Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach
Conclusions This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems and more comprehensive pre-service health education for prison officers. (Source: Health Policy and Planning)
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Topp, S. M., Moonga, C. N., Luo, N., Kaingu, M., Chileshe, C., Magwende, G., Heymann, S. J., Henostroza, G. Tags: Original Articles Source Type: research
Financial sustainability versus access and quality in a challenged health system: an examination of the capitation policy debate in Ghana
This article examines claims and counter-claims made by coalitions and individual stakeholders in a capitation payment policy debate within Ghana’s National Health Insurance Scheme. Using content analysis of public and parliamentary proceedings, we situate the debate within policy making and health insurance literature. We found that the ongoing capitation payment debate stems from challenges in implementation of earlier health insurance claims payment systems, which reflect broader systemic challenges facing the health insurance scheme in Ghana. The study illustrates the extent to which various sub-systems in the po...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Atuoye, K. N., Vercillo, S., Antabe, R., Galaa, S. Z., Luginaah, I. Tags: Original Articles Source Type: research
Healthcare providers on the frontlines: a qualitative investigation of the social and emotional impact of delivering health services during Sierra Leones Ebola epidemic
This study draws on 54 qualitative interviews with 35 providers working in eight peripheral health units of Sierra Leone's Bo and Kenema Districts. Data collection started near the height of the outbreak in December 2014 and lasted 1 month. Providers recounted changes in their professional, personal and social lives as they became de facto first responders in the outbreak. A theme articulated across interviews was Ebola’s destruction of social connectedness and sense of trust within and across health facilities, communities and families. Providers described feeling lonely, ostracized, unloved, afraid, saddened and no...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: McMahon, S. A., Ho, L. S., Brown, H., Miller, L., Ansumana, R., Kennedy, C. E. Tags: Original Articles Source Type: research
One year of campaigns in Cameroon: effects on routine health services
The objective of this study was to evaluate the average effect of public health campaigns over 1 year on routine services such as antenatal care, routine vaccination and outpatient services.
Method: We collected daily activity data in 60 health facilities in two regions of Cameroon that traditionally undergo different intensities of campaign activity, the Centre region (low) and the Far North (high), to ascertain effects on routine services. For each outcome, we restricted our analysis to the public health centres for which good data were available and excluded private health facilities given their small number. We used se...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Mounier-Jack, S., Edengue, J. M., Lagarde, M., Baonga, S. F., Ongolo-Zogo, P. Tags: Original Articles Source Type: research
Explaining socio-economic inequalities in immunization coverage in Nigeria
This article seeks to assess inequalities in full and partial immunization coverage in Nigeria. It also assesses inequality in the ‘intensity’ of immunization coverage and it explains the factors that account for disparities in child immunization coverage in the country. Using nationally representative data, this article shows that disparities exist in the coverage of immunization to the advantage of the rich. Also, factors such as mother’s literacy, region and location of the child, and socio-economic status explain the disparities in immunization coverage in Nigeria. Apart from addressing these issues, ...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Ataguba, J. E., Ojo, K. O., Ichoku, H. E. Tags: Original Articles Source Type: research
Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform
This article proposes a conceptual framework integrating these variables and tests it on three cases of policy change in Burkina Faso, addressing the need for theoretical integration with networks as well as the broader aim of theory-driven health policy analysis research in low- and middle-income countries. We use historical process tracing, a type of comparative case study, to interpret and compare documents and in-depth interview data within and between cases. We found that while network changes were indeed associated with policy reform, this relationship was mediated by one or more of institutions, interests and ideas....
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Shearer, J. C., Abelson, J., Kouyate, B., Lavis, J. N., Walt, G. Tags: Original Articles Source Type: research
Using microfinance to facilitate household investment in sanitation in rural Cambodia
Improved sanitation access is extremely low in rural Cambodia. Non-governmental organizations have helped build local supply side latrine markets to promote household latrine purchase and use, but households cite inability to pay as a key barrier to purchase. To examine the extent to which microfinance can be used to facilitate household investment in sanitation, we applied a two-pronged assessment: (1) to address the gap between interest in and use of microfinance, we conducted a pilot study to assess microfinance demand and feasibility of integration with a sanitation marketing program and (2) using a household survey (n...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Geissler, K. H., Goldberg, J., Leatherman, S. Tags: Original Articles Source Type: research
The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi
This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were us...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Manthalu, G., Yi, D., Farrar, S., Nkhoma, D. Tags: Original Articles Source Type: research
What factors drive heterogeneity of preferences for micro-health insurance in rural Malawi?
