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Sassy Molyneux

Helen M Nabwera, Sophie E Moore, Martha K Mwangome, Sassy C Molyneux, Momodou K Darboe, Nyima Camara-Trawally, Bakary Sonko, Alhagie Darboe, Seedy Singhateh, Anthony J Fulford, Andrew M Prentice
BACKGROUND: Severe wasting affects 16 million under 5's and carries an immediate risk of death. Prevalence remains unacceptably high in sub-Saharan Africa and early infancy is a high-risk period. We aimed to explore risk factors for severe wasting in rural Gambian infants. METHODS: We undertook a case-control study from November 2014 to June 2015, in rural Gambia. Cases had WHO standard weight-for-length z-scores (WLZ) < -3 on at least 1 occasion in infancy...
January 6, 2018: BMC Public Health
George Okello, Rene Gerrets, Scholastica Zakayo, Sassy Molyneux, Caroline Jones
BACKGROUND: Intermittent preventive treatment for malaria in pregnancy (IPTp) is part of a multi-pronged strategy aimed at preventing malaria in pregnancy in areas of moderate to high transmission in sub-Saharan Africa. Despite being formally adopted as a malaria prevention policy over a decade ago, IPTp coverage has remained low. Recent demands for action have incorporated calls to strengthen IPTp monitoring and evaluation systems, including the use of routine data, to measure coverage, track implementation and identify roadblocks to improving uptake...
2018: PloS One
Sally Theobald, Rosemary Morgan, Kate Hawkins, Sarah Ssali, Asha George, Sassy Molyneux
This editorial discusses a collection of papers examining gender across a range of health policy and systems contexts, from access to services, governance, health financing, and human resources for health. The papers interrogate differing health issues and core health systems functions using a gender lens. Together they produce new knowledge on the multiple impacts of gender on health experiences and demonstrate the importance of gender analyses and gender sensitive interventions for promoting well-being and health systems strengthening...
December 1, 2017: Health Policy and Planning
Kelly W Muraya, Caroline Jones, James A Berkley, Sassy Molyneux
Gender roles and relations play an important role in child health and nutritional status. While there is increasing recognition of the need to incorporate gender analysis in health planning and programme development, there has been relatively little attention paid to the gendered nature of child nutrition interventions. This qualitative study undertaken in rural Coastal Kenya aimed to explore the interaction between household gender relations and a community-based child nutrition programme, with a focus on household decision-making dynamics related to joining the intervention...
December 1, 2017: Health Policy and Planning
Lucy Gilson, Edwine Barasa, Nonhlanhla Nxumalo, Susan Cleary, Jane Goudge, Sassy Molyneux, Benjamin Tsofa, Uta Lehmann
Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, primarily qualitative research conducted in three different district health system settings in Kenya and South Africa, and adopting principles from case study research methodology and meta-synthesis in its analytic approach...
2017: BMJ Global Health
Paulina Tindana, Sassy Molyneux, Susan Bull, Michael Parker
In recent years, there has been an increase in the establishment of biobanks for genetic and genomic studies around the globe. One example of this is the Human Heredity and Health in Africa Initiative (H3Africa), which has established biobanks in the sub-region to facilitate future indigenous genomic studies. The concept of 'broad consent' has been proposed as a mechanism to enable potential research participants in biobanks to give permission for their samples to be used in future research studies. However, questions remain about the acceptability of this model of consent...
October 23, 2017: Developing World Bioethics
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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