Disappearing health system building blocks in the health promotion policy context in South Australia (2003–2013)

2018 ◽  
Vol 29 (2) ◽  
pp. 228-240 ◽  
Author(s):  
Lori Baugh Littlejohns ◽  
Fran Baum ◽  
Angela Lawless ◽  
Toby Freeman
Keyword(s):  
Health Promotion ◽  
Health System ◽  
South Australia ◽  
Building Blocks ◽  
Promotion Policy ◽  
System Building ◽  
Policy Context ◽  
Health System Building Blocks

scholarly journals Evaluating and strengthening the health system of Curaҫao to improve its performance for future outbreaks of vector-borne diseases

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Vaitiare Mulderij-Jansen ◽  
Izzy Gerstenbluth ◽  
Ashley Duits ◽  
Adriana Tami ◽  
Ajay Bailey
Keyword(s):  
Qualitative Study ◽  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
Entomological Surveillance ◽  
Vector Borne Diseases ◽  
System Building ◽  
Vector Borne ◽  
Dutch Caribbean ◽  
Health System Building Blocks

Abstract Background Vector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore, countries are encouraged to work towards more resilient health systems. This qualitative study aims to examine the performance of the health system of the Dutch Caribbean island of Curaҫao regarding the prevention and control of VBDs in the last decade by using the WHO health system building blocks. Methods From November 2018 to December 2020, a multi-method qualitative study was performed in Curaçao, applying content analysis of documents (n = 50), five focus group discussions (n = 30), interviews with experts (n = 11) and 15 observation sessions. The study was designed based on the WHO framework: health system building blocks. Two cycles of inductive and deductive coding were employed, and Nvivo software was used to analyse the data. Results This study’s data highlighted the challenges (e.g. insufficient oversight, coordination, leadership skills, structure and communication) that the departments of the health system of Curaҫao faced during the last three epidemics of VBDs (2010–2020). Furthermore, low levels of collaboration between governmental and non-governmental organisations (e.g. semi-governmental and private laboratories) and insufficient capacity building to improve skills (e.g. entomological, surveillance skills) were also observed. Lastly, we observed how bottlenecks in one building block negatively influenced other building blocks (e.g. inadequate leadership/governance obstructed the workforce's performance). Conclusions This study uncovers potential organisational bottlenecks that have affected the performance of the health system of Curaҫao negatively. We recommend starting with the reinforcement of oversight of the integrated vector management programme to ensure the development, implementation and evaluation of related legislation, policies and interventions. Also, we recommend evaluating and reforming the existing administrative and organisational structure of the health system by considering the cultural style, challenges and barriers of the current health system. More efforts are needed to improve the documentation of agreements, recruitment and evaluation of the workforce's performance. Based on our findings, we conceptualised actions to strengthen the health system's building blocks to improve its performance for future outbreaks of infectious diseases. Graphical abstract

scholarly journals Health System Building Blocks and Organ Transplantation in India

2021 ◽  
Vol 105 (8) ◽  
pp. 1631-1634
Author(s):  
Smita Divyaveer ◽  
Sanjay Nagral ◽  
K.T. Prasad ◽  
Ashish Sharma ◽  
Vivekanand Jha
Keyword(s):  
Health System ◽  
Organ Transplantation ◽  
Building Blocks ◽  
System Building ◽  
Health System Building Blocks

scholarly journals Evaluating and Strengthening the Health System of Curaҫao to Improve its Performance for Future Outbreaks of Infectious Diseases.

2021 ◽  
Author(s):  
Vaitiare Mulderij-Jansen ◽  
Izzy Gerstenbluth ◽  
Ashley Duits ◽  
Adriana Tami ◽  
Ajay Bailey
Keyword(s):  
Qualitative Study ◽  
Infectious Diseases ◽  
Health System ◽  
Building Blocks ◽  
Healthcare Systems ◽  
Management Program ◽  
Entomological Surveillance ◽  
Vector Borne Diseases ◽  
System Building ◽  
Health System Building Blocks

