Sub-Saharan Africa

The last decade has witnessed massive growth in the African economy, accompanied by an unprecedented uptake of novel communications technologies across the five sub-regions. At the same time, the burden of various diseases – both communicable and non-communicable – is also escalating. Thus, the objective of this research was to analyze and highlight uncommon applications of novel technologies toward healthcare delivery in Africa. [from abstract]

Developed by the World Health Organization (WHO) and partners, the correct adaptation and implementation of the global guidelines on prevention of mother-to-child transmission (PMTCT) of HIV is critical. This study explored the challenges that health workers face implementing WHO’s PMTCT guidelines, and the experiences of HIV-positive clients receiving these services. [from abstract]

Volunteer community health workers (VCHW) are health care providers who are trained but do not
have any professional certification. They are intended to fill the gap for unmet curative, preventative, and health promotion health needs of communities. This study aims to investigate the non-financial incentives for VCHWs and factors affecting their motivation. [from abstract]

Pharmacist participation in ward rounds is of increasing interest for better pharmaceutical care, yet most pharmacists do not engage in this activity. The objective was to obtain public sector pharmacists’ views and perceptions on their involvement in ward rounds. [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.

Making the final decision to terminate a pregnancy can be influenced by different circumstances involving various individuals. This paper describes the key players involved in the decision-making process regarding abortions among women who elected to undergo an induced abortion in a cosmopolitan urban setting in Ghana. [from abstract]

Pay for performance schemes are increasingly being implemented in low income countries to improve health service coverage and quality. This paper describes the context within which a pay for performance programme was introduced in Tanzania and discusses the potential for pay for performance to address health system constraints to meeting targets. [from abstract]

Performance-based incentives (PBIs) are currently receiving attention as a strategy for improving the quality of care that health providers deliver. Experiences from several African countries have shown that PBIs can trigger improvements, particularly in the area of maternal and neonatal health. The involvement of health workers in deciding how their performance should be measured is recommended. Only limited information is available about how such schemes can be made sustainable. [from introduction]

The objective of this study is to explore and identify gaps in knowledge and information communication at all levels of health delivery system in Tanzania. [adapted 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]

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]

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.

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 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]

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]

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.