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Publications

Filtering by Category: 2014

Informal rural healthcare providers in North and South India

Future Health Systems

Rural households in India rely extensively on informal biomedical providers, who lack valid medical qualifications. Their numbers far exceed those of formal providers. Our study reports on the education, knowledge, practices and relationships of informal providers (IPs) in two very different districts: Tehri Garhwal in Uttarakhand (north) and Guntur in Andhra Pradesh (south).

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Maternal and Newborn Health Symposium 2014: Sharing Experiences & Learning from Stakeholders

Future Health Systems

The Makerere University School of Public Health (MakSPH) has conducted several maternal health related projects over the years. MakSPH held a Maternal and Newborn Health symposium on May 14, 2014 in Kampala to herald a new beginning in dealing with key stakeholders. This publication recaps the key takeaways from the symposium and captures various views of participants.

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Roundtable discussion: what is the future role of the private sector in health?

Future Health Systems

The role for the private sector in health remains subject to much debate, especially within the context of achieving universal health coverage. This roundtable discussion offers diverse perspectives from a range of stakeholders - a health funder, a representative from an implementing organization, a national-level policy-maker, and an expert working in a large multi-national company - on what the future may hold for the private sector in health.

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Accelerating learning for pro-poor health markets

Future Health Systems

Given the rapid evolution of health markets, learning is key to promoting the identification and uptake of health market policies and practices that better serve the needs of the poor. However there are significant challenges to learning about health markets. We discuss the different forms that learning takes, from the development of codified scientific knowledge, through to experience-based learning, all in relationship to health markets.

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Innovation in regulation of rapidly changing health markets

Future Health Systems

The rapid evolution and spread of health markets across low and middle-income countries (LMICs) has contributed to a significant increase in the availability of health-related goods and services around the world. The support institutions needed to regulate these markets have lagged behind, with regulatory systems that are weak and under-resourced. This paper explores the key issues associated with regulation of health markets in LMICs, and the different goals of regulation, namely quality and safety of care, value for money, social agreement over fair access and financing, and accountability.

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Private sector, for-profit health providers in low and middle income countries: can they reach the poor at scale?

Future Health Systems

The bottom of the pyramid concept suggests that profit can be made in providing goods and services to poor people, when high volume is combined with low margins. To-date there has been very limited empirical evidence from the health sector concerning the scope and potential for such bottom of the pyramid models. This paper analyzes private for-profit (PFP) providers currently offering services to the poor on a large scale, and assesses the future prospects of bottom of the pyramid models in health.

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Catastrophic out-of-pocket payment for healthcare and implications for household coping strategies: evidence from West Bengal, India'

Future Health Systems

Using data from a household survey in West Bengal, the purpose of this paper is to identify the relative risks of catastrophic healthcare expenditures for different types of health need, and the impact of such expenditure on household coping strategies. It concludes that Catastrophic health spending is an important problem for the population in West Bengal. More attention is needed on the poverty-inducing effects of long-term expenditures on chronic illness, given that existing schemes only address hospitalization.

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eHealth and mHealth initiatives in Bangladesh: A scoping study

Future Health Systems

The health system of Bangladesh is haunted by challenges of accessibility and affordability. Despite impressive gains in many health indicators, recent evidence has raised concerns regarding the utilization, quality and equity of healthcare. In the context of new and unfamiliar public health challenges including high population density and rapid urbanization, eHealth and mHealth are being promoted as a route to cost-effective, equitable and quality healthcare in Bangladesh. The aim of this paper is to highlight such initiatives and understand their true potential.

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Institutional capacity for health systems research in East and Central African schools of public health: knowledge translation and effective communication

Future Health Systems

Local health systems research (HSR) provides policymakers and practitioners with contextual, evidence-based solutions to health problems. However, producers and users of HSR rarely understand the complexities of the context within which each operates, leading to the "know-do" gap. Universities are well placed to conduct knowledge translation (KT) integrating research production with uptake. The HEALTH Alliance Africa Hub, a consortium of seven schools of public health (SPHs) in East and Central Africa, was formed to build capacity in HSR. This paper presents information on the capacity of the various SPHs to conduct KT activities.

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Institutional capacity for health systems research in East and Central African schools of public health: experiences with a capacity assessment tool

Future Health Systems

Despite significant investments in health systems research (HSR) capacity development, there is a dearth of information regarding how to assess HSR capacity. An alliance of schools of public health (SPHs) in East and Central Africa developed a tool for the self-assessment of HSR capacity with the aim of producing institutional capacity development plans.

