scholarly journals 22.F. Workshop: What makes for resilient health systems? Evidence from the State of Health in the EU country profiles

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
The State ◽  
Lessons Learned ◽  
Three Dimensions ◽  
Health System Strengthening ◽  
New Work ◽  
State Of Health ◽  
The Eu

Abstract The European Commission's State of Health in the EU (SoHEU) initiative aims to provide factual, comparative data and insights into health and health systems in EU countries. The resulting Country Health Profiles, published every two years (current editions: November 2019) are the joint work of the European Observatory on Health Systems and Policies and the OECD, in cooperation with the European Commission. They are designed to support the efforts of Member States in their evidence-based policy making and to contribute to health care systems' strengthening. In addition to short syntheses of population health status, determinants of health and the organisation of the health system, the Country Profiles provide an assessment of the health system, looking at its effectiveness, accessibility and resilience. The idea of resilient health systems has been gaining traction among policy makers. The framework developed for the Country Profiles template sets out three dimensions and associated policy strategies and indicators as building blocks for assessing resilience. The framework adopts a broader definition of resilience, covering the ability to respond to extreme shocks as well as measures to address more predictable and chronic health system strains, such as population ageing or multimorbidity. However, the current framework predates the onset of the novel coronavirus pandemic as well as new work on resilience being done by the SoHEU project partners. This workshop aims to present resilience-enhancing strategies and challenges to a wide audience and to explore how using the evidence from the Country Profiles can contribute to strengthening health systems and improving their performance. A brief introduction on the SoHEU initiative will be followed by the main presentation on the analytical framework on resilience used for the Country Profiles. Along with country examples, we will present the wider results of an audit of the most common health system resilience strategies and challenges emerging from the 30 Country Profiles in 2019. A roundtable discussion will follow, incorporating audience contributions online. The Panel will discuss the results on resilience actions from the 2019 Country Profiles evidence, including: Why is resilience important as a practical objective and how is it related to health system strengthening and performance? How can countries use their resilience-related findings to steer national reform efforts? In addition, panellists will outline how lessons learned from country responses to the Covid-19 pandemic and new work on resilience by the Observatory (resilience policy briefs), OECD (2020 Health at a Glance) and the EC (Expert Group on Health Systems Performance Assessment (HSPA) Report on Resilience) can feed in and improve the resilience framework that will be used in the 2021 Country Profiles. Key messages Knowing what makes health systems resilient can improve their performance and ability to meet the current and future needs of their populations. The State of Health in the EU country profiles generate EU-wide evidence on the common resilience challenges facing countries’ health systems and the strategies being employed to address them.

scholarly journals 29.F. Workshop: The Health Systems and Policy Monitor network: reforms and health system changes in the spotlight

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Health Policy ◽  
Knowledge Transfer ◽  
Health System ◽  
Health Systems ◽  
Comparative Research ◽  
World Health ◽  
State Of Health ◽  
Wide Range ◽  
Cross Country ◽  
The Eu

