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Publications

Filtering by Category: Working paper

Accountability in Health Systems and the Potential of mHealth

Future Health Systems

This Working Paper explores the literature on accountability in health systems and on mHealth and to build theoretical and empirical bridges between them. In so doing, the authors lay out a clearer understanding of the role that mHealth can play in accountability for public health services in LMICs, as well as its limitations. At the centre of this role is technology-facilitated information which, for instance, can help governments enforce and improve existing health policy, and which can assist citizens and civil society to communicate with each other to learn more about their rights, and to engage in data collection, monitoring and advocacy. Ultimately however, information, facilitated as it may be by mHealth, does not automatically lead to improved accountability. Different forms of health care come with different accountability challenges to which mHealth is only variably up to task. Furthermore, health systems, embedded as they are in diverse political, social and economic contexts, are extremely complex, and accountability requires far more than information. Thus, mHealth can serve as a tool for accountability, but is likely only able to make a difference in institutional systems that support accountability in other ways (both formal and informal) and in which political actors and health service providers are willing and able to change their behaviour. 

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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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Addressing Resistance To Antibiotics In Pluralistic Health Systems

Future Health Systems

There is growing international concern about the threat to public health of the emergence and spread of bacteria resistant to existing antibiotics. An effective response must invest in both the development of new drugs and measures to slow the emergence of resistance. This paper addresses the former. It focuses on low and middle-income countries with pluralistic health systems, where people obtain much of their antibiotics in unorganised markets. 

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Building a Resilient Health System: Lessons from Northern Nigeria

Future Health Systems

The overarching aim of this paper is to address the issue of building resilient health systems in the context of the Ebola outbreak in West Africa which has brought renewed attention to this challenge. The paper highlights insight gained from two decades work creating resilient health systems in Nigeria—in Northern Nigeria in particular. In highlighting how the “simple” basics of outbreak control tie into larger, complex adaptive systems, this paper summarises key learning from the Nigerian experience as a basis for suggesting both how such outbreaks can be averted in the future and how sustainable development goals around eliminating excess mortality and improving health equity can be realised in practice.

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সুন্দরবনের শিশুদের স্বাস্থ্য: বাংলা সংস্করণ - ২০১৪

Future Health Systems

এফ.এইচ.এস.- ইন্ডিয়া ২০০৯ সাল থেকেই সুন্দরবনের মানুষের স্বাস্থ্যের ওপর গবেষণার কাজ চালাচ্ছে। বর্তমানে  (২০১০ সাল থেকে) এফ.এইচ.এস. শিশু স্বাস্থ্যের ওপর বেশি গুরুত্ব দিয়ে কাজ করছে। সম্প্রতি সুন্দরবনের পাথরপ্রতিমা ব্লকে শিশু -স্বাস্থ্যের ওপর একটি সমীক্ষা করা হয়েছে। বর্তমান রিপোর্টটিতে এলাকার শিশু স্বাস্থ্যের বিভিন্ন দিক ও তার বর্তমান অবস্থা, স্বাস্থ্য পরিষেবার ক্ষেত্রে ফাঁকফোকর গুলি ও সম্ভাব্য সমাধানসূত্র তুলে ধরার চেষ্টা করা হয়েছে। এফ.এইচ.এস.- ইন্ডিয়ার এই গবেষণাটি আরও বেশি করে সুন্দরবনের মানুষের মাঝে পৌঁছে দেওয়ার জন্য এই বাংলা সংস্করণটি প্রকাশিত হল।

 

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Engaging with Health Markets in Low and Middle-Income Countries

Future Health Systems

Many low and middle-income countries have pluralistic health systems with a variety of providers of health-related goods and services in terms of their level of training, their ownership (public or private) and their relationship with the regulatory system. The development of institutional arrangements to influence their performance has lagged behind the spread of these markets. This paper presents a framework for analysing a pluralistic health system. 

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Sundarbans Health Watch - Series 1: How healthy are the children of the Sundarbans

Future Health Systems

The present report focuses on one of the more vulnerable blocks of the Sundarbans in West Bengal, India -- namely Patharpratima -- as a representative block of the Sundarbans. To understand the root of the problem, the study takes a child health right approach and attempts to understand whether and to what extent the rights are protected, especially in climatically challenged areas such as the Sundarbans. In a nutshell, this report generates research evidence on the barriers to service delivery and access of health care services for children and endeavours to find out ways to make the system more effective in the Sundarbans.
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WP16 - Child health in the Sundarbans: How far mutually reinforcing shocks act as contextual determinants?

