scholarly journals Innovations, contestations and fragilities of the health system response to COVID-19 in the Gauteng Province of South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261339
Author(s):  
Laetitia C. Rispel ◽  
Carol Marshall ◽  
Busisiwe Matiwane ◽  
Immaculate Sabelile Tenza
Keyword(s):  
Health System ◽  
Psychosocial Support ◽  
Health Sector ◽  
System Response ◽  
Multiple Perspectives ◽  
Gauteng Province ◽  
Key Informants ◽  
Pandemic Response ◽  
Epidemic Wave

Background Gauteng province, with 26.3% of South Africa’s population, is the commercial and industrial powerhouse of the country. During the first epidemic wave in 2020, Gauteng accounted for 32.0% of South Africa’s reported COVID-19 cases. Aim The aim of this study was to describe the health system response to the COVID-19 pandemic during the first epidemic wave in Gauteng province and to explore the perspectives of key informants on the provincial response. Material and methods Using an adapted Pandemic Emergency Response Conceptual Framework, this was a qualitative case study design consisting of 36 key informant interviews and a document analysis. We used thematic analysis to identify themes and sub-themes from the qualitative data. Results Our case study found that Gauteng developed an innovative, multi-sectoral and comprehensive provincial COVID-19 response that aimed to address the dual challenge of saving lives and the economy. However, the interviews revealed multiple perspectives, experiences, contestations and contradictions in the pandemic response. The COVID-19 pandemic exposed and amplified the fragilities of existing systems, reflected in the corruption on personal protective equipment, poor data quality and inappropriate decisions on self-standing field hospitals. Rooted in a chronic under-investment and insufficient focus on the health workforce, the response failed to take into account or deal with their fears, and to incorporate strategies for psychosocial support, and safe working environments. The single-minded focus on COVID-19 exacerbated these fragilities, resulting in a de facto health system lockdown and reported collateral damage. The key informants identified missed opportunities to invest in primary health care, partner with communities and to include the private health sector in the pandemic response. Conclusion Gauteng province should build on the innovations of the multi-sectoral response to the COVID-19 pandemic, while addressing the contested areas and health system fragilities.

scholarly journals The complexity of scaling up an mHealth intervention: the case of SMS for Life in Tanzania from a health systems integration perspective

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carmen Sant Fruchtman ◽  
Selemani Mbuyita ◽  
Mary Mwanyika-Sando ◽  
Marcel Braun ◽  
Don de Savigny ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Large Scale ◽  
Digital Health ◽  
Health Sector ◽  
Building Blocks ◽  
Scaling Up ◽  
Stock Management ◽  
Study Approach

Abstract Background SMS for Life was one of the earliest large-scale implementations of mHealth innovations worldwide. Its goal was to increase visibility to antimalarial stock-outs through the use of SMS technology. The objective of this case study was to show the multiple innovations that SMS for Life brought to the Tanzanian public health sector and to discuss the challenges of scaling up that led to its discontinuation from a health systems perspective. Methods A qualitative case-study approach was used. This included a literature review, a document review of 61 project documents, a timeline of key events and the collection and analysis of 28 interviews with key stakeholders involved in or affected by the SMS for Life programme. Data collection was informed by the health system building blocks. We then carried out a thematic analysis using the WHO mHealth Assessment and Planning for Scale (MAPS) Toolkit as a framework. This served to identify the key reasons for the discontinuation of the programme. Results SMS for Life was reliable at scale and raised awareness of stock-outs with real-time monitoring. However, it was discontinued in 2015 after 4 years of a national rollout. The main reasons identified for the discontinuation were the programme’s failure to adapt to the continuous changes in Tanzania’s health system, the focus on stock-outs rather than ensuring appropriate stock management, and that it was perceived as costly by policy-makers. Despite its discontinuation, SMS for Life, together with co-existing technologies, triggered the development of the capacity to accommodate and integrate future technologies in the health system. Conclusion This study shows the importance of engaging appropriate stakeholders from the outset, understanding and designing system-responsive interventions appropriately when scaling up and ensuring value to a broad range of health system actors. These shortcomings are common among digital health solutions and need to be better addressed in future implementations.

