sábado, 6 de julio de 2019

Practicing governance towards equity in health systems: LMIC perspectives and experience

Practicing governance towards equity in health systems: LMIC perspectives and experience



Practicing governance towards equity in health systems: LMIC perspectives and experience

© Lucy GilsonEdited by Lucy Gilson and Ana Lorena Ruano
International Journal for Equity in Health
The unifying theme of the papers in this series is a concern for understanding the everyday practice of governance in LMIC health systems. 
Rather than seeing governance as a normative health system goal addressed through the architecture and design of accountability and regulatory frameworks, these papers provide insights into the real-world decision-making of health policy and system actors. Their multiple, routine decisions translate policy intentions into practice – and are filtered through relationships, underpinned by values and norms, influenced by organizational structures and resources, and embedded in historical and socio-political contexts. These decisions are also political acts – in that they influence who accesses benefits and whose voices are heard in decision-making, reinforcing or challenging existing institutional exclusion and power inequalities. In other words, the everyday practice of governance has direct impacts on health system equity.
The papers in the series address governance through diverse health policy and system issues, consider actors located at multiple levels of the system and draw on multidisciplinary perspectives. They present detailed examination of experiences in a range of African and Indian settings, led by authors who live and work in these settings. The overall purpose of the papers in this series is thus to provide an empirical and embedded research perspective on governance and equity in health systems. 
The papers were discussed at an April 2016 workshop hosted by the Collaboration for Health Systems Analysis and Innovation (CHESAI) in Cape Town, South Africa. They were sponsored either by CHESAI, with funding from the International Development Research Centre, Canada, or by the Resilient and Responsive Health Systems Consortium (RESYST), with funding from the UK’s Department for International Development. All articles have undergone the journal’s standard peer review process. The Editors declare no competing interests.
View all collections published in International Journal for Equity in Health
  1. Content Type:Research

    In 2012 the South African National Department of Health (SA NDoH) set out, using a top down process, to implement several innovations in eleven health districts in order to test reforms to strengthen the distr...
    Authors:Marsha Orgill, Lucy Gilson, Wezile Chitha, Janet Michel, Ermin Erasmus, Bruno Marchal and Bronwyn Harris
    Citation:International Journal for Equity in Health 2019 18:53
    Published on: 
  2. Content Type:Research

    The importance of strong and transformative leadership is recognised as essential to the building of resilient and responsive health systems. In this regard, Sustainable Development Goals (SDG) 5 prioritises a...
    Authors:Maylene Shung-King, Lucy Gilson, Chinyere Mbachu, Sassy Molyneux, Kelly W. Muraya, Nkoli Uguru and Veloshnee Govender
    Citation:International Journal for Equity in Health 2018 17:148
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  3. Content Type:Research

    Health systems globally are under pressure to ensure value for money, and the people working within the system determine the extent and nature of health services provided. A performance assessment (PA); an imp...
    Authors:Nonhlanhla Nxumalo, Jane Goudge, Lucy Gilson and John Eyles
    Citation:International Journal for Equity in Health 2018 17:141
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  4. Content Type:Research

    The Nigerian National Health Act proposes a radical shift in health financing in Nigeria through the establishment of a fund – Basic Healthcare Provision Fund, (BHCPF). This Fund is intended to improve the fun...
    Authors:Benjamin Uzochukwu, Emmanuel Onwujekwe, Chinyere Mbachu, Chinyere Okeke, Sassy Molyneux and Lucy Gilson
    Citation:International Journal for Equity in Health 2018 17:100
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  5. Content Type:Research

    Current policy priorities to strengthen the nursing sector in India have focused on increasing the number of nurses in the health system. However, the nursing sector is afflicted by other, significant problems...
    Authors:Joe Varghese, Anneline Blankenhorn, Prasanna Saligram, John Porter and Kabir Sheikh
    Citation:International Journal for Equity in Health 2018 17:98
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  6. Content Type:Research

    Public Private Partnerships (PPP) are increasingly utilized as a public health strategy for strengthening health systems and have become a core component for the delivery of TB control services in India, as pr...
    Authors:Solomon Salve, Kristine Harris, Kabir Sheikh and John D. H. Porter
    Citation:International Journal for Equity in Health 2018 17:73
    Published on: 
  7. Content Type:Research

    Implementation Research (IR) in and around health systems comes with unique challenges for researchers including implementation, multi-layer governance, and ethical issues. Partnerships between researchers, im...
    Authors:Gupteswar Patel, Surekha Garimella, Kerry Scott, Shinjini Mondal, Asha George and Kabir Sheikh
    Citation:International Journal for Equity in Health 2017 16:198
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  9. Content Type:Research

    Decentralisation is argued to promote community participation, accountability, technical efficiency, and equity in the management of resources, and has been a recurring theme in health system reforms for sever...
    Authors:Benjamin Tsofa, Catherine Goodman, Lucy Gilson and Sassy Molyneux
    Citation:International Journal for Equity in Health 2017 16:169
    Published on: 
  10. Content Type:Research

    This paper uses the concepts of organisational culture and organisational trust to explore the implementation of equity-oriented policies – the Uniform Patient Fee Schedule (UPFS) and Patients’ Rights Charter ...
    Authors:Ermin Erasmus, Lucy Gilson, Veloshnee Govender and Moremi Nkosi
    Citation:International Journal for Equity in Health 2017 16:164
    Published on: 
  11. Content Type:Research

    Governance, which includes decision-making at all levels of the health system, and information have been identified as key, interacting levers of health system strengthening. However there is an extensive lite...
    Authors:Vera Scott and Lucy Gilson
    Citation:International Journal for Equity in Health 2017 16:159
    Published on: 
  12. Content Type:Research

    A common challenge for health sector planning and budgeting has been the misalignment between policies, technical planning and budgetary allocation; and inadequate community involvement in priority setting. He...
    Authors:Benjamin Tsofa, Sassy Molyneux, Lucy Gilson and Catherine Goodman
    Citation:International Journal for Equity in Health 2017 16:151
    Published on: 
  13. Content Type:Research

    In March 2013, Kenya transitioned from a centralized to a devolved system of governance. Within the health sector, this entailed the transfer of service provision functions to 47 newly formed semi-autonomous c...
    Authors:Mary M. Nyikuri, Benjamin Tsofa, Philip Okoth, Edwine W. Barasa and Sassy Molyneux
    Citation:International Journal for Equity in Health 2017 16:113
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  14. Content Type:Research

    Decision-making on postings and transfers – that is, the geographic deployment of the health workforce – is a key element of health workforce governance. When poorly managed, postings and transfers result in m...
    Authors:Aku Kwamie, Miriam Asiamah, Marta Schaaf and Irene Akua Agyepong
    Citation:International Journal for Equity in Health 2017 16:85
    Published on: 
  15. Content Type:Research

    Participatory health initiatives ideally support progressive social change and stronger collective agency for marginalized groups. However, this empowering potential is often limited by inequalities within com...
    Authors:Kerry Scott, Asha S. George, Steven A. Harvey, Shinjini Mondal, Gupteswar Patel and Kabir Sheikh
    Citation:International Journal for Equity in Health 2017 16:84
    Published on: 
  16. Content Type:Research

    National community health worker (CHW) programmes are returning to favour as an integral part of primary health care systems, often on the back of pre-existing community based initiatives. There are significan...
    Authors:Helen Schneider and Nonhlanhla Nxumalo
    Citation:International Journal for Equity in Health 2017 16:72
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