Abstract The European Observatory established the Health Systems and Policy Monitor (HSPM) network in 2008, bringing together an international group of high-profile institutions from Europe and beyond with high academic standing in health systems and policy analysis. An important step was taken in 2011, when the Bertelsmann Health Policy Monitor, a 20-country-project with already significant overlap with the current HSPM network, merged with the Observatory's network of national lead institutions. Today, the network includes 40 institutions from 31 countries, with members participating in a wide range of activities and collaborations, such as writing the Observatory's flagship health system reports (HiTs), keeping the health policy community up-to-date on health system developments via the HSPM web platform, and contributing their expertise to reports, studies and knowledge transfer exercises co-ordinated by the Observatory for a variety of audiences, including ministries of health and international organisations such as the World Health Organization and the European Commission. In addition, network members participate in an annual meeting, hosted in a different member country every year, coming together over two days to exchange knowledge and experiences about the various health system reforms happening in their countries. The aim of these meetings is to present, discuss and start comparative research collaborations of the members that can inform policymaking. As part of a collaboration with the journal Health Policy, researchers of the HSPM network have published more than 100 articles on cross-country comparisons of policies or on ongoing nation health reforms in a special section - the Health Reform Monitor - of the journal. This workshop aims to provide the audience with an overview of the network and its expanding range of activities. An introductory presentation will briefly introduce the origins of the network and discuss its current line of work. The second presentation will provide an overview of reform trends that are routinely collected during the annual meetings as part of the “reform roundup”. The third presentation will give an example of how the network has contributed to the European Commission's State of Health in the EU initiative, by performing a 'rapid response” that informed the companion report to the State of Health in the EU country health profiles 2019. The fourth presentation is a typical example of the kind of collaborative work that the network is undertaking, i.e. involving multiple countries on a topic of shared interest. The workshop will conclude with a debate with the audience about the conceptual and methodological challenges as well as opportunities and future directions of cross-country comparative research and the HSPM network in particular. Key messages The Health Systems and Policy Monitor Network provides detailed descriptions of health systems and provides up to date information on reforms and changes that are particularly policy relevant. The Health Systems and Policy Monitor Network increasingly engages in comparative health systems research and knowledge transfer activities.

scholarly journals Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Maya Semrau ◽  
Atalay Alem ◽  
Jose L. Ayuso-Mateos ◽  
Dan Chisholm ◽  
Oye Gureje ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Human Resource Development ◽  
Health Systems ◽  
Building Blocks ◽  
Health System Strengthening ◽  
Mental Health Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BackgroundThere is a large treatment gap for mental, neurological or substance use (MNS) disorders. The ‘Emerging mental health systems in low- and middle-income countries (LMICs)’ (Emerald) research programme attempted to identify strategies to work towards reducing this gap through the strengthening of mental health systems.AimsTo provide a set of proposed recommendations for mental health system strengthening in LMICs.MethodThe Emerald programme was implemented in six LMICs in Africa and Asia (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda) over a 5-year period (2012–2017), and aimed to improve mental health outcomes in the six countries by building capacity and generating evidence to enhance health system strengthening.ResultsThe proposed recommendations align closely with the World Health Organization's key health system strengthening ‘building blocks’ of governance, financing, human resource development, service provision and information systems; knowledge transfer is included as an additional cross-cutting component. Specific recommendations are made in the paper for each of these building blocks based on the body of data that were collected and analysed during Emerald.ConclusionsThese recommendations are relevant not only to the six countries in which their evidential basis was generated, but to other LMICs as well; they may also be generalisable to other non-communicable diseases beyond MNS disorders.Declaration of interestNone.

scholarly journals Decision-making and health system strengthening: bringing time frames into perspective

2020 ◽  
Author(s):  
Abelali Belghiti Alaoui ◽  
Vincent De Brouwere ◽  
Bruno Meessen ◽  
Maryam Bigdeli
Keyword(s):  
Decision Making ◽  
Health System ◽  
Health Systems ◽  
Building Blocks ◽  
Analytical Framework ◽  
Health System Strengthening ◽  
Health Staff ◽  
Middle Income ◽  
Starting Point ◽  
Decision Making Processes

Abstract In many low-and middle-income countries, health systems decision-makers are facing a host of new challenges and competing priorities. They must not only plan and implement as they used to do but also deal with discontented citizens and health staff, be responsive and accountable. This contributes to create new political hazards susceptible to disrupt the whole execution of health plans. The starting point of this article is the observation by the first author of the limitations of the building-blocks framework to structure decision-making as for strengthening of the Moroccan health system. The management of a health system is affected by different temporalities, the recognition of which allows a more realistic analysis of the obstacles and successes of health system strengthening approaches. Inspired by practice and enriched thanks a consultation of the literature, our analytical framework revolves around five dynamics: the services dynamic, the programming dynamic, the political dynamic, the reform dynamic and the capacity-building dynamic. These five dynamics are differentiated by their temporalities, their profile, the role of their actors and the nature of their activities. The Moroccan experience suggests that it is possible to strengthen health systems by opening up the analysis of temporalities, which affects both decision-making processes and the dynamics of functioning of health systems.

