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Sassy Molyneux

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https://www.readbyqxmd.com/read/28911332/-we-are-toothless-and-hanging-but-optimistic-sub-county-managers-experiences-of-rapid-devolution-in-coastal-kenya
#1
Mary M Nyikuri, Benjamin Tsofa, Philip Okoth, Edwine W Barasa, Sassy Molyneux
BACKGROUND: In March 2013, Kenya transitioned from a centralized to a devolved system of governance. Within the health sector, this entailed the transfer of service provision functions to 47 newly formed semi-autonomous counties, while policy and regulatory functions were retained at the national level. The devolution process was rapid rather than progressive. METHODS: We conducted qualitative research within one county to examine the early experiences of devolution in the health sector...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911328/devolution-and-its-effects-on-health-workforce-and-commodities-management-early-implementation-experiences-in-kilifi-county-kenya
#2
Benjamin Tsofa, Catherine Goodman, Lucy Gilson, Sassy Molyneux
BACKGROUND: Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for several decades. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous county governments, with substantial transfer of responsibility for health service delivery from the central government to these counties. Focusing on two key elements of the health system, Human Resources for Health (HRH) and Essential Medicines and Medical Supplies (EMMS) management, we analysed the early implementation experiences of this major governance reform at county level...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28911325/how-does-decentralisation-affect-health-sector-planning-and-financial-management-a-case-study-of-early-effects-of-devolution-in-kilifi-county-kenya
#3
Benjamin Tsofa, Sassy Molyneux, Lucy Gilson, Catherine Goodman
BACKGROUND: A common challenge for health sector planning and budgeting has been the misalignment between policies, technical planning and budgetary allocation; and inadequate community involvement in priority setting. Health system decentralisation has often been promoted to address health sector planning and budgeting challenges through promoting community participation, accountability, and technical efficiency in resource management. In 2010, Kenya passed a new constitution that introduced 47 semi-autonomous devolved county governments, and a substantial transfer of responsibility for healthcare from the central government to these counties...
September 15, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28771558/recentralization-within-decentralization-county-hospital-autonomy-under-devolution-in-kenya
#4
Edwine W Barasa, Anthony M Manyara, Sassy Molyneux, Benjamin Tsofa
BACKGROUND: In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. METHODS: We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya...
2017: PloS One
https://www.readbyqxmd.com/read/28670602/-facing-our-fears-using-facilitated-film-viewings-to-engage-communities-in-hiv-research-involving-msm-in-kenya
#5
Bernadette Kombo, Salla Sariola, Evanson Gichuru, Sassy Molyneux, Eduard J Sanders, Elise van der Elst
Kenya is a generally homophobic country where homosexuality is criminalised and people who engage in same sex sexuality face stigma and discrimination. In 2013, we developed a 16 min documentary entitled "Facing Our Fears" that aimed at sharing information on how and why men who have sex with men (MSM) are involved in on-going KEMRI HIV prevention research, and associated community engagement. To consider the film's usefulness as a communication tool, and its perceived security risks in case the film was publicly released, we conducted nine facilitated viewings with 122 individuals representing seven different stakeholder groups...
2017: Cogent Medicine
https://www.readbyqxmd.com/read/28024239/hospitals-as-complex-adaptive-systems-a-case-study-of-factors-influencing-priority-setting-practices-at-the-hospital-level-in-kenya
#6
Edwine W Barasa, Sassy Molyneux, Mike English, Susan Cleary
There is a dearth of literature on priority setting and resource allocation (PSRA) practices in hospitals, particularly in low and middle income countries (LMICs). Using a case study approach, we examined PSRA practices in 2 public hospitals in coastal Kenya. We collected data through a combination of in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), review of documents such as hospital plans and budgets, minutes of meetings and accounting records, and non-participant observations of PSRA practices in case study hospitals over a period of 7 months...
February 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/27716185/the-influence-of-power-and-actor-relations-on-priority-setting-and-resource-allocation-practices-at-the-hospital-level-in-kenya-a-case-study
#7
Edwine W Barasa, Susan Cleary, Mike English, Sassy Molyneux
BACKGROUND: Priority setting and resource allocation in healthcare organizations often involves the balancing of competing interests and values in the context of hierarchical and politically complex settings with multiple interacting actor relationships. Despite this, few studies have examined the influence of actor and power dynamics on priority setting practices in healthcare organizations. This paper examines the influence of power relations among different actors on the implementation of priority setting and resource allocation processes in public hospitals in Kenya...
September 30, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27699954/research-involving-health-providers-and-managers-ethical-issues-faced-by-researchers-conducting-diverse-health-policy-and-systems-research-in-kenya
#8
Sassy Molyneux, Benjamin Tsofa, Edwine Barasa, Mary Muyoka Nyikuri, Evelyn Wanjiku Waweru, Catherine Goodman, Lucy Gilson
There is a growing interest in the ethics of Health Policy and Systems Research (HPSR), and especially in areas that have particular ethical salience across HPSR. Hyder et al (2014) provide an initial framework to consider this, and call for more conceptual and empirical work. In this paper, we respond by examining the ethical issues that arose for researchers over the course of conducting three HPSR studies in Kenya in which health managers and providers were key participants. All three studies involved qualitative work including observations and individual and group interviews...
December 2016: Developing World Bioethics
https://www.readbyqxmd.com/read/27679522/setting-healthcare-priorities-a-description-and-evaluation-of-the-budgeting-and-planning-process-in-county-hospitals-in-kenya
#9
Edwine W Barasa, Susan Cleary, Sassy Molyneux, Mike English
This paper describes and evaluates the budgeting and planning processes in public hospitals in Kenya. We used a qualitative case study approach to examine these processes in two hospitals in Kenya. We collected data by in-depth interviews of national level policy makers, hospital managers, and frontline practitioners in the case study hospitals (n = 72), a review of documents, and non-participant observations within the hospitals over a 7 month period. We applied an evaluative framework that considers both consequentialist and proceduralist conditions as important to the quality of priority-setting processes...
April 1, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/27484493/perceptions-of-childhood-undernutrition-among-rural-households-on-the-kenyan-coast-a-qualitative-study
#10
Kelly W Muraya, Caroline Jones, James A Berkley, Sassy Molyneux
BACKGROUND: Nutrition plays an important role in child survival and development. Treatment action in the management of child health and nutrition is influenced by perceptions of illness, and gender plays an important role. However, little is known about if and how moderate undernutrition is recognised among lay populations, or how local social norms and intra-household dynamics affect decisions to seek biomedical assistance for nutritional concerns. In this paper we describe how childhood nutritional problems are recognised and understood within rural households...
August 2, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27234212/public-community-engagement-in-health-research-with-men-who-have-sex-with-men-in-sub-saharan-africa-challenges-and-opportunities
#11
Sassy Molyneux, Salla Sariola, Dan Allman, Maartje Dijkstra, Evans Gichuru, Susan Graham, Dorcas Kamuya, Gloria Gakii, Brian Kayemba, Bernadette Kombo, Allan Maleche, Jessie Mbwambo, Vicki Marsh, Murugi Micheni, Noni Mumba, Michael Parker, Jasmine Shio, Clarence Yah, Elise van der Elst, Eduard Sanders
BACKGROUND: Community engagement, incorporating elements of the broader concepts of public and stakeholder engagement, is increasingly promoted globally, including for health research conducted in developing countries. In sub-Saharan Africa, community engagement needs and challenges are arguably intensified for studies involving gay, bisexual and other men who have sex with men, where male same-sex sexual interactions are often highly stigmatised and even illegal. This paper contextualises, describes and interprets the discussions and outcomes of an international meeting held at the Kenya Medical Research Institute-Wellcome Trust in Kilifi, Kenya, in November 2013, to critically examine the experiences with community engagement for studies involving men who have sex with men...
May 27, 2016: Health Research Policy and Systems
https://www.readbyqxmd.com/read/27216095/clinical-trials-cannot-substitute-for-health-system-strengthening-initiatives-or-specifically-designed-health-policy-and-systems-research
#12
Kwaku Poku Asante, Caroline Jones, Sodiomon Bienvenu Sirima, Sassy Molyneux
No abstract text is available yet for this article.
June 2016: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/27117482/how-to-do-or-not-to-do-%C3%A2-gender-analysis-in-health-systems-research
#13
Rosemary Morgan, Asha George, Sarah Ssali, Kate Hawkins, Sassy Molyneux, Sally Theobald
Gender-the socially constructed roles, behaviours, activities and attributes that a given society considers appropriate for males, females and other genders-affects how people live, work and relate to each other at all levels, including in relation to the health system. Health systems research (HSR) aims to inform more strategic, effective and equitable health systems interventions, programs and policies; and the inclusion of gender analysis into HSR is a core part of that endeavour. We outline what gender analysis is and how gender analysis can be incorporated into HSR content, process and outcomes Starting with HSR content, i...
October 2016: Health Policy and Planning
https://www.readbyqxmd.com/read/26673332/setting-healthcare-priorities-at-the-macro-and-meso-levels-a-framework-for-evaluation
#14
REVIEW
Edwine W Barasa, Sassy Molyneux, Mike English, Susan Cleary
BACKGROUND: Priority setting in healthcare is a key determinant of health system performance. However, there is no widely accepted priority setting evaluation framework. We reviewed literature with the aim of developing and proposing a framework for the evaluation of macro and meso level healthcare priority setting practices. METHODS: We systematically searched Econlit, PubMed, CINAHL, and EBSCOhost databases and supplemented this with searches in Google Scholar, relevant websites and reference lists of relevant papers...
