The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

Agyepong, Irène Akua; Sewankambo, Nelson K.; Binagwaho, Agnès; Coll-Seck, Awa Marie; Corrah, Tumani; Ezeh, Alex; Fekadu, Abebaw; Kilonzo, Nduku; Lamptey, Peter; Masiye, Felix; Mayosi, Bongani M.; Mboup, Souleymane; Muyembe, Jean‐Jacques; Pate, Muhammad Ali; Sidibe, Myriam; Simons, Bright; Tlou, Sheila; Gheorghe, Adrian; Legido‐Quigley, Helena; McManus, Joanne; Ng, Edmond S. W.; O’Leary, Maureen; Enoch, Jamie; Kassebaum, Nicholas J; Piot, Peter

doi:10.1016/s0140-6736(17)31509-x

Cited by 186 publications

(227 citation statements)

References 170 publications

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“…South African public healthcare also suffers from inadequate investments in training (Agyepong et al, ), insufficient IT investment and support (Buh et al, ), and a lack of a relevant BPM methodology and standards (Künzle & Reichert, ). All of these challenges were experienced in the project.…”

Section: Discussionmentioning

confidence: 99%

“…Generally, governance of BPM is lacking (Bandara, Indulska, Chong, & Shazia, ; Buh, Kovačič, & Indihar Štemberger, ). Appropriate governance can reduce corruption: In South Africa, the siphoning of scarce resources due to corruption has gravely affected health (Agyepong et al, ).…”

Section: Literature Reviewmentioning

confidence: 99%

“…Appropriate governance can reduce corruption: In South Africa, the siphoning of scarce resources due to corruption has gravely affected health (Agyepong et al, 2017).…”

Section: Bpm Challengesmentioning

confidence: 99%

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Applied business process management: An information systems approach to improve service delivery in public hospitals of low‐ and middle‐income countries

Seymour

Mwalemba

Weimann

2019

E J Info Sys Dev Countries

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South African public hospitals are faced with many challenges comprising inefficient processes, lack of digitalisation, severe austerity measures, and the rising burden of disease. Irrespective of the many existing initiatives in place, a critical challenge is the shortage of necessary resources required to fund, implement, and sustain new interventions. This deprives public hospitals from the efficiencies and quality of service experienced in private hospitals or other business entities. Through a case study strategy, this paper has abstracted two practice contributions. First, it describes and prescribes a low‐cost approach in which business process redesign was applied in a public hospital through a partnership between the hospital and a higher learning institution. The initiative involved third year students majoring in Information Systems performing, as part of their class project, process analysis at the hospital at no cost to the hospital other than their employees' time. The second contribution is a priority list of redesign and lean management principles that were abstracted from these initiatives. These include improving staff training, distributing and adhering to up‐to‐date standard operating procedures, performing tasks in parallel rather than in series, reducing handovers by avoiding certain tasks, incentivizing use of existing mobile software by doctors, developing low‐cost task automation solutions such as Microsoft Office applications, redesigning and standardizing forms, capturing data at source electronically rather than later, redesigning physical spaces, and improved key performance indicators and reporting. The study confirms the usefulness of this collaborative business process redesign approach for public hospitals as stakeholders got relevant information and practical, low‐cost, creative solutions with the potential to improve efficiencies and subsequently service delivery.

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Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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Applied business process management: An information systems approach to improve service delivery in public hospitals of low‐ and middle‐income countries

Seymour

Mwalemba

Weimann

2019

E J Info Sys Dev Countries

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“…Another important impediment holding back the tackling of CVDs in SSA is scarcity of cardiologists. There is a very low proportion of physicians to population, with a majority of SSA countries having <5 physicians per 10,000 people [125]. In a recent survey, 18% of the sub-Saharan African countries did not have a registered cardiologist [19,126].…”

Section: Shortage Of Cardiac Professionalsmentioning

confidence: 99%

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

et al. 2020

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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations. Highlights:-The burden of non-communicable diseases including cardiovascular diseases is rising in SSA.-Levels of hypertension diagnosis, treatment, and control are low at <40%, <35%, and 10-20%, respectively, and more than 40% of patients with diabetes are not aware of their diagnosis in SSA. -SSA has 23% of the world's prevalent rheumatic heart disease cases.-The leading causes of heart failure in SSA are hypertensive heart disease, cardiomyopathy, and rheumatic heart disease, with ischemic heart disease accounting for <10% of cases compared to >50% in high-income countries.

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“…The study represents a vulnerable population and is a community-based intervention study that aims to improve the health and well-being of disadvantaged women before and during pregnancy to improve health outcomes in their children. Other recent studies commissioned by The Lancet serve to underpin a necessary focus on understanding the determinants of healthy living in Africa [15,16]. …”

Section: Introductionmentioning

confidence: 99%

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study

Ali

Soo

Agongo

et al. 2018

Global Health Action

152

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There is an alarming tide of cardiovascular and metabolic disease (CMD) sweeping across Africa. This may be a result of an increasingly urbanized lifestyle characterized by the growing consumption of processed and calorie-dense food, combined with physical inactivity and more sedentary behaviour. While the link between lifestyle and public health has been extensively studied in Caucasian and African American populations, few studies have been conducted in Africa. This paper describes the detailed methods for Phase 1 of the AWI-Gen study that were used to capture phenotype data and assess the associated risk factors and end points for CMD in persons over the age of 40 years in sub-Saharan Africa (SSA). We developed a population-based cross-sectional study of disease burden and phenotype in Africans, across six centres in SSA. These centres are in West Africa (Nanoro, Burkina Faso, and Navrongo, Ghana), in East Africa (Nairobi, Kenya) and in South Africa (Agincourt, Dikgale and Soweto). A total of 10,702 individuals between the ages of 40 and 60 years were recruited into the study across the six centres, plus an additional 1021 participants over the age of 60 years from the Agincourt centre. We collected socio-demographic, anthropometric, medical history, diet, physical activity, fat distribution and alcohol/tobacco consumption data from participants. Blood samples were collected for disease-related biomarker assays, and genomic DNA extraction for genome-wide association studies. Urine samples were collected to assess kidney function. The study provides base-line data for the development of a series of cohorts with a second wave of data collection in Phase 2 of the study. These data will provide valuable insights into the genetic and environmental influences on CMD on the African continent.

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The path to longer and healthier lives for all Africans by 2030: the Lancet Commission on the future of health in sub-Saharan Africa

Cited by 186 publications

References 170 publications

Applied business process management: An information systems approach to improve service delivery in public hospitals of low‐ and middle‐income countries

Applied business process management: An information systems approach to improve service delivery in public hospitals of low‐ and middle‐income countries

Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study

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