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Publications

Filtering by Category: 2015

Briefing – Ebola: Myths, Realities and Structural Violence

Future Health Systems

Wilkinson A and Leach M (2015) Briefing – Ebola: Myths, Realities and Structural Violence, African Affairs, Jan 2015, 114 (454): 136-148 doi:10.1093/afraf/adu080

Abstract

Ten months after the first infection, Margaret Chan, Director-General of the World Health Organization, described the Ebola epidemic in West Africa as the ‘most severe acute public health emergency in modern times’. The disaster, she said, represents a ‘crisis for international peace and security’ and threatens the ‘very survival of societies and governments in already very poor countries’. As of October 2014, the disease had killed 4,951 and infected 13,567. It has crippled families, health systems, livelihoods, food supplies and economies in its wake. These numbers are likely to be vastly underestimated. How did it get to this? Why has this outbreak been so much larger than previous ones? The scale of the disaster has been attributed to the weak health systems of affected countries, their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This answer, however, is woefully de-contextualized and de-politicized. This briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development.

Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh: an analysis over a 24-year period

Future Health Systems

Khan JAM, Trujillo AJ, Ahmed S, Siddiquee AT, Alam N, Mirelman AJ, Koehlmoos TP, Niessen LW and Peters DH (2015) Distribution of chronic disease mortality and deterioration in household socioeconomic status in rural Bangladesh - an analysis over a 24 year period, International Journal of Epidemiology, 44 (6), 1917-1926, doi: 10.1093/ije/dyv197

Little is known about long-term changes linking chronic diseases and poverty in low-income countries such as Bangladesh. This study examines how chronic disease mortality rates change across socioeconomic groups over time in Bangladesh, and whether such mortality is associated with households falling into poverty.

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Utility and limitations of measures of health inequities: a theoretical perspective

Future Health Systems

Alonge O, Peters DH, (2015) Utility and limitations of measures of health inequities: a theoretical perspective, Global Health Action, 8: 27591 - http://dx.doi.org/10.3402/gha.v8.27591

This paper examines common approaches for quantifying health inequities and assesses the extent to which they incorporate key theories necessary for explicating the definition of health inequity. The first theoretical analysis examined the distinction between inter-individual and inter-group health inequalities as measures of health inequities. The second analysis considered the notion of fairness in health inequalities from different philosophical perspectives. 

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Assessing the pro-poor effect of different contracting schemes for health services on health facilities in rural Afghanistan

Future Health Systems

Alonge O, Gupta S, Engineer C, Salehi AS, Peters DH, (2015) Assessing the pro-poor effect of different contracting schemes for health services on health facilities in rural Afghanistan, Health Policy & Plannning, 30 (10): 1229-1242, doi: 10.1093/heapol/czu127

Despite progress in improving health outcomes in Afghanistan by contracting public health services through non-governmental organizations (NGOs), inequity in access persists between the poor and non-poor. This study examined the distributive effect of different contracting types on primary health services provision between the poor and non-poor in rural Afghanistan.

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Assessing National Health Systems: Why and How

Future Health Systems

Bennett S and Peters D, (2015) Assessing National Health Systems: Why and How, Health Systems & Reform 1(1):9-17, DOI:10.1080/23288604.2014.997107

In reviewing national health systems assessments (HSAs), the authors identify four primary rationales for doing HSAs: (i) to motivate health systems reform, (ii) to promote harmonization and alignment across actors in the health system, (iii) to help translate health systems reforms into meaningful ways to track performance, and (iv) to facilitate learning through cross-country comparisons. The authors propose a set of principles to guide HSAs. 

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Corporate social responsibility in global health: an exploratory study of multinational pharmaceutical firms

Future Health Systems

Droppert H, Bennett S (2015) Corporate social responsibility in global health: an exploratory study of multinational pharmaceutical firms, Globalization and Health 2015 11:15, DOI: 10.1186/s12992-015-0100-5

As pharmaceutical firms experience increasing civil society pressure to act responsibly in a changing globalized world, many are expanding and/or reforming their corporate social responsibility (CSR) strategies. The authors of this journal article sought to understand how multinational pharmaceutical companies currently engage in CSR activities in the developing world aimed at global health impact, their motivations for doing so and how their CSR strategies are evolving.