This study used a discrete choice experiment to explore heterogeneity of preferences for a prospective micro-health insurance (MHI) product in Malawi. Through an extensive qualitative study, six attributes, each associated with three levels, were derived and used to construct a D-efficient design. The attributes included unit of enrollment, management structure, health service benefit package, copayment levels, transportation coverage and monthly premium. The experiment was interviewer administered to a stratified random sample of household heads and their spouse(s). Using mixed logit and generalized multinomial logit mode...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Abiiro, G. A., Torbica, A., Kwalamasa, K., De Allegri, M. Tags: Original Articles Source Type: research
How do we know? An assessment of integrated community case management data quality in four districts of Malawi
The World Health Organization contracted annual data quality assessments of Rapid Access Expansion (RAcE) projects to review integrated community case management (iCCM) data quality and the monitoring and evaluation (M&E) system for iCCM, and to suggest ways to improve data quality. The first RAcE data quality assessment was conducted in Malawi in January 2014 and we present findings pertaining to data from the health management information system at the community, facility and other sub-national levels because RAcE grantees rely on that for most of their monitoring data. We randomly selected 10 health facilities (10% ...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Yourkavitch, J., Zalisk, K., Prosnitz, D., Luhanga, M., Nsona, H. Tags: Original Articles Source Type: research
The impact of delays on maternal and neonatal outcomes in Ugandan public health facilities: the role of absenteeism
Maternal mortality in low- and middle-income countries continues to remain high. The Ugandan Ministry of Health’s Strategic Plan suggests that little, if any, progress has been made in Uganda in terms of improvements in Maternal Health [Millennium Development Goal (MDG) 5] and, more specifically, in reducing maternal mortality. Furthermore, the UNDP report on the MDGs describes Uganda’s progress as ‘stagnant’. The importance of understanding the impact of delays on maternal and neonatal outcomes in low resource settings has been established for some time. Indeed, the ‘3-delays’ model has...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Ackers, L., Ioannou, E., Ackers-Johnson, J. Tags: Original Articles Source Type: research
Investigating the remuneration of health workers in the DR Congo: implications for the health workforce and the health system in a fragile setting
The financial remuneration of health workers (HWs) is a key concern to address human resources for health challenges. In low-income settings, the exploration of the sources of income available to HWs, their determinants and the livelihoods strategies that those remunerations entail are essential to gain a better understanding of the motivation of the workers and the effects on their performance and on service provision. This is even more relevant in a setting such as the DR Congo, characterized by the inability of the state to provide public services via a well-supported and financed public workforce. Based on a quantitati...
Source: Health Policy and Planning - September 24, 2016 Category: Health Management Authors: Bertone, M. P., Lurton, G., Mutombo, P. B. Tags: Original Articles Source Type: research
Option B+ for the prevention of mother-to-child transmission of HIV infection in developing countries: a review of published cost-effectiveness analyses
Conclusions: Across five model-based cost-effectiveness analyses of strategies for the PMTCT of HIV, the most comprehensive analysis reported that option B+ is highly likely to be cost-effective. This evaluation may have been overly favourable towards option B+ with respect to some input parameter values, but potentially important additional benefits were omitted. Decision makers might be best advised to review this analysis, with a view to requesting additional analyses of the model to inform local funding decisions around alternative strategies for the PMTCT of HIV. (Source: Health Policy and Planning)
Source: Health Policy and Planning - September 6, 2016 Category: Health Management Authors: Karnon, J., Orji, N. Tags: Reviews Source Type: research
Recent trends in working with the private sector to improve basic healthcare: a review of evidence and interventions
The private sector provides the majority of health care in Africa and Asia. A number of interventions have, for many years, applied different models of subsidy, support and engagement to address social and efficiency failures in private health care markets. We have conducted a review of these models, and the evidence in support of them, to better understand what interventions are currently common, and to what extent practice is based on evidence. Using established typologies, we examined five models of intervention with private markets for care: commodity social marketing, social franchising, contracting, accreditation and...
Source: Health Policy and Planning - September 6, 2016 Category: Health Management Authors: Montagu, D., Goodman, C., Berman, P., Penn, A., Visconti, A. Tags: Reviews Source Type: research
The cost of not breastfeeding in Southeast Asia
This study estimates the costs of not breastfeeding across seven countries in Southeast Asia and presents a cost-benefit analysis of a modeled comprehensive breastfeeding strategy in Viet Nam, based on a large programme. There have been very few such studies previously for low- and middle-income countries. The estimates used published data on disease prevalence and breastfeeding patterns for the seven countries, supplemented by information on healthcare costs from representative institutions. Modelling of costs of not breastfeeding used estimated effects obtained from systematic reviews and meta-analyses. Modelling of cost...
Source: Health Policy and Planning - September 6, 2016 Category: Health Management Authors: Walters, D., Horton, S., Siregar, A. Y. M., Pitriyan, P., Hajeebhoy, N., Mathisen, R., Phan, L. T. H., Rudert, C. Tags: Original Articles Source Type: research