scholarly journals Health system gaps in cardiovascular disease prevention and management in Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Archana Shrestha ◽  
Rashmi Maharjan ◽  
Biraj Man Karmacharya ◽  
Swornim Bajracharya ◽  
Niharika Jha ◽  
...  
Keyword(s):  
Human Resources ◽  
Health System ◽  
Health Systems ◽  
National Health ◽  
Task Force ◽  
Health Spending ◽  
Building Blocks ◽  
Critical System ◽  
Government Organizations ◽  
The Government

Abstract Background Cardiovascular diseases (CVDs) are the leading cause of deaths and disability in Nepal. Health systems can improve CVD health outcomes even in resource-limited settings by directing efforts to meet critical system gaps. This study aimed to identify Nepal’s health systems gaps to prevent and manage CVDs. Methods We formed a task force composed of the government and non-government representatives and assessed health system performance across six building blocks: governance, service delivery, human resources, medical products, information system, and financing in terms of equity, access, coverage, efficiency, quality, safety and sustainability. We reviewed 125 national health policies, plans, strategies, guidelines, reports and websites and conducted 52 key informant interviews. We grouped notes from desk review and transcripts’ codes into equity, access, coverage, efficiency, quality, safety and sustainability of the health system. Results National health insurance covers less than 10% of the population; and more than 50% of the health spending is out of pocket. The efficiency of CVDs prevention and management programs in Nepal is affected by the shortage of human resources, weak monitoring and supervision, and inadequate engagement of stakeholders. There are policies and strategies in place to ensure quality of care, however their implementation and supervision is weak. The total budget on health has been increasing over the past five years. However, the funding on CVDs is negligible. Conclusion Governments at the federal, provincial and local levels should prioritize CVDs care and partner with non-government organizations to improve preventive and curative CVDs services.

scholarly journals Resilience Testing of Health Systems: How Can It Be Done?

2021 ◽  
Vol 18 (9) ◽  
pp. 4742
Author(s):  
Heather L. Rogers ◽  
Pedro Pita Barros ◽  
Jan De Maeseneer ◽  
Lasse Lehtonen ◽  
Christos Lionis ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Phase 1 ◽  
Action Planning ◽  
Health System Strengthening ◽  
System Transformation ◽  
Traffic Light ◽  
Phase 0 ◽  
Five Phases ◽  
Quantitative Indicators

The resilience of health systems has received considerable attention as of late, yet little is known about what a resilience test might look like. We develop a resilience test concept and methodology. We describe key components of a toolkit and a 5-phased approach to implementation of resilience testing that can be adapted to individual health systems. We develop a methodology for a test that is balanced in terms of standardization and system-specific characteristics/needs. We specify how to work with diverse stakeholders from the health ecosystem via participatory processes to assess and identify recommendations for health system strengthening. The proposed resilience test toolkit consists of “what if” adverse scenarios, a menu of health system performance elements and indicators based on an input-output-outcomes framework, a discussion guide for each adverse scenario, and a traffic light scorecard template. The five phases of implementation include Phase 0, a preparatory phase to adapt the toolkit materials; Phase 1: facilitated discussion groups with stakeholders regarding the adverse scenarios; Phase 2: supplemental data collection of relevant quantitative indicators; Phase 3: summarization of results; Phase 4: action planning and health system transformation. The toolkit and 5-phased approach can support countries to test resilience of health systems, and provides a concrete roadmap to its implementation.

Preparedness for Mitigating Noncommunicable Diseases in Gaindakot Municipality, Nepal: Perspectives of Key informants

2021 ◽  
Vol 6 (1) ◽  
pp. 1320-1324
Author(s):  
Narayan Sapkota ◽  
Damaru Prasad Paneru
Keyword(s):  
Health System ◽  
Health Workforce ◽  
Prevention And Control ◽  
Local Level ◽  
Building Blocks ◽  
Health System Strengthening ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Screening Services ◽  
And Control

