scholarly journals Developing a workbook to support the contextualisation of global health systems guidance: a case study identifying steps and critical factors for success in this process at WHO

2018 ◽  
Vol 16 (1) ◽  
Author(s):  
Elizabeth Alvarez ◽  
John N. Lavis ◽  
Melissa Brouwers ◽  
Lisa Schwartz
2020 ◽  
Author(s):  
Ahmed Razavi ◽  
Ngozi Erondu ◽  
Katie Haddock ◽  
Gurnam Johal ◽  
Oyeronke Oyebanji ◽  
...  

Abstract Background: Bilateral Institutional Health Partnerships (IHPs) are a means of strengthening health systems and are becoming increasing prevalent in global health. Nigeria Centre for Disease Control (NCDC) and Public Health England (PHE) have engaged in one such IHP as part of Public Health England’s International Health Regulations Strengthening project. Presently, there have been limited evaluations of IHPs resulting in limited evidence of their effectiveness in strengthening health systems despite the concept being used across the world.Methods: The ESTHER EFFECt tool was used to evaluate the IHP between NCDC and PHE. Senior leadership from both organisations participated in a two-day workshop where their perceptions of various elements of the partnership were evaluated. This was done through an initial quantitative survey followed by a facilitated discussion to further explore any arising issues.Results: This evaluation is the first published evaluation of a bilateral global health partnership undertaken by NCDC and PHE. NCDC scores were consistently higher than PHE scores. Key strengths and weaknesses of the partnership were identified such as having wide ranging institutional engagement, however needing to improve dissemination mechanisms following key learning activity.Conclusions: There is a dearth of evidence measuring the effectiveness of international health partnerships; of the studies that exist, many are lacking in academic rigour. We used the ESTHER EFFECt tool as it is an established method of evaluating the progress of the partnership, with multiple previous peer-reviewed publications. This will hopefully encourage more organisations to publish evaluations of their international health partnerships and build the evidence base.


2017 ◽  
Vol 45 (4) ◽  
pp. 664-681
Author(s):  
Bridget Pratt ◽  
Adnan A. Hyder

Global health research partnerships are increasingly taking the form of consortia. Recent scholarship has proposed what features of governance may be necessary for these consortia to advance justice in global health. That guidance purports three elements of global health research consortia are essential — their research priorities, research capacity development strategies, research translation strategies — and should be structured to promote the health of the worst-off globally. This paper adopted a reflective equilibrium approach, testing the proposed ethical guidance against the experience of a global health research consortium with equity objectives. Case study research was performed with Future Health Systems (FHS), a health systems research consortium funded over two phases. Data on FHS Phase-2 were gathered through in-depth interviews with steering committee members and junior researchers and collection of consortium-related documents. Thematic analysis of the data for consistency with the proposed guidance generated recommendations for how the guidance might be better articulated and identified areas where it could usefully be expanded. Factors facilitating FHS alignment with the ethical guidance were also identified, including early engagement and partnership with low and middle-income country stakeholders, the learning developed during FHS Phase-1, and aspects of the grant program funding it.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kathleen Murphy ◽  
Erica Di Ruggiero ◽  
Ross Upshur ◽  
Donald J. Willison ◽  
Neha Malhotra ◽  
...  

Abstract Background Artificial intelligence (AI) has been described as the “fourth industrial revolution” with transformative and global implications, including in healthcare, public health, and global health. AI approaches hold promise for improving health systems worldwide, as well as individual and population health outcomes. While AI may have potential for advancing health equity within and between countries, we must consider the ethical implications of its deployment in order to mitigate its potential harms, particularly for the most vulnerable. This scoping review addresses the following question: What ethical issues have been identified in relation to AI in the field of health, including from a global health perspective? Methods Eight electronic databases were searched for peer reviewed and grey literature published before April 2018 using the concepts of health, ethics, and AI, and their related terms. Records were independently screened by two reviewers and were included if they reported on AI in relation to health and ethics and were written in the English language. Data was charted on a piloted data charting form, and a descriptive and thematic analysis was performed. Results Upon reviewing 12,722 articles, 103 met the predetermined inclusion criteria. The literature was primarily focused on the ethics of AI in health care, particularly on carer robots, diagnostics, and precision medicine, but was largely silent on ethics of AI in public and population health. The literature highlighted a number of common ethical concerns related to privacy, trust, accountability and responsibility, and bias. Largely missing from the literature was the ethics of AI in global health, particularly in the context of low- and middle-income countries (LMICs). Conclusions The ethical issues surrounding AI in the field of health are both vast and complex. While AI holds the potential to improve health and health systems, our analysis suggests that its introduction should be approached with cautious optimism. The dearth of literature on the ethics of AI within LMICs, as well as in public health, also points to a critical need for further research into the ethical implications of AI within both global and public health, to ensure that its development and implementation is ethical for everyone, everywhere.


2021 ◽  
Vol 6 (4) ◽  
pp. e004882
Author(s):  
Yibeltal Assefa ◽  
Charles F Gilks ◽  
Remco van de Pas ◽  
Simon Reid ◽  
Dereje Gedle Gete ◽  
...  

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Amare Worku Tadesse ◽  
Kassu Ketema Gurmu ◽  
Selamawit Tesfaye Kebede ◽  
Mahlet Kifle Habtemariam

Abstract Background Evidence exists about synergies among universal health coverage, health security and health promotion. Uniting these three global agendas has brought success to the country’s health sector. This study aimed to document the efforts Ethiopia has made to apply nationally synergistic approaches uniting these three global health agendas. Our study is part of the Lancet Commission on synergies between these global agendas. Methods We employed a case study design to describe the synergistic process in the Ethiopian health system based on a review of national strategies and policy documents, and key informant interviews with current and former policymakers, and academics. We analyzed the “hardware” (using the World Health Organization’s building blocks) and the “software” (ideas, interests, and power relations) of the Ethiopian health system according to the aforementioned three global agendas. Results Fragmentation of health system primarily manifested as inequities in access to health services, low health workforce and limited capacity to implementation guidelines. Donor driven vertical programs