role of the private services is therefore much more significant. Nationally, there is a mismatch between the numbers of pharmacists and where are they worked, and the demand for pharmacy services. [from abstract]

Interactions between patients and service providers frequently influence uptake of prevention of mother-to-child
transmission (PMTCT) HIV services in sub-Saharan Africa, but this process has not been examined in depth. [from abstract]

Quality of care plays an important role in the status of tuberculosis (TB) control, by influencing timely diagnosis, treatment adherence,and treatment completion. In this study,we aimed at establishing the quality of TB service care in Kamuli district health care centres using Donabedian structure, process, and outcomes model of health care. One of the worst performance indicators was low percentage of cure.

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]

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!

The Ebola epidemic has highlighted the importance of bridging trust and building common goals between the health profession and the communities they serve. [from introduction]

The aim of this study is to define the research capacity and training needs for professionals working on non-communicable diseases (NCDs) in the public health arena in Turkey. [from abstract]

Access to medical staff differs across Europe. In 2011, the country that had the smallest number of physicians in all European Union was Poland. During last ten years, the number of doctors per capita increased in all European countries except Poland and Estonia. The aim of the study is to analyse the availability of medical staff in Poland and selected EU countries in the years 2003-2011. [from abstract]

The study sought to investigate the factors contributing to the high turnover of clinical staff at two Catholic Health Services (CHS) hospitals of Andara and Nyangana in the Kavango region of Namibia. The conceptual framework, factors related to the decision to stay in or leave rural and remote areas, was adapted from Henderson and Tulloch (2008) and guided this study. [from abstract]

This research was aimed mainly at determining the significance of the primary health care learning programme in health care service delivery, focusing mainly in the Ehlanzeni Health district of Mpumalanga Province [South Africa]. The focus was on how professional nurses trained in the Primary Health Care programme confidently apply the skills and expertise to the benefit of clients in community health facilities. [from abstract]

In this article, we open the debate on whether or not South Africa’s Youth-friendly Services (YFS) programmes should be linked to community health worker (CHW) programmes. Both are important in South Africa’s efforts to re-engineer primary healthcare in the country. This article presents the pros and cons of linking the two programmes by incorporating YFS into the current list of CHW competencies. Also, we explore the alternative of training specialist CHWs to deliver YFS. [from abstract]

There is an evolving need for better utilization of ICT resources which are direct, cost effective, time-saving, and highly persuasive in pursuit of quality healthcare delivery. Therefore this research proposes a ten-layer ICT model converging advanced Mobile and Internet interventions, to disseminate health messages for patients suffering from fatal diseases. Using breast cancer as an instance, a communication strategy is exemplified using the ten-layer model.

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]

Infant Mortality Rate (IMR) is one of the most vital health indicators. A number of factors impact and
influence IMR. One of the most important ones could be public health spending. Health spending however is not
uniform throughout Asia and varies from region to region. [from abstract]

This article presents results from a study that explored the association between community capacity for maternal health promotion and women’s use of preventive and curative maternal health services. Implemented in the Republic of Guinea, the intervention aimed to build the capacity of community-level committees to heighten awareness about maternal health risks and to promote use of professional maternal health services throughout pregnancy and childbirth. Data were collected through a population-based survey. [from abstract]

This paper assesses some analytical problems and approaches towards improving the utilization of primary health care services by the rural communities in Nigeria. This article examines some cross cutting issues in [Primary Health Care] PHC and outlines approaches to improve the use of health services by rural people. [adapted from abstract]

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]

Health facilities in rural, resource limited settings face multiple challenges responding to a growing demand for HIV treatment, including lack of adequate numbers of trained health workers. Many programs have used community health support workers (CHSWs) to provide specific services related to HIV care, and to complement facility-based treatment. [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.

The public health sector in South Africa faces a number of human resource–related inundations. Solving these challenges requires the provision of empirically derived information on these matters. This study investigated the relationship between three work-related factors, person-environment fit, work-family balance and perceived job security, and employee satisfaction and organisational commitment. A conceptual framework that links these factors is proposed and tested. [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.

Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth.