Health Systems
- Prioritizing Health-Sector Interventions for Noncommunicable Diseases and Injuries in Low- and Lower-Middle Income Countries: National NCDI Poverty Commissions
Noncommunicable Disease and Injury (NCDI) Poverty Commissions in 16 low- and middle-income countries provided evidence-based recommendations on a local, expanded set of priority NCDIs and health-sector interventions needed in national initiatives to attain universal health coverage. These commissions provide a collective platform for policy, research, and advocacy efforts to improve coverage of cost-effective and equitable health-sector interventions for populations living in extreme poverty.
- Issue Analysis: A Use-Driven Approach to Data Governance Can Promote the Quality of Routine Health Data in India
India lacks a functional public policy framework to guide health data use and sharing practices, which stymies data quality. Embedding data governance in health data systems can promote quality and make service delivery more efficient. Much of the discourse on health information systems has focused on technology while the concern of using data for health system management and improving quality of care remains largely unaddressed.
- Institutionalizing a Regional Model for Improving Quality of Newborn Care at Birth Across Hospitals in Eastern Uganda: A 4-Year Story
A locally developed, low-cost package of interventions implemented in a regional network of hospitals resulted in significant reductions in mortality for mothers and newborns as well as the institutionalization of the quality improvement initiative. This work demonstrates that it is possible to achieve the World Health Organization/United Nations Children's Fund Quality of Care targets in hospitals.
- Implementing a Social Accountability Approach for Maternal, Neonatal, and Child Health Service Performances in Ethiopia: A Pre-Post Study Design
Implementing a community scorecard approach may help increase utilization of maternal, neonatal, and child health services in primary health care facilities. The results of our study show the importance of engaging both the community and health workers to measure and continuously improve health care processes and improve the health system performance.
- The Evolving Landscape of Medical Device Regulation in East, Central, and Southern Africa
Most existing medical devices were not built for the challenges often present in many African countries. Regulatory systems for medical devices are essential to ensuring device safety and efficacy. Yet, currently, most African countries do not have a well-defined regulatory process. This discourages both innovators within Africa and companies outside of Africa from developing quality medical devices suitable for these challenges.
- Bugs in the Bed: Addressing the Contradictions of Embedded Science with Agile Implementation Research
Implementation research often fails to have its intended impact on what programs actually do. Embedding research within target organizational systems is an effective response to this problem. We present case examples from Bangladesh, Ghana, and Tanzania that demonstrate challenges associated with embedded science. We propose “agile science” as a means of sustaining scientific rigor while simultaneously catalyzing evidence utilization.
- Strength in Diversity: Integrating Community in Primary Health Care to Advance Universal Health Coverage
The supplement highlights a systems approach that recognizes the communities' roles and their interactions with other health system actors to accelerate outcomes and reflect the diversity of the community health ecosystem. Several cross-cutting priorities emerge from the articles, namely coverage, community health financing, policy change, institutionalization, resilience, accountability, community engagement, and whole-of-society efforts.
- Institutionalizing Community Health Services in Kenya: A Policy and Practice Journey
The process of institutionalizing community health services in Kenya required strong leadership by the Ministry of Health, effective coordination and support of stakeholders, and alignment of community health with the political priorities at the national and decentralized government levels to facilitate adequate prioritization and financing of the community health strategy.
- The Community Health Systems Reform Cycle: Strengthening the Integration of Community Health Worker Programs Through an Institutional Reform Perspective
Efforts to scale community health worker programs within primary health care systems in 7 countries illustrated that these efforts are best understood as a complex process of institutional reform. Successful scale up depends on a problem-driven political process; requires that models develop solutions that align with resources, capabilities, and commitments of key stakeholders; and emerges from iterative cycles of learning and improvement.
- Galvanizing Action on Primary Health Care: Analyzing Bottlenecks and Strategies to Strengthen Community Health Systems in West and Central Africa
In West and Central Africa, “leaving no one behind” requires strengthening community health systems by increasing health financing, improving supply chain system, and fostering community ownership and partnerships in all settings. Countries with high child mortality rates should improve service delivery through better integration. Galvanizing context-specific country actions is fundamental to improve primary health care services and move toward universal health coverage.