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Institutional capacity for health systems research in East and Central Africa schools of public health: enhancing capacity to design and implement teaching programs

Future Health Systems

The role of health systems research (HSR) in informing and guiding national programs and policies has been increasingly recognized. Yet, many universities in sub-Saharan African countries have relatively limited capacity to teach HSR. Seven schools of public health (SPHs) in East and Central Africa undertook an HSR institutional capacity assessment, which included a review of current HSR teaching programs. This study determines the extent to which SPHs are engaged in teaching HSR-relevant courses and assessing their capacities to effectively design and implement HSR curricula whose graduates are equipped to address HSR needs while helping to strengthen public health policy.

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Institutional capacity for health systems research in East and Central African Schools of Public Health: strengthening human and financial resources

Future Health Systems

Despite its importance in providing evidence for health-related policy and decision-making, an insufficient amount of health systems research (HSR) is conducted in low-income countries (LICs). Schools of public health (SPHs) are key stakeholders in HSR. This paper, one in a series of four, examines human and financial resources capacities, policies and organizational support for HSR in seven Africa Hub SPHs in East and Central Africa.

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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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People-centred science: strengthening the practice of health policy and systems research

Future Health Systems

Health policy and systems research (HPSR) is a transdisciplinary field of global importance, with its own emerging standards for creating, evaluating, and utilizing knowledge, and distinguished by a particular orientation towards influencing policy and wider action to strengthen health systems. In this commentary, we argue that the ability of the HPSR field to influence real world change hinges on its becoming more people-centred. We see people-centredness as recognizing the field of enquiry as one of social construction, requiring those conducting HPSR to locate their own position in the system, and conduct and publish research in a manner that foregrounds human agency attributes and values, and is acutely attentive to policy context. 

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E-health and M-health in Bangladesh: Opportunities and Challenges

Future Health Systems

There is growing enthusiasm amongst analysts of global health for the possibilities opened up by the rapid spread of mobile phone coverage. This includes substantially increasing access to health-related information and advice and to expert medical consultations.This report presents a snapshot of how information and communication technologies (ICTs) are influencing health system development in Bangladesh.

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FHS Annual Report (2012-13)

Future Health Systems

The goal of Future Health Systems (FHS) is to improve access, affordability and quality of health services for the poor. In order to build resilient health systems for the future, we generate high quality scientific knowledge about how health systems can better deliver basic health services to the world’s poor. FHS supports its country research teams to identify and respond to health system challenges identified by local stakeholders. This annual report from the period 2012-13 captures our ongoing research, research uptake, and capacity building activities.

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A bioethical framework for health systems activity: a conceptual exploration applying ‘systems thinking’

Future Health Systems

Recognizing that the health system is a complex and dynamic network of actors and activities, this paper seeks to push the field of bioethics to develop a more holistic approach from the health systems perspective. Expanding upon the work of existing public health frameworks and drawing upon concepts from related areas such as governance, human rights, and organizational ethics, our provisional list of ethical considerations for health systems fall under the following categories: Holism, Sustainability, Evidence & Effectiveness, Efficiency, Public Engagement & Transparency, Accountability & Feedback, Equity & Empowerment, Justice & Fairness, Responsiveness, Collaboration, and Quality.

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FHS Bangladesh Research Brief 6: Knowledge of, Attitude towards, and Use of mHealth Services in Chakaria, Bangladesh

Future Health Systems

Bangladesh has a serious shortage of physicians, paramedics, nurses, and midwives. The available qualified care providers are centred in urban areas, resulting in an inequitable access of the rural and disadvantaged sections of the population to healthcare. Under these circumstances, the use of mHealth meaning provision of healthcare services through mobile devices provides a new opportunity to ensure access to quality healthcare services for the population in general, and for people from poorer sections and hard-to-reach areas in particular. There are currently around 20 mHealth service initiatives in the country which are mostly telephone hotlines for consulting physicians and/or obtaining healthcare information. Effectiveness of these services depends on the evidence-informed development of appropriate programmes designed around people’s perceptions of mHealth and user feedback. To that end, FHS Bangladesh partner, ICDDR,B recently conducted a survey on mHealth in Chakaria, a rural area in the southeast coastal area of Bangladesh. This brief presents the findings from this survey.

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