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Publications

FHS Key Message Brief 4: Galvanising gender analysis and practice in health systems: Reflections from Research in Gender and Ethics: Building Stronger Health Systems (RinGs)

Future Health Systems

This brief outlines some of the challenges of incorporating gender analysis into existing research programmes, along with ways in which Research in Gender and Ethics (RinGs): Building Stronger Health Systems has responded to them. RinGs is a cross research programme consortium (RPC) bringing together three health systems RPCs – Future Health Systems, ReBUILD, and RESYST – to better understand gendered dynamics in health systems and to galvanise gender analysis in HSR. 

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FHS India Research Brief 9 - Voices from the ground: Photovoice research on children’s health in the Indian Sundarbans

Future Health Systems

The objective of this brief is to introduce the Photovoice method, highlight how it helped capture the voices of mothers in the Sundarbans, and demonstrate how the method can bridge the gap between communities and local decision-makers. 

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The Human Capital of Knowledge Brokers: An analysis of attributes, capacities and skills of academic teaching and research faculty at Kenyan schools of public health

Future Health Systems

Jessani N, Kennedy C and Bennett S (2016) The Human Capital of Knowledge Brokers: An analysis of attributes, capacities and skills of academic teaching and research faculty at Kenyan schools of public health, Health Research Policy and Systems, 14:58, doi:10.1186/s12961-016-0133-0

Academic faculty involved in public health teaching and research serve as the link and catalyst for knowledge synthesis and exchange, enabling the flow of information resources, and nurturing relations between ‘two distinct communities’ – researchers and policymakers – who would not otherwise have the opportunity to interact. Their role and their characteristics are of particular interest, therefore, in the health research, policy and practice arena, particularly in low- and middle-income countries. We investigated the individual attributes, capacities and skills of academic faculty identified as knowledge brokers (KBs) in schools of public health (SPH) in Kenya with a view to informing organisational policies around the recruitment, retention and development of faculty KBs.

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Enhancing evidence-informed decision making: strategies for engagement between public health faculty and policymakers in Kenya

Future Health Systems

Jessani N, Kennedy C and Bennett S (2016) Enhancing evidence-informed decision making: strategies for engagement between public health faculty and policymakers in Kenya, Evidence & Policy: A Journal of Research, Debate and Practice, DOI: http://dx.doi.org/10.1332/174426416X14595114153349

Abstract

This article examines the complex interactions and strategies for engagement – both existing as well as desired – between academic Knowledge Brokers (KBs) and national health policymakers in Kenya. Based on semi-structured interviews with academic KBs and university leaders from six Schools of Public Health (SPHs) as well as national policymakers, the authors found that a delicate balance between leveraging personal individual relationships and establishing more sustained institutional partnerships is important for engagement. The authors provide a list of recommended strategies for effective and tailored engagement, and highlight the important but under-appreciated dual role of academic KBs within Kenyan universities.

Towards deep inclusion for equity-oriented health research priority-setting: A working model

Future Health Systems

Pratt B, Merritt M and Hyder AA (2016) Towards deep inclusion for equity-oriented health research priority-setting: A working model, Social Science and Medicine, vol 151, pp 215-224, doi:10.1016/j.socscimed.2016.01.018

Growing consensus that health research funders should align their investments with national research priorities presupposes that such national priorities exist and are just. Arguably, justice requires national health research priority-setting to promote health equity. Such a position is consistent with recommendations made by the World Health Organization and at global ministerial summits that health research should serve to reduce health inequalities between and within countries. Thus far, no specific requirements for equity-oriented research priority-setting have been described to guide policymakers. As a step towards the explication and defence of such requirements, we propose that deep inclusion is a key procedural component of equity-oriented research priority-setting.

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Availability and utilization of medical devices in Jimma zone hospitals, Southwest Ethiopia: a case study

Future Health Systems

Ademe BW, Tebeje B and Molla A (2016) Availability and utilization of medical devices in Jimma zone hospitals, Southwest Ethiopia: a case study, BMC Health Services Research, 16:287, DOI 10.1186/s12913-016-1523-2

Health systems throughout the world, whether in developed or developing countries, are struggling with the challenge of how to manage health-care delivery in conditions of resource constraint. The availability and utilization of various health care equipments at all levels of the health care system has been emphasized for effective and efficient service delivery. In Ethiopia lack of proper management of medical equipment limited the capacity of health institutions to deliver adequate health care. The main objective of this study was to assess availability and utilization of medical devices and identify reported reasons that affect availability and utilization of medical devices among hospitals in Jimma Zone. 

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FHS Key Message Brief 3: Unlocking community capability: key to more responsive, resilient and equitable health systems

Future Health Systems

In Future Health Systems, we focused on communities as active service delivery participants across a wide variety of contexts. In this brief, we reflect on the process of unlocking community capabilities, the key actors involved, and the productive tensions within community partnerships forged to build more responsive, resilient and equitable health systems.

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Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans

Future Health Systems

Vadrevu L and Kanjilal B (2016) Measuring spatial equity and access to maternal health services using enhanced two step floating catchment area method (E2SFCA) – a case study of the Indian Sundarbans, International Journal for Equity in Health, 15:87, DOI: 10.1186/s12939-016-0376-y

Inaccessibility due to terrain and lack of transport leaves mothers travelling for long hours before reaching a facility to deliver a child. This article analyzes the issue of spatial inaccessibility and inequity of maternal health services in the Indian Sundarbans where complex topography and repeated climatic adversities make access to health services very difficult. 

