scholarly journals Community participation in demanding accountability for health systems strengthening

2021 ◽  
pp. 279-281
Author(s):  
YK Sandhya ◽  
Renu Khanna
Keyword(s):  
Health Systems ◽  
Community Action ◽  
Social Accountability ◽  
Health Systems Strengthening ◽  
Contextual Analysis ◽  
Health System Strengthening ◽  
Public And Private ◽  
Call To Action ◽  
Transformative Potential

This paper describes how the COPASAH Global Symposium treated the Theme of ‘Community Action in Governance and Accountability for Health System Strengthening’. We first lay out COPASAH’s understanding of Social Accountability in health systems as centre-staging the transformative potential of the power of the communities rather than seeing social accountability as merely a tokenistic participation of the community. Through case studies presented by practitioners from across the globe, the Theme positioned communities and civil society at large as central to the governance and accountability of health systems (both public and private). The important role of contextual analysis in defining the strategies and interventions for demanding accountability was discussed. Participants’ experiences of demanding accountability brought out clearly the importance of linkages from local action to global mobilisation. Further, the discussions reaffirmed the COPASAH’s principles of Social Accountability in Health that informed the COPASAH Charter and Call to Action for Social Accountability for Health.

scholarly journals Exploring the role of gender and women in the political economy of health in armed conflict: a narrative review

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Kristen Meagher ◽  
Bothaina Attal ◽  
Preeti Patel
Keyword(s):  
Political Economy ◽  
Health Systems ◽  
Armed Conflict ◽  
Narrative Review ◽  
Health Systems Strengthening ◽  
The Political ◽  
Systems Research ◽  
Political Economy Of Health ◽  
And Gender

Abstract Background The ripple effects of protracted armed conflicts include: significant gender-specific barriers to accessing essential services such as health, education, water and sanitation and broader macroeconomic challenges such as increased poverty rates, higher debt burdens, and deteriorating employment prospects. These factors influence the wider social and political determinants of health for women and a gendered analysis of the political economy of health in conflict may support strengthening health systems during conflict. This will in turn lead to equality and equity across not only health, but broader sectors and systems, that contribute to sustainable peace building. Methods The methodology employed is a multidisciplinary narrative review of the published and grey literature on women and gender in the political economy of health in conflict. Results The existing literature that contributes to the emerging area on the political economy of health in conflict has overlooked gender and specifically the role of women as a critical component. Gender analysis is incorporated into existing post-conflict health systems research, but this does not extend to countries actively affected by armed conflict and humanitarian crises. The analysis also tends to ignore the socially constructed patriarchal systems, power relations and gender norms that often lead to vastly different health system needs, experiences and health outcomes. Conclusions Detailed case studies on the gendered political economy of health in countries impacted by complex protracted conflict will support efforts to improve health equity and understanding of gender relations that support health systems strengthening.

Stiffen the sinews, summon up the blood, and strain upon the start: enfranchising the medical profession for clinically proximate advocacy of improved healthcare

2021 ◽  
pp. 103985622110250
Author(s):  
Jeffrey C L Looi ◽  
Stephen Allison ◽  
Stephen R Kisely ◽  
Tarun Bastiampillai
Keyword(s):  
Resource Allocation ◽  
Health Systems ◽  
Medical Profession ◽  
Continuing Professional Development ◽  
Health Advocacy ◽  
Public And Private ◽  
Medical Practitioners ◽  
The Public ◽  
Team Activity

Objective: To discuss and reflect upon the role of medical practitioners, including psychiatrists, as health advocates on behalf of patients, carers and staff. Conclusions: Health advocacy is a key professional competency of medical practitioners, and is part of the RANZCP framework for training and continuing professional development. Since advocacy is often a team activity, there is much that is gained experientially from volunteering and working with other more experienced health advocates within structurally and financially independent (of health systems and governments) representative groups (RANZCP, AMA, unions). Doctors may begin with clinically proximate advocacy for improved healthcare in health systems, across the public and private sectors. Health advocacy requires skill and courage, but can ultimately influence systemic outcomes, sway policy decisions, and improve resource allocation.

The Role of International NGOs in Health Systems Strengthening: The Case of Timor-Leste

2014 ◽  
Vol 44 (2) ◽  
pp. 323-335 ◽  
Author(s):  
Mary Anne Mercer ◽  
Susan M. Thompson ◽  
Rui Maria de Araujo
Keyword(s):  
Health Systems ◽  
Health Systems Strengthening ◽  
Timor Leste ◽  
International Ngos

Post 9/11 Somalia: the strategic role of health systems strengthening in global security

2011 ◽  
Vol 27 (4) ◽  
pp. 205-210
Author(s):  
Alexander E.T. Finlayson ◽  
Jorge Zeron ◽  
Luke Beaumont ◽  
Jibril Handuleh ◽  
Andy Leather
Keyword(s):  
Health Systems ◽  
Health Systems Strengthening ◽  
Global Security ◽  
Strategic Role

scholarly journals A multi-center prospective cohort study to evaluate the effect of differential pricing and health systems strengthening on access to medicines and management of hypertension and diabetes in Ghana: A study protocol

2018 ◽  
Vol 2 ◽  
pp. 6 ◽  
Author(s):  
Linda Meta Mobula ◽  
Stephen Sarfo ◽  
Lynda Arthur ◽  
Gilbert Burnham ◽  
Jacob Plange-Rhule ◽  
...  
Keyword(s):  
Health Systems ◽  
Teaching Hospital ◽  
Pragmatic Trial ◽  
Access To Medicines ◽  
Health Systems Strengthening ◽  
Health System Strengthening ◽  
Access To Treatment ◽  
Middle Income ◽  
District Hospitals ◽  
Differential Pricing

Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs).  Access to treatment is likely a key barrier to the control and prevention of NCD outcomes.  Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability. Methods: This is a quasi-experimental study, with a pragmatic trial design, to be conducted over the course of three years. A mixed methods design will be used to evaluate the effects of health systems strengthening and differential pricing on the management of diabetes, hypertension and selected cancers in Ghana. A public private partnership was established between all sites that will receive multi-level interventions, including health systems strengthening  and access to medicines interventions. Study populations and sites: Study participants will include individuals with new or recently diagnosed hypertension and diabetes (n=3,300), who present to two major referral hospitals, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital, as well as three district hospitals, namely Kings Medical Centre, Agogo Presbyterian District Hospital, and Atua Government Hospital. Discussion: The objective of this study aims to test approaches intended to improve access to drugs for the treatment of hypertension and diabetes, and improve disease control. Patients with these conditions will benefit from health systems strengthening interventions (education, counseling, improved management of disease), and increased access to innovative medicines via differential pricing. Pilot programs also will facilitate health system strengthening at the participating institutions, which includes training of clinicians and updating of guidelines and production of protocols for the treatment of diabetes, hypertension and cancer.

scholarly journals Harnessing the health systems strengthening potential of quality improvement using realist evaluation: an example from southern Tanzania

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii9-ii21
Author(s):  
Fatuma Manzi ◽  
Tanya Marchant ◽  
Claudia Hanson ◽  
Joanna Schellenberg ◽  
Elibariki Mkumbo ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Health Systems ◽  
Building Blocks ◽  
Realist Evaluation ◽  
Health Systems Strengthening ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Empowerment Theory ◽  
Multiple Sources ◽  
Programme Theory

Abstract Quality improvement (QI) is a problem-solving approach in which stakeholders identify context-specific problems and create and implement strategies to address these. It is an approach that is increasingly used to support health system strengthening, which is widely promoted in Sub-Saharan Africa. However, few QI initiatives are sustained and implementation is poorly understood. Here, we propose realist evaluation to fill this gap, sharing an example from southern Tanzania. We use realist evaluation to generate insights around the mechanisms driving QI implementation. These insights can be harnessed to maximize capacity strengthening in QI and to support its operationalization, thus contributing to health systems strengthening. Realist evaluation begins by establishing an initial programme theory, which is presented here. We generated this through an elicitation approach, in which multiple sources (theoretical literature, a document review and previous project reports) were collated and analysed retroductively to generate hypotheses about how the QI intervention is expected to produce specific outcomes linked to implementation. These were organized by health systems building blocks to show how each block may be strengthened through QI processes. Our initial programme theory draws from empowerment theory and emphasizes the self-reinforcing nature of QI: the more it is implemented, the more improvements result, further empowering people to use it. We identified that opportunities that support skill- and confidence-strengthening are essential to optimizing QI, and thus, to maximizing health systems strengthening through QI. Realist evaluation can be used to generate rich implementation data for QI, showcasing how it can be supported in ‘real-world’ conditions for health systems strengthening.

scholarly journals A multi-center prospective cohort study to evaluate the effect of differential pricing and health systems strengthening on access to medicines and management of hypertension and diabetes in Ghana: A study protocol

2018 ◽  
Vol 2 ◽  
pp. 6 ◽  
Author(s):  
Linda Meta Mobula ◽  
Stephen Sarfo ◽  
Lynda Arthur ◽  
Gilbert Burnham ◽  
Jacob Plange-Rhule ◽  
...  
Keyword(s):  
Health Systems ◽  
Teaching Hospital ◽  
Pragmatic Trial ◽  
Access To Medicines ◽  
Health Systems Strengthening ◽  
Health System Strengthening ◽  
Access To Treatment ◽  
Middle Income ◽  
District Hospitals ◽  
Differential Pricing

Background: There is evidence to suggest that the prevalence of non-communicable diseases (NCDs), in particular cardiovascular diseases and diabetes, are being recognized as forming a substantial proportion of the burden of disease among populations in Low- and Middle-Income Countries (LMICs).  Access to treatment is likely a key barrier to the control and prevention of NCD outcomes.  Differential pricing, an approach used to price drugs based on the purchasing power of patients in different socioeconomic segments, has been shown to be beneficial and leads to improved access and affordability. Methods: This is a quasi-experimental study, with a pragmatic trial design, to be conducted over the course of three years. A mixed methods design will be used to evaluate the effects of health systems strengthening and differential pricing on the management of diabetes, hypertension and selected cancers in Ghana. A public private partnership was established between all sites that will receive multi-level interventions, including health systems strengthening  and access to medicines interventions. Study populations and sites: Study participants will include individuals with new or previously diagnosed hypertension and diabetes (n=3,300), who present to two major referral hospitals, Komfo Anokye Teaching Hospital and Tamale Teaching Hospital, as well as three district hospitals, namely Kings Medical Centre, Agogo Presbyterian District Hospital, and Atua Government Hospital. Discussion: The objective of this study aims to test approaches intended to improve access to drugs for the treatment of hypertension and diabetes, and improve disease control. Patients with these conditions will benefit from health systems strengthening interventions (education, counseling, improved management of disease), and increased access to innovative medicines via differential pricing. Pilot programs also will facilitate health system strengthening at the participating institutions, which includes training of clinicians and updating of guidelines and production of protocols for the treatment of diabetes, hypertension and cancer.

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