Table of Contents
Advancing Learning Health Systems: Lessons from the African Health Initiative
- Learning Health Systems to Bridge the Evidence-Policy-Practice Gap in Primary Health Care: Lessons From the African Health Initiative
The compilation of lessons in this supplement on the Doris Duke Charitable Foundation’s African Health Initiative’s work in the application of implementation research in primary health care in sub-Saharan Africa reflects the evolution of the discipline that is now increasingly recognized as integral to health systems strengthening.
- The African Health Initiative’s Role in Advancing the Use of Embedded Implementation Research for Health Systems Strengthening
The African Health Initiative has demonstrated the feasibility of changing the traditional knowledge generation paradigm by using an embedded implementation research approach to improve health systems’ performance and strengthen capacity for knowledge generation and use.
- Embedding Research on Implementation of Primary Health Care Systems Strengthening: A Commentary on Collaborative Experiences in Ethiopia, Ghana, and Mozambique
The African Health Initiative prioritized embedded implementation research using a multidisciplinary partnership model that empowered decision makers and embedded research and capacity building at multiple levels of health systems.
- Barriers and Facilitators to Data Use for Decision Making: The Experience of the African Health Initiative Partnerships in Ethiopia, Ghana, and Mozambique
Data for decision making on clinical care and health service management is crucial, yet implementers lack knowledge on the determinants of effective implementation. Findings from this study conducted in the context of primary health care systems in Ethiopia, Ghana, and Mozambique fill this knowledge gap.
- Improving Primary Care Quality Through Supportive Supervision and Mentoring: Lessons From the African Health Initiative in Ethiopia, Ghana, and Mozambique
Systematic approaches to positioning technical support, enhancing systems, and promoting sustainment are crucial to strengthening supportive supervision and mentoring in primary health care systems. The African Health Initiative projects in Ethiopia, Ghana, and Mozambique have lessons to share from such experiences that stakeholders can apply to similar efforts in other countries.
- “You Can’t Look at an Orange and Draw a Banana”: Using Research Evidence to Develop Relevant Health Policy in Ghana
We explored inhibitors and enablers of using health policy and systems research to inform the policy process in Ghana. The findings suggest a myriad of factors influencing evidence-based policy development, including the strength of the relationships between policy makers and research producers.
- The Use of Research for Health Systems Policy Development and Implementation in Mozambique: A Descriptive Study
There are still considerable gaps in the process of using research evidence for policy making in Mozambique. We recommend key actions to take to improve the research-to-policy pipeline.
- Drivers and Barriers to Improved Data Quality and Data-Use Practices: An Interpretative Qualitative Study in Addis Ababa, Ethiopia
The Ethiopia government’s implementation of strategies to improve data quality, as outlined in its Information Revolution Roadmap, has led to higher data quality and improved data use, but barriers to optimal data-use practices must be addressed to create a culture of information use.
- Primary Health Care Management Effectiveness as a Driver of Family Planning Service Readiness: A Cross-Sectional Analysis in Central Mozambique
We found higher levels of management effectiveness in primary health care facilities to be independently associated with an increased likelihood of improved family planning service readiness in central Mozambique. Strengthening management capabilities and reinforcing management roles at the primary health care level may improve health system readiness and provision of quality family planning services.
- Health Policy and Systems Research Capacities in Ethiopia and Ghana: Findings From a Self-Assessment
Government investment in strengthening health policy and systems research capacities is needed to enhance the generation of evidence for effective policy making. Researchers’ engagement in the policy-making process helps shape policy-relevant research and support policy-relevant decisions.
- Maternal Service Coverage and Its Relationship To Health Information System Performance: A Linked Facility and Population-Based Survey in Ethiopia
Coverage for most maternal services showed promising performance. Improving the health information system performance can further improve maternal service uptake and quality.
- Applying the Consolidated Framework for Implementation Research to Identify Implementation Determinants for the Integrated District Evidence-to-Action Program, Mozambique
We combined the Consolidated Framework for Implementation Research with an extended case study and flexible dissemination strategy. This approach enabled the identification of facilitators and barriers that demonstrated implementation science potential to inform timely adjustments to the implementation of an audit and feedback intervention across multiple sites in Mozambique.
- Maternal and Child Health Care Service Disruptions and Recovery in Mozambique After Cyclone Idai: An Uncontrolled Interrupted Time Series Analysis
Timely and relevant information is vital to help identify and track areas of improvement after extreme weather events and during emergencies to prioritize limited resources. Routine data can provide useful evidence of health system performance during and after natural disasters, contributing to an effective and efficient response.
- Lessons Learned From the Capacity-Building and Mentorship Program to Improve Health Information Systems in 11 Districts of Ethiopia
Health information systems strengthening interventions, such as the capacity-building and mentorship program used, leverages the expertise of stakeholders from multiple disciplines and can help improve data quality and information use at health facilities.
- Using Health Systems and Policy Research to Achieve Universal Health Coverage in Ghana
Health system implementation research, combined with knowledge management processes, directly contributed to Community-based Health Planning and Services geographic coverage expansion. Research was less deliberately employed for guiding financial access expansion through the National Health Insurance Scheme.
- Health System Resilience: Withstanding Shocks and Maintaining Progress
Building a resilient system capable of responding to health threats while maintaining essential health service delivery requires health systems to embed implementation research capacity to create the knowledge needed, ensure the affordability and accessibility of health care services at all levels of delivery, and provide the range of services needed to meet the population’s needs.
