scholarly journals Implementation Research: An Efficient and Effective Tool to Accelerate Universal Health Coverage

2019 ◽  
Author(s):  
Agnes Binagwaho ◽  
Miriam F. Frisch ◽  
Kelechi Udoh ◽  
Laura Drown ◽  
Jovial Thomas Ntawukuriryayo ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Universal Health Coverage ◽  
Implementation Research ◽  
Implementation Strategies ◽  
Health Coverage ◽  
Positive Health ◽  
Implementation Framework ◽  
Variable Success ◽  
Positive Health Outcomes ◽  
Universal Health

Success in the implementation of evidence-based interventions (EBIs) in different settings has had variable success. Implementation research offers the approach needed to understand the variability of health outcomes from implementation strategies in different settings and why interventions were successful in some countries and failed in others. When mastered and embedded into a policy and implementation framework, the application of implementation research by countries can provide policy-makers and implementers with the knowledge necessary to work towards universal health coverage (UHC) with the effectiveness, efficiency, sustainability, and fidelity needed to achieve sustainable positive health outcomes for all. To achieve this goal however, work is needed by the communities of research producers and consumers to create more clarity on implementation research methodologies and to build capacity to apply them as a critical tool for countries on their path to achieving UHC.

The impact of Universal Health Coverage on health care consumption and risky behaviours: evidence from Thailand

2014 ◽  
Vol 10 (3) ◽  
pp. 251-266 ◽  
Author(s):  
Simone Ghislandi ◽  
Wanwiphang Manachotphong ◽  
Viviana M.E. Perego
Keyword(s):  
Health Care ◽  
Universal Health Coverage ◽  
Hospital Admissions ◽  
Health Coverage ◽  
Positive Health ◽  
Health Care Consumption ◽  
Thai Population ◽  
Risky Behaviours ◽  
The Impact ◽  
Universal Health

AbstractThailand is among the first non-OECD countries to have introduced a form of Universal Health Coverage (UHC). This policy represents a natural experiment to evaluate the effects of public health insurance on health behaviours. In this paper, we examine the impact of Thailand’s UHC programme on preventive activities, unhealthy or risky behaviours and health care consumption using data from the Thai Health and Welfare Survey. We use doubly robust estimators that combine propensity scores and linear regressions to estimate differences-in-differences (DD) and differences-in-DD models. Our results offer important insights. First, UHC increases individuals’ likelihood of having an annual check-up, especially among women. Regarding health care consumption, we observe that UHC increases hospital admissions by over 2% and increases outpatient visits by 13%. However, there is no evidence that UHC leads to an increase in unhealthy behaviours or a reduction of preventive efforts. In other words, we find no evidence ofex antemoral hazard. Overall, these findings suggest positive health impacts among the Thai population covered by UHC.

scholarly journals Implementation research: towards universal health coverage with more doctors in Brazil

2017 ◽  
Vol 95 (2) ◽  
pp. 103-112 ◽  
Author(s):  
Leonor Maria Pacheco Santos ◽  
Aimê Oliveira ◽  
Josélia Souza Trindade ◽  
Ivana CHC Barreto ◽  
Poliana Araújo Palmeira ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Implementation Research ◽  
Health Coverage ◽  
Universal Health

scholarly journals Implementation research approaches to promoting universal health coverage in Africa: a scoping review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chukwudi A. Nnaji ◽  
Charles S. Wiysonge ◽  
Joseph C. Okeibunor ◽  
Thobile Malinga ◽  
Abdu A. Adamu ◽  
...  
Keyword(s):  
Universal Health Coverage ◽  
Scoping Review ◽  
Implementation Research ◽  
Reference Lists ◽  
Political Support ◽  
Cochrane Library ◽  
Health Coverage ◽  
Hand Search ◽  
Scoping Reviews ◽  
Universal Health

Abstract Background Implementation 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 initiatives promoting the uptake of implementation research in Africa, its role and effectiveness remain unclear, particularly in the context of universal health coverage (UHC). Hence, this scoping review aimed to identify and characterise the use of implementation research initiatives for assessing UHC-related interventions or programmes in Africa. Methods The review protocol was developed based on the methodological framework proposed by Arksey and O’Malley, as enhanced by the Joanna Briggs Institute. The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). MEDLINE, Scopus and the Cochrane Library were searched. The search also included a hand search of relevant grey literature and reference lists. Literature sources involving the application of implementation research in the context of UHC in Africa were eligible for inclusion. Results The database search yielded 2153 records. We identified 12 additional records from hand search of reference lists. After the removal of duplicates, we had 2051 unique records, of which 26 studies were included in the review. Implementation research was used within ten distinct UHC-related contexts, including HIV; maternal and child health; voluntary male medical circumcision; healthcare financing; immunisation; healthcare data quality; malaria diagnosis; primary healthcare quality improvement; surgery and typhoid fever control. The consolidated framework for implementation research (CFIR) was the most frequently used framework. Qualitative and mixed-methods study designs were the commonest methods used. Implementation research was mostly used to guide post-implementation evaluation of health programmes and the contextualisation of findings to improve future implementation outcomes. The most commonly reported contextual facilitators were political support, funding, sustained collaboration and effective programme leadership. Reported barriers included inadequate human and other resources; lack of incentives; perception of implementation as additional work burden; and socio-cultural barriers. Conclusions This review demonstrates that implementation research can be used to achieve UHC-related outcomes in Africa. It has identified important facilitators and barriers to the use of implementation research for promoting UHC in the region.

