Population health, the health system and policy

2008 ◽  
pp. 41-54
Author(s):  
Heather Gardner
Keyword(s):  
Health System ◽  
Population Health

scholarly journals Impact of a health system strengthening intervention on maternal and child health outputs and outcomes in rural Rwanda 2005–2010

2018 ◽  
Vol 3 (2) ◽  
pp. e000674 ◽  
Author(s):  
Dana R Thomson ◽  
Cheryl Amoroso ◽  
Sidney Atwood ◽  
Matthew H Bonds ◽  
Felix Cyamatare Rwabukwisi ◽  
...  
Keyword(s):  
Child Health ◽  
Health Outcomes ◽  
Health System ◽  
Population Health ◽  
Maternal And Child Health ◽  
Rural Areas ◽  
Health System Strengthening ◽  
Live Births ◽  
Intervention Area ◽  
And Child Health

IntroductionAlthough Rwanda’s health system underwent major reforms and improvements after the 1994 Genocide, the health system and population health in the southeast lagged behind other areas. In 2005, Partners In Health and the Rwandan Ministry of Health began a health system strengthening intervention in this region. We evaluate potential impacts of the intervention on maternal and child health indicators.MethodsCombining results from the 2005 and 2010 Demographic and Health Surveys with those from a supplemental 2010 survey, we compared changes in health system output indicators and population health outcomes between 2005 and 2010 as reported by women living in the intervention area with those reported by the pooled population of women from all other rural areas of the country, controlling for potential confounding by economic and demographic variables.ResultsOverall health system coverage improved similarly in the comparison groups between 2005 and 2010, with an indicator of composite coverage of child health interventions increasing from 57.9% to 75.0% in the intervention area and from 58.7% to 73.8% in the other rural areas. Under-five mortality declined by an annual rate of 12.8% in the intervention area, from 229.8 to 83.2 deaths per 1000 live births, and by 8.9% in other rural areas, from 157.7 to 75.8 deaths per 1000 live births. Improvements were most marked among the poorest households.ConclusionWe observed dramatic improvements in population health outcomes including under-five mortality between 2005 and 2010 in rural Rwanda generally and in the intervention area specifically.

scholarly journals Baseline population health conditions ahead of a health system strengthening program in rural Madagascar

2017 ◽  
Vol 10 (1) ◽  
pp. 1329961 ◽  
Author(s):  
Ann C. Miller ◽  
Ranto H. Ramananjato ◽  
Andres Garchitorena ◽  
Victor R. Rabeza ◽  
Djordje Gikic ◽  
...  
Keyword(s):  
Health System ◽  
Population Health ◽  
Health System Strengthening ◽  
Health Conditions

An equity - effectiveness framework linking health programs and healthy life expectancy

2011 ◽  
Vol 17 (4) ◽  
pp. 309 ◽  
Author(s):  
David Banham ◽  
John Lynch ◽  
Jon Karnon
Keyword(s):  
Life Expectancy ◽  
Health System ◽  
Population Health ◽  
South Australia ◽  
Relevant Information ◽  
Intervention Programs ◽  
Health Programs ◽  
Healthy Life Expectancy ◽  
Healthy Life ◽  
Health Gains

South Australia’s Strategic Plan includes a target to improve the population’s healthy life expectancy. A common question among health policy and service planners is: ‘How do health programs and services in the community relate to healthy life expectancy?’ In response, this paper outlines an effectiveness and equity framework (EEF) for evaluating health interventions in applied settings. Using the example of coronary heart disease (CHD) management in general practice in South Australia, the EEF: (1) applies an internally consistent approach to accounting for population healthy life expectancy at state and smaller geographic levels; (2) estimates average population health gains from health programs, and gains across different socioeconomic subgroups within the community; (3) conducts economic evaluation by equating health gains against health system costs in population subgroups; (4) summarises relevant information about candidate intervention programs within a multi-criteria performance matrix for presentation to decision makers; (5) reassesses outcomes (and processes) following the implementation of a program and iteratively adds to the relevant knowledge and evidence base. The EEF offers a practical approach to selecting and evaluating intervention programs. The challenge is to develop system culture and data capture methods clearly focussed on linking health system activities to population health outcomes.

