Do Perceptions Match Provision? Investigating the Gap between Levels of Service Provision and Citizen Perceptions in Sub-Saharan Africa

2019 ◽  
Author(s):  
Paige Bollen ◽  
Andrew Halterman ◽  
Blair Read
Keyword(s):  
Service Provision ◽  
Sub Saharan Africa ◽  
Citizen Perceptions ◽  
Sub Saharan ◽  
Levels Of Service

A Critical Examination of the State versus Non-Governmental Organizations (NGOs) in the Policy Sphere in the Global South: Will the State Die as the NGOs Thrive in Sub-Saharan Africa and Asia?

2005 ◽  
Vol 4 (3) ◽  
pp. 301-326 ◽  
Author(s):  
A. Sat Obiyan
Keyword(s):  
Service Provision ◽  
Market Failure ◽  
Third Sector ◽  
The State ◽  
Sub Saharan Africa ◽  
Critical Examination ◽  
Special Focus ◽  
Governmental Organizations ◽  
Non Governmental Organizations ◽  
Sub Saharan

Abstract This paper examines the role of non-governmental organizations (NGOs) in service provision with a special focus on Sub-Saharan Africa and Asia. First, it reviews the conceptual and taxonomic issues in NGOs. It then proceeds to examine the performance of NGOs in some countries. The paper notes the increased relevance of NGOs in many countries. It, however, argues that any expectation that the NGOs will supplant the state in service provision is likely to be utopian. It contends that just as we have government failure and market failure, we can also have third sector failure. The paper argues for an appropriate balance between the state and NGOs in meeting the needs of the poor. It concludes that while it may be necessary to continue to strengthen the private sector and the third sector, it would be useful to continue to inquire into how the state can be effective.

scholarly journals Availability of Standard Operating Guidelines for Primary Healthcare Facilities in Sub-saharan Africa: A Scoping Review Protocol

2020 ◽  
Author(s):  
Nelly Sharpley ◽  
Desmond Kuupiel ◽  
Jacqueline Marina van Wyk
Keyword(s):  
Patient Care ◽  
Scoping Review ◽  
Primary Healthcare ◽  
Service Provision ◽  
Sub Saharan Africa ◽  
Quality Monitoring ◽  
Future Research ◽  
Standard Operating ◽  
Operational Management ◽  
Sub Saharan

Abstract Background: Primary healthcare (PHC) clinics play an essential role in the delivery of community-based health services, particularly in resource-limited settings. However, there is little systematic documentation on the availability of standard operating guidelines governing their operation or evaluating the services provided by PHC facilities. This study, therefore, will aim to systematically map literature and describe the evidence on the availability of standard operating guidelines or procedures for PHC facilities in sub-Saharan Africa (SSA).Methods: This scoping review study will be conducted inline with the Arksey and O'Malley's framework. PubMed, EBSCOhost (Academic search complete, CINAHL with full text, and Health Sources), Scopus, and Google Scholar will be searched from 2010 to 2020 for relevant evidence sources using a search strategy comprising of keywords, Boolean terms, and medical subject headings. This study will include evidence sources/studies written/published in English that focused standard on standard operating guidelines for staffing and operational management, patient care and service provision, and quality monitoring procedures to assess the functioning of PHC facilities in SSA. The screening of the evidence sources/studies at all the stages and the data extraction will be conducted independently by two reviewers. Thematic analysis will be carried out to identify the themes and sub-themes and the findings relating to this study's research question summarised and reported for each theme narratively. Discussion: This scoping review anticipates to highlight standard operating guidelines available for staffing and operational management, patient care and service provision, and quality monitoring procedures to assess the functioning of PHC facilities to inform the development of relevant standard operating guidelines to improve healthcare services at the primary level. This study also anticipates revealing literature gaps for future research to ensure the attainment of universal health coverage by 2030.

scholarly journals Health service provision for people with epilepsy in sub-Saharan Africa: A situational review

2017 ◽  
Vol 70 ◽  
pp. 24-32 ◽  
Author(s):  
Musa M. Watila ◽  
Mark R. Keezer ◽  
Samuel A. Angwafor ◽  
Andrea S. Winkler ◽  
Josemir W. Sander
Keyword(s):  
Health Service ◽  
Service Provision ◽  
Sub Saharan Africa ◽  
Health Service Provision ◽  
Sub Saharan

scholarly journals Making voluntary medical male circumcision services sustainable: Findings from Kenya’s pilot models, baseline and year 1