Introduction: Non-communicable Diseases (NCDs) are the major public health problem that leads to high morbidity and mortality in the world including Nepal. Government of Nepal has launched the Multi-sectoral NCD Action Plan in 2014 and established NCD and Injuries Poverty Commission in 2016 for the management and control of NCDs nevertheless the implementation status and its outcomes are not identified till date at the local level. Objectives: To explore the preparedness of the local government for the prevention and control of NCDs at Gaindakot, Nawalpur, Nepal. Methodology: A qualitative study was conducted in the Gaindakot municipality; Nawalpur to document the key informant's perspectives on health system's preparedness to prevent the potential impacts of NCDs. Face to face Indepth interview was performed using open-ended questions. Interview guidelines were prepared on the basis of building blocks of health system. Information was processed basis on thematic analysis. Result: The study revealed that health section has NCD preparedness structure but need to strengthening for the better delivery of health services. The study highlights that screening services and the medicine for major NCDs like hypertension and diabetes were available at local level. Limited budget was allocated and health workforce was not trained for NCDs prevention and control. There was no reporting mechanism for NCD related data from local level. Conclusion: Basic medicine and screening services were provided from the local level to the selected NCDs such as hypertension and diabetes. There was no provision of reporting NCD related information and health workforce were not trained to respond NCDs. Local level health system strengthening is an urgent need to address the increasing burden of NCDs.  

scholarly journals Emerging challenges in the health systems of Kerala, India: qualitative analysis of literature reviews

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Manesh Muraleedharan ◽  
Alaka Omprakash Chandak
Keyword(s):  
Health Care ◽  
Health Economic ◽  
Health System ◽  
Health Systems ◽  
Significant Proportion ◽  
Vital Statistics ◽  
The State ◽  
Future Research ◽  
Health Seeking ◽  
Content Type

PurposeThe substantial increase in non-communicable diseases (NCDs) is considered a major threat to developing countries. According to various international organizations and researchers, Kerala is reputed to have the best health system in India. However, many economists and health-care experts have discussed the risks embedded in the asymmetrical developmental pattern of the state, considering its high health-care and human development index and low economic growth. This study, a scoping review, aims to explore four major health economic issues related to the Kerala health system.Design/methodology/approachA systematic review of the literature was performed using PRISMA to facilitate selection, sampling and analysis. Qualitative data were collected for thematic content analysis.FindingsChronic diseases in a significant proportion of the population, low compliance with emergency medical systems, high health-care costs and poor health insurance coverage were observed in the Kerala community.Research limitations/implicationsThe present study was undertaken to determine the scope for future research on Kerala's health system. Based on the study findings, a structured health economic survey is being conducted and is scheduled to be completed by 2021. In addition, the scope for future research on Kerala's health system includes: (1) research on pathways to address root causes of NCDs in the state, (2) determine socio-economic and health system factors that shape health-seeking behavior of the Kerala community, (3) evaluation of regional differences in health system performance within the state, (4) causes of high out-of-pocket expenditure within the state.Originality/valueGiven the internationally recognized standard of Kerala's vital statistics and health system, this review paper highlights some of the challenges encountered to elicit future research that contributes to the continuous development of health systems in Kerala.

scholarly journals Integration of an Academic Medical Center and a Large Health System: Implications for Pharmacy

2019 ◽  
Vol 54 (3) ◽  
pp. 170-174
Author(s):  
Brian L. Erstad ◽  
Tina Aramaki ◽  
Kurt Weibel
Keyword(s):  
Health System ◽  
Health Systems ◽  
Integration Method ◽  
Medical Center ◽  
Academic Medical Center ◽  
Lessons Learned ◽  
Faculty Members ◽  
Pharmacy Services ◽  
Academic Medical ◽  
High Level