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Promoting equity through health systems research in low and middle-income countries: Practices of researchers

Future Health Systems

Pratt B, Allen K A, Hyder A A (2015) Promoting equity through health systems research in low and middle-income countries: Practices of researchers, AJOB Empirical Bioethics, doi:10.1080/23294515.2015.1122669

Health systems research is increasingly identified as an indispensable means to achieve the goal of health equity between and within countries. While conceptual work has explored what form of health systems research in low and middle-income countries (LMICs) is needed to promote health equity, there have been few attempts to investigate whether it is being performed in practice. This paper describes the results of a survey undertaken with health systems researchers worldwide to assess how equity-oriented current practice is in LMICs.

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Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system

Future Health Systems

Edward, A., Branchini, C., Aitken, I., Roach, M., Osei-Bonsu, K., & Arwal, S. H. (2015) Toward universal coverage in Afghanistan: A multi-stakeholder assessment of capacity investments in the community health worker system, Social Science & Medicine, Vol 145, pp 173-183, doi:10.1016/j.socscimed.2015.06.011

Global efforts to scale-up the community health workforce have accelerated as a result of the growing evidence of their effectiveness to enhance coverage and health outcomes. Reconstruction efforts in Afghanistan integrated capacity investments for community based service delivery, including the deployment of over 28,000 community health workers (CHWs) to ensure access to basic preventive and curative services. The study aimed to conduct capacity assessments of the CHW system and determine stakeholder perspectives of CHW performance. 

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Determinants of readiness to adopt mHealth in a rural community of Bangladesh

Future Health Systems

 

Khatuna F, Heywood AE, Ray PK, SMA Hanifi, Bhuiya A, Liaw ST (2015) Determinants of readiness to adopt mHealth in a rural community of Bangladesh, International Journal of Medical Informatics, Volume 84, Issue 10, Pages 847–856, http://dx.doi.org/10.1016/j.ijmedinf.2015.06.008

Evidence in favour of mHealth for healthcare delivery in settings where trained health workforce is limited or unavailable is accumulating. With rapid growth in access to mobile phones and an acute shortage of health workforce in Bangladesh, mHealth initiatives are increasing with more than 20 current initiatives in place. “Readiness” is a crucial prerequisite to the successful implementation of telehealth programs. However, systematic assessment of the community readiness for mHealth-based services in the country is lacking. This article reports on a recent study describing the influence of community readiness for mHealth of a rural Bangladesh community.

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Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh

Future Health Systems

Khan NUZ, Rasheed S, Sharmin T, Ahmed T, Mahmood SS, Khatun F, Hanifi SMA, Hoque S, Iqbal M and Bhuiya A (2015) Experience of using mHealth to link village doctors with physicians: lessons from Chakaria, Bangladesh, BMC Medical Informatics and Decision Making, 15:62, doi:10.1186/s12911-015-0188-9

Bangladesh is facing serious shortage of trained health professionals. In the pluralistic healthcare system of Bangladesh, formal health care providers constitute only 5 % of the total workforce; the rest are informal health care providers. Information Communication Technologies (ICTs) are increasingly seen as a powerful tool for linking the community with formal healthcare providers. This study assesses an intervention that linked village doctors (a cadre of informal health care providers practising modern medicine) to formal doctors through call centres from the perspective of the village doctors who participated in the intervention.

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Are free anti-tuberculosis drugs enough? An empirical study from three cities in China

Future Health Systems

Chen S, Zhang H, Pan Y, Long Q, Xiang L, Yao L and Lucas H (2015) Are free anti-tuberculosis drugs enough? An empirical study from three cities in China, Infectious Diseases of Poverty, 4:47, doi:10.1186/s40249-015-0080-y

Tuberculosis (TB) patients in China still face a number of barriers in seeking diagnosis and treatment. There is evidence that the economic burden on TB patients and their households discourages treatment compliance.  Data were collected using a questionnaire survey, key informant interviews and focus group discussions with TB patients to gain an understanding of the economic burden of TB and implications of this burden for treatment compliance.

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Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya

Future Health Systems

The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role—serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, the authors administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks.

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Community Participation in Health Systems Research: A Systematic Review

Future Health Systems

George AS, Mehra V, Scott K, Sriram V (2015) Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities. PLoS ONE 10(10): e0141091. doi:10.1371/journal.pone.0141091

Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research.

This systematic review explores the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries.

It concludes that despite positive examples, community participation in health systems interventions was variable, with few being truly community directed. Future research should more thoroughly engage with community participation theory, recognize the power relations inherent in community participation, and be more realistic as to how much communities can participate and cognisant of who decides that.

Symposium on the Private Sector in Health: Sydney 2013

Future Health Systems

There is a growing appreciation and recognition of the role of the private sector in the development of better health systems and the improvement of healthcare worldwide.

