scholarly journals Prevention of Congenital Transmission of Malaria in Sub-Saharan African Countries: Challenges and Implications for Health System Strengthening

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Kayode O. Osungbade ◽  
Olubunmi O. Oladunjoye
Keyword(s):  
Health System ◽  
Health Systems ◽  
Preventive Measures ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
African Countries ◽  
Congenital Transmission ◽  
Public Health Burden ◽  
Sub Saharan ◽  
Congenital Malaria

Objectives. Review of burden of congenital transmission of malaria, challenges of preventive measures, and implications for health system strengthening in sub-Saharan Africa.Methods. Literature from Pubmed (MEDLINE), Biomed central, Google Scholar, and Cochrane Database were reviewed.Results. The prevalence of congenital malaria in sub-Saharan Africa ranges from 0 to 23%. Diagnosis and existing preventive measures are constantly hindered by weak health systems and sociocultural issues. WHO strategic framework for prevention: intermittent preventive therapy (IPT), insecticide-treated nets (ITNs), and case management of malaria illness and anaemia remain highly promising; though, specific interventions are required to strengthen the health systems in order to improve the effectiveness of these measures.Conclusion. Congenital malaria remains a public health burden in sub-Saharan Africa. Overcoming the challenges of the preventive measures hinges on the ability of national governments and development partners in responding to the weak health systems.

scholarly journals Improving quality of surgical and anaesthesia care at hospital level in sub-Saharan Africa: a systematic review protocol of health system strengthening interventions

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e036615
Author(s):  
Nataliya Brima ◽  
Justine Davies ◽  
Andrew JM Leather
Keyword(s):  
Systematic Review ◽  
Health System ◽  
Primary Outcome ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
African Countries ◽  
Implementation Outcomes ◽  
Sub Saharan ◽  
Anaesthesia Care

IntroductionOver 5 billion people in the world do not have access to safe, affordable surgical and anaesthesia care when needed. In order to improve health outcomes in patients with surgical conditions, both access to care and the quality of care need to be improved. A recent commission on high-quality health systems highlighted that poor-quality care is now a bigger barrier than non-utilisation of the health system for reducing mortality.AimTo carry out a systematic review to provide an evidence-based summary of hospital-based interventions associated with improved quality of surgical and anaesthesia care in sub-Saharan African countries (SSACs).Methods and analysisThree search strings (1) surgery and anaesthesia, (2) quality improvement hospital-based interventions and (3) SSACs will be combined. The following databases EMBASE, Global Health, MEDLINE, CINAHL, Web of Science and Scopus will be searched. Further relevant studies will be identified from national and international health organisations and publications and reference lists of all selected full-text articles. The review will include all type of original articles in English published between 2008 and 2019. Article screening, data extraction and assessment of methodological quality will be done by two reviewers independently and any disputes will be resolved by a third reviewer or team consensus. Three types of outcomes will be collected including clinical, process and implementation outcomes. The primary outcome will be mortality. Secondary outcomes will include other clinical outcomes (major and minor complications), as well as process and implementation outcomes. Descriptive statistics and outcomes will be summarised and discussed. For the primary outcome, the methodological rigour will be assessed.Ethics and disseminationThe results will be published in a peer reviewed open access journal and presented at national and international conferences. As this is a review of secondary data no formal ethical approval is required.PROSPERO registration numberCRD42019125570.

scholarly journals Implementation Science Protocol for a participatory, theory-informed implementation research programme in the context of health system strengthening in sub-Saharan Africa (ASSET-ImplementER)

2021 ◽  
Author(s):  
Nadine Seward ◽  
Jamie Murdoch ◽  
Charlotte Hanlon ◽  
Ricardo Araya ◽  
Wei Gao ◽  
...  
Keyword(s):  
Health System ◽  
Implementation Science ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Science Methods ◽  
African Countries ◽  
Implementation Phase ◽  
Implementation Outcomes ◽  
Resource Poor ◽  
Sub Saharan

