Realigning Health Systems Strategies and Approaches; What Should African Countries Do to Strengthen Health Systems for the Sustainable Development Goals?

Ibeneme, Sunny; Ongom, M; Ukor, Nkiruka; Okeibunor, Joseph

doi:10.3389/fpubh.2020.00372

Cited by 13 publications

(16 citation statements)

References 18 publications

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“…Given that donors prioritize HIV programs, this negative spillover effect deserves further attention and should inform roundtable discussions on focused system-wide approaches to sustainable health systems nancing among Low-and Middle-Income Countries (LMICs). Donors and policy-makers are to use study results for planning purposes in-view of consolidating sustainable investments with system-wide impacts [23].…”

Section: Discussionmentioning

confidence: 99%

“…These groups are also lost to international jobs for better wages, thereby widening the gap in HRH available to coordinate strategic health mandates. Focusing donor resources to a particular disease area could lead to a diversion of attention of health leadership to prioritized disease areas with attendant systemic negative spillover effects [21,23].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the systemic vertical approach to most HIV programs further widens the gap and exacerbates the dearth of the health sector workforce. Thereby, weakening national health systems and impacting outcomes [21,22,23].…”

Section: Introductionmentioning

confidence: 99%

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Spillover Effects of HIV Foreign Aid on the Delivery of Maternal and Child Health Services in Nigeria: 2008 – 2018

Ibeneme

Croke

Karamagi

et al. 2021

Preprint

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BackgroundThis study expands the current body of knowledge by investigating the impact of the Global Health Initiatives (GHI) on the Nigerian health system. Using robust multilevel analytic approaches, this study examined system-wide impacts of foreign aid on the Nigerian health system– a country that has witnessed substantial Development Assistance for Health disbursements in the last two decades, yet has one of the worst maternal and child health indices globally. Most of the health aid to Nigeria has been for HIV programs; and has sparked debates among stakeholders. Critics have asserted the possibility that HIV aid might not be working and could have had unintended negative consequences on the delivery of non-HIV services. Others maintained that such prioritized attention to HIV could have had a crowding-out or negative spillover effect on the delivery of other health programs in Nigeria. Thus, the focus of this study is to ascertain the nature of the spillover effect of HIV aid on the delivery of maternal and child health services in NigeriaResultsThis study identified that donor HIV financing to Nigeria increased up to 2012, and decreased steadily afterwards between 2008 – 2018. This was suggested to be linked to PEPFAR priority shift to health systems strengthening in the second round of their funding cycle. This study also identified a negative spillover effect of HIV-specific aid on the delivery of non-HIV services, and is suggested to be attributed to the prioritized attention given to HIV programs by global health systems.ConclusionsStudy findings provide systematic evidence to inform policy on the frameworks for developing a national roadmap for the effective alignment of GHIs’ coordinating mechanisms with national health priorities. Future studies should explore the effects of the Development Assistance for Health among low- and middle-income countries including Nigeria to provide evidence for policy, and substantiate how the growing interests in health systems strengthening is overcoming vertical programs and fostering systemic improvements. Government should identify turnaround strategies to strengthen Nigerian health systems for the Sustainable Development Goals, and formulate policies that improve the effectiveness of GHIs in Nigeria.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Spillover Effects of HIV Foreign Aid on the Delivery of Maternal and Child Health Services in Nigeria: 2008 – 2018

Ibeneme

Croke

Karamagi

et al. 2021

Preprint

Self Cite

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“…The WHO Africa Region has made a commitment to improving the quality of care of health systems in the Region as part of the framework of actions for progress in the attainment of UHC and health-related SDG targets [16,17]. The framework, which was endorsed by the Region's Ministers of Health, at the 67 th Regional Committee Meeting, provides three dimensions of quality of care to consider: improving user experience in the care process, assuring patient safety, and improving the effectiveness of interventions, which are described in Table 1.…”

Section: Monitoring Quality Of Care In the Who Africa Region: A Proposal For A Quality Indexmentioning

confidence: 99%

“…As a process to consolidate composite indicators for the proposed index, we subjected proposed indicators to expert consultations with Member States over a twoyear (2016-18) process, involving the 47 countries of the region [16,18]. Additionally, a comprehensive search of the literature, and recognition of the limitations and capacities of the Region's health information systems, was taken into consideration for the indicator selection process.…”

Section: Selection Of Indicators For Quality Of Care Indexmentioning

confidence: 99%

Monitoring Quality of Care in the WHO Africa Region-A study design for measurement and tracking, towards UHC attainment

Titi-Ofei

Osei-Afriyie

Karamagi

2021

Global Health Action

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This paper reports on the design of a study to generate a quality of care index for countries in the World Health Organization Africa Region. Quality of care, for all people at all times, remains pivotal to the advancement of the 2030 agenda and the attainment of Universal Health Coverage. We present a study protocol for deriving a quality of care index, hinged on indicators and data elements currently monitored through routine information systems and institutionalized facility assessments in the World Health Organization Africa Region. This paper seeks to offer more insight into options in the Region for strengthening monitoring processes of quality of care, as a step towards generating empirical evidence which can galvanize action towards an improved care process. The methodology proposed in this study design has broad implications for policymaking and priority setting for countries, emphasizing the need for robust empirical measures to understand the functionality of health systems for the delivery of quality essential services. Application of this protocol will guide policymaking, as countries work to increasingly improve quality of care and adopt policies that will best facilitate their advancement towards Universal Health Coverage.

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Global public health policies: gathering public health associations’ perspectives

Wilson

Hamwi

Zanni

et al. 2023

Global Health Action

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Background Advocacy is one of the core functions of public health and is a key tool for achieving Sustainable Development Goals. Public health associations play a key role in advocating for the development and implementation of strategies to prevent diseases and promote health and well-being. Objective This study aims to map out the focus of public health advocacy carried out by selected national public health associations over 4 years, between 2018 and 2021, in order to identify gaps and strengths and support associations and professionals in their advocacy efforts. Methods Twelve national public health associations participated in the study. Official policy documents produced between 2018 and 2021 were collected and analysed. The title and summary of the policy documents were examined line by line and coded into the main subject categories and themes. A qualitative thematic analysis was conducted. Policies were assessed from global and regional perspectives. Results A total of 220 policy documents were analysed. Overall, the largest number of policy documents came from high-income countries and dealt with environmental health and communicable diseases, including COVID-19, with, however, important differences among regions. In the African region, public health advocacy focused mainly on strengthening health systems; Europe and South America were mostly concerned with communicable diseases and pandemic management; and North America and the Western Pacific regions focused primarily on climate change. Limited attention was paid to international health and health as a human right in all regions. Conclusion Our study showed that, especially in high-income countries, public health associations actively engage in advocacy; however, more effort needs to be devoted to implementing a more international and intersectoral approach at the global level, anchored in health as a human right and aligned with the Sustainable Development Goals.

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Realigning Health Systems Strategies and Approaches; What Should African Countries Do to Strengthen Health Systems for the Sustainable Development Goals?

Cited by 13 publications

References 18 publications

Spillover Effects of HIV Foreign Aid on the Delivery of Maternal and Child Health Services in Nigeria: 2008 – 2018

Spillover Effects of HIV Foreign Aid on the Delivery of Maternal and Child Health Services in Nigeria: 2008 – 2018

Monitoring Quality of Care in the WHO Africa Region-A study design for measurement and tracking, towards UHC attainment

Global public health policies: gathering public health associations’ perspectives

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