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Health Policy and Planning

Shiwei Gong, Hongbing Cai, Yufeng Ding, Weijie Li, Xu Juan, Jinlan Peng, Si Jin
Based on the high prevalence and undiagnosed rate of diabetes mellitus in China in recent years, the aim of this work was to evaluate the availability, price and affordability of pharmacotherapy for diabetes in public hospitals in Hubei province, China. In 2016, a cross-sectional survey was conducted using World Health Organization/Health Action International (WHO/HAI) methodology. Information on the availability and prices of 20 antidiabetic drugs was collected from 34 public hospitals representing three levels of care...
September 11, 2018: Health Policy and Planning
Hinda Ruton, Angele Musabyimana, Erick Gaju, Atakilt Berhe, Karen A Grépin, Joseph Ngenzi, Emmanuel Nzabonimana, Michael R Law
Maternal and child mortality rates remain unacceptably high globally, particularly in sub-Saharan Africa. A popular approach to counter these high rates is interventions delivered using mobile phones (mHealth). However, few mHealth interventions have been implemented nationwide and there has been little evaluation of their effectiveness, particularly at scale. Therefore, we evaluated the Rwanda RapidSMS programme-one of the few mHealth programmes in Africa that is currently operating nationwide. Using interrupted time series analysis and monthly data routinely reported by public health centres (n = 461) between 2012 and 2016, we studied the impact of RapidSMS on four indicators: completion of four antenatal care visits, deliveries in a health facility, postnatal care visits and malnutrition screening...
August 28, 2018: Health Policy and Planning
Katerini Tagmatarchi Storeng, Antoine de Bengy Puyvallée
The growth of global public-private partnerships for health has opened up new spaces for civil society participation in global health governance. Such participation is often justified by the claim that civil society organizations, because of their independence and links to communities, can help address democratic deficits in global-level decision-making processes. This article examines the notion of 'civil society engagement' within major public-private partnerships for health, where civil society is often said to play a particularly important role in mediating between public and private spheres...
August 28, 2018: Health Policy and Planning
Adélio Fernandes Antunes, Bart Jacobs, Richard de Groot, Kouland Thin, Piya Hanvoravongchai, Steffen Flessa
Since the end of its internal conflict in 1998, Cambodia has experienced tremendous developments in the social, economic and health sectors, with the government embarking on substantial reforms in health financing. Health equity funds that have improved access to public health services for poor people have gradually been extended to the entire country. Using the World Health Organization's methods for the analysis of healthcare expenditure and household survey data from the 2004, 2009 and 2014 Cambodian Socio-Economic Survey, we assessed trends in reported illness, utilization of healthcare services and associated financial burden on households...
August 27, 2018: Health Policy and Planning
Edson Serván-Mori, Carlos Chivardi, Miguel Ángel Mendoza, Gustavo Nigenda
We assess technical efficiency (TE) level for Mexican Ministry of Health (MoH) primary care units. Assessment was focused on the production of adequate maternal health services defined as the coverage level of women who received timely and frequent antenatal care, and institutional and medical care during childbirth. We conducted a longitudinal analysis of administrative and socio-demographic information concerning 233 health jurisdictions for the period 2008-15. Crude TE was calculated using window data envelopment analysis (Windows-DEA)...
August 20, 2018: Health Policy and Planning
Steven F Koch
We present a revised method for estimating equivalence scales. Such scales are used to adjust household welfare to account for the size of the household, and are used extensively in the application of the World Health Organization's (WHO) methodology for the evaluation of catastrophic health payments. Applications of the WHO method are underpinned by early estimates that do not control for household income, and, therefore, are likely to overstate equivalence. Thus, in addition to revising the method, we update the scale estimates for one country, South Africa, using more recent data...