ABSTRACTBackgroundASSET (Health System Strengthening in Sub-Saharan Africa) is a health system strengthening (HSS) programme that aims to develop and evaluate effective and sustainable solutions that support high-quality care that involve eight work packages across four sub-Saharan African countries. Here we present the protocol for the implementation science (IS) theme within ASSET that aims to (1) understand what HSS interventions work, for whom and how; and (2) how implementation science methodologies can be adapted to improve the design and evaluation of HSS interventions within resource-poor contexts.MethodsPre-implementation phaseThe IS theme, jointly with ASSET work-packages, applies IS determinant frameworks to identify factors that influence the effectiveness of delivering evidence-informed care. Determinants are used to select a set of HSS interventions for further evaluation, where work packages also theorise selective mechanisms to achieve the expected outcomes.Piloting phase and rolling implementation phaseWork-packages pilot the HSS interventions. An iterative process then begins involving evaluation, refection and adaptation. Throughout this phase, IS determinant frameworks are applied to monitor and identify barriers and enablers to implementation in a series of workshops, surveys and interviews. Selective mechanisms of action are also investigated. In a final workshop, ASSET teams come together, to reflect and explore the utility of the selected IS methods and provide suggestions for future use.Structured templates are used to organise and analyse common and heterogeneous patterns across work-packages. Qualitative data are analysed using thematic analysis and quantitative data is analysed using means and proportions.ConclusionsWe use a novel combination of implementation science methods at a programmatic level to facilitate comparisons of determinants and mechanisms that influence the effectiveness of HSS interventions in achieving implementation outcomes across different contexts. The study will also contribute conceptual development and clarification at the underdeveloped interface of implementation science, HSS and global health.Strengths and limitations of this studyThe purpose of this protocol paper is to describe the methodology for the implementation science theme within ASSET (ASSET-ImplementER).The overall aim of the ASSET-ImplementER theme is to advance our understanding of how to design and evaluate HSS interventions using a systems level approach informed by implementation science, across different health systems and contexts.This is one of the first large-scale implementation research programmes for health system strengthening in Sub-Saharan Africa that spanning three care platforms (primary care for the integrated treatment of chronic conditions in adults, maternal and newborn care, surgical care), involving eight work packages in four sub-Saharan African countries that aims to apply robust, implementation science and other theory-informed approaches to understand what works for whom and how. Equally as important, we aim to improve implementation science methodologies to design and evaluate HSS interventions within LMIC settings.Although our programme is theory-informed through the use of ToC workshops andimplementation science determinant frameworks, we have not used implementation science theories or other middle-range theories to guide the design and evaluate of ASSET as a programme. This is a pragmatic approach given many of the work-packages teams were unfamiliar with implementation science methods at the time of ASSET set-up.To mitigate the effects of this approach to our research, we work with the different work packages throughout the different phases of research, to theorise and conceptualise how the selected determinants interact with mechanisms introduced by the selected HSS on implementation outcomes.Although there are limitations to our approach, we expect to begin advance our understanding of what HSS work for whom, and how. It is also hoped that we will start to address the issues in understanding the complexity surrounding how to effectively strengthen health systems in resource-poor contexts within LMICs.

scholarly journals How Clinical Research Can Contribute to Strengthening Health Systems in Low Resource Countries

2020 ◽  
Vol 5 (2) ◽  
pp. 48
Author(s):  
Florent Mbo ◽  
Wilfried Mutombo ◽  
Digas Ngolo ◽  
Patrice Kabangu ◽  
Olaf Valverde Mordt ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Health System ◽  
Health Systems ◽  
Neglected Tropical Diseases ◽  
Information Provision ◽  
International Standards ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Low Resource

Clinical research on neglected tropical diseases is a challenge in low-resource countries, and the contribution of clinical and operational research to health system strengthening is poorly documented. Developing new, simple, safe, and effective treatments may improve the effectiveness of health systems, and conducting research directly in health structures may have an additional impact. This study describes the process of conducting clinical trials in the Democratic Republic of Congo (DRC) in compliance with international standards, and the role of the trials in strengthening health system functions, including governance, human resources, health information, provision of care, and the equipping of health services with the necessary supplies and infrastructure. We conclude that conducting clinical trials in endemic areas has not only reinforced and supported the aim of conducting high-level clinical research in endemic countries, but has also brought lasting benefits to researchers, staff, and hospitals, as well as to broader health systems, which have positive knock-on effect on patients outside of the clinical trials and their communities. Sustainability, however, remains a challenge in an underfunded health system, especially with respect to specialized equipment. Clinical research in most of sub-Saharan Africa is highly dependent on international input and external technical support; there are areas of weaknesses in trial design and documentation, as well as in data management and analysis. Financing remains a critical issue, as African investigators have difficulties in directly accessing sources of international research funding.

scholarly journals Challenges of healthcare delivery in the context of COVID-19 pandemic in Sub-Saharan Africa

2020 ◽  
Vol 2 (2) ◽  
pp. 100-109
Author(s):  
Bamidele Johnson Alegbeleye ◽  
◽  
Rana Kadhim Mohammed ◽  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Healthcare Delivery ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Health Security ◽  
Public Health Systems ◽  
Public Health Infrastructure ◽  
Health Infrastructure ◽  
Sub Saharan

