Health Systems
- Implementing an Integrated Pharmaceutical Management Information System for Antiretrovirals and Other Medicines: Lessons From Namibia
Integrating patient and commodity data into one system while maintaining specialized functionality has allowed managers to monitor and mitigate stock-out risks more effectively, as well as provide earlier warning for HIV drug resistance.
- Implementation Research to Strengthen Health Care Financing Reforms Toward Universal Health Coverage in Indonesia: A Mixed-Methods Approach to Real-World Monitoring
Implementation research enabled stakeholders to formulate questions, assess implications of research results that informed changes in regulations and payment at the primary care level, and strengthen monitoring capacity. While the national health insurance system had some impact on performance of primary care facilities, individual providers remained unsatisfied because payment was largely based on factors outside of their control such as tenure and position, rather than their contributions to improved performance.
- Local Sourcing and Supplier Development in Global Health: Analysis of the Supply Chain Management System's Local Procurement in 4 Countries
Local suppliers reported that after doing business with PEPFAR's global procurement and distribution project for essential HIV/AIDS medicines and supplies, they achieved revenue and asset growth, improved their quality standards, acquired new contracts with other businesses, and hired more employees.
- At Last! Universal Health Coverage That Prioritizes Health Impact: The Latest Edition of Disease Control Priorities (DCP3)
Sadly, we face a vast sea of health problems in global health. Universal health coverage programming should prioritize interventions with the most health impact, but instead largely succumbs to emphasizing less impactful clinical curative services. In contrast, DCP3 provides an evidence-based template that prioritizes impact. Yet even the most basic and realistic DCP3 package comes at a formidable price.
- Universal Health Coverage in Francophone Sub-Saharan Africa: Assessment of Global Health Experts' Confidence in Policy Options
Even within the fairly homogenous context of francophone Africa, among 18 options presented to experts on how to proceed toward universal health coverage (UHC), consensus was reached on only 1 with respect to effectiveness and another with respect to feasibility. The complexity and challenges of UHC as well as the weak evidence base likely contribute to this uncertainty.
- A New World Health Era
Unprecedented economic progress and demands for social protection have engendered an economic transition in health in many low- and middle-income countries, characterized by major increases in domestic health spending and growing national autonomy. At the global level, development assistance is refocusing on fragile states, the poorest communities, and cooperation on global public goods like health security, technical norms, and innovation. Intergovernmental organizations like WHO need the wherewithal and support to provide leadership and to properly advance this new world health era.
- More Than Bar Codes: Integrating Global Standards-Based Bar Code Technology Into National Health Information Systems in Ethiopia and Pakistan to Increase End-to-End Supply Chain Visibility
Bar codes can help track and trace health products in the supply chain. But to do so efficiently, they should be based on global standards rather than a proprietary system, and the captured data should be integrated into national health information systems to achieve end-to-end data visibility.
- Routine Health Facility and Community Information Systems: Creating an Information Use Culture
Substantial progress has been made to strengthen health information systems, with most efforts focusing on digitization, improving data quality and analysis, and identifying problems. But the ultimate goal is using information to solve problems, which requires building an information use culture over time. How? Human-centered design, role modeling by senior managers in use of data, and incentive-based systems hold considerable promise.
- Using Data to Improve Programs: Assessment of a Data Quality and Use Intervention Package for Integrated Community Case Management in Malawi
Use of simple wall charts by community and facility health workers to collect and visualize data helped inform data-based decision making for community health education activities, tracking stock-outs, staffing decisions, and other programming issues. Since intervention scale-up, however, use of the wall chart has dropped, demonstrating need for continued investment in supportive supervision.
- National Assessment of Data Quality and Associated Systems-Level Factors in Malawi
Nearly all facility registers were available and complete. But accuracy varied, with antenatal care and HIV testing and counseling performing the best and family planning and acute respiratory infections data less well. Most facilities visibly displayed routine health data and most hospitals and district health offices had staff trained in health management information systems, but training was lacking at the facility level as were routine data quality checks and regular supervision.