scholarly journals Towards universal health coverage: advancing the development and use of traditional medicines in Africa

2019 ◽  
Vol 4 (Suppl 9) ◽  
pp. e001517 ◽  
Author(s):  
Ossy Muganga Julius Kasilo ◽  
Charles Wambebe ◽  
Jean-Baptiste Nikiema ◽  
Juliet Nabyonga-Orem
Keyword(s):  
Universal Health Coverage ◽  
Conventional Medicine ◽  
Health Coverage ◽  
African Region ◽  
African Countries ◽  
Traditional Medicines ◽  
Policy Practice ◽  
Health Practitioners ◽  
Advance Research ◽  
Universal Health

African traditional medicine (ATM) and traditional health practitioners (THPs) could make significant contributions to the attainment of universal health coverage (UHC). Consequently, the WHO provided technical tools to assist African countries to develop ATM as a significant component of healthcare. Many African countries adopted the WHO tools after appropriate modifications to advance research and development (R&D) of ATM. An analysis of the extent of this development was undertaken through a survey of 47 countries in the WHO African region. Results show impressive advances in R&D of ATM, the collaboration between THP and conventional health practitioners, quality assurance as well as regulation, registration and THP integration into the national health systems. We highlight the various ways investment in the R&D of ATM can impact on policy, practice and the three themes of UHC. We underscore the need for frameworks for fair and equitable sharing of all benefits arising from the R&D of ATM products involving all the stakeholders. We argue for further investment in ATM as a complement to conventional medicine to promote attainment of the objectives of UHC.

Implementing health technology assessment in Ghana to support universal health coverage: building relationships that focus on people, policy, and process

2019 ◽  
Vol 36 (1) ◽  
pp. 8-11 ◽  
Author(s):  
Samantha Hollingworth ◽  
Martha Gyansa-Lutterodt ◽  
Lydia Dsane-Selby ◽  
Justice Nonvignon ◽  
Ruth Lopert ◽  
...  
Keyword(s):  
Resource Allocation ◽  
Health Technology Assessment ◽  
Universal Health Coverage ◽  
Technology Assessment ◽  
Health Technology ◽  
Health Coverage ◽  
African Countries ◽  
Allocation Decisions ◽  
Universal Health ◽  
Resource Allocation Decisions

AbstractGhana is one of the few African countries to enact legislation and earmark significant funding to establish universal health coverage (UHC) through the National Health Insurance Scheme, although donor funds have declined recently. Given a disproportionate level of spending on medicines, health technology assessment (HTA) can support resource allocation decisions in the face of highly constrained budgets, as commonly found in low-resource settings. The Ghanaian Ministry of Health, supported by the International Decision Support Initiative (iDSI), initiated a HTA study in 2016 to examine the cost-effectiveness of antihypertensive medicines. We aimed to summarize key insights from this work that highlights success factors beyond producing purely technical outputs. These include the need for capacity building, academic collaboration, and ongoing partnerships with a broad range of experts and stakeholders. By building on this HTA study, and with ongoing interactions with iDSI, HTAi, WHO, and others, Ghana will be well positioned to institutionalize HTA in resource allocation decisions and support progress toward UHC.

scholarly journals How is equity approached in universal health coverage? An analysis of global and country policy documents in Benin and Senegal

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Elisabeth Paul ◽  
Céline Deville ◽  
Oriane Bodson ◽  
N’koué Emmanuel Sambiéni ◽  
Ibrahima Thiam ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Health Coverage ◽  
African Countries ◽  
Policy Documents ◽  
Guiding Principle ◽  
Country Level ◽  
Gender Based ◽  
And Gender ◽  
Universal Health ◽  
Country Specific

Abstract Background Equity seems inherent to the pursuance of universal health coverage (UHC), but it is not a natural consequence of it. We explore how the multidimensional concept of equity has been approached in key global UHC policy documents, as well as in country-level UHC policies. Methods We analysed a purposeful sample of UHC reports and policy documents both at global level and in two Western African countries (Benin and Senegal). We manually searched each document for its use and discussion of equity and related terms. The content was summarised and thematically analysed, in order to comprehend how these concepts were understood in the documents. We distinguished between the level at which inequity takes place and the origin or types of inequities. Results Most of the documents analysed do not define equity in the first place, and speak about “health inequities” in the broad sense, without mentioning the dimension or type of inequity considered. Some dimensions of equity are ambiguous – especially coverage and financing. Many documents assimilate equity to an overall objective or guiding principle closely associated to UHC. The concept of equity is also often linked to other concepts and values (social justice, inclusion, solidarity, human rights – but also to efficiency and sustainability). Regarding the levels of equity most often considered, access (availability, coverage, provision) is the most often quoted dimension, followed by financial protection. Regarding the types of equity considered, those most referred to are socio-economic, geographic, and gender-based disparities. In Benin and Senegal, geographic inequities are mostly pinpointed by UHC policy documents, but concrete interventions mostly target the poor. Overall, the UHC policy of both countries are quite similar in terms of their approach to equity. Conclusions While equity is widely referred to in global and country-specific UHC policy documents, its multiple dimensions results in a rather rhetorical utilisation of the concept. Whereas equity covers various levels and types, many global UHC documents fail to define it properly and to comprehend the breadth of the concept. Consequently, perhaps, country-specific policy documents also use equity as a rhetoric principle, without sufficient consideration for concrete ways for implementation.

