The research in this technical brief is part of a multi-country study commissioned by the Alliance for Health Policy and Systems Research to understand the evidence-to-policy process around health decisions in Ghana, Ethiopia and Mozambique. Through surveys and in-depth interviews with representatives from 54 locally based research institutions and 41 health policy-makers, the studies explored the entire chain of evidence generation, from conception of the research idea, through to its synthesis and dissemination. For each country, this included discussions with key actors involved in tracer policies. This technical brief distils regional lessons from the studies and offers a set of recommendations to support efforts to develop and strengthen existing institutions towards enhanced uptake of research.
The challenges to better health services in Africa are well known: Africa lags behind all regions of the world, including other developing regions, on all indicators of better health. A recent report from the World Health Organisation for instance shows that while Africa has 20% of the world's sick people, it has only 4% of its healthcare workers - many of them vulnerable to the high mortality rate associated with malaria and notably the AIDS epidemic. The state of investment in healthcare infrastructure is also grossly inadequate as is the efficiency of healthcare delivery. But does this need to be so? What factors are responsible for this unacceptable state of affairs? Contributors to the volume examine the evolution of healthcare services in Africa, the ongoing national, regional and continental efforts to improve the delivery of healthcare in the continent, and the direct and indirect obstacles militating against the maturation of the services and their efficient delivery. The contributors - all distinguished experts in the field, who hold either challenging responsibilities in health in Africa or have worked in multiple components of the healthcare delivery system in the continent - also provide powerful personal insights and lessons learned in their current or previous work in the health sector in Africa. Some of the themes covered include clinical care and centers of excellence, healthcare finance and resource mobilization, primary health care systems and community health; preventive care and risk reduction in health; the role of reference laboratories; clinical research and partnerships, the role of epidemiology, statistics, monitoring and evaluation in health services; the role of the African Diaspora, and the role of politics in the organization of healthcare and the training of medical and other health professionals. From their analyses and experience the authors articulate proven strategies and solutions based on consensus expert opinions on how to improve the quality of health services and health outcomes in the continent.
Contemporary Healthcare Issues in Sub-Saharan Africa: Social, Economic, and Cultural Perspectives discusses contemporary healthcare issues in Sub-Saharan Africa to identify deficiencies in the system and provide workable recommendations for strengthening healthcare delivery on the continent. Contributors address topical issues such as drug quality, malaria control, health insurance, geriatric care, and the environment-health nexus. The contributors also study intimate partner violence and maternal-child health, food safety, prevalence of childhood tuberculosis, and cardiovascular diseases. This book provides in-depth analyses of current issues in Sub-Saharan Africa that blend theory and practice. The diverse group of contributors includes experts in clinical medicine, pharmacy, economics, anthropology, public health, and the social sciences.
This book focuses on Africa’s challenges, achievements, and failures over the past several centuries using an interdisciplinary approach that combines theory and fact and evidence-based practices and interventions in public health, and argues that most of the health problems in Africa are not a result of scarce or lack of resources, but of the misconceived and misplaced priorities that have left the continent behind every other on the globe in terms of health, education, and equitable distribution of opportunities and access to (quality) health as agreed by the United Nations member states at Alma-Ata in 1978.
"The essays in this collection are written to make readers (re)consider what is possible in Africa. The essays shake the tree of received wisdom and received categories, and hone in on the complexities of life under ecological and economic constraints. Yet, throughout this volume, people do not emerge as victims, but rather as inventors, engineers, scientists, planners, writers, artists, and activists, or as children, mothers, fathers, friends, or lovers - all as future-makers. It is precisely through agents such as these that Africa is futuring: rethinking, living, confronting, imagining, and relating in the light of its many emerging tomorrows"--
This volume addresses the ideational and policy-oriented challenges of Africa’s health governance due to voluntary and involuntary cross-border migration of people and diseases in a growing 'mobile Africa'. The collected set of specialized contributions in this volume examines how national and regional policy innovation can address the competing conception of sovereignty in dealing with Africa’s emerging healthcare problems in a fast-paced, interconnect world.
Traditional health practitioners in Africa are an important human resource in health care, and there are reasons why ministries of health might want to formulate an overt policy toward traditional medicine. Here are some policy options to consider.
1, 2017 Organization of the Article This article examines how social health insurance can be made workable in spite of the challenges facing the idea by drawing on the experiences of four countries in sub-Saharan Africa in the administration of health insurance. [...] Although the ascendancy of the market economy, the trend towards minimalist government, a poor economic outlook and different interpretations of the role of the African state (as outlined by Kawabata 2006, for example) have combined to gradually alter the roles of government in the developing world, and Africa in particular, the importance of government as an organizer, implementer and regulator o. [...] a powerful equalizer that abolishes distinctions between the rich and the poor, the privileged and the marginalized, the young and the old, ethnic groups, and women and men (Chan 2012). [...] Depth of coverage corresponds to the number and quality of services and assesses the range of health services available to meet the healthcare needs of covered populations. [...] Strong political leadership also featured in the cases of South Africa and Nigeria, although for the former, the apartheid root of the health insurance system deprived the scheme of equity as a key UHC objective, which has not been redressed in the post-apartheid period.
Interest in implementation research is growing, largely in recognition of the contribution it can make to maximizing the beneficial impact of health interventions. As a relatively new and, until recently, rather neglected field within the health sector, implementation research is something of an unknown quantity for many. There is therefore a need for greater clarity about what exactly implementation research is, and what it can offer. This Guide is designed to provide that clarity. Intended to support those conducting implementation research, those with responsibility for implementing programs, and those who have an interest in both, the Guide provides an introduction to basic implementation research concepts and language, briefly outlines what it involves, and describes the many opportunities that it presents. The main aim of the Guide is to boost implementation research capacity as well as demand for implementation research that is aligned with need, and that is of particular relevance to health systems in low- and middle-income countries (LMICs). Research on implementation requires the engagement of diverse stakeholders and multiple disciplines in order to address the complex implementation challenges they face. For this reason, the Guide is intended for a variety of actors who contribute to and/or are impacted by implementation research. This includes the decision-makers responsible for designing policies and managing programs whose decisions shape implementation and scale-up processes, as well as the practitioners and front-line workers who ultimately implement these decisions along with researchers from different disciplines who bring expertise in systematically collecting and analyzing information to inform implementation questions. The opening chapters (1-4) make the case for why implementation research is important to decision-making. They offer a workable definition of implementation research and illustrate the relevance of research to problems that are often considered to be simply administrative and provide examples of how such problems can be framed as implementation research questions. The early chapters also deal with the conduct of implementation research, emphasizing the importance of collaboration and discussing the role of implementers in the planning and designing of studies, the collection and analysis of data, as well as in the dissemination and use of results. The second half of the Guide (5-7) detail the various methods and study designs that can be used to carry out implementation research, and, using examples, illustrates the application of quantitative, qualitative, and mixed-method designs to answer complex questions related to implementation and scale-up. It offers guidance on conceptualizing an implementation research study from the identification of the problem, development of research questions, identification of implementation outcomes and variables, as well as the selection of the study design and methods while also addressing important questions of rigor.