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.

scholarly journals The Future Health Workforce: Integrated Solutions and Models of Care

2021 ◽  
Vol 18 (6) ◽  
pp. 2849
Author(s):  
Madhan Balasubramanian ◽  
Stephanie Short
Keyword(s):  
Sustainable Development ◽  
Health Outcomes ◽  
Universal Health Coverage ◽  
Health Workforce ◽  
Sustainable Development Goals ◽  
Models Of Care ◽  
Health Coverage ◽  
Future Health ◽  
Development Goals ◽  
Universal Health

The health workforce is a vital aspect of health systems, both essential in improving patient and population health outcomes and in addressing contemporary challenges such as universal health coverage (UHC) and sustainable development goals (SDGs) [...]

The Path Toward Universal Health Coverage

2016 ◽  
Vol 47 (2) ◽  
pp. 352-373 ◽  
Author(s):  
Rami Yassoub ◽  
Mohamad Alameddine ◽  
Shadi Saleh
Keyword(s):  
Universal Health Coverage ◽  
Social Protection ◽  
Stakeholder Analysis ◽  
Health Sector ◽  
World Health ◽  
Health Coverage ◽  
Implementation Framework ◽  
Middle Income ◽  
Out Of Pocket Payments ◽  
Universal Health

Lebanon is a middle-income country with a market-maximized healthcare system that provides limited social protection for its citizens. Estimates reveal that half of the population lacks sufficient health coverage and resorts to out-of-pocket payments. This study triangulated data from a comprehensive review of health packages of countries similar to Lebanon, the Ministry of Public Health statistics, and services suggested by the World Health Organization for inclusion in a health benefits package (HBP). To determine the acceptability and viability of implementing the HBP, a stakeholder analysis was conducted to identify the knowledge, positions, and available resources for the package. The results revealed that the private health sector, having the most resources, is least in favor of implementing the package, whereas the political and civil society sectors support implementation. The main divergence in opinions among stakeholders was on the abolishment of out-of-pocket payments, mainly attributed to the potential abuse of the HBP’s services by users. The study’s findings encourage health decision makers to capitalize on the current political readiness by proposing the HBP for implementation in the path toward universal health coverage. This requires a consultative process, involving all stakeholders, in devising the strategy and implementation framework of a HBP.

The Right to Health

2018 ◽  
pp. 360-391
Author(s):  
Kajal Bhardwaj ◽  
Veena Johari ◽  
Vivek Divan
Keyword(s):  
Health Planning ◽  
Right To Health ◽  
Health Coverage ◽  
Positive Health ◽  
Human Organs ◽  
Medical Termination ◽  
The Right ◽  
Supreme Court Rulings ◽  
Positive Health Outcomes ◽  
Universal Health

The right to health has been variously influenced by a web of laws and structures. Health is legislated primarily by the states, causing variances in laws and implementation systems across states. The Parliament has also legislated on health in some instances, thereby creating national laws on certain issues, such as the Medical Termination of Pregnancy Act, the Transplantation of Human Organs Act and so on. Policy planning also articulates priorities in the context of health, for example through the National Rural Health Mission, and proposals on universal health coverage. Illustrating certain national and state legislations and key Supreme Court rulings, this chapter reveals the complexity that confronts effective health planning in India and offers insights that are required to achieve positive health outcomes for society.

scholarly journals Comparing Health Care Financing in Indonesia and Thailand from 1995-2010: What Lessons Could Be Learned?

10.36469/9869 ◽  
2013 ◽  
Vol 1 (3) ◽  
pp. 224-238
Author(s):  
Darius Erlangga ◽  
Lizheng Shi
Keyword(s):  
Health Care ◽  
Health Outcomes ◽  
Health Systems ◽  
Universal Health Coverage ◽  
Health Care Financing ◽  
Health Financing ◽  
Financial Resources ◽  
Health Coverage ◽  
The Right ◽  
Universal Health

Purpose: In 2010, the World Health Organization (WHO) released its report about health system financing and identified universal coverage as the best way to attain the right of every human being to enjoy “the highest attainable standard of health”. Over the past decade, Thailand has successfully implemented a universal health coverage scheme for its population, while its neighbor country, Indonesia, is still struggling to achieve the same goal. The purpose of this paper is to compare the health financing systems between Thailand and Indonesia. Both countries almost have similar socioeconomic conditions and suffered from severe financial crisis during the late 1990s. The objective of this study is to examine health systems in each country and to determine lessons on how health care financing can affect the health status of a population. Methods: The study is based on statistical data from various publicly available resources. For analysis, the authors followed The Health Systems Assessment Approach: A How-To Manual Version 1.0 issued by Health Systems 20/20 supported by United States Agency for International Development (USAID). The countries were compared using three groups of indicators in health systems performance and functioning: 1. Health Insurance System, 2. Amount and Sources of Financial Resources, and 3. Health Outcomes and Health Workforce Density. Results: In comparing the health financing of the two countries, we found that Thailand initiated much earlier health systems reforms in order to achieve universal health coverage. Indonesia, while on the right track, has moved at a slower pace than Thailand. Thailand and Indonesia have shown improving trends over time in all indicators, but Thailand outperformed Indonesia, especially in the groups of indicators regarding the amount and sources of financial resources. Conclusions: One important lesson identified in this study is that health care reform is unlikely to succeed without strong political support and constant pressure from the nation as a whole, which can be represented by local organizations or professional associations. However, the mere increase of available resources devoted to the health sector does not guarantee significant improvements of health outcomes of a population.

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