September 16, 2015: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/26331716/research-stakeholders-views-on-benefits-and-challenges-for-public-health-research-data-sharing-in-kenya-the-importance-of-trust-and-social-relations
#15
Irene Jao, Francis Kombe, Salim Mwalukore, Susan Bull, Michael Parker, Dorcas Kamuya, Sassy Molyneux, Vicki Marsh
BACKGROUND: There is increasing recognition of the importance of sharing research data within the international scientific community, but also of the ethical and social challenges this presents, particularly in the context of structural inequities and varied capacity in international research. Public involvement is essential to building locally responsive research policies, including on data sharing, but little research has involved stakeholders from low-to-middle income countries. METHODS: Between January and June 2014, a qualitative study was conducted in Kenya involving sixty stakeholders with varying experiences of research in a deliberative process to explore views on benefits and challenges in research data sharing...
2015: PloS One
https://www.readbyqxmd.com/read/26323604/snap-shots-from-a-photo-competition-what-does-it-reveal-about-close-to-community-providers-gender-and-power-in-health-systems
#16
Asha George, Sally Theobald, Rosemary Morgan, Kate Hawkins, Sassy Molyneux
In this commentary, we discuss a photography competition, launched during the summer of 2014, to explore the everyday stories of how gender plays out within health systems around the world. While no submission fees were charged nor financial awards involved, the winning entries were exhibited at the Global Symposium on Health Systems Research in Cape Town, South Africa, in October 2014, with credits to the photographers involved. Anyone who had an experience of, or interest in, gender and health systems was invited to participate...
2015: Human Resources for Health
https://www.readbyqxmd.com/read/26297748/involving-research-stakeholders-in-developing-policy-on-sharing-public-health-research-data-in-kenya-views-on-fair-process-for-informed-consent-access-oversight-and-community-engagement
#17
Irene Jao, Francis Kombe, Salim Mwalukore, Susan Bull, Michael Parker, Dorcas Kamuya, Sassy Molyneux, Vicki Marsh
Increased global sharing of public health research data has potential to advance scientific progress but may present challenges to the interests of research stakeholders, particularly in low-to-middle income countries. Policies for data sharing should be responsive to public views, but there is little evidence of the systematic study of these from low-income countries. This qualitative study explored views on fair data-sharing processes among 60 stakeholders in Kenya with varying research experience, using a deliberative approach...
July 2015: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/26010783/benefits-in-cash-or-in-kind-a-community-consultation-on-types-of-benefits-in-health-research-on-the-kenyan-coast
#18
Maureen Njue, Sassy Molyneux, Francis Kombe, Salim Mwalukore, Dorcas Kamuya, Vicki Marsh
BACKGROUND: Providing benefits and payments to participants in health research, either in cash or in kind, is a common but ethically controversial practice. While much literature has concentrated on appropriate levels of benefits or payments, this paper focuses on less well explored ethical issues around the nature of study benefits, drawing on views of community members living close to an international health research centre in Kenya. METHODS: The consultation, including 90 residents purposively chosen to reflect diversity, used a two-stage deliberative process...
2015: PloS One
https://www.readbyqxmd.com/read/25978465/-the-one-who-chases-you-away-does-not-tell-you-go-silent-refusals-and-complex-power-relations-in-research-consent-processes-in-coastal-kenya
#19
Dorcas M Kamuya, Sally J Theobald, Vicki Marsh, Michael Parker, Wenzel P Geissler, Sassy C Molyneux
Consent processes have attracted significant research attention over the last decade, including in the global south. Although relevant studies suggest consent is a complex negotiated process involving multiple actors, most guidelines assume consent is a one-off encounter with a clear 'yes' or 'no' decision. In this paper we explore the concept of 'silent refusals', a situation where it is not clear whether potential participants want to join studies or those in studies want to withdraw from research, as they were not actively saying no...
2015: PloS One
https://www.readbyqxmd.com/read/25933429/health-providers-perceptions-of-clinical-trials-lessons-from-ghana-kenya-and-burkina-faso
#20
Vibian Angwenyi, Kwaku-Poku Asante, Abdoulaye Traoré, Lawrence Gyabaa Febir, Charlotte Tawiah, Anthony Kwarteng, Alphonse Ouédraogo, Sodiomon Bienvenue Sirima, Seth Owusu-Agyei, Egeruan Babatunde Imoukhuede, Jayne Webster, Daniel Chandramohan, Sassy Molyneux, Caroline Jones
BACKGROUND: Clinical trials conducted in Africa often require substantial investments to support trial centres and public health facilities. Trial resources could potentially generate benefits for routine health service delivery but may have unintended consequences. Strengthening ethical practice requires understanding the potential effects of trial inputs on the perceptions and practices of routine health care providers. This study explores the influence of malaria vaccine trials on health service delivery in Ghana, Kenya and Burkina Faso...
2015: PloS One
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