Exploring corruption in the South African health sector
Recent scholarly attention has focused on weak governance and the negative effects of corruption on the provision of health services. Employing agency theory, this article discusses corruption in the South African health sector. We used a combination of research methods and triangulated data from three sources: Auditor-General of South Africa reports for each province covering a 9-year period; 13 semi-structured interviews with health sector key informants and a content analysis of print media reports covering a 3-year period. Findings from the Auditor-General reports showed a worsening trend in audit outcomes with marked ...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Rispel, L. C., de Jager, P., Fonn, S. Tags: Original Articles Source Type: research
Health insurance for people with citizenship problems in Thailand: a case study of policy implementation
This study sought to examine the operational constraints faced by health providers in implementing the HIS-PCP policy. Qualitative methods were used, and a case study was conducted to explore the implementation of the HIS-PCP in Ranong and Tak provinces. Individual in-depth interviews and group interviews were conducted with a total of 33 key informants. Interview data were analysed by a thematic approach. The study found that the HIS-PCP faced several operational challenges. Inadequate communication and unclear service guidelines contributed to ineffectiveness in budget spend and service provision. Other problems included...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Suphanchaimat, R., Kantamaturapoj, K., Pudpong, N., Putthasri, W., Mills, A. Tags: Original Articles Source Type: research
A comparison of hierarchical cluster analysis and league table rankings as methods for analysis and presentation of district health system performance data in Uganda
This study explores the use of hierarchical cluster analysis for analysing and presenting district health systems performance data and compares this approach with the use of the league table in Uganda. Ministry of Health and district plans and reports, and published documents were used to provide information on the development and utilization of the Uganda district league table. Quantitative data were accessed from the Ministry of Health databases. Statistical analysis using SPSS version 20 and hierarchical cluster analysis, utilizing Wards’ method was used. The hierarchical cluster analysis was conducted on the basi...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Tashobya, C. K., Dubourg, D., Ssengooba, F., Speybroeck, N., Macq, J., Criel, B. Tags: Original Articles Source Type: research
Valuing the work of unpaid community health workers and exploring the incentives to volunteering in rural Africa
We examined the costs and benefits of volunteering in a sample of 45 CHWs providing integrated community case management of common childhood illnesses in rural Uganda in February 2012 using different methods. We assessed the value of CHW time using the minimum public sector salary rate and a CHW-elicited replacement wage, as well as the opportunity cost of time based on CHW-estimated annual income and alternative work opportunities, respectively. Reported monthly CHW workload, a median of 19.3 h (range 2.5–57), was valued at USD 6.9 (range 0.9–20.4) per month from the perspective of the healthcare system (appli...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Kasteng, F., Settumba, S., Källander, K., Vassall, A., the inSCALE Study Group Tags: Original Articles Source Type: research
A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres
Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational management to strengthen providers’ trust in their employer(s) and colleagues, as an entry-point for developing both the capacity and a work culture oriented towards respectful and patient-centred care. (Source: Health Policy and Planning)
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Topp, S. M., Chipukuma, J. M. Tags: Original Articles Source Type: research
The effects of decentralizing anti-retroviral services in Nigeria on costs and service utilization: two case studies
This study is limited by not including costs incurred above the facility level, such as training, or costs borne by patients. (Source: Health Policy and Planning)
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Johns, B., Baruwa, E. Tags: Original Articles Source Type: research
Decentralization and decision space in the health sector: a case study from Karnataka, India
This study presents the findings of an on-going research effort to build empirical evidence on decentralization in the health sector and its impact on system performance. The focus here is on analyzing the responses of health personnel at the district level and below on their perceived ‘Decision Space’—the range of choice or autonomy they see themselves as having along a series of functional dimensions. Overall, the data indicate that there is a substantial gap between the spirit of the NRHM guidelines on decentralization and the actual implementation on the ground. There is a need for substantial capacit...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Seshadri, S. R., Parab, S., Kotte, S., Latha, N., Subbiah, K. Tags: Original Articles Source Type: research
Strengthening capacity to apply health research evidence in policy making: experience from four countries
We describe the experiences of five projects (in Bangladesh, Gambia, India and Nigeria), where collaborative teams of researchers and policy makers/policy influencers worked to strengthen policy maker capacity to increase the use of evidence in policy. Activities were focused on three (interlinked) levels of capacity building: individual, organizational and, occasionally, institutional. Interventions included increasing access to research/data, promoting frequent interactions between researchers and members of the policy communities, and increasing the receptivity towards research/data in policy making or policy-implementi...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Hawkes, S., K Aulakh, B., Jadeja, N., Jimenez, M., Buse, K., Anwar, I., Barge, S., Odubanjo, M. O., Shukla, A., Ghaffar, A., Whitworth, J. Tags: Original Articles Source Type: research