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252725
Author(s):  
Stephanie M. Davis ◽  
Nandi Owuor ◽  
Elijah Odoyo-June ◽  
Jonesmus Wambua ◽  
Eunice Omanga ◽  
...  
Keyword(s):  
Service Delivery ◽  
Male Circumcision ◽  
Service Provision ◽  
Sub Saharan Africa ◽  
Voluntary Medical Male Circumcision ◽  
Community Perception ◽  
Medical Male Circumcision ◽  
Target Volumes ◽  
Group A ◽  
Sub Saharan

Voluntary medical male circumcision is a crucial HIV prevention program for men in sub-Saharan Africa. Kenya is one of the first countries to achieve high population coverage and seek to transition the program to a more sustainable structure designed to maintain coverage while making all aspects of service provision domestically owned and implemented. Using pre-defined metrics, we created and evaluated three models of circumcision service delivery (static, mobile and mixed) to identify which had potential for sustaining high circumcision coverage among 10-14-year-olds group, a historically high-demand and accessible age group, at the lowest possible cost. We implemented each model in two distinct geographic areas, one in Siaya and the other in Migori county, and assessed multiple aspects of each model’s sustainability. These included numerical achievements against targets designed to reach 80% coverage over two years; quantitative expenditure outcomes including unit expenditure plus its primary drivers; and qualitative community perception of program quality and sustainability based on Likert scale. Outcome values at baseline were compared with those for year one of model implementation using bivariate linear regression, unpaired t-tests and Wilcoxon rank tests as appropriate. Across models, numerical target achievement ranged from 45–140%, with the mixed models performing best in both counties. Unit expenditures varied from approximately $57 in both countries at baseline to $44-$124 in year 1, with the lowest values in the mixed and static models. Mean key informant perception scores generally rose significantly from baseline to year 1, with a notable drop in the area of community engagement. Consistently low scores were in the aspects of domestic financing for service provision. Sustainability-focused circumcision service delivery models can successfully achieve target volumes at lower unit expenditures than existing models, but strategies for domestic financing remain a crucial challenge to address for long-term maintenance of the program.

scholarly journals Integrating diabetes, hypertension and HIV care in sub-Saharan Africa: a Delphi consensus study on international best practice

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Geoff McCombe ◽  
Sara Murtagh ◽  
Jeffrey V. Lazarus ◽  
Marie Claire Van Hout ◽  
Max Bachmann ◽  
...  
Keyword(s):  
Service Provision ◽  
Chronic Conditions ◽  
Best Practice ◽  
Healthcare Delivery ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Delphi Consensus ◽  
Integrated Healthcare ◽  
Sub Saharan

Abstract Background Although HIV continues to have a high prevalence among adults in sub-Saharan Africa (SSA), the burden of noncommunicable diseases (NCD) such as diabetes and hypertension is increasing rapidly. There is an urgent need to expand the capacity of healthcare systems in SSA to provide NCD services and scale up existing chronic care management pathways. The aim of this study was to identify key components, outcomes, and best practice in integrated service provision for the prevention, identification and treatment of HIV, hypertension and diabetes. Methods An international, multi stakeholder e-Delphi consensus study was conducted over two successive rounds. In Round 1, 24 participants were asked to score 27 statements, under the headings ‘Service Provision’ and ‘Benefits of Integration’, by importance. In Round 2, the 16 participants who completed Round 1 were shown the distribution of scores from other participants along with the score that they attributed to an outcome and were asked to reflect on the score they gave, based on the scores of the other participants and then to rescore if they wished to. Nine participants completed Round 2. Results Based on the Round 1 ranking, 19 of the 27 outcomes met the 70% threshold for consensus. Four additional outcomes suggested by participants in Round 1 were added to Round 2, and upon review by participants, 22 of the 31 outcomes met the consensus threshold. The five items participants scored from 7 to 9 in both rounds as essential for effective integrated healthcare delivery of health services for chronic conditions were improved data collection and surveillance of NCDs among people living with HIV to inform integrated NCD/HIV programme management, strengthened drug procurement systems, availability of equipment and access to relevant blood tests, health education for all chronic conditions, and enhanced continuity of care for patients with multimorbidity. Conclusions This study highlights the outcomes which may form key components of future complex interventions to define a model of integrated healthcare delivery for diabetes, hypertension and HIV in sub-Saharan Africa.

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