This article provides an overview of health planning and its links with health policy. The first ... more This article provides an overview of health planning and its links with health policy. The first part provides a definition of planning and describes the main values and elements of planning. Four contextual characteristics of planning are then reviewed. Different approaches to, and types of, health planning are described and compared. Six stages of the planning spiral are described in detail. The article concludes with the main challenges health planning currently faces.
IntroductionPregnancy and postpartum-related mental health problems pose serious public health th... more IntroductionPregnancy and postpartum-related mental health problems pose serious public health threat to the society, but worryingly, neglected in sub-Saharan Africa (SSA). This review will assess the burden and distribution of maternal mental health (MMH) problems in SSA, with the aim to inform the implementation of context sensitive interventions and policies.Methods and analysisAll relevant databases, grey literature and non-database sources will be searched. PubMed, LILAC, CINAHL, SCOPUS and PsycINFO, Google Scholar, African Index Medicus, HINARI,African Journals Onlineand IMSEAR will be searched from inception to 31 May 2023, without language restriction. The reference lists of articles will be reviewed, and experts contacted for additional studies missed by our searches. Study selection, data extraction and risk of bias assessment will be done independently by at least two reviewers and any discrepancies will be resolved through discussion between the reviewers. Binary outcome...
Health policy and systems research (HPSR) is critical in developing health systems to better meet... more Health policy and systems research (HPSR) is critical in developing health systems to better meet the health needs of their populations. The highly contextualised nature of health systems point to the value of local knowledge and the need for context-embedded HPSR. Despite such need, relatively few individuals, groups or organisations carry out HPSR, particularly in low-income and middle-income countries. Greater effort is required to strengthen capacity for, and build the field of, HPSR by capturing the multilevel and nuanced representation of HPSR across contexts. No comprehensive frameworks were found that inform systemic HPSR capacity strengthening. Existing literature on capacity strengthening for health research and development tends to focus on individual-level capacity with less attention to collective, organisational and network levels. This paper proposes a comprehensive framework for systemic capacity strengthening for HPSR, uniquely drawing attention to the blurred bound...
Background: Community Health Workers (CHWs) are an essential component of resilient and responsiv... more Background: Community Health Workers (CHWs) are an essential component of resilient and responsive health systems, within which they are a bridge between the community and formal health service to increase access to services. Although evidence shows that CHW programmes are effective in improving maternal and child health (MCH), greater clarity is required to understand what makes CHW programmes work, for whom and under what circumstances. This presentation draws lessons from using logic mapping as a tool to de-construct a multi-intervention CHW programme in Nigeria, which aimed to increase access to quality maternity services and improve MCH outcomes. The presentation should be of interest to policymakers and researchers interested in innovative approaches for evaluating and/or strengthening health systems. Methods: A logic map (LM) is a graphic way of organizing and displaying information about a strategy, programme or policy. A coherent LM is a thread of evidence-based logic that ...
The purpose of this article is to close the gap in frameworks for the use of evidence in mental h... more The purpose of this article is to close the gap in frameworks for the use of evidence in mental health policy agenda-setting in low- and middle-income countries (LMICs). Agenda-setting is important because mental health remains a culturally-sensitive and neglected issue in LMICs. Moreover, effective evidence-informed agenda-setting can help achieve, and sustain, the status of mental health as a policy priority in these low resource contexts. A scoping review of reviews of evidence-to-policy frameworks was conducted which followed PRISMA guidelines. Nineteen reviews met the inclusion criteria. A meta-framework was developed from analysis and narrative synthesis of these 19 reviews which integrates the key elements identified across studies. It comprises the concepts of evidence, actors, process, context, and approach which are linked via the cross-cutting dimensions of: beliefs, values and interests; capacity; power and politics; and, trust and relationships. Five accompanying questi...
IntroductionStrengthening of mental health information systems (MHIS) is essential to monitor and... more IntroductionStrengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa.MethodsWe report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews w...
IntroductionUniversal availability and affordability of essential medicines are determined by eff... more IntroductionUniversal availability and affordability of essential medicines are determined by effective design and implementation of relevant policies, typically involving multiple stakeholders. This paper examined stakeholder engagements, powers and resultant influences over design and implementation of four medicines pricing policies in Ghana: Health Commodity Supply Chain Master Plan, framework contracting for high demand medicines, Value Added Tax (VAT) exemptions for selected essential medicines, and ring-fencing medicines for local manufacturing.MethodsData were collected using reviews of policy documentation (n=16), consultative meetings with key policy actors (n=5) and in-depth interviews (n=29) with purposefully identified national-level policymakers, public and private health professionals including members of the National Medicine Pricing Committee, pharmaceutical wholesalers and importers. Data were analysed using thematic framework.ResultsA total of 46 stakeholders were...
This article provides an overview of health planning and its links with health policy. The first ... more This article provides an overview of health planning and its links with health policy. The first part provides a definition of planning and describes the main values and elements of planning. Four contextual characteristics of planning are then reviewed. Different approaches to, and types of, health planning are described and compared. Six stages of the planning spiral are described in detail. The article concludes with the main challenges health planning currently faces.