Introduction: Public health security is concerned with infection prevention and control worldwide. These measures are the concern of all and sundry to ensure prevention of any outbreaks of diseases that has epidemic potential. Africa may be uniquely positioned to have the most severe and under-detected outcomes related to COVID-19 infection. This article seeks to highlight such challenges of healthcare delivery systems in the context of the COVID-19 pandemic in sub-Saharan Africa. The communique also suggests possible strategies for improvement in such settings. Method: We identified relevant articles to date using a manual library search, journal publications on the subject, and critically reviewed them. Results: We identified and exhaustively discussed the main limitations to public health security in sub-Saharan Africa as follows i) Continuing deterioration of the public health infrastructure for disease control, ii) The changing outlooks of contagious diseases, iii) Private sector reforms like the managed care, iv) Relatively weak health care systems, and v) Poor organizational structures. Conclusion: Most Africans are eager to see the desired transformation in our public health systems. Unfortunately, the political will to invest in public health infrastructure is lacking. Also, the system is characterized by human resources shortage and diverted resources, which significantly impacted the provision for emerging COVID-19 pandemic –related care. Interestingly the monumental breakthroughs in research development for bio-therapeutics and vaccines in African countries appear a mirage even with extensive past study experience with such products from China and the Western world. Finally, notwithstanding these challenges in our public health systems as elaborated, the facts are that enormous capacities exist that can be harnessed in African countries for the COVID-19 preparedness and response.

scholarly journals Institutionalizing Leadership Management and Governance for Health System Strengthening in Emerging Economies: Evidence from the Partnership for Health System Strengthening in Africa (PHSSA)Programme

2021 ◽  
Vol 6 (6) ◽  
pp. 47-52
Author(s):  
Jennifer Chepkorir ◽  
Naphtali Agata ◽  
Nicholas Kiambi ◽  
Brenda Nangehe
Keyword(s):  
Health System ◽  
Health Systems ◽  
Universal Coverage ◽  
Emerging Economy ◽  
Sub Saharan Africa ◽  
Health System Strengthening ◽  
Health Coverage ◽  
Leadership Management ◽  
Health System Governance ◽  
Universal Health

Health systems in an emerging economy, specifically Sub-Saharan Africa (SSA) are characterized as fragile with low implementation of Universal Health Coverage. While acknowledging that the cause of the inadequacy in emerging economies is multi-factorial, other arguments are that the root cause is inadequate political and technical leadership. Evidence reveals that visionary, imaginative, decisive, responsible, and responsive leadership is insufficient to persuade all stakeholders in low-income nations in Sub-Saharan Africa to work together to attain the constructive goal of universal coverage. On the contrary, other academics suggest that successful leadership would establish a clear national vision for universal coverage and a commitment to achieving that objective over time. These contrasting observations motivated an interrogation of the link between health system governance and Universal Health Coverage in an emerging economy taking evidence from the PHSSA programme. Through a meta-analysis of the existing literature as well as analysis of the findings from the programme, the paper explores experiences, critical success factors and recommendations for improvement of UHC through institutionalizing health system governance in an emerging economy. The research provides evidence that the governance linkages in health systems and the outcomes they produce are contingent rather than assured, due to the variety and complexity inherent in the health system governance paradigm. The situation-specific setting of a country's health system determines what can be accomplished through health governance strategy design and implementation efforts. The paper recommends a need to create a conducive environment for adoption of health systems programmes by contextualizing health governance with regard to the larger set of governance institutions that surround it. A competency framework should also be adopted in recruitment of competent health managers. The study also recommends a need for the countries in seeking to institutionalize health system governance to develop and support an organizational structure and context that sustains leadership practices through advocacy, create an enabling environment for health systems leadership, management and governance through the development of ethics and other competences specific to universal health care situations as well as provide proper financial support system so that institutionalization of leadership, management and governance can have maximum impact on the effectiveness and efficiency of health systems. There is also a need to institutionalize short courses, seminars and conferences in health leadership, management, and governance so as to entrench participatory leadership in health systems.

scholarly journals COVID-19: an opportunity to re-evaluate the implementation of a One Health approach to tackling emerging infections in Nigeria and other sub-Saharan African countries

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Olaniyi Ayobami ◽  
Godwin Mark ◽  
Zaharat Kadri-Alabi ◽  
Chioma Rita Achi ◽  
Joy Chinwendu Jacob
Keyword(s):  
Health Systems ◽  
National Health ◽  
One Health ◽  
Policy Support ◽  
Sub Saharan Africa ◽  
Local Context ◽  
Main Body ◽  
Emerging Infections ◽  
African Countries ◽  
Sub Saharan