scholarly journals A systematic review of health sector responses to the coincidence of disasters and COVID-19

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sanaz Sohrabizadeh ◽  
Shiva Yousefian ◽  
Amirhosein Bahramzadeh ◽  
Mohammad Hossein Vaziri
Keyword(s):  
Health System ◽  
Descriptive Analysis ◽  
Health Sector ◽  
Final Analysis ◽  
Lessons Learned ◽  
World Health ◽  
System Response ◽  
Policy Makers ◽  
Health Organization ◽  
Abstract Screening

Abstract Background In December 2019, the Chinese city of Wuhan reported a novel pneumonia caused by COVID-19. While the COVID-19 pandemic has been increasingly affecting the world, the occurrence of disasters resulted in complex emergencies. The present review is aimed to identify the literature focused on health system response to coincidence of COVID-19 and disasters as well as describing their finding, implications and lessons-learned. Methods This study was conducted and reported based on PRISMA guideline. The databases of Web of Sciences, PubMed, Scopus, Google Scholar and World Health Organization Library were searched. The inclusion criteria were all forms of published articles which investigated the coincidence of disasters and COVID-19 pandemic. Using the title and abstract screening, the selections of studies were performed by two researchers. Once, the relevant papers were finalized, the analysis was done in two parts of descriptive analysis and implications for health systems. Results Out of 1245 studies generated by initial search, a number of 13 articles was selected for final analysis. Earthquake was the most frequent disaster which its coincidence with COVID-19 was studied by researchers (31%). The implications of researchers for healthcare system were explained in three sections of climatic events, earthquakes and all hazard approach in relation to COVID-19. Conclusion Extracting the lessons learned from the regions affected by disasters at the time of COVID-19 pandemic can be helpful for healthcare professionals and policy-makers to improve their preparedness and response during disasters and a serious pandemic such as COVID-19. Further research is needed to identify the factors which strengthen the preparedness of health system for the dual risk of natural hazards and pandemics.

scholarly journals Qualitative exploration of health system response to COVID-19 pandemic applying the WHO health systems framework: Case study of a Nigerian state

2021 ◽  
Vol 13 ◽  
pp. e00945
Author(s):  
Oluwaseun Oladapo Akinyemi ◽  
Oluwafemi Akinyele Popoola ◽  
Adeola Fowotade ◽  
Olukemi Adekanmbi ◽  
Eniola O. Cadmus ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
System Response ◽  
Qualitative Exploration ◽  
Systems Framework

scholarly journals Gambaran Pola Asuh Ibu dengan Balita Stunting dan Tidak Stunting di Kelurahan Tengah, Kecamatan Kramat Jati, DKI Jakarta

2021 ◽  
Vol 3 (2) ◽  
pp. 71
Author(s):  
Hira Fitriani Aisyah
Keyword(s):  
Preliminary Data ◽  
Psychosocial Support ◽  
Case Study Approach ◽  
Exclusion Criteria ◽  
Key Informants ◽  
Purposive Sampling ◽  
Study Approach ◽  
Urban Village ◽  
Primary Location

