Sub-Saharan Africa

This chapter gives an account of one relatively modest but effective intervention in an orthopaedic outpatient clinic at the New Somerset Hospital (NSH) in Cape Town in 2013. This project aimed to reduce patient waiting times in the clinic, and improve patient satisfaction. [from introduction]

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]

This chapter reviews progress made by the health sector in implementing the eHealth Strategy 2012–2016, which was approved by the Ministry of Health and published in July 2012. The finalisation of this Strategy following
several attempts, and its placement in the public domain, created optimism that a clear vision for improving health information systems in South Africa had been successfully articulated. [from introduction]

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]

The general objective of the study was to assess the effect of integrating mobile communication strategies, as part of existing health service packages, on maternal and newborn health (MNH) service utilization in one health district, Bombali, in Sierra Leone. [from executive summary]

In an effort to support country-wide learning in improvement initiatives, the USAID ASSIST Project conducted an information needs assessment with government and non-governmental organization (NGO) staff working at the national and district levels of the Ugandan health system from March 2014 to June 2014.

The World Health Organization (WHO) has developed a new strategy on people-centered health care that places a strong focus on the re-orienting the health system as a whole, including the importance of engaging community and patient groups. ASSIST principles of people-centeredness are complementary to the WHO strategy, particularly with respect to coordination and continuity of care, information, and the micro-level interactions between a client and the health care service delivery team that promote or hinder people-centeredness.

These Standard Operating Procedures aim to clarify the responsibilities and procedures for effective management of aggregated routine health services. These SOPs for provinces present basic and practical steps to be followed by
provincial health information management personnel, programme/line managers and clinic supervisors at provincial level to ensure that data is appropriately handled and used to improve service delivery at local level, prior
to submission to next level of the health system, within the specified time frames.

These Standard Operating Procedures aim to clarify the responsibilities and procedures for effective management of aggregated routine health services. These SOPs for the National DoH present basic and practical steps to be
followed by national health information management personnel, programme/line managers and clinic supervisors at national level to ensure that data is appropriately handled and used to improve service delivery at local level, prior
to submission to next level of the health system, within the specified time frames.

The objective of the prevention of Mother-to-Child Transmission (pMTCT) cascade analysis tool is to
provide frontline health managers at the facility level with the means to rapidly, independently and quantitatively
track patient flows through the pMTCT cascade, and readily identify priority areas for clinic-level improvement
interventions. [from abstract]

Definitions of fragile states focus on state willingness and capacity to ensure security and provide essential
services, including health. Conventional analyses and subsequent policies that focus on state-delivered essential services miss many developments in severely disrupted healthcare arenas. The research seeks to gain insights about the large sections of the health field left to evolve spontaneously by the absent or diminished state. ]from abstract]

In this qualitative descriptive study, we explored the perceived impact and sustainability of the first accredited
Paediatric Nursing Training Programme (PNTP) in Ghana, established in 2010 by a north-south Ghanaian-Canadian
partnership to address child health care access and quality issues in the country. [from abstract]

The increasing number of people requiring HIV treatment in South Africa calls for efficient use of its human
resources for health in order to ensure optimum treatment coverage and outcomes. This paper describes an innovative
public-private partnership model which uses private sector doctors to treat public sector patients and ascertains the
model’s ability to maintain treatment outcomes over time. [from abstract]

Health care workers are exposed to different kinds of occupational hazards due to their day to day activities. The most common occupational exposure like body fluids are a potential risk of transmission of blood born infection like human immunodeficiency virus. [from abstract]

This article analyzes community health workers’ (CHW) capacities for empathic service within an AIDS treatment program in Addis Ababa. I show how CHWs’ capacities to build relationships with stigmatized people, reconcile family disputes, and confront death draw on a constellation of values, desires, and emotions encouraged by CHWs’ families and religious teachings. I then examine the ways in which the capacities of CHWs were valued by the
institutions that deployed them.

In 2003, the Government of Ethiopia launched the Health Extension Programme and introduced a new cadre, health extension workers (HEWs), to improve access to care in rural communities. In 2013, to inform the government’s plans for HEWs to take on an enhanced role in community-based newborn care, a time and motion study was conducted to understand the range of HEW responsibilities and how they allocate their time across health and non-health activities. [from abstract]

The importance of health policy and systems research and analysis (HPSR?+?A) has been increasingly recognised, but it is still unclear how most effectively to strengthen the capacity of the different organisations involved in this field. Universities are particularly crucial but the expansive literature on capacity development has little to offer the unique needs of HPSR?+?A activity within universities, and often overlooks the pivotal contribution of capacity assessments to capacity strengthening. [from abstract]

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]

Taking a perspective of frontline health workers as internal clients within health systems, this study explored how perceived injustice in policy and organizational matters influence frontline health worker motivation and the consequent effect on workers’ attitudes and performance in delivering maternal and neonatal health care in public hospitals. [from abstract]

To improve monitoring and evaluation (M&E) of health programs in Botswana, 51 recent university graduates with no experience in M&E were recruited and provided with on-the-job training and mentoring to develop a new cadre of health worker: the district M&E officer. Three years after establishment of the cadre, an assessment was conducted to document achievements and lessons learnt. [from abstract]

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.

Public health services in sub-Sahara Africa countries face severe health workforce shortages exacerbated by both outward migration and internal public-to-private sector migration—Tanzania is no exception. This review was conducted to characterize the extent of health workforce shortages in Tanzania, and the factors impacting on the shortage. [from abstract]

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]

Very few studies have assessed performance of Botswana public hospitals. We draw from a large research study assessing performance of the Botswana Ministry of Health (MoH) to evaluate the performance of public hospital system using the World Health Organization Health Systems Performance Assessment Framework (WHO HSPAF).

In the 20 years since South Africa underwent a peaceful transition from apartheid to a constitutional democracy, considerable social progress has been made toward reversing the discriminatory practices that pervaded all aspects of life before 1994.1-5 Yet the health and well-being of most South Africans remain plagued by a relentless burden of infectious and noncommunicable diseases, persisting social disparities, and inadequate human resources to provide care for a growing population with a rising tide of refugees and economic migrants. [from abstract]

The development of comprehensive community based health information systems is increasingly becoming important for measuring and improving the quality of health services. Many developing countries including Kenya have made efforts to strengthen their national health information systems to provide information
for decision-making in managing health care services. The purpose of this paper is to explore how data collected at the community level is utilised by various stakeholders within the community in order to produce actionable information for decision making. [from abstract]

This predominantly quantitative research paper interrogates the attraction and retention of health professionals at eleven randomly selected health centres in Gweru municipality, Zimbabwe. [from abstract]

Accessing maternal health information by the women can easily make community members
make their own informed decisions that can lead to improving their health. Women are usually
disadvantaged as far as accessing health information is concerned. It is against this background
that this study is therefore concerned with studying the sources of maternal health information
amongst the rural women of reproductive age in. [from abstract]

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.