This Health Policy and Planning supplement reflects contributions to a Symposium of the Health Systems Global Private Sector in Health Thematic Working Group during the 9th World Congress on Health Economics, held in Sydney in July 2013. Members of the PSIH TWG that convened the Symposium included FHS members David Bishai (JHBSPH) and Gerry Bloom (IDS), and was generously supported by Rockefeller, Gates, USAID, AusAid (DFAT), and DFID.

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Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda

Future Health Systems

Musoke D., Ekirapa-Kiracho E., Ndejjo R. and George A. (2015) Using photovoice to examine community level barriers affecting maternal health in rural Wakiso district, Uganda, Reproductive Health Matters, 23(45):136-47, doi: 10.1016/j.rhm.2015.06.011

Uganda continues to have poor maternal health indicators including a high maternal mortality ratio. This paper explores community level barriers affecting maternal health in rural Wakiso district, Uganda. Using photovoice, a community-based participatory research approach, over a five-month period, ten young community members aged 18-29 years took photographs and analysed them, developing an understanding of the emerging issues and engaging in community dialogue on them. Photovoice's strength is in generating evidence by community members in ways that articulate their perspectives, support local action and allow direct communication with stakeholders.

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Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review

Future Health Systems

George AS, Branchini C, Portela A (2015) Do Interventions that Promote Awareness of Rights Increase Use of Maternity Care Services? A Systematic Review. PLoS ONE 10(10): e0138116. doi:10.1371/journal.pone.0138116

Twenty years after the rights of women to go through pregnancy and childbirth safely were recognized by governments, The authors of this systematic review assessed the effects of interventions that promote awareness of these rights to increase use of maternity care services. Using inclusion and exclusion criteria defined in a peer-reviewed protocol, the authors searched published and grey literature from one database of studies on maternal health, two search engines, an internet search and contact with experts.

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Logics of government innovation and reform management in China

Future Health Systems

Since the beginning of reforms in the late 1970s, China has developed rapidly, transforming itself into a middle-income country, raising hundreds of millions out of poverty and, latterly, developing broad-based social protection systems. The country’s approach to reform has been unorthodox, leading many to talk of a specific Chinese model of development. This paper analyses the role of innovation (chuangxin) and experimentation in the Chinese government repertoire and their contribution to management of change during the rapid, complex and interconnected reforms that China is undergoing. 

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Sexual and reproductive health and rights and mHealth in policy and practice in South Africa

Future Health Systems

Waldman, L. and Stevens, M. (2015) Sexual and reproductive health and rights and mHealth in policy and practice in South Africa, Reproductive Health Matters, Vol 23, Issue 45, PP 93 - 102, doi:10.1016/j.rhm.2015.06.009

Information and Communications Technology (ICT) offers enormous opportunity and innovation to improve public health and health systems.This paper explores the intersections between mHealth and sexual and reproductive health and rights in both policy and practice. It is a qualitative study, informed by policy review and key informant interviews. Three case studies provide evidence of what is happening on the ground in relation to ICTs and reproductive health and rights.

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Reflections of Child Health Rights: Perspectives from Healthcare Stakeholders in North India

Future Health Systems

Bhati, D. K. (2015) Reflections of Child Health Rights: Perspectives from Healthcare Stakeholders in North India, European Scientific Journal, Vol 11, No 18, pp 143-15

In health-care settings, stakeholder’s knowledge, attitudes and perspectives influence their perception towards children, including children’s rights and right to health. The knowledge and attitudes generally present a culture of how children’s right are perceived and treated. This study explored the knowledge, attitudes and perspectives of 35 Indian health care stakeholders regarding children’s rights and right to health and their perspectives on realization of the selected domains of rights in reality. 

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Understanding Health Information Seeking from an Actor-Centric Perspective

Future Health Systems

This paper presents a conceptual approach for discussing health information seeking among poor households in Africa and Asia. This approach is part of a larger research endeavor aimed at understanding how health systems are adapting; with possibilities and constraints emerging. These health systems can be found in a context of the changing relationships between states, markets and civil society in low and middle income countries. The paper starts from an understanding of the health sector as a “health knowledge economy”, organized to provide people with access to knowledge and advice. The use of the term “health knowledge economy” draws attention to the ways the health sector is part of a broader knowledge economy changing the way individuals and households obtain and use specialist information. The paper integrates an actor centric approach with the theory of planned behavior. It seeks to identify the actors engaged in the health knowledge economy as a precursor to longer term studies on the uptake of innovations integrating health services with mobile phones, commonly designated as mHealth, contributing to an understanding of the potential vulnerabilities of poor people, and highlighting possible dangers if providers of health information and advice are strongly influenced by interest groups.

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