Latar Belakang. Wilayah Jakarta Timur menduduki posisi lokasi fokus stunting, salah satunya di Kelurahan Tengah. Berdasarkan pengolahan data awal, diketahui prevalensi stunting pada enam posyandu di dua RW terpilih mencapai angka 25,9%.Tujuan. Mengetahui perbandingan pola asuh balita stunting dan tidak stunting di Kelurahan Tengah, Kecamatan Kramat Jati Metode. Penelitian kualitatif dengan pendekatan studi kasus melalui wawancara mendalam secara daring. Sampel dipilih secara purposive sampling sesuai kriteria inklusi dan eksklusi dengan 12 informan utama yang memiliki balita stunting dan tidak stunting usia 24-59 bulan, serta informan kunci terdiri dari, Tenaga Pelaksana Gizi dan kader posyandu.Hasil. Hasil penelitian terhadap informan utama dengan balita stunting menunjukkan bahwa sebagian besar ibu tidak memberikan ASI Eksklusif kepada anaknya, memberikan makan dengan frekuensi yang kurang, variasi makanan tidak beragam karena anak banyak diberikan jajanan. Selain itu, ibu dengan anak stunting juga mendapatkan dukungan psikososial yang rendah serta rendahnya partisipasi ke Posyandu.Kesimpulan. Terdapat perbedaan antara pola asuh ibu dengan balita stunting dan ibu dengan balita tidak stunting. ABSTRACTBackground. East Jakarta region has become the primary location of stunting, one of which is Tengah Village. Based on the weighing and preliminary data, the prevalence of stunting in 6 Posyandu in the two selected RWs reached 25.9%. Objective to find out the comparison of parenting patterns of stunting toddlers and non-stunting toddlers in Tengah Urban-Village, Kramat Jati Sub-District Method. This research is qualitative, with a case-study approach and collected through in-depth online interviews. The sample was selected by purposive sampling, based on the inclusion and exclusion criteria which 12 main informants had stunting and not stunting toddlers aged 24-59 months and key informants consisting of Nutrition Workers in the Puskesmas Tengah and Posyandu cadres. Results. The research results on key informants with stunting toddlers show that most mothers didn’t give exclusive breastfeeding to their children, provide food with less frequency, food variations are not varied because children are given a lot of snacks. Mothers with stunting toddlers also experienced low psychosocial support and low participation in Posyandu.Conclusion. There is a difference between mothers with stunting toddlers' parenting patterns and mothers with non-stunting toddlers.  

scholarly journals The Role of Health System to Support PMTCT Program Implementation in Jayawijaya Regency

2015 ◽  
Vol 1 (1) ◽  
Author(s):  
Lea Meirina Trisnawati ◽  
Hasbulah Thabrany
Keyword(s):  
Health Services ◽  
Health System ◽  
Psychosocial Support ◽  
Health Sector ◽  
Antiretroviral Drugs ◽  
Hiv And Aids ◽  
Primary Data ◽  
Access To Health Services ◽  
Keywords Hiv

 Abstract. The incidence of HIV and AIDS in Indonesia continues to increase. The possibility of mother to child transmission will be greater if intervention is not performed. The purpose of this study is to assess the role of health systems in health and non-health sector affecting the implementation of PMTCT. This qualitative research took place in Jayawijaya. Primary data collection was conducted through in-depth interviews, and observation. Secondary data was derived from the survey of health facilities conducted in Papua. We interviewed eleven (11) informants. The results of this study confirmed that the implementation of PMTCT was still inadequate, only 64% of the health services in Jayawijaya provide PMTCT services. Considering the vast area and the difficulty of access to health services, local government should undertake expansion of comprehensive PMTCT services, provide antiretroviral drugs for pregnant women, and reagents, as well as psychosocial support to PLHIV. Keywords: HIV/AIDS, PMTCT, health system

Governance

2017 ◽  
Author(s):  
Joia S. Mukherjee
Keyword(s):  
Global Health ◽  
Health System ◽  
Global Governance ◽  
Health Sector ◽  
Nation State ◽  
System A ◽  
Health Strategy ◽  
External Forces ◽  
Globalized World ◽  
Global Governance For Health

This chapter focuses on governance, a key building block of a health system. A government is responsible for the health of its people. It sets the health strategy and oversees the implementation of health programs. External forces and actors influence the governance of the health sector. This chapter explores governance of health from the perspective of the nation-state coordinating its own health system (sometimes called governance for global health). The chapter examines the internal and external forces that influence national governance for global health. The chapter also looks beyond the level of the nation-state to explore the concept of global governance for health. In the interconnected and globalized world, global governance for health is needed to coordinate the geopolitical forces that impact health and its social determinants.

Sign in / Sign up

Export Citation Format

Share Document