Future Health Systems

Childhood chronic undernutrition and common childhood illness is highly prevalent in the Sundarbans delta region of West Bengal, India. The present work tested the hypothesis- frequent climatic shock is likely to predispose chronic and transient health shocks through behavioural responses of households in the presence of inaccessibility, inadequacy and acceptability barriers which act in the economy as long wave shocks.
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WP15 - Nutritional Status of Children in India: Household Socio-Economic Condition as the Contextual Determinant

Future Health Systems

Despite recent achievement in economic progress in India, the fruit of development has failed to secure a better nutritional status among all children of the country. Growing evidence suggest there exists a socioeconomic gradient of childhood malnutrition in India. The present paper is an attempt to measure the extent of socio-economic inequality in chronic childhood malnutrition across major states of India and to realize the role of household socio-economic status (SES) as the contextual determinant of nutritional status of children.
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WP14 - Revisiting the Role of Geographical Accessibility in Women's Access to Healthcare

Future Health Systems

The objectives of this working papers are studying the differentials of health service availability and uptake of services particularly for women's health needs related to out-patient care and institutional childbirth. Understanding their various predictors, along with the issues related to geographical accessibility, in the context of the Sundarbans.
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WP13 - Engaging the private sector in maternal and neonatal health in low and middle income countries

Future Health Systems

We reviewed existing literature on private sector initiatives that have shown effectiveness in improving maternal and neonatal health. The private sector constitutes a significant proportion of delivery services for women in developing countries and it also plays a key role in family planning, abortion, nutrition, and antenatal care. We primarily address maternal health outcomes and include interventions that improve neonatal health outcomes where they are included in the study design or interventional strategy alongside maternal outcomes. We do not review evidence that addresses neonatal outcomes alone, as this would go beyond the scope of this paper.
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WP12: Who Are ‘Informal Health Providers’ and What Do They Do? Perspectives from Medical Anthropology

Future Health Systems

This paper explores gaps and limitations in the conceptualisation, methodology and policy implications of debates about informal health care providers by examining a cross section of empirical studies. Drawing on a tradition of critical medical anthropology, we argue that existing debates hinge on a particular understanding of what constitutes appropriate knowledge and on particular expectations of how economic actors in the medical marketplace will behave.
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WP10: Health Shock Vulnerabilities and Its Correlates Exploring the Linkages for In-patient Care Seekers in West Bengal

Future Health Systems

The objective of this working paper was to find out the correlates of health shock vulnerabilities for in-patient care seekers and understanding the process through which the impact of immediate determinants change after controlling for different basic and underlying factors in West Bengal, India.
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WP9 - Demand and Supply side barriers in Access to Childhood Immunization Services - A Case Study of Murshidabad, West Bengal

Future Health Systems

The objective of this paper is to elucidate the independent role of various demand side and supply side factors as barriers to access childhood immunization and how their impact change when both these sides are taken together, in the Mushidabad district or West Bengal, India.
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WP7 - Provider performance and information and communication technologies

Future Health Systems

There has been much discussion of the role that recent advances in information and communication technologies (ICTs) can play in improving health provider performance, though as yet there seems to be little reliable, independently verified evidence to support the claims of those who initially viewed the new ICTs as offering ―a revolution in global healthcare management‖ (Séror 2001, p. 1). In particular, limited systematic attention has been given to the application of ICTs by private providers in developing countries, with most of the international agencies concerned with these issues tending to focus on large-scale public sector innovations (e.g., Chetley 2006; WHO 2006).
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WP6 - Making health markets work better for poor people: Improving provider performance

Future Health Systems

Much analysis of health care markets draws heavily on the experiences of the advanced market economies where there is a much clearer demarcation of the roles of, and boundaries between, the public and private sectors in delivering services. This has led to a tendency to seek models for ―working with the private sector‖ from these countries, without taking sufficient account of their strong institutional and regulatory arrangements for both market and non-market services (Bloom and Standing 2008). This paper argues for a different approach to policy formulation that bases the assessment of the likely outcome of different reform options on a closer understanding of the realities of the markets that have emerged in developing and transitional economies.
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WP5 - Innovative service models to improve quality and access

Future Health Systems

This paper discusses the economic rationale for innovative service models in private sector health care delivery. Social franchising and other business models of health care delivery secure cooperation between providers, and coordinating agencies in order to improve quality, access, and efficiency of primary health care (PHC) in the private sector.
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WP4 - Health, Equity and Poverty Exploring the Links in West Bengal, India

Future Health Systems

India is on a fast-track growth path and the health care market is opening up with new opportunities. However, impressive growth with inadequate social protection may lead to newer vulnerabilities, inequalities, and health related poverty. The study focused on one Indian state (West Bengal) to explore the link between health, poverty, and equity against this dynamic backdrop. Primary data - from households and different types of providers - were collected from three districts of the state.
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WP3 - Financial protection in health in rural China, 1978-2005: Trends and current status

Future Health Systems

In this paper, we focus on financial protection in rural China, where 745 million–57% of the Chinese people–reside (National Bureau of Statistics of China, 2006). First, we illustrate the degree of financial protection that rural residents have after a series of reforms and changes since 1978. Then we review the current rural health insurance reforms as well as the results from the pilot programs. We conclude with recommendations for future policies and programs.
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