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Sassy Molyneux

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
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
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
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
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
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
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
Susanne H Hodgson, Elizabeth Juma, Amina Salim, Charles Magiri, Daniel Njenga, Sassy Molyneux, Patricia Njuguna, Ken Awuondo, Brett Lowe, Peter F Billingsley, Andrew O Cole, Caroline Ogwang, Faith Osier, Roma Chilengi, Stephen L Hoffman, Simon J Draper, Bernhards Ogutu, Kevin Marsh
BACKGROUND: Controlled human malaria infection (CHMI) studies, in which healthy volunteers are infected with Plasmodium falciparum to assess the efficacy of novel malaria vaccines and drugs, have become a vital tool to accelerate vaccine and drug development. CHMI studies provide a cost-effective and expeditious way to circumvent the use of large-scale field efficacy studies to deselect intervention candidates. However, to date few modern CHMI studies have been performed in malaria-endemic countries...
April 28, 2015: Malaria Journal
Evelyn Waweru, Catherine Goodman, Sarah Kedenge, Benjamin Tsofa, Sassy Molyneux
In many African countries, user fees have failed to achieve intended access and quality of care improvements. Subsequent user fee reduction or elimination policies have often been poorly planned, without alternative sources of income for facilities. 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...
March 2016: Health Policy and Planning
Benjamin Tsofa, Sassy Molyneux, Catherine Goodman
Operational planning is considered an important tool for translating government policies and strategic objectives into day-to-day management activities. However, developing countries suffer from persistent misalignment between policy, planning and budgeting. The Medium Term Expenditure Framework (MTEF) was introduced to address this misalignment. Kenya adopted the MTEF in the early 2000s, and in 2005, the Ministry of Health adopted the Annual Operational Plan process to adapt the MTEF to the health sector. This study assessed the degree to which the health sector Annual Operational Plan process in Kenya has achieved alignment between planning and budgeting at the national level, using document reviews, participant observation and key informant interviews...
July 2016: International Journal of Health Planning and Management
Dorcas M Kamuya, Vicki Marsh, Patricia Njuguna, Patrick Munywoki, Michael Parker, Sassy Molyneux
BACKGROUND: Benefit sharing in health research has been the focus of international debates for many years, particularly in developing countries. Whilst increasing attention is being given to frameworks that can guide researchers to determine levels of benefits to participants, there is little empirical research from developing countries on the practical application of these frameworks, including in situations of extreme poverty and vulnerability. In addition, the voices of those who often negotiate and face issues related to benefits in practice - frontline researchers and fieldworkers (FWs) - are rarely included in these debates...
December 24, 2014: BMC Medical Ethics
Maureen Njue, Francis Kombe, Salim Mwalukore, Sassy Molyneux, Vicki Marsh
BACKGROUND: Planning study benefits and payments for participants in international health research in low- income settings can be a difficult and controversial process, with particular challenges in balancing risks of undue inducement and exploitation and understanding how researchers should take account of background inequities. At an international health research programme in Kenya, this study aimed to map local residents' informed and reasoned views on the effects of different levels of study benefits and payments to inform local policy and wider debates in international research...
2014: PloS One
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