Abstract BackgroundVector-borne diseases (VBDs) such as dengue, chikungunya, and Zika pose a significant challenge to health systems in countries they affect, especially countries with less developed healthcare systems. Therefore countries are encouraged to strengthen their healthcare systems to achieve more resilient systems. This qualitative study aims to examine the performance of the health system of the Dutch Caribbean island of Curaҫao with regards to the prevention and control of VBDs in the last decennium by using the WHO health system building blocks.MethodsFrom January 2019 to February 2020, a multi-method qualitative study was performed in Curaçao., applying content analysis of documents (n = 50), five focus group discussions (n = 30), interviews with experts (n = 11), and fifteen observation sessions. The study was designed based on the WHO framework: health system building blocks. Two cycles of inductive and deductive coding were employed, and Nvivo software was used to analyse the data.ResultsThis study’s data highlighted the challenges (e.g., insufficient oversight, coordination, leadership skills, structure, and communication) that the departments of the health system of Curaҫao faced during the last three epidemics of VBDs (2010–2020). Furthermore, low levels of collaboration between governmental and non-governmental organisations (e.g., semi-governmental and private laboratories) and insufficient capacity building to improve skills (e.g., entomological, surveillance skills) were also observed. Lastly, we observed how bottlenecks in one building block negatively influenced other building blocks (e.g., inadequate leadership/governance obstructed the workforce's performance).ConclusionsThis study uncovers potential organisational bottlenecks that have affected the performance of the health system of Curaҫao negatively. We recommend starting with the reinforcement of oversight of the integrated vector management program to ensure the development, implementation, and evaluation of related legislation, policies, and interventions. Also, we recommend evaluating and reform the existing administrative and organisational structure of the health system by taking the cultural style, challenges, and barriers of the current health system into account. More efforts are needed to improve the documentation of agreements, the recruitment, and evaluation of the workforce's performance. Based on our findings, we conceptualised actions to strengthen the health system's building blocks to improve its performance for future outbreaks of infectious diseases.

scholarly journals Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fariba Mirbaha-Hashemi ◽  
Batool Tayefi ◽  
Zahra Rampisheh ◽  
Arash Tehrani-Banihashemi ◽  
Mozhdeh Ramezani ◽  
...  
Keyword(s):  
Action Plan ◽  
Scale Up ◽  
Newborn Care ◽  
Building Blocks ◽  
Neonatal Care ◽  
Patient Transfer ◽  
Analysis Tool ◽  
System Building ◽  
Bottleneck Analysis ◽  
Health System Building Blocks

Abstract Background Neonatal mortality accounts for more than 47% of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitable and high-quality care for mothers and newborns. We applied the bottleneck analysis tool offered by ENAP to identify obstacles and bottlenecks hindering the scale-up of newborn care across seven health system building blocks. Methods We applied the every newborn bottleneck analysis tool to identify obstacles hindering the scale-up of newborn care across seven health system building blocks. We used qualitative methods to collect data from five medical universities and their corresponding hospitals in three provinces. We also interviewed other national experts, key informants, and stakeholders in neonatal care. In addition, we reviewed and qualitatively analyzed the performance report of neonatal care and services from 16 medical universities around the country. Results We identified many challenges and bottlenecks in the scale-up of newborn care in Iran. The major obstacles included but were not limited to the lack of a single leading and governing entity for newborn care, insufficient financial resources for neonatal care services, insufficient number of skilled health professionals, and inadequate patient transfer. Conclusions To address identified bottlenecks in neonatal health care in Iran, some of our recommendations were as follows: establishing a single national authorizing and leading entity, allocating specific budget to newborn care, matching high-quality neonatal health care providers to the needs of all urban and rural areas, maintaining clear policies on the distribution of NICUs to minimize the need for patient transfer, and using the available and reliable private sector NICU ambulances for safe patient transfer.

scholarly journals What health systems do? Functions as a starting point to assess health systems performance

2021 ◽  
Vol 31 (Supplement_3) ◽  
Author(s):  
Irini Papanicolas
Keyword(s):  
Health System ◽  
Performance Assessment ◽  
Health Systems ◽  
Building Blocks ◽  
Performance Outcomes ◽  
Starting Point ◽  
Common Framework ◽  
System Assessment ◽  
Health Systems Performance ◽  
Health System Building Blocks

Abstract Health system assessment (HSA) tools are often built around static health system building blocks, which lead to largely descriptive narrative and lack of linkages to health system outcomes. The development of a common framework that would also focus on performance outcomes is long overdue. We analysed the key HSA frameworks and tools based on them, with the purpose of identifying a common approach that would allow to link health system components to specific outcomes. The presentation will focus on using the health system functions as the basis of conducting the performance assessment. In a second step, the presentation will elaborate on the intermediate and final health system goals as part of the HSPA framework. It will explain their links to the four functions and thus, discuss their relevance for performance assessment.

scholarly journals Scaling up integrated primary mental health in six low- and middle-income countries: obstacles, synergies and implications for systems reform

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Inge Petersen ◽  
André van Rensburg ◽  
Fred Kigozi ◽  
Maya Semrau ◽  
Charlotte Hanlon ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Chronic Care ◽  
Mental Healthcare ◽  
Building Blocks ◽  
Scaling Up ◽  
Task Sharing ◽  
Middle Income ◽  
Middle Income Countries ◽  
System Building