scholarly journals A review of prospective pathways and impacts of COVID-19 on the accessibility, safety, quality, and affordability of essential medicines and vaccines for universal health coverage in Africa

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Floriano Amimo ◽  
Ben Lambert ◽  
Anthony Magit ◽  
Masahiro Hashizume
Keyword(s):  
Universal Health Coverage ◽  
Regional Cooperation ◽  
International System ◽  
Grey Literature ◽  
Essential Medicines ◽  
International Technology Transfer ◽  
Health Coverage ◽  
Equitable Access ◽  
African Countries ◽  
Universal Health

Abstract Background The ongoing pandemic of coronavirus disease 2019 (COVID-19) has the potential to reverse progress towards global targets. This study examines the risks that the COVID-19 pandemic poses to equitable access to essential medicines and vaccines (EMV) for universal health coverage in Africa. Methods We searched medical databases and grey literature up to 2 October 2020 for studies reporting data on prospective pathways and innovative strategies relevant for the assessment and management of the emerging risks in accessibility, safety, quality, and affordability of EMV in the context of the COVID-19 pandemic. We used the resulting pool of evidence to support our analysis and to draw policy recommendations to mitigate the emerging risks and improve preparedness for future crises. Results Of the 310 records screened, 134 were included in the analysis. We found that the disruption of the international system affects more immediately the capability of low- and middle-income countries to acquire the basket of EMV. The COVID-19 pandemic may facilitate dishonesty and fraud, increasing the propensity of patients to take substandard and falsified drugs. Strategic regional cooperation in the form of joint tenders and contract awarding, joint price negotiation and supplier selection, as well as joint market research, monitoring, and evaluation could improve the supply, affordability, quality, and safety of EMV. Sustainable health financing along with international technology transfer and substantial investment in research and development are needed to minimize the vulnerability of African countries arising from their dependence on imported EMV. To ensure equitable access, community-based strategies such as mobile clinics as well as fees exemptions for vulnerable and under-served segments of society might need to be considered. Strategies such as task delegation and telephone triage could help reduce physician workload. This coupled with payments of risk allowance to frontline healthcare workers and health-literate healthcare organization might improve the appropriate use of EMV. Conclusions Innovative and sustainable strategies informed by comparative risk assessment are increasingly needed to ensure that local economic, social, demographic, and epidemiological risks and potentials are accounted for in the national COVID-19 responses.

scholarly journals How and why policy-practice gaps come about: a South African Universal Health Coverage context

2019 ◽  
Author(s):  
Janet Michel ◽  
Natsayi Chimbindi ◽  
Nthabiseng Mohlakoana ◽  
Marsha Orgill ◽  
Till Bärnighausen ◽  
...  
Keyword(s):  
South African ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Policy Practice ◽  
Practice Gaps ◽  
Universal Health

scholarly journals How and why policy-practice gaps come about: a South African Universal Health Coverage context

2019 ◽  
Vol 3 ◽  
Author(s):  
Janet Michel ◽  
Natsayi Chimbindi ◽  
Nthabiseng Mohlakoana ◽  
Marsha Orgill ◽  
Till Bärnighausen ◽  
...  
Keyword(s):  
South African ◽  
Universal Health Coverage ◽  
Health Coverage ◽  
Policy Practice ◽  
Practice Gaps ◽  
Universal Health

scholarly journals Developing a specialist children’s nursing workforce in sub-Saharan Africa: a descriptive programme evaluation

BMC Nursing ◽  
2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Jennifer Ruthe ◽  
Natasha North
Keyword(s):  
Nursing Education ◽  
Workforce Development ◽  
Universal Health Coverage ◽  
Course Completion ◽  
Programme Evaluation ◽  
Nursing Workforce ◽  
Health Coverage ◽  
African Countries ◽  
Sub Saharan ◽  
Universal Health