Objective: To provide lessons learned for colleges of pharmacy and large health systems that are contemplating or in the process of undergoing integration. Method: This report describes the merger of an academic medical center and large health system with a focus on the implications of the merger for pharmacy from the perspectives of both a college of pharmacy and a health system’s pharmacy services. Results: Overarching pharmacy issues to consider include having an administrator from the college of pharmacy directly involved in the merger negotiation discussions, having at least one high-level administrator from the college of pharmacy and one high-level pharmacy administrator from the health system involved in ongoing discussions about implications of the merger and changes that are likely to affect teaching, research, and clinical service activities, having focused discussions between college and health system pharmacy administrators on the implications of the merger on experiential and research-related activities, and anticipating concerns by clinical faculty members affected by the merger. Conclusion: The integration of a college of pharmacy and a large health system during the acquisition of an academic medical center can be challenging for both organizations, but appropriate pre- and post-merger discussions between college and health system pharmacy administrators that include a strategic planning component can assuage concerns and problems that are likely to arise, increasing the likelihood of a mutually beneficial collaboration.

Harnessing instability as an opportunity for health system strengthening: A review of health system resilience

2019 ◽  
Vol 32 (3) ◽  
pp. 128-135 ◽  
Author(s):  
Caroline Chamberland-Rowe ◽  
François Chiocchio ◽  
Ivy Lynn Bourgeault
Keyword(s):  
Global Health ◽  
Health System ◽  
Health Systems ◽  
Health System Strengthening ◽  
Operational Model ◽  
Academic Literature ◽  
System Resilience

In recent years, resilience has emerged as a prominent topic in global health systems discourse as a result of the increasing variety and volume of sources of instability inflicting strain on systems. In line with this study’s intent to bring together existing literature on health system resilience as a means to understand the process through which systems achieve resilience, a review of academic literature related to health system resilience was conducted. Emerging from this review is an operational model of resilience that builds on existing health systems frameworks. The model highlights health system resilience as a process through which leaders in all sectors need to be mobilized in order to harness instability as an opportunity for health system strengthening rather than a threat to the system’s sustainability and integrity.

scholarly journals Health systems readiness to provide geriatric friendly care services in Uganda: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jude Thaddeus Ssensamba ◽  
Moses Mukuru ◽  
Mary Nakafeero ◽  
Ronald Ssenyonga ◽  
Suzanne N. Kiwanuka
Keyword(s):  
Public Health ◽  
Health System ◽  
Health Facility ◽  
Health Systems ◽  
Building Blocks ◽  
Health Facilities ◽  
Health Centers ◽  
World Health ◽  
Care Services ◽  
Southern Central

Abstract Background As ageing emerges as the next public health threat in Africa, there is a paucity of information on how prepared its health systems are to provide geriatric friendly care services. In this study, we explored the readiness of Uganda’s public health system to offer geriatric friendly care services in Southern Central Uganda. Methods Four districts with the highest proportion of old persons in Southern Central Uganda were purposively selected, and a cross-section of 18 randomly selected health facilities (HFs) were visited and assessed for availability of critical items deemed important for provision of geriatric friendly services; as derived from World Health Organization’s Age-friendly primary health care centres toolkit. Data was collected using an adapted health facility geriatric assessment tool, entered into Epi-data software and analysed using STATA version 14. Kruskal-Wallis and Dunn’s post hoc tests were conducted to determine any associations between readiness, health facility level, and district. Results The overall readiness index was 16.92 (SD ±4.19) (range 10.8–26.6). This differed across districts; Lwengo 17.91 (SD ±3.15), Rakai 17.63 (SD ±4.55), Bukomansimbi 16.51 (SD ±7.18), Kalungu 13.74 (SD ±2.56) and facility levels; Hospitals 26.62, Health centers four (HCIV) 20.05 and Health centers three (HCIII) 14.80. Low readiness was due to poor scores concerning; leadership (0%), financing (0%), human resources (1.7%) and health management information systems (HMIS) (11.8%) WHO building blocks. Higher-level HFs were statistically significantly friendlier than lower-level HFs (p = 0.015). The difference in readiness between HCIIIs and HCIVs was 2.39 (p = 0.025). Conclusion There is a low readiness for public health facilities to provide geriatric friendly care services in Uganda. This is due to gaps in all of the health system building blocks. There is a need for health system reforms in Uganda to adequately cater for service provision for older adults if the 2020 global healthy ageing goal is to be met.

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