August 10, 2018: Health Policy and Planning
Aisling Walsh, Anne Matthews, Lucinda Manda-Taylor, Ruairi Brugha, Daniel Mwale, Tamara Phiri, Elaine Byrne
Traditional leaders play a prominent role at the community level in Malawi, yet limited research has been undertaken on their role in relation to policy implementation. This article seeks to analyse the role of traditional leaders in implementing national maternal, newborn and child health (MNCH) policy and programmes at the community level. We consider whether the role of the chief embodies a top-down (utilitarian) or bottom-up (empowerment) approach to MNCH policy implementation. Primary data were collected in 2014/15, through 85 in-depth interviews and 20 focus group discussions in two districts in Malawi...
July 31, 2018: Health Policy and Planning
Susan Cleary, Ermin Erasmus, Lucy Gilson, Catherine Michel, Artur Gremu, Kenneth Sherr, Jill Olivier
Health system strengthening (HSS) has often been undertaken by global health actors working through vertical programmes. However, experience has shown the challenges of this approach, and the need to recognize health systems as open complex adaptive systems-which in turn has implications for the design and implementation approach of more 'horizontal' HSS interventions. From 2009 to 2016, the Doris Duke Charitable Foundation supported the African Health Initiative, establishing Population Health Implementation and Training partnerships in five African countries (Ghana, Mozambique, Rwanda, Tanzania and Zambia)...
September 1, 2018: Health Policy and Planning
Rakesh Gupta, Ruby Nimesh, Girdhari Lal Singal, Parveen Bhalla, Shankar Prinja
The Government of India launched a nationwide programme to save and educate the girl child, Beti Bachao Beti Padhao (B3P), by stringent prohibition of sex-selective abortion, enforcement of Preconception and Prenatal Diagnostic Technique (PC-PNDT) and Medical Termination of Pregnancy (MTP) Acts, and social mobilization. We undertook this study to assess the effectiveness of intervention in Haryana state to improve sex ratio at birth (SRB). The monthly data on SRB (represented as girls per 1000 boys) were collected from civil registration system for the entire state of Haryana to evaluate the impact of B3P programme...
September 1, 2018: Health Policy and Planning
Musah Khalid, John Serieux
Ghana introduced a social health insurance scheme in 2003. One of its motivations was to protect consumers against adverse health shocks. Financing for the programme comes from a 2.5% goods and service tax, contributions by formal sector workers directly transferred from their social security savings and individual premiums from informal members. This arrangement makes formal workers compulsory members of the scheme while informal members voluntarily enroll. We view this as a natural experiment in which one section of the population automatically acquires insurance (with formal sector employment), and the remainder choose to obtain the same coverage (or not)...
September 1, 2018: Health Policy and Planning
Veena Sriram, Rama Baru, Sara Bennett
Regulation is essential to health systems and is central to advancing equity-oriented policy objectives in health. Regulating new medical specialties is an emerging, yet underexplored, aspect of health sector governance in low- and middle-income countries (LMICs), such as India. Limited research exists regarding how regulatory institutions in India decide what specialties should be formally recognized and how training programmes for these specialties should be organized. Understanding these regulatory functions provides a lens into how policymakers envision the role of these specialties in the broader health system and how they view the linkages between medical education, health system needs and equity...
September 1, 2018: Health Policy and Planning
Lauren Suchman, Beth Ann Hart, Dominic Montagu
No abstract text is available yet for this article.
September 1, 2018: Health Policy and Planning
Timothee Fruhauf, Linnea Zimmerman, Simon Peter Sebina Kibira, Fredrick Makumbi, Peter Gichangi, Solomon Shiferaw, Assefa Seme, Georges Guiella, Amy Tsui
The individual impacts of several components of family planning service quality on contraceptive use have been studied, but the influence of a composite measure synthesizing these components has not been often investigated. We (1) develop a composite score for family planning service quality based on health facility data from Burkina Faso, Ethiopia, Kenya and Uganda and (2) examine the influence of structural quality on contraceptive practice in these four countries. We used nationally representative cross-sectional survey data of health facilities and women of reproductive age...