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MANIFEST Issue Brief 9: What a highly effective VHT for maternal and newborn health looks like

Future Health Systems

Makerere University School of Public health in collaboration with Ministry of Health and the three districts of Kamuli, Pallisa and Kibuku designed and implemented a four year (2012-2015) maternal and newborn study (MANIFEST) that aimed at improving access to institutionalized deliveries. One of the study components was community mobilization through use of Village Health Teams (VHTs), essentially community health workers. The VHTs were trained for five days and supervised by district level health workers and district health team (DHT) members with support from external trainers following a training of trainers (TOT). The VHTs effectively sensitized communities and improved awareness on birth preparedness, knowledge of danger signs and health facility service utilization. This brief therefore highlights the key characteristics of a good performing VHT based on observations of VHT performances over three years of implementation.

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MANIFEST Issue Brief 8: Supporting Local Saving groups improves financial management and their savings

Future Health Systems

Women in resource constrained settings often fail to seek care because of inadequate money, even though they often belong to small financial social networks where they save to help each other during funerals, buy meat during festive days, and contribute to wedding preparations among many other things. The Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study implemented in the districts of Kamuli, Kibuku and Pallisa exploited this opportunity by encouraging households to join existing financial social networks where households can save money, such as women’s saving groups, burial groups and financial circles, for maternal health. This Issue Brief outlines the key messages and recommendations from MANIFEST's experience.

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MANIFEST Issue Brief 7: Using integrated strategies can help improve knowledge of maternal & newborn danger signs and service utilization

Future Health Systems

Reducing maternal and newborn deaths has been a key goal for the Government of Uganda. Focus has been put on increasing access to reproductive health services including antenatal care and skilled birth attendance. Reducing maternal and newborn deaths cannot be solely achieved through increasing access to reproductive health services and skilled birth attendance. 

This brief shares key findings under the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study in both the intervention and control area. Integrated strategies were implemented to reduce maternal and newborn deaths in the districts of Kamuli, Kibuku and Pallisa, in Eastern Uganda.

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MANIFEST Issue Brief 5: Mentorship Contributes to Quality Improvement in Maternal and Newborn Care, Health Worker Motivation

Future Health Systems

Mentorship is deliberate pairing of a more skilled or experienced person with a lesser skilled or inexperienced one, with the agreed-upon goal of having the less experienced person to grow and develop specific competencies. Here, the more experienced (Mentor) guides the less experienced (Mentee) in the development of specific professional knowledge and skills which will promote personal and professional development of the mentee. This Brief is based on lessons learned from mentors and mentees following a one year mentorship exercise in three districts in Eastern Uganda.

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MANIFEST Issue Brief 4: Good Practices for District Health Teams to Improve Quality of Service Delivery: Lessons from MANIFEST

Future Health Systems

This MANIFEST Issue Brief shares lessons learned on how to enhance the commitment of district health teams, and presents the findings from quarterly district implementation committee review meeting minutes (four from each district), interviews with nine district health team members and observations made by the research team during the implementation of the project.

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MANIFEST Issue Brief 3: Professionalizing the Cadre of Facility Health Managers

Future Health Systems

Under the decentralized system of governance, health facilities are not only points of delivery but also hold resources that require management. The findings of this issue brief are based on 22 key informant interviews undertaken among health facility managers and select district health team members of three rural districts in Eastern Uganda. Pallisa, Kibuku and Kamuli were the districts in which Makerere University School of Public Health, through the MANIFEST study, intervened to improve management practices among health facility managers among other things.

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MANIFEST Issue Brief 2: Focussed Consistent Supportive Supervision Improves Management and Performance at Facility Level

Future Health Systems

In order to enhance quality of maternal and newborn care, the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study team championed a support supervision programme in Kamuli, Kibuku and Pallisa Districts. This MANIFEST Issue Brief outlines the issue, the MANIFEST experience and the results.

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MANIFEST Research Brief: Improving maternal and newborn health outcomes in Kamuli, Kibuku and Pallisa Districts in Eastern Uganda

Future Health Systems

This MANIFEST Research brief presents some of the key results from the end line survey of the 4-year study which aimed at contributing to the reduction of maternal and neonatal deaths through the use of a participatory action research approach.

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Health Systems Research Consortia and the Promotion of Health Equity in Low and Middle-Income Countries

Future Health Systems

Pratt B, Allen KA and Hyder AA (2016) Health Systems Research Consortia and the Promotion of Health Equity in Low and Middle-Income Countries, Developing World Bioethics, doi: 10.1111/dewb.12116

Recent conceptual work has explored what features might be necessary for health systems research consortia and their research programs to promote health equity. Identified features include selecting research priorities that focus on improving access to high-quality health services and/or financial protection for disadvantaged populations in LMICs and conducting research capacity strengthening that promotes the independent conduct of health systems research in LMICs. Yet, there has been no attempt to investigate whether existing consortia have such characteristics. This paper describes the results of a survey undertaken with health systems research consortia leaders worldwide to assess how consistent current practice is with the proposed ethical guidance.

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Addressing antimicrobial resistance in China: policy implementation in a complex context

Future Health Systems

Wang L, Zhang X, Liang X and Bloom G (2016) Addressing antimicrobial resistance in China: policy implementation in a complex context, Globalization and Health, 12:30, DOI: 10.1186/s12992-016-0167-7

The effectiveness of antibiotics in treating bacterial infections is decreasing in China because of the widespread development of resistant organisms. Although China has enacted a number of regulations to address this problem, but the impact is very limited. This paper investigates the implementation of these regulations through the lens of complex adaptive systems (CAS).

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