Abstract Background Achieving Universal Health Coverage in low and lower-middle income countries requires an estimated additional five and a quarter million nurses. Despite an increasing focus on specialist nursing workforce development, the specialist children’s workforce in most African countries falls well below recommended densities. The Child Nursing Practice Development Initiative was established with the aim of building the children’s nursing workforce in Southern and Eastern Africa, and Ghana. The purpose of this evaluation was to enable scrutiny of programme activities conducted between 2008 and 2018 to inform programme review and where possible to identify wider lessons of potential interest in relation to specialist nursing workforce strengthening initiatives. Methods The study took the form of a descriptive programme evaluation. Data analysed included quantitative programme data and contextual information from documentary sources. Anonymised programme data covering student enrolments between January 2008 and December 2018 were analysed. Findings were member-checked for accuracy. Results The programme recorded 348 enrolments in 11 years, with 75% of students coming from South Africa and 25% from other sub-Saharan African countries. With a course completion rate of 94, 99% of known alumni were still working in Africa at the end of 2018. Most graduates were located at top-tier (specialist) public hospital facilities. Nine percent of known alumni were found to be working in education, with 54% of graduates at centres that offer or plan to offer children’s nursing education. Conclusion The programme has made a quantifiable, positive and sustained contribution to the capacity of the specialist clinical and educational children’s nursing workforce in nine African countries. Data suggest there may be promising approaches within programme design and delivery in relation to very high course completion rates and the retention of graduates in service which merit further consideration. Outputs from this single programme are however modest when compared to the scale of need. Greater clarity around the vision and role of specialist children’s nurses and costed plans for workforce development are needed for investment in specialist children’s nursing education to realise its potential in relation to achievement of Universal Health Coverage.

scholarly journals Towards universal health coverage in the WHO African Region: assessing health system functionality, incorporating lessons from COVID-19

2021 ◽  
Vol 6 (3) ◽  
pp. e004618
Author(s):  
Humphrey Cyprian Karamagi ◽  
Prosper Tumusiime ◽  
Regina Titi-Ofei ◽  
Benson Droti ◽  
Hillary Kipruto ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Universal Health Coverage ◽  
System Development ◽  
Health Coverage ◽  
African Region ◽  
Policy Action ◽  
Related Services ◽  
Essential Services ◽  
Universal Health

The move towards universal health coverage is premised on having well-functioning health systems, which can assure provision of the essential health and related services people need. Efforts to define ways to assess functionality of health systems have however varied, with many not translating into concrete policy action and influence on system development. We present an approach to provide countries with information on the functionality of their systems in a manner that will facilitate movement towards universal health coverage. We conceptualise functionality of a health system as being a construct of four capacities: access to, quality of, demand for essential services and its resilience to external shocks. We test and confirm the validity of these capacities as appropriate measures of system functionality. We thus provide results for functionality of the 47 countries of the WHO African Region based on this. The functionality of health systems ranges from 34.4 to 75.8 on a 0–100 scale. Access to essential services represents the lowest capacity in most countries of the region, specifically due to poor physical access to services. Funding levels from public and out-of-pocket sources represent the strongest predictors of system functionality, compared with other sources. By focusing on the assessment on the capacities that define system functionality, each country has concrete information on where it needs to focus, in order to improve the functionality of its health system to enable it respond to current needs including achieving universal health coverage, while responding to shocks from challenges such as the 2019 coronavirus disease. This systematic and replicable approach for assessing health system functionality can provide the guidance needed for investing in country health systems to attain universal health coverage goals.

scholarly journals Protocol for a scoping review of implementation research approaches to universal health coverage in Africa

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e041721
Author(s):  
Chukwudi A Nnaji ◽  
Charles S Wiysonge ◽  
Joseph Okeibunor ◽  
Thobile Malinga ◽  
Abdu A Adamu ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Scoping Review ◽  
Implementation Research ◽  
Grey Literature ◽  
Cochrane Library ◽  
Health Coverage ◽  
African Region ◽  
Quantitative Evidence ◽  
Scoping Reviews ◽  
Universal Health

IntroductionImplementation research has emerged as part of evidence-based decision-making efforts to plug current gaps in the translation of research evidence into health policy and practice. While there has been a growing number of institutions and initiatives promoting the uptake of implementation research in Africa, their role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). This review aims to extensively identify and characterise the nature, facilitators and barriers to the use of implementation research for assessing or evaluating UHC-related interventions or programmes in Africa.Methods and analysisThis scoping review will be developed based on the methodological framework proposed by Arksey and O’Malley and enhanced by the Joanna Briggs Institute. It will be reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. A comprehensive search of the following electronic databases will be conducted: Medline (via PubMed), Scopus and the Cochrane Library. Relevant grey literature and reference lists will also be searched. All publications describing the application of implementation research in the context of UHC will be considered for inclusion. Findings will be narratively synthesised and analysed using a predefined conceptual framework. Where applicable, quantitative evidence will be aggregated using summary statistics. There will be consultation of stakeholders, including UHC-oriented health professionals, programme managers, implementation researchers and policy-makers; to provide methodological, conceptual and practical insights.Ethics and disseminationThe data used in this review will be sourced from publicly available literature; hence, this study will not require ethical approval. Findings and recommendations will be disseminated to reach a diverse audience, including UHC advocates, implementation researchers and key health system stakeholders within the African region. Additionally, findings will be disseminated through an open-access publication in a relevant peer-reviewed journal.

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