Background There is a global drive to improve access to mental healthcare by scaling up integrated mental health into primary healthcare (PHC) systems in low- and middle-income countries (LMICs). Aims To investigate systems-level implications of efforts to scale-up integrated mental healthcare into PHC in districts in six LMICs. Method Semi-structured interviews were conducted with 121 managers and service providers. Transcribed interviews were analysed using framework analysis guided by the Consolidated Framework for Implementation Research and World Health Organization basic building blocks. Results Ensuring that interventions are synergistic with existing health system features and strengthening of the healthcare system building blocks to support integrated chronic care and task-sharing were identified as aiding integration efforts. The latter includes (a) strengthening governance to include technical support for integration efforts as well as multisectoral collaborations; (b) ring-fencing mental health budgets at district level; (c) a critical mass of mental health specialists to support task-sharing; (d) including key mental health indicators in the health information system; (e) psychotropic medication included on free essential drug lists and (f) enabling collaborative and community- oriented PHC-service delivery platforms and continuous quality improvement to aid service delivery challenges in implementation. Conclusions Scaling up integrated mental healthcare in PHC in LMICs is more complex than training general healthcare providers. Leveraging existing health system processes that are synergistic with chronic care services and strengthening healthcare system building blocks to provide a more enabling context for integration are important. Declaration of interest None.

scholarly journals Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Meredith P. Fort ◽  
William Mundo ◽  
Alejandra Paniagua-Avila ◽  
Sayra Cardona ◽  
Juan Carlos Figueroa ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Needs Assessment ◽  
Public Health System ◽  
Building Blocks ◽  
Hypertension Control ◽  
The Public ◽  
Multi Level ◽  
Health System Building Blocks

Abstract Background Uncontrolled hypertension represents a substantial and growing burden in Guatemala and other low and middle-income countries. As a part of the formative phase of an implementation research study, we conducted a needs assessment to define short- and long-term needs and opportunities for hypertension services within the public health system. Methods We conducted a multi-method, multi-level assessment of needs related to hypertension within Guatemala’s public system using the World Health Organization’s health system building blocks framework. We conducted semi-structured interviews with stakeholders at national (n = 17), departmental (n = 7), district (n = 25), and community (n = 30) levels and focus groups with patients (3) and frontline auxiliary nurses (3). We visited and captured data about infrastructure, accessibility, human resources, reporting, medications and supplies at 124 health posts and 53 health centers in five departments of Guatemala. We conducted a thematic analysis of transcribed interviews and focus group discussions supported by matrix analysis. We summarized quantitative data observed during visits to health posts and centers. Results Major challenges for hypertension service delivery included: gaps in infrastructure, insufficient staffing and high turnover, limited training, inconsistent supply of medications, lack of reporting, low prioritization of hypertension, and a low level of funding in the public health system overall. Key opportunities included: prior experience caring for patients with chronic conditions, eagerness from providers to learn, and interest from patients to be involved in managing their health. The 5 departments differ in population served per health facility, accessibility, and staffing. All but 7 health posts had basic infrastructure in place. Enalapril was available in 74% of health posts whereas hydrochlorothiazide was available in only 1 of the 124 health posts. With the exception of one department, over 90% of health posts had a blood pressure monitor. Conclusions This multi-level multi-method needs assessment using the building blocks framework highlights contextual factors in Guatemala’s public health system that have been important in informing the implementation of a hypertension control trial. Long-term needs that are not addressed within the scope of this study will be important to address to enable sustained implementation and scale-up of the hypertension control approach.

scholarly journals Active Lives South Australia health economic analysis: an evidence base for the potential of health promotion strategies supporting physical activity guidelines to reduce public health costs while improving wellbeing

2021 ◽  
Author(s):  
Simon Eckermann ◽  
Andrew R. Willan
Keyword(s):  
Physical Activity ◽  
Health Promotion ◽  
Cost Saving ◽  
Health System ◽  
South Australia ◽  
Emergency Department Visits ◽  
Hospital Inpatient ◽  
System Cost ◽  
Health System Cost ◽  
Promotion Strategies

Abstract Aim The COVID-19 pandemic has threatened individual and population wellbeing and strategies to jointly address these challenges within budget constraints are required. The aim of our research is to analyse evidence from the Active Lives South Australia study to consider the potential of physical activity (PA) health promotion strategies to be health-system cost saving while addressing wellbeing challenges. Methods The Active Lives South Australia study compares adult populations who meet and do not meet physical activity (PA) guidelines (150+ minutes of weekly physical activity) with respect to their subjective wellbeing and health care utilisation. Subject and results Adults who met PA guidelines had better wellbeing across all aspects with and without adjustment for age, sex and income covariates. Analysis showed significant associations between meeting guidelines and lower probabilities of visiting and utilisation of GPs, specialist doctors, other health professionals, hospital inpatient admissions, outpatient clinic and emergency department visits, and an overall A$1760 lower cost per person annually. Controlling for age, sex and income, health expenditure for adults who met PA guidelines was significantly lower by A$1393 per person annually. That translated to A$804 million potential annual SA health system cost saving by shifting all adults to meeting PA guidelines. Conclusion There is significant potential for effective health promotion strategies to be net cost saving while addressing wellbeing challenges of COVID-19 recovery where they can shift target populations from not meeting to meeting PA guidelines.

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