Abstract Background One Health (OH) has resurfaced in the light of the ravaging COVID-19 pandemic. It has been accepted by many local and global health authorities as a suitable approach for preventing and responding to infectious disease outbreaks including pandemics. Main body One Health (OH) is a multisectoral and interdisciplinary framework for managing the animal, human, and ecosystem determinants of health. Globally, the majority of emerging infections in humans including SARS-Cov2—the causative agent of COVID-19—are transmitted from animals through environmental contacts in the last few decades. Yet, even when the biological and social interactions at the human, animal, and environmental interface that drive spillover of zoonotic diseases have been proven, OH strategies to address associated complex health challenges today are still rudimentary in many national health systems. Despite the disproportionate burden of infectious diseases in sub-Saharan Africa, OH is minimally incorporated into routine disease control and national health security programs. Challenges include poor policy support for OH in sub-Saharan Africa, and where some form of policy framework does exist, there are significant implementation bottlenecks. In this paper, we identified ideological, technical, operational, and economic barriers to OH implementation in Nigeria and sub-Saharan Africa, and highlighted possible recommendations across these domains. In order to yield sustainable benefits, a relevant OH policy approach in the sub-Saharan African health systems must derive from a buy-in of the critical mass of stakeholders in the society. Conclusion The implementation of sustainable OH approaches as a countermeasure to recurring emerging infections is a developmental priority for sub-Saharan African countries. A deep understanding of the local context must be leveraged to develop integrative OH solutions that are bold, rooted in science, and proven to be compatible with the level of development in sub-Saharan Africa.

scholarly journals Integrating Prevention of Mother-to-Child Transmission of HIV Care into General Maternal Child Health Care in Western Kenya

2020 ◽  
Vol 10 (1) ◽  
pp. 19-28
Author(s):  
Michelle Berlacher ◽  
Timothy Mercer ◽  
Edith O. Apondi ◽  
Winfred Mwangi ◽  
Edwin Were ◽  
...  
Keyword(s):  
Child Health ◽  
Global Health ◽  
Health System ◽  
Health Systems ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Maternal Child Health ◽  
Child Transmission ◽  
Sub Saharan ◽  
Maternal Child

Background: Health systems integration is becoming increasingly important as the global health community transitions from acute, disease-specific health programming to models of care built for chronic diseases, primarily designed to strengthen public-sector health systems. In many countries across sub-Saharan Africa, including Kenya, prevention of mother-to-child transmission of HIV (pMTCT) services are being integrated into the general maternal child health (MCH) clinics. The objective of this study was to evaluate the benefits and challenges for integration of care within a developing health system, through the lens of an evaluative framework. Methods: A framework adapted from the World Health Organization’s six critical health systems functions was used to evaluate the integration of pMTCT services with general MCH clinics in western Kenya. Perspectives were collected from key stakeholders, including pMTCT and MCH program leadership and local health providers. The benefits and challenges of integration across each of the health system functions were evaluated to better understand this approach. Results: Key informants in leadership positions and MCH staff shared similar perspectives regarding benefits and challenges of integration. Benefits of integration included convenience for families through streamlining of services and reduced HIV stigma. Concerns and challenges included confidentiality issues related to HIV status, particularly in the context of high-volume, crowded clinical spaces. Conclusion and Global Health Implications: The results from this study highlight areas that need to be addressed to maximize the effectiveness and clinical flow of the pMTCT-MCH integration model. The lessons learned from this integration may be applied to other settings in sub-Saharan Africa attempting to integrate HIV care into the broader public-sector health system. Key words: • HIV prevention • Maternal-child health • Prevention of maternal-to-child transmission • Health services • Integration • Kenya • Sub-Saharan Africa Copyright © 2020 Berlacher et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

scholarly journals Systematic review of hypertension prevalence and awareness in Sub-Saharan Africa

2018 ◽  
Vol 1 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Eléazar Ndabarora ◽  
Clemence Nishimwe ◽  
Dariya Mukamusoni
Keyword(s):  
Preventive Measures ◽  
Sub Saharan Africa ◽  
High Rate ◽  
African Countries ◽  
High Increase ◽  
Hypertensive Patients ◽  
High Prevalence ◽  
Sub Saharan ◽  
And Control ◽  
Very High

Several studies have reported high prevalence of hypertension in Africa, but little is known on awareness and determinants of preventive measures uptake. The purpose of the review was to identify and review the studies which reported at the same time on the prevalence of hypertension and awareness among the participants in sub-Saharan Africa, and to recommend needed research studies and interventions to prevent and control hypertension increase. High prevalence of hypertension was found across sub-Saharan African countries. The increasing hypertension rate moved from 19.7% in 1990 to 30.8% in 2010, with very high increase in some sub-regions up to 77%. A low awareness was found, less than 50% and in some place less than 10%. Also a high rate of hypertensive patients who were not on treatment was found. There is a very increasing prevalence of hypertension and unawareness in sub-Saharan Africa. There is also a high rate of hypertensive patients who are not on treatment.  Studies and interventions aiming at understanding determinants of hypertension screening and treatment uptake are much recommended.

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