Prices and mark-ups on antimalarials: evidence from nationally representative studies in six malaria-endemic countries
This study seeks to better understand consumer antimalarial prices by documenting and exploring the pricing behaviour of retailers and wholesalers. Using data collected in 2009–10, we present survey estimates of antimalarial retail prices, and wholesale- and retail-level price mark-ups from six countries (Benin, Cambodia, the Democratic Republic of Congo, Nigeria, Uganda and Zambia), along with qualitative findings on factors affecting pricing decisions. Retail prices were lowest for nATs, followed by ACTs and artemisinin monotherapies (AMTs). Retailers applied the highest percentage mark-ups on nATs (range: 40% in N...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Palafox, B., Patouillard, E., Tougher, S., Goodman, C., Hanson, K., Kleinschmidt, I., Torres Rueda, S., Kiefer, S., OConnell, K., Zinsou, C., Phok, S., Akulayi, L., Arogundade, E., Buyungo, P., Mpasela, F., Poyer, S., Chavasse, D. Tags: Original Articles Source Type: research
Tracking implementation and (un)intended consequences: a process evaluation of an innovative peripheral health facility financing mechanism in Kenya
We describe early implementation of an innovative national health financing intervention in Kenya; the health sector services fund (HSSF). In HSSF, central funds are credited directly into a facility’s bank account quarterly, and facility funds are managed by health facility management committees (HFMCs) including community representatives. HSSF is therefore a finance mechanism with potential to increase access to funds for peripheral facilities, support user fee reduction and improve equity in access. We conducted a process evaluation of HSSF implementation based on a theory of change underpinning the intervention. ...
Source: Health Policy and Planning - February 9, 2016 Category: Health Management Authors: Waweru, E., Goodman, C., Kedenge, S., Tsofa, B., Molyneux, S. Tags: Original Articles Source Type: research
Using routine health information systems for well-designed health evaluations in low- and middle-income countries
Routine health information systems (RHISs) are in place in nearly every country and provide routinely collected full-coverage records on all levels of health system service delivery. However, these rich sources of data are regularly overlooked for evaluating causal effects of health programmes due to concerns regarding completeness, timeliness, representativeness and accuracy. Using Mozambique’s national RHIS (Módulo Básico) as an illustrative example, we urge renewed attention to the use of RHIS data for health evaluations. Interventions to improve data quality exist and have been tested in low-and mid...
Source: Health Policy and Planning - January 23, 2016 Category: Health Management Authors: Wagenaar, B. H., Sherr, K., Fernandes, Q., Wagenaar, A. C. Tags: Methodological Musings Source Type: research
Primary health care research in Bolivia: systematic review and analysis
This study aims to serve as an aid towards PHC development efforts at the national level, as well as provide lessons for countries globally attempting to build effective health systems accommodating of a multi-national population in the midst of development. (Source: Health Policy and Planning)
Source: Health Policy and Planning - January 23, 2016 Category: Health Management Authors: Alvarez, F. N., Leys, M., Merida, H. E. R., Guzman, G. E. Tags: Reviews Source Type: research
Programmes for advance distribution of misoprostol to prevent post-partum haemorrhage: a rapid literature review of factors affecting implementation
We present key outcomes and features of advanced distribution programmes that are in operation or have been piloted globally. We categorized factors influencing implementation into those that operate at the health system level, factors related to the community and policy context and those factors more closely connected to the end user.
Debates around advance distribution have centred on the potential risks and benefits of making misoprostol available to pregnant women and community members during pregnancy for administration in the home. However, the risks of advance distribution appear manageable and the benefits of self-...
Source: Health Policy and Planning - January 23, 2016 Category: Health Management Authors: Smith, H. J., Colvin, C. J., Richards, E., Roberson, J., Sharma, G., Thapa, K., Gulmezoglu, A. M. Tags: Reviews Source Type: research
National malaria vector control policy: an analysis of the decision to scale-up larviciding in Nigeria
Conclusions: This study demonstrates that national vector control policy change can be facilitated by linking malaria control objectives to wider socioeconomic considerations and through engaging powerful policy champions to drive policy change and thereby accelerate access to new vector control tools. (Source: Health Policy and Planning)
Source: Health Policy and Planning - January 23, 2016 Category: Health Management Authors: Tesfazghi, K., Hill, J., Jones, C., Ranson, H., Worrall, E. Tags: Original Articles Source Type: research
Does pay-for-performance benefit patients with multiple chronic conditions? Evidence from a universal coverage health care system
Conclusion: This study suggests that a financial incentive programme may improve the provision of necessary health care, COC and health care outcomes for diabetic patients both with and without comorbid hypertension. Health authorities could develop policies to increase participation in P4P programmes and encourage continued improvement in health care outcomes. (Source: Health Policy and Planning)
Source: Health Policy and Planning - January 23, 2016 Category: Health Management Authors: Chen, C.-C., Cheng, S.-H. Tags: Original Articles Source Type: research
