Monitoring progress towards achieving Universal Health Coverage (UHC) is seen to be critical at both country and global level, and a monitoring framework for UHC was proposed by a joint WHO/World Bank discussion paper in December 2013. This study determined the feasibility of the proposed framework in Kenya. The study used the WHO/World Bank UHC monitoring framework and the Bellagio meeting report sponsored by WHO and the Rockefeller Foundation to informed the list of indicators used to determine the feasibility of the framework using published literature. Kenya has yet to establish an official policy on UHC that provides a clear mandate on the goals, targets and monitoring and evaluation of performance. The country has the capacity to reasonably report on five out of the seven proposed UHC indicators, but very limited capacity to report on the two service coverage indicators for the chronic condition and injury interventions and wider systemic challenges to meet the data requirements of the proposed UHC monitoring framework.
Monitoring equity and research policy
Despite substantial investment in health capacity building in developing countries, evaluations of capacity building effectiveness are scarce. By analysing projects in Africa that had successfully built sustainable capacity, the authors of this stuy aimed to identify evidence that could indicate that capacity building was likely to be sustainable. Four projects were selected as case studies using pre-determined criteria, including the achievement of sustainable capacity. The authors found that indicators of sustainable capacity building increased in complexity as projects matured and included: early engagement of stakeholders; improved resources; and funding for core activities secured, with management and decision-making led by Southern partners. Projects became sustainable after a median of 66 months. The authors identified the main challenges to achieving sustainability as high turnover of staff and stakeholders, and difficulties in embedding new activities into existing systems, securing funding and influencing policy development.
"Inequalities in health are important for overall well-being even in developing countries. But research into this area has lagged behind developed countries partly because of the lack of routine and longitudinal data. Insights from developed countries have highlighted how risk factors are clustered around poor people and the ways in which pathways of poverty and poor health are formed during their lives. This is being overlaid by the process of globalization that seems to be accentuating these processes. The paucity of reliable routine data should encourage public health researchers in developing countries to stretch their methodological imagination to include qualitative insights in order to facilitate a more probing investigation that moves beyond describing inequalities but begins to describe how they are produced and reproduced."
Most Ministries of Health across Africa invest substantial resources in some form of health management information system (HMIS) to coordinate the routine acquisition and compilation of monthly treatment and attendance records from health facilities nationwide. Despite the expense of these systems, poor data coverage means they are rarely, if ever, used to generate reliable evidence for decision makers. One critical weakness across Africa is the current lack of capacity to monitor effectively patterns of service use through time so that the impacts of changes in policy or service delivery can be evaluated. Here we present a new approach that, for the first time, allows national changes in health service use during a time of major health policy change to be tracked reliably using imperfect data from a national HMIS. The methodological approach presented can compensate for missing records in health information systems to provide robust estimates of national patterns of outpatient service use. This represents the first such use of HMIS data and contributes to the resurrection of these hugely expensive but underused systems as national monitoring tools. Applying this approach to Kenya has yielded output with immediate potential to enhance the capacity of decision makers in monitoring nationwide patterns of service use and assessing the impact of changes in health policy and service delivery.
The Canadian Institutes of Health Research (CIHR) requests your assistance in identifying African researchers/professionals involved in grassroots/national/international health issues of Africans. CIHR is taking a lead, through a Global Health Research Initiative partnership, on the consultative process leading up to the G8 meeting in June where the approval of the Africa Action Plan will take place. This Plan will define how G8 member countries will meet the objectives of the New Partnership for Africa's Development (NEPAD). CIHR seek to inform the G8 process by providing a recommendation and supporting background paper on how increased investment in health research contributes to improved health and economic development in Africa. The partners and the Coalition are seeking additional input through consultative processes that are designed to coordinate the views of the developing country researcher community, and invite the views of international and national research organizations with shared interest in global health research. Interested participants could provide input through the website of the Coalition for Global Health Research.
In this paper, the authors outline the process of developing country-specific spreadsheet-based models to explore the financial resource requirements of health system reform options in South Africa and Tanzania. Their intention is to provide guidance for analysts who wish to develop their own models, and to illustrate, with reference to the South African and Tanzanian modelling experience, how one has to adapt to data constraints and context-specific modelling requirements. They found that using modelling to assess the financial feasibility and implications of alternative health system reform paths can be of great value in supporting evidence-informed policy-making. Developing one's own spreadsheet model has a number of advantages, including allowing greater flexibility to reflect specific country circumstances and requiring the analyst to carefully evaluate the assumptions built into the model. A pragmatic approach should be adopted in data scarce contexts, but all assumptions should be made explicit and justified. A major advantage of the modelling process is that it can highlight priority areas for improved data collection.
This document contains guidelines for assessing the integration of gender, rights and sexuality (GRS) issues into sexual and reproductive health services. The guidelines include a self-assessment GRS questionnaire designed to guide discussions among staff with the aim of producing concrete solutions to improve the integration of GRS issues. The questionnaire is divided into two sections: the needs of staff providers and the needs of clients.
Most developing countries do not have fully effective civil registration systems to provide necessary information about population health. Interim approaches—both innovative strategies for collection of data, and methods of assessment or estimation of these data—to fill the resulting information gaps have been developed and refined over the past four decades. To respond to the needs for data for births, deaths, and causes of death, data collection systems such as population censuses, sample vital registration systems, demographic surveillance sites, and internationally-coordinated sample survey programmes in combination with enhanced methods of assessment and analysis have been successfully implemented to complement civil registration systems. Methods of assessment and analysis of incomplete information or indirect indicators have also been improved, as have approaches to ascertainment of cause of death by verbal autopsy, disease modelling, and other strategies. Our knowledge of demography and descriptive epidemiology of populations in developing countries has been greatly increased by the widespread use of these interim approaches; although gaps remain, particularly for adult mortality.
The use of international comparisons is an essential element of modern, professional policy making. Looking abroad to see what other governments have done can point us towards a new understanding of shared problems; towards new solutions to those problems; or to new mechanisms for implementing policy and improving the delivery of public services. This toolkit pack is intended to provide help and guidance in the use of international comparisons in policy making.
Boston, MA, USA - December 7 - 9, 2001. Health Policy Statistics Section (HPSS) - American Statistical Association.
The conference provides a forum for discussing research needs and solutions to the methodological challenges in health services research. Its specific aim is to create the interface for methodologists and health service researchers. The Program will cover several technical areas including hierarchical models, longitudinal data, causal inference, techniques for assessing quality of care and for profiling providers, techniques for inferring disparities, decision making, data mining, and survey design. The deadline for abstracts: September 17, 2001.