BackgroundThe rising burden of disease and weak health systems are being compounded by the persistent economic downturn, re-emerging diseases, and violent conflicts. There is a growing recognition that the global health agenda needs to shift from an emphasis on disease-specific approaches to strengthening of health systems, including dealing with social, environmental, and economic determinants through multisectoral responses.MethodsA review and analysis of data on strengthening health sector reform and health systems was conducted. Attention was paid to the goal of health and interactions between health sector reforms and the functions of health systems. Further, we explored how these interactions contribute toward delivery of health services, equity, financial protection, and improved health.FindingsHealth sector reforms cannot be developed from a single global or regional policy formula. Any reform will depend on the country's history, values and culture, and the population's expectations. Some of the emerging ingredients that need to be explored are infusion of a health systems agenda; development of a comprehensive policy package for health sector reforms; improving alignment of planning and coordination; use of reliable data; engaging ‘street level’ policy implementers; strengthening governance and leadership; and allowing a holistic and developmental approach to reforms.ConclusionsThe process of reform needs a fundamental rather than merely an incremental and evolutionary change. Without radical structural and systemic changes, existing governance structures and management systems will continue to fail to address the existing health problems.

Background:The epidemiology of COVID-19 remains speculative in Africa. To the best of our knowledge, no study, using robust methodology provides its trajectory for the region or accounts for local context. This paper is the first systematic attempt to provide prevalence, incidence, and mortality estimates across Africa.Methods: Caseloads and incidence forecasts are from a co-variate-based instrumental variable regression model. Fatality rates from Italy and China were applied to generate mortality estimates after making relevant health system and population-level characteristics related adjustments between each of the African countries.Results: By June 30 2020, around 16.3 million people in Africa will contract 403 to 98,358,799). Northern and Eastern Africa will be the most and least areas affected. Cumulative cases on June 30 are expected to reach around 2.9 million (95% CI 465,028 to 18,286,358) in Southern Africa, 2.8 million (95% CI 517,489 to 15,056,314) in Western Africa, and 1.2 million (95% CI 229,111 to 6,138,692) in Central Africa. Incidence for the month of April 2020 is expected to be highest in Djibouti, 32.8 per 1000 (95% CI 6.25 to 171.77), while Morocco will experience among the highest fatalities (1,045 deaths, 95% CI 167 to 6,547). Conclusion:Less urbanized countries with low levels of socio-economic development (hence least connected to the world), are likely to register lower and slower transmissions at the early stages of an epidemic. However, the same enabling factors that worked for their benefit can hinder interventions that have lessened the impact of COVID-19 elsewhere.

BackgroundA functional national health research system (NHRS) is crucial in strengthening a country’s health system to promote, restore and maintain the health status of its population. Progress towards the goal of universal health coverage in the post-2015 sustainable development agenda will be difficult for African countries without strengthening of their NHRS to yield the required evidence for decision-making. This study aims to develop a barometer to facilitate monitoring of the development and performance of NHRSs in the African Region of WHO.MethodsThe African national health research systems barometer algorithm was developed in response to a recommendation of the African Advisory Committee for Health Research and Development of WHO. Survey data collected from all the 47 Member States in the WHO African Region using a questionnaire were entered into an Excel spreadsheet and analysed. The barometer scores for each country were calculated and the performance interpreted according to a set of values ranging from 0% to 100%.ResultsThe overall NHRS barometer score for the African Region was 42%, which is below the average of 50%. Among the 47 countries, the average NHRS performance was less than 20% in 10 countries, 20–40% in 11 countries, 41–60% in 16 countries, 61–80% in nine countries, and over 80% in one country. The performance of NHRSs in 30 (64%) countries was below 50%.ConclusionAn African NHRS barometer with four functions and 17 sub-functions was developed to identify the gaps in and facilitate monitoring of NHRS development and performance. The NHRS scores for the individual sub-functions can guide policymakers to locate sources of poor performance and to design interventions to address them.Electronic supplementary materialThe online version of this article (doi:10.1186/s12961-016-0121-4) contains supplementary material, which is available to authorized users.

The Sustainable Development Goals (SDGs) herald a new phase for international development. This article presents the results of a consultative exercise to collaboratively identify 100 research questions of critical importance for the post‐2015 international development agenda. The final shortlist is grouped into nine thematic areas and was selected by 21 representatives of international and non‐governmental organisations and consultancies, and 14 academics with diverse disciplinary expertise from an initial pool of 704 questions submitted by 110 organisations based in 34 countries. The shortlist includes questions addressing long‐standing problems, new challenges and broader issues related to development policies, practices and institutions. Collectively, these questions are relevant for future development‐related research priorities of governmental and non‐governmental organisations worldwide and could act as focal points for transdisciplinary research collaborations.

Happiness is characterized by experiencing positive emotions while simultaneously perceiving one’s life as meaningful and worthwhile. Research on the mental health of healthcare professionals usually focuses on psychopathology as opposed to the positive aspects of mental health. Thus, the purpose of this study is to examine recent literature on individual-level and organization-level determinants of healthcare professionals happiness. The EBSCOhost, PubMed, Scopus, and Web of Science databases were searched for articles published between 2009 and 2019 that focused on happiness among healthcare professionals. Based on the eligibility criteria, both quantitative and qualitative studies were selected for this systematic review. The final review included a total of 18 studies. The main measures of healthcare professionals happiness in cross-sectional and intervention studies were self-report measures, and the main measures of happiness in qualitative studies were interviews. Multiple determinants of healthcare professionals happiness were identified in this systematic review. The interplay between individual-level and organization-level determinants collectively contributes to the happiness of healthcare professionals. Existing evidence highlights the importance of healthcare professionals happiness in the strengthening of the healthcare workforce and healthcare systems. This review also highlights the importance of health policy makers, health authorities and healthcare professionals in creating and effectively implementing policies and strategies to increase healthcare professionals happiness. Future similar studies should use large and more heterogeneous samples of healthcare professionals from various settings to generate contextually relevant and robust evidence regarding methods to enhance healthcare professionals happiness and ultimately the performance of health systems globally.