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Blog

Filtering by Category: HSRsymposium

Thinking of Health Insurance beyond OOPs

Future Health Systems

Out-of-pocket payments (OOPs) dominate the discourse on health insurance. The success of health insurance schemes is typically measured by whether such expenses decrease for the insured. Financial hardships can indeed significantly hinder access to health care. But other barriers exist within households and across social groups that can also restrict access to health care. Health insurance schemes can improve such situations and enhance access to health care. While they are well recognised for their potential to offer financial risk protection, their ability to promote equity in other ways is not as well understood. This blog draws from a recent presentation at the Fifth Global Symposium on Health Systems Research (HSR2018) to highlight how inter- and intra-household equity can be promoted through health insurance schemes for the poor. Empirical evidence from the Rashtriya Swasthya Bima Yojana (RSBY) - a state funded health insurance scheme for the poor in India – is cited to make the case.

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Enhancing the capacity of national and local governments to drive quality improvements

Future Health Systems

Improving the effectiveness with which health services are delivered has continued to be a major concern especially in low- and middle-income countries. The ills from poor quality services have now exceeded those from non-utilization of services, with about five million deaths attributed to poor quality services. FHS Uganda Country Coordinator Elizabeth Ekirapa-Kiracho, blogs about the session that she attended at the Fifth Global Symposium on Health Systems Research in Liverpool, which focused on improving quality to promote equity and effectiveness in the SDG era.

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Including marginalised people in ‘people centred health systems’

Future Health Systems

At the upcoming Global Symposium on Health Systems Research, we will be running a participatory session that builds on research from Uganda, Bangladesh and Nepal, entitled Amplifying Marginalised Voices: Towards Meaningful Inclusion in Social Accountability Mechanisms for Health. This session applies an intersectional lens to accountability mechanisms, asking about the inclusion of specific, marginalised categories within communities in mainstream accountability initiatives.

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Resilient health systems and social resilience

Future Health Systems

The experience of the West African Ebola epidemic and its devastating impact on health and also the capacity of health services to carry out basic public health functions has led to a growing interest in ways to make health systems more resilient. This is the theme of the forthcoming symposium of the Fourth Global Symposium on Health Systems Research

It is important to differentiate between the contributions of a health system to social resilience and the factors that make a health system resilient to health crises. Both are important. In fact, the dimensions of the relationship between resilience and health systems are also interlinked.

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People-centeredness of a resilient health system – an illustration and few questions for the forthcoming HSR Symposium 2016

Future Health Systems

Health system and policy researchers and practitioners, civil society, academia and policy makers from around the world will gather in Vancouver, Canada for the Fourth Global Symposium on Health Systems Research (#HSR2016). The build-up to this biennial conference shows that there is considerable excitement and debate on this year’s symposium theme – Resilient and Responsive Health Systems for a changing world. Can we think of a resilient health system without it being people-centred? The answer is most certainly no.

 

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Are informal providers a dangerous detour on the road to universal health coverage?

Future Health Systems

At the Second Global Symposium on Health Systems Research, the unifying theme was 'universal health coverage' (UHC). A commitment to achieving UHC was enshrined in the Beijing Statement, and much discussion at the symposium targeted the post-2015 agenda with one health goal. But the road to universal health coverage is long, and the devil is in the details. Human resources for health is critical in meeting the access element of universal health coverage, and working with informal providers to improve care is one way of bolstering the health workforce.
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Participatory action research for health systems

Future Health Systems

There were many methodologically focused sessions during the 2nd Sympsoium on Health Systems Research, including several focusing on more qualitative methods. Future Health Systems participated in one on participatory action research, highlighting their research in Easter Uganda to help improve mothers’ access to safe deliveries. Below are some reflections from the two FHS participants.
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Would you pee on your tomatoes? Where the HSR approach to knowledge translation is falling short

Future Health Systems

As the Policy Influence and Research Uptake Manager for the Future Health Systems research consortium, knowledge translation is central to what I do. I was very pleased to hear, then, that it was a key theme of the 2nd Global Symposium on Health Systems Research. During the symposium, I had the opportunity to participate in several related sessions, and while there were a few interesting insights, it seems to me the health systems research (HSR) approach to knowledge translation is still falling short. Here's why.
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Where have all the taxis gone? Complex Adaptive Systems in Action in Beijing

Future Health Systems

I was cold, and I was wet – having waited for a taxi home for about an hour. And despite my interest in the subject, I somehow took little solace in the fact that getting soaked was the failure of a complex adaptive system. In order to keep Beijing taxi drivers in check, local government made the drivers themselves directly responsible for the costs associated with an accident. That may help keep speeding and reckless driving to a minimum when the skys are blue(ish -- it is Beijing after all), but when it comes to driving in more difficult road conditions, when demand is at its peak, in means that taxi drivers make something of a different economic calculation and stay off the roads. Talk about unintended consequences. But the local transport system was not the only complex adaptive system (CAS) on show here in Beijing. As a PhD student who is currently grappling with understanding Uganda’s complex health workforce dynamics for my dissertation research, I was unsure what to expect to hear about complex adaptive systems (CAS) at the 2nd Global Symposium on HSR. I was fortunate to have participated in the 1st Global Symposium on HSR in Montreux in 2010, which included a handful of discussions on this topic. In Montreux, the discourse was focused on conceptualizing CAS and systems thinking, asking what it they are and why should we apply them in health systems research.

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The 2nd Symposium on HSR: As daunting as Kabul?

Future Health Systems

I’ve just arrived in Beijing, China, after a long journey from Kabul, Afghanistan. To say it’s a change of pace is an understatement. The sheer scale of the city is impressive – if a bit daunting – as is the 2nd Global Symposium on Health Systems Research, which I’m here for. I hear there are more than 1,850 participants, which sounds like a lot to me, but is but a mere drop in the ocean of Beijing. The poster session will be a first for me, though I’m lucky to have practiced such an activity in one of my epidemiology classes at the Johns Hopkins Bloomberg School of Public Health. The poster presentation was the relatively easy practical element of the aforementioned epidemiology class, which just goes to reinforce a conclusion I came to a long time ago: the tougher classes are the ones that equip students best for work outside the classroom!

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Forgetting John Snow at the Beijing HSR Symposium

Future Health Systems

This week the world will gather at the 2nd Global Symposium on Health Systems Research in Beijing meeting to collectively forget everything that John Snow stood for. Almost all the programming is about improving the delivery and financing of medical services. Attendees will forget that the best solutions are local solutions based on local data used by local health advocates in harmony with their local community. Few presenters seem to notice that the best and most important part of any health system is not the gleaming hospitals and ICUs. The part that of the health system that creates health changes the social and physical determinants of health through good old fashioned public health practice. Most participants are content to sway to the siren’s song of universal coverage and pretend that doctors are the solution to every malady. The good news is that at least one woman in Beijing remembers John Snow. Dr. Afisah Zakariah is Director of Policy, Planning, Monitoring, and Evaluation for the Ministry of Health in Ghana.

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