IntroductionPregnancy and postpartum-related mental health problems pose serious public health th... more IntroductionPregnancy and postpartum-related mental health problems pose serious public health threat to the society, but worryingly, neglected in sub-Saharan Africa (SSA). This review will assess the burden and distribution of maternal mental health (MMH) problems in SSA, with the aim to inform the implementation of context sensitive interventions and policies.Methods and analysisAll relevant databases, grey literature and non-database sources will be searched. PubMed, LILAC, CINAHL, SCOPUS and PsycINFO, Google Scholar, African Index Medicus, HINARI,African Journals Onlineand IMSEAR will be searched from inception to 31 May 2023, without language restriction. The reference lists of articles will be reviewed, and experts contacted for additional studies missed by our searches. Study selection, data extraction and risk of bias assessment will be done independently by at least two reviewers and any discrepancies will be resolved through discussion between the reviewers. Binary outcome...
Health policy and systems research (HPSR) is critical in developing health systems to better meet... more Health policy and systems research (HPSR) is critical in developing health systems to better meet the health needs of their populations. The highly contextualised nature of health systems point to the value of local knowledge and the need for context-embedded HPSR. Despite such need, relatively few individuals, groups or organisations carry out HPSR, particularly in low-income and middle-income countries. Greater effort is required to strengthen capacity for, and build the field of, HPSR by capturing the multilevel and nuanced representation of HPSR across contexts. No comprehensive frameworks were found that inform systemic HPSR capacity strengthening. Existing literature on capacity strengthening for health research and development tends to focus on individual-level capacity with less attention to collective, organisational and network levels. This paper proposes a comprehensive framework for systemic capacity strengthening for HPSR, uniquely drawing attention to the blurred bound...
Background: Community Health Workers (CHWs) are an essential component of resilient and responsiv... more Background: Community Health Workers (CHWs) are an essential component of resilient and responsive health systems, within which they are a bridge between the community and formal health service to increase access to services. Although evidence shows that CHW programmes are effective in improving maternal and child health (MCH), greater clarity is required to understand what makes CHW programmes work, for whom and under what circumstances. This presentation draws lessons from using logic mapping as a tool to de-construct a multi-intervention CHW programme in Nigeria, which aimed to increase access to quality maternity services and improve MCH outcomes. The presentation should be of interest to policymakers and researchers interested in innovative approaches for evaluating and/or strengthening health systems. Methods: A logic map (LM) is a graphic way of organizing and displaying information about a strategy, programme or policy. A coherent LM is a thread of evidence-based logic that ...
The purpose of this article is to close the gap in frameworks for the use of evidence in mental h... more The purpose of this article is to close the gap in frameworks for the use of evidence in mental health policy agenda-setting in low- and middle-income countries (LMICs). Agenda-setting is important because mental health remains a culturally-sensitive and neglected issue in LMICs. Moreover, effective evidence-informed agenda-setting can help achieve, and sustain, the status of mental health as a policy priority in these low resource contexts. A scoping review of reviews of evidence-to-policy frameworks was conducted which followed PRISMA guidelines. Nineteen reviews met the inclusion criteria. A meta-framework was developed from analysis and narrative synthesis of these 19 reviews which integrates the key elements identified across studies. It comprises the concepts of evidence, actors, process, context, and approach which are linked via the cross-cutting dimensions of: beliefs, values and interests; capacity; power and politics; and, trust and relationships. Five accompanying questi...
IntroductionStrengthening of mental health information systems (MHIS) is essential to monitor and... more IntroductionStrengthening of mental health information systems (MHIS) is essential to monitor and evaluate mental health services in low and middle-income countries. While research exists assessing wider health management information systems, there is limited published evidence exploring the design and implementation of MHIS in these settings. This paper aims to identify and assess the key factors affecting the design and implementation of MHIS, as perceived by the key stakeholders in Ghana and South Africa.MethodsWe report findings from the Mental Health and Poverty Project, a 5-year research programme implemented within four African countries. The MHIS strengthening in South Africa and Ghana included two related components: intervention and research. The intervention component aimed to strengthen MHIS in the two countries, and the research component aimed to document interventions in each country, including the key influences. Data were collected using semi structured interviews w...
IntroductionUniversal availability and affordability of essential medicines are determined by eff... more IntroductionUniversal availability and affordability of essential medicines are determined by effective design and implementation of relevant policies, typically involving multiple stakeholders. This paper examined stakeholder engagements, powers and resultant influences over design and implementation of four medicines pricing policies in Ghana: Health Commodity Supply Chain Master Plan, framework contracting for high demand medicines, Value Added Tax (VAT) exemptions for selected essential medicines, and ring-fencing medicines for local manufacturing.MethodsData were collected using reviews of policy documentation (n=16), consultative meetings with key policy actors (n=5) and in-depth interviews (n=29) with purposefully identified national-level policymakers, public and private health professionals including members of the National Medicine Pricing Committee, pharmaceutical wholesalers and importers. Data were analysed using thematic framework.ResultsA total of 46 stakeholders were...
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