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Publications

Filtering by Category: 2015

Lessons learnt during the process of setup and implementation of the voucher scheme in Eastern Uganda: a mixed methods study

Future Health Systems

In spite of the investments made by the Ugandan Government, the utilisation of maternal health services has remained low, resulting in a high maternal mortality (438 maternal deaths per 100,000 live births). Aiming to reduce poor women’s constraints to the utilisation of services, an intervention consisting of a voucher scheme and health system strengthening was implemented. This paper presents the lessons learnt during the setup and implementation of the intervention in Eastern Uganda, in order to inform the design and scale up of similar future interventions.

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Study on Policy of Medical Assistance (MA) for Catastrophic Diseases/ 重特大疾病医疗救助政策研究

Future Health Systems

Establishment of medical security and assistance mechanisms for catastrophic diseases is the focus of health care reform to tackle the large medical expense burden. Based on sorting out the stage of the development of China's severe illness security policy, point out the cotent and difficulties of the connection of medical assistance and medical insurance for catastrophic diseases, analyse the main problems of medical assistance for catastrophic diseases and give appropriate policy recommendations.

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What Lessons for Sustainability of Maternal Health Interventions Can Be Drawn from Rural Water And Sanitation Projects? Perspectives from Eastern Uganda

Future Health Systems

Sustainability of health interventions is a global concern, as program benefits are lost as soon as programs lose donor funding. An assessment of the Uganda Rural Water and Sanitation (RUWASA) project revealed that program gains can be sustained decades later. The authors of this journal article analysed RUWASA implementation to draw sustainability lessons for maternal and child health interventions in Uganda and found that community engagement, contributions, use of structures and ownership of RUWASA was critical for the sustainability of the intervention.

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Honouring the Value of People in Public Health

Future Health Systems

Complex and dynamic public health problems require a different approach: an emphasis on the value of people. People who own the problem can anticipate the most likely social obstacles to its resolution, and their participation is essential to maintain an evolving strategy that can institutionalize an approach to the problem.

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Productive Global Health Research from Africa: It Takes More

Future Health Systems

In this editorial in the International Journal of Public Health, Peter Waiswa, Makerere University School of Public Health, Uganda, says that without significant and sustained building of African research capacity, progress towards achieving development goals and overcoming health challenges will be difficult.

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MANIFEST Progress Brief 3: Mentorship Contributes to Quality Improvement in Maternal and Newborn Care, Health Worker Motivation

Future Health Systems

The concept of clinical mentorship is increasingly becoming important in order to improve the delivery of quality healthcare services.  This MANIFEST Progress Brief is based on perspectives of mentors and mentees following a six month mentorship exercise in the districts of Kamuli, Kibuku and Pallisa in eastern Uganda. It outlines the issue, the approach taken, preliminary results, a summary of findings, improvements in clinical care, administrative improvements and challenges. 

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MANIFEST Progress Brief 2: Working with Communities to Save Money for Meeting Maternal and Newborn Needs

Future Health Systems

This Progress Brief looks at the component of the MANIFEST study that aims to  increase financial and physical access to maternal health services by promoting financial preparedness as well as availability of routine and referral transport. It outlines the approach taken, the preliminary findings, the challenges and the lessons learnt.

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MANIFEST Progress Brief 1: Village Health Teams (VHTs) are an Important Resource for Community Mobilization and Health Information

Future Health Systems

This Progress Brief brief highlights implementation experiences from the Maternal and Neonatal Implementation for Equitable Systems (MANIFEST) study using VHTs to stimulate demand for maternal and newborn health services. It outlines the approach taken, preliminary findings, challenges and lessons learnt.

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mHealth and Gender: Making the Connection

Future Health Systems

The use of mHealth interventions within health systems research is increasing, with few taking into account the connections between gender and mHealth.

This policy brief attempts to fill this gap by exploring key connections between mHealth and gender that need to be taken into account when conducting or implementing mHealth research and interventions. 

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Global Justice and Health Systems Research in Low- and Middle-Income Countries

Future Health Systems

Pratt, B. and Hyder, A. A. (2015), Global Justice and Health Systems Research in Low- and Middle-Income Countries. The Journal of Law, Medicine & Ethics, 43: 143–161. doi: 10.1111/jlme.12202

Scholarship focusing on how international research can contribute to justice in global health has primarily explored requirements for the conduct of clinical trials. Yet health systems research in low- and middle-income countries (LMICs) has increasingly been identified as vital to the reduction of health disparities between and within countries. This paper expands an existing ethical framework based on the health capability paradigm – research for health justice – to externally-funded health systems research in LMICs. It argues that a specific form of health systems research in LMICs is required if the enterprise is to advance global health equity. “Research for health justice” requirements for priority setting, research capacity strengthening, and post-study benefits in health systems research are derived in light of the field's distinctive characteristics. Specific obligations are established for external research actors, including governments, funders, sponsors, and investigators. How these framework requirements differ from those for international clinical research is discussed.

FHS India Research Brief 8: Early Childhood Development in the Sundarbans Neglect in the face of risks and adversity

Future Health Systems

Risks and adversities during early childhood majorly hamper this neurological development. They are also irreversible with long standing impact on the eventual productivity in life. Given the huge impact that deficits in the early years have in terms of human productivity and sustainable development, early childhood development needs serious attention. This research brief provides formative evidence on the gaps in the care practices needed for Early Childhood Development in the Sundarbans. It will begin by first gauging the status of child development, the gaps and challenges in key practices needed for it and it will conclude with key recommendations.

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FHS India Research Brief 7: Open defecation and childhood undernutrition in the Indian Sundarbans: A case study from rural West Bengal

Future Health Systems

Among the several determinants of child malnutrition – ranging from individual factors to societal ones – recent evidence indicates open defecation as an important determinant responsible for child malnutrition. This research brief explores the association between underweight children (0-6 years) and open defecation in the context of Indian Sundarbans, where low body weight is considered as an indicator of childhood malnutrition.

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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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Applying a Global Justice Lens to Health Systems Research Ethics: An Initial Exploration

Future Health Systems

B. Pratt and A. A. Hyder (2015) Applying a Global Justice Lens to Health Systems Research Ethics: An Initial Exploration, Kennedy Institute of Ethics Journal, Volume 25, Number 1, March 2015, pp. 35-66, DOI: 10.1353/ken.2015.0005

Health systems research is increasingly being performed in low and middle income countries and is essential to reducing global health disparities. This paper provides an initial description of the ethical issues related to priority setting, capacity-building, and the provision of post-study benefits that arise during the conduct of such research. It presents a selection of issues discussed in the health systems research literature and argues that they constitute ethical concerns based on their being inconsistent with a particular theory of global justice (the health capability paradigm).

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Gender Differentials in the Impact of Multi-Morbidity on Self Rated Health in Rural West Bengal in India

Future Health Systems

Vadrevu L, Kumar V, Kanjilal B (2015) Gender Differentials in the Impact of Multi-Morbidity on Self Rated Health in Rural West Bengal in India. IOSR J Nurs Heal Sci 2015, 4:16–21. DOI: 10.9790/1959-04231621

Self Rated Health (SRH) has widely been used as an indicator of overall health in a population. Given the rising burden of chronic conditions even in the rural region of India, the present study explores the gender differentials in the impact of multi-morbidity on SRH in the Sundarbans of West Bengal.

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Strengthening Health Systems for Resilience

Future Health Systems

In countries with high levels of poverty or instability and with poor health system management and governance, people are highly vulnerable to shocks associated with ill health, including major epidemics. An effective health system can help build their resilience by reducing exposure to infection and minimising the impact of sickness on livelihoods and economic development. 

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