scholarly journals Community-Engaged Research: Common Themes and Needs Identified by Investigators and Research Teams at an Emerging Academic Learning Health System

2021 ◽  
Vol 18 (8) ◽  
pp. 3893
Author(s):  
Megan B. Irby ◽  
Keena R. Moore ◽  
Lilli Mann-Jackson ◽  
DeWanna Hamlin ◽  
Isaiah Randall ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Population Health ◽  
Southeastern United States ◽  
Academic Learning ◽  
Structured Interviews ◽  
Research Teams ◽  
Community Engaged Research ◽  
Learning Health System ◽  
Academic Partnerships

Community-engaged research (CEnR) has emerged within public health and medicine as an approach to research designed to increase health equity, reduce health disparities, and improve community and population health. We sought to understand how CEnR has been conducted and to identify needs to support CEnR within an emerging academic learning health system (aLHS). We conducted individual semi-structured interviews with investigators experienced in CEnR at an emerging aLHS in the southeastern United States. Eighteen investigators (16 faculty and 2 research associates) were identified, provided consent, and completed interviews. Half of participants were women; 61% were full professors of varied academic backgrounds and departments. Interviews were audio-recorded, transcribed, coded, and analyzed using constant comparison, an approach to grounded theory. Twenty themes emerged that were categorized into six domains: Conceptualization and Purpose, Value and Investment, Community-Academic Partnerships, Sustainability, Facilitators, and Challenges. Results also identified eight emerging needs necessary to enhance CEnR within aLHSs. The results provide insights into how CEnR approaches can be harnessed within aLHSs to build and nurture community-academic partnerships, inform research and institutional priorities, and improve community and population health. Findings can be used to guide the incorporation of CEnR within aLHSs.

scholarly journals Understanding fragility: implications for global health research and practice

2019 ◽  
Vol 35 (2) ◽  
pp. 235-243 ◽  
Author(s):  
Karin Diaconu ◽  
Jennifer Falconer ◽  
Nicole Vidal ◽  
Fiona O’May ◽  
Esther Azasi ◽  
...  
Keyword(s):  
Global Health ◽  
Health Outcomes ◽  
Health System ◽  
Population Health ◽  
Local Community ◽  
Grey Literature ◽  
Health Service Delivery ◽  
Global Health Research ◽  
Health Seeking ◽  
Conflict Affected States

Abstract Advances in population health outcomes risk being slowed—and potentially reversed—by a range of threats increasingly presented as ‘fragility’. Widely used and critiqued within the development arena, the concept is increasingly used in the field of global health, where its relationship to population health, health service delivery, access and utilization is poorly specified. We present the first scoping review seeking to clarify the meaning, definitions and applications of the term in the global health literature. Adopting the theoretical framework of concept analysis, 10 bibliographic and grey literature sources, and five key journals, were searched to retrieve documents relating to fragility and health. Reviewers screened titles and abstracts and retained documents applying the term fragility in relation to health systems, services, health outcomes and population or community health. Data were extracted according to the protocol; all documents underwent bibliometric analysis. Narrative synthesis was then used to identify defining attributes of the concept in the field of global health. A total of 377 documents met inclusion criteria. There has been an exponential increase in applications of the concept in published literature over the last 10 years. Formal definitions of the term continue to be focused on the characteristics of ‘fragile and conflict-affected states’. However, synthesis indicates diverse use of the concept with respect to: level of application (e.g. from state to local community); emphasis on particular antecedent stressors (including factors beyond conflict and weak governance); and focus on health system or community resources (with an increasing tendency to focus on the interface between two). Amongst several themes identified, trust is noted as a key locus of fragility at this interface, with critical implications for health seeking, service utilization and health system and community resilience.

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