September 1, 2018: Health Policy and Planning
Suhang Song, Xiaochen Ma, Luyu Zhang, Beibei Yuan, Qingyue Meng
A strong health workforce is widely recognized as a prerequisite for health care and a crucial determinant of health system performance. The number of health professionals in China increased following the 2009 health system reform, which, in part, aimed to address the shortage and unequal distribution of health professionals. We examined whether the distribution of health professionals was more equitable following the reform and whether the reform had targeted impacts in terms of the quantity of health professionals...
September 1, 2018: Health Policy and Planning
Collins Chansa, Jesper Sundewall, Numi Östlund
Development assistance for health (DAH) remains a significant and important source of health financing in many low and lower middle-income countries. However, this assistance has not been fully effective. This study explores the effect of currency exchange rate fluctuations on volatility of DAH in Zambia using a mixed methods approach. Data covering the period 1997-2008 were collected from various financial and programmatic reports, while six key informant interviews were conducted to validate and translate findings from the quantitative analysis...
September 1, 2018: Health Policy and Planning
Adam Bertscher, Leslie London, Marsha Orgill
Alcohol is a major contributor to the Non-Communicable Disease burden in South Africa. In 2000, 7.1% of all deaths and 7% of total disability-adjusted life years were ascribed to alcohol-related harm in the country. Regulations proposed to restrict alcohol advertising in South Africa present an evidence-based upstream intervention. Research on policy formulation in low- and middle-income countries is limited. This study aims to describe and explore the policy formulation process of the 2013 draft Control of Marketing of Alcoholic Beverages Bill in South Africa between March 2011 and May 2017...
September 1, 2018: Health Policy and Planning
Pamela Lilleston, Liliane Winograd, Spogmay Ahmed, Dounia Salamé, Dayana Al Alam, Kirsten Stoebenau, Ilaria Michelis, Sunita Palekar Joergensen
As the landscape of humanitarian response shifts from camp-based to urban- and informal-tented settlement-based responses, service providers and policymakers must consider creative modes for delivering health services. Psychosocial support and case management can be life-saving services for refugee women and girls who are at increased risk for physical, sexual and psychological gender-based violence (GBV). However, these services are often unavailable in non-camp refugee settings. We evaluated an innovative mobile service delivery model for GBV response and mitigation implemented by the International Rescue Committee (IRC) in Lebanon...
September 1, 2018: Health Policy and Planning
Lauren Suchman, Elizabeth Hart, Dominic Montagu
Social health insurance (SHI), one mechanism for achieving universal health coverage, has become increasingly important in low- and middle-income countries (LMICs) as they work to achieve this goal. Although small private providers supply a significant proportion of healthcare in LMICs, integrating these providers into SHI systems is often challenging. Public-private partnerships in health are one way to address these challenges, but we know little about how these collaborations work, how effectively, and why...
September 1, 2018: Health Policy and Planning
T Mathole, M Lembani, D Jackson, C Zarowsky, L Bijlmakers, D Sanders
Maternal mortality remains high in Eastern Cape Province, South Africa, despite over 90% of pregnant women utilizing maternal health services. A recent survey showed wide variation in performance among districts in the province. Heterogeneity was also found at the district level, where maternal health outcomes varied considerably among district hospitals. In ongoing research, leadership emerged as one of the key health systems factors affecting the performance of maternal health services at facility level. This article reports on a subsequent case study undertaken to examine leadership practices and the functioning of maternal health services in two resource-limited hospitals with disparate maternal health outcomes...
July 1, 2018: Health Policy and Planning
Susan Cleary, Alison du Toit, Vera Scott, Lucy Gilson
Strong management and leadership competencies have been identified as critical in enhancing health system performance. While the need for strong health system leadership has been raised, an important undertaking for health policy and systems researchers is to generate lessons about how to support leadership development (LD), particularly within the crisis-prone, resource poor contexts that are characteristic of Low- and Middle-Income health systems. As part of the broader DIALHS (District Innovation and Action Learning for Health Systems Development) collaboration, this article reflects on 5 years of action learning and engagement around leadership and LD within primary healthcare (PHC) services...
July 1, 2018: Health Policy and Planning
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