Browsing by Subject "health policy"

Now showing 1 - 7 of 7
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    Open Access
    Community participation strategies to improve health in slum settings: a qualitative systematic review
    (2024) Dambisya, Philip; Gilson, Lucy
    With more than a billion people living in slum settings, the need to better health in slums is ever-growing. Community participation (CP) is continually gaining prominence as integral when addressing the complex challenges of those living in slums. Specific to health interventions in slums, an understanding of "what truly works" and what forms or approaches to CP support such efforts is under-researched. To understand the current knowledge base, this qualitative systematic review addressed the questions: What depth of community participation is seen in slum health improvement interventions, and what enables or constrains the deeper levels of participation? Articles were sought across ten databases: Academic Search Premier, Africa-Wide Information, APA PsycInfo, Business Source Premier, CINAHL, EconLit, Health Source: Nursing/Academic Edition, Scopus, SocINDEX with Full Text, and Web of Science. From the 653 unique studies identified, and subsequent citation tracking, reference list evaluation and snowballing further papers, nine articles published between 2000 and 2021 were included for review. Six of the studies were situated in the African region (three in South Africa, two in Kenya and one in Zimbabwe), two in South-East Asia (India) and one in South America (Brazil). Through a thematic analysis of the included papers, key themes of experiences were identified. The ‘depth' of participation of each reported slum health intervention was then assessed using Arnstein's ladder of citizen participation. In addition, the review identified what community participatory strategies were used within interventions in slum health contexts in low- and middle-income countries and analysed what factors enable or constrain CP. Six studies revealed that the interventions examined exhibited 'pseudo' forms of participation, with three presenting 'true' forms of participation. Findings revealed a mix of strategies within each intervention, but the number of CP strategies did not appear to affect the depth of participation in an intervention. Instead, the way in which a strategy was implemented appeared important – for example, establishing committees that represent the views of their constituents versus their own interests impacts on participation depth. In addition, integrating communities into planning and decision-making while engaging the broader social networks within communities in slums may lead to the improved buy-in of interventions. There is a need for an expansion of research in the field of slum health as well as ensuring that ways of assessing CP are included in evaluations of projects speaking to using CP as an underpinning concept of their actions.
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    Open Access
    Consortium for Health Policy & Systems Analysis in Africa
    (2014-09-15) Gilson, Lucy
    All CHEPSAA’s African members have produced reports that provide an overview of the HPSR+A capacity needs and assets in their organizations and its wider context. They each include recommendations about how to develop capacity. The assessment reports are from Ghana, South Africa, Tanzania, Kenya and Nigeria, and there are also comparative assessments with guidance on how to approach the needs assessment. CHEPSAA (the Consortium for Health Policy & Systems Analysis in Africa) works to develop the emerging field of health policy and systems research and analysis (HPSR+A) in Africa through harnessing synergies among a consortium of African and European universities.
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    Evidence map of knowledge translation strategies, outcomes, facilitators and barriers in African health systems
    (BioMed Central, 2019-02-07) Edwards, Amanda; Zweigenthal, Virginia; Olivier, Jill
    Abstract Background The need for research-based knowledge to inform health policy formulation and implementation is a chronic global concern impacting health systems functioning and impeding the provision of quality healthcare for all. This paper provides a systematic overview of the literature on knowledge translation (KT) strategies employed by health system researchers and policy-makers in African countries. Methods Evidence mapping methodology was adapted from the social and health sciences literature and used to generate a schema of KT strategies, outcomes, facilitators and barriers. Four reference databases were searched using defined criteria. Studies were screened and a searchable database containing 62 eligible studies was compiled using Microsoft Access. Frequency and thematic analysis were used to report study characteristics and to establish the final evidence map. Focus was placed on KT in policy formulation processes in order to better manage the diversity of available literature. Results The KT literature in African countries is widely distributed, problematically diverse and growing. Significant disparities exist between reports on KT in different countries, and there are many settings without published evidence of local KT characteristics. Commonly reported KT strategies include policy briefs, capacity-building workshops and policy dialogues. Barriers affecting researchers and policy-makers include insufficient skills and capacity to conduct KT activities, time constraints and a lack of resources. Availability of quality locally relevant research was the most reported facilitator. Limited KT outcomes reflect persisting difficulties in outcome identification and reporting. Conclusion This study has identified substantial geographical gaps in knowledge and evidenced the need to boost local research capacities on KT practices in low- and middle-income countries. Evidence mapping is also shown to be a useful approach that can assist local decision-making to enhance KT in policy and practice.
