Counting the cost of child mortality in the World Health Organization African region

Background: Worldwide, a total of 6.282 million deaths occurred among children aged less than 5 years in 2013. About 47.4 % of those were borne by the 47 Member States of the World Health Organization (WHO) African Region. Sadly, even as we approach the end date for the 2015 Millennium Development Goals (MDGs), only eight African countries are on track to achieve the MDG 4 target 4A of reducing under-five mortality by two thirds between 1990 and 2015. The post-2015 Sustainable Development Goal (SDG) 3 target is "by 2030, end preventable deaths of new-borns and children under 5 years ...

Modernization and development: impact on health care decision-making in Uganda

Uganda has faced numerous challenges over the past 50 years from overcoming political conflict and civil unrest, to rapid population growth, to combating the HIV epidemic and ever-growing health needs. Women in Uganda have had a major role to play in the health of families and communities. The researchers' purpose in this study, undertaken in rural Uganda, was to

• a) identify a people-centered definition of development,
• b) compare it to the process of modernization, and
• c) investigate how these processes have changed the role women play in decision-making, in areas directly and indirectly related to their health and that of ...

Action learning for health system governance: the reward and challenge of co-production

Health policy and systems research (HPSR) is centrally concerned with people, their relationships and the actions and practices they can implement towards better health systems. These concerns suggest that HPS researchers must work in direct engagement with the practitioners and practice central to the inquiry, acknowledging their tacit knowledge and drawing it into generating new insights into health system functioning. Social science perspectives are of particular importance in this field because health policies and health systems are themselves social and political constructs. However, how can social science methodologies such as action research and narrative and appreciative enquiry enable such research ...

Exploring perceptions of community health policy in Kenya and identifying implications for policy change

BACKGROUND:

Global interest and investment in close-to-community health services is increasing. Kenya is currently revising its community health strategy (CHS) alongside political devolution, which will result in revisioning of responsibility for local services. This article aims to explore drivers of policy change from key informant perspectives and to study perceptions of current community health services from community and sub-county levels, including perceptions of what is and what is not working well. It highlights implications for managing policy change.

METHODS:

We conducted 40 in-depth interviews and 10 focus group discussions with a range of participants to capture plural perspectives, including those ...

Global Challenges in People-Centered E-Health

People-centered health care seeks an active role for the patient while empowering all other members of the health care team. By promoting greater patient responsibility and optimal usage, patient-centered health care leads to improved health outcomes, quality of life and optimal value for health care investment. This paper reviews some definitions of people-centered health care and various e-health approaches around the world used to implement this vision. The barriers and enablers to implementation this type of approach are explored. This paper provides a proposed research agenda for future implementations of people-centered e-health.

Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study

Enhancing governance and health system accountability for people centered healthcare: an exploratory study of community scorecards in Afghanistan

BACKGROUND:

The premise of patient-centered care is to empower patients to become active participants in their own care and receive health services focused on their individual needs and preferences. Afghanistan has evidenced enormous gains in coverage and utilization, but the quality of care remains suboptimal, as evidenced in the balanced scorecard (BSC) performance assessments. In the United States and throughout Africa and Asia, community scorecards (CSC) have proved effective in improving accountability and responsiveness of services. This study represents the first attempt to assess CSC feasibility in a fragile context (Afghanistan) through joint engagement of service providers and community members ...

Community Participation in Health Systems Research: A Systematic Review Assessing the State of Research, the Nature of Interventions Involved and the Features of Engagement with Communities

BACKGROUND:

Community participation is a major principle of people centered health systems, with considerable research highlighting its intrinsic value and strategic importance. Existing reviews largely focus on the effectiveness of community participation with less attention to how community participation is supported in health systems intervention research.

OBJECTIVE:

To explore the extent, nature and quality of community participation in health systems intervention research in low- and middle-income countries.

METHODOLOGY:

We searched for peer-reviewed, English language literature published between January 2000 and May 2012 through four electronic databases. Search terms combined the concepts of community, capability/participation, health systems research and low- ...

Framework on integrated, people-centred health services

This Framework proposes five interdependent strategies for health services to become more integrated and people-centred. It calls for reforms to reorient health services, putting individuals, families, carers and communities at their centre, supported by responsive services that better meet their needs and respect their preferences, and that are coordinated both within and beyond the health sector, irrespective of country setting or development status. These reforms also incorporate a human rights approach, enshrining access to health care as a basic right, without distinction of ethnicity, religion, gender, age, disability, political belief, and economic or social condition.

This document builds on the ...

I’m Still Me: A Narrative For Coordinated Support For Older People

Care coordination should be a means to achieving specific outcomes, rather than an end in itself. In turn, it is important that these outcomes reflect what patients want. In December 2014, National Voices, Age UK and UCLPartners jointly published I’m Still Me, a document that focuses on what older people consider to be the most important outcomes of coordinated support. The report is based on a variety of research methods, including 74 semi-structured interviews with older individuals. The research identifies a number of outcomes which are key to older people, such as maintaining their independence and retaining their own ...