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    Exploring the perspectives of health service providers on mental health policy and interventions for school children in the Western Cape, South Africa
    (2021) Mgoqi, Khusela; Shung-King, Maylene
    Background: Mental health is recognised as a critical public health challenge globally, yet child and adolescent mental health receive low priority, particularly in low- and middle-income countries. Children and adolescents spend a significant proportion of their lives in school, suggesting that educational settings are potentially important environments where child and adolescent mental health (CAMH) can be strengthened to improve early identification and treatment. This study explored the perspectives of key service providers on needs, barriers and facilitators of child and adolescent mental health services (CAMHS) in schools in the Western Cape province of South Africa. Methods: This study employed an exploratory qualitative approach. In-depth individual interviews were conducted by one of the authors (SM), and the first author (KM) conducted a thematic analysis on the interview data. Results: There were nine interviewees selected who were diverse health service providers involved in child and adolescent health which included school doctors, school nurses, psychiatrists, occupational therapist, clinical nurse and mental health nurse. Thematic findings were grouped under: a) perceived needs, b) barriers and c) facilitators. The need to improve intersectoral collaboration, following a referral pathway, a strong multidisciplinary team (MDT) and integration of services were all identified important in the delivery of CAMHS. The neglect of CAMHS in both education and health sectors and limited resources were identified as barriers. Facilitators included intersectoral collaboration, task shifting from nurses and doctors to community health workers, and committed health workers. Conclusion: CAMHS receives very low priority in comparison to other health issues such as HIV/TB in South Africa. There is an urgent need to address CAMHS in South Africa, and the school setting is an important site of intervention. Intersectoral collaboration, task-shifting, continuous training of teachers and health professionals are potential strategies that could be used to strengthen access to CAMHS in education sector and have integrated services in the Western Cape Province.
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    Levels of research evidence in health policy assessment in Malawi
    (2019) Mapulanga, Patrick; Raju, Jaya; Matingwina, Thomas
    Purpose – The paper examines levels of health research evidence in health policies in Malawi. Design/Methodology/Approach – The study selected a typology of health policies in Malawi from 2002 to 2017. The study adopted the SPIRIT conceptual framework and assessed the levels of research evidence in health policy, systems and services research using the revised SAGE policy assessment tool. Documentary analysis was used to assess levels of health research evidence in health policies in Malawi. Findings – In 29 (96.7%) of the health policies, policy formulators including healthcare directors and managers used generic search engines such as Google or Google Scholar to look for heath research evidence. In 28 (93.3%) of the health policies they searched for grey literature and other government documents. In only 6 (20%) of the heath policy documents, they used academic literature in a form of journal articles and randomised controlled trials. No systematic reviews or policy briefs were consulted. Overall, in 23 (76.7%) of the health policy documents research evidence played a minimal role and had very little influence on the policy documents. Research limitations/implications – The empirical evidence in the health policy documents are limited due to insufficient research citation, low retrievability of health research evidence in the policy documents and biased selectivity of what constitutes health research evidence. Practical implications – The paper indicates that unfiltered information (data from policy evaluations and registries) constitutes majority of the research evidence in health policies both in health policy, systems and services research. The paper seeks to advocate for the use of filtered information (peer reviewed, clinical trials and data from systematic reviews) in formulating health policies. Originality/value – There is dearth of literature on the levels of health research evidence in health policy-making both in health policy, systems and services research. This study seeks to bridge the gap with empirical evidence from a developing country perspective.
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    Strengthening the science of addressing antimicrobial resistance: a framework for planning, conducting and disseminating antimicrobial resistance intervention research
    (2020-06-08) Rogers Van Katwyk, S; Hoffman, S J; Mendelson, M; Taljaard, M; Grimshaw, J M
    Antimicrobial resistance (AMR) has the potential to threaten tens of millions of lives and poses major global economic and development challenges. As the AMR threat grows, it is increasingly important to strengthen the scientific evidence base on AMR policy interventions, to learn from existing policies and programmes, and to integrate scientific evidence into the global AMR response. While rigorous evaluations of AMR policy interventions are the ideal, they are far from the current reality. To strengthen this evidence base, we describe a framework for planning, conducting and disseminating research on AMR policy interventions. The framework identifies challenges in AMR research, areas for enhanced coordination and cooperation with decision-makers, and best practices in the design of impact evaluations for AMR policies. This framework offers a path forward, enabling increased local and global cooperation, and overcoming common limitations in existing research on AMR policy interventions.
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    Transforming Health Systems: Case studies of critical health system analyses to support reform
    (2014-08-21) McIntyre, Diane; Gilson, Lucy
    A set of case studies to enhance critical analysis for health system reform. Over the years, the Health Economics Unit (University of Cape Town) and Centre for Health Policy (University of the Witwatersrand) have developed a range of training materials to strengthen critical analysis skills that can support health system reform. One of the case studies considers how national health accounts data can contribute to critically assessing existing health systems to identify key challenges that could potentially be addressed through reforms. The two key areas of health system reform focused on in these training materials are health care financing and decentralisation. These are complemented by case studies on resource allocation between and within health districts. While technical skills are important for health system reform, so are skills to understand and manage key policy actors or stakeholders. The set of materials, therefore, concludes with case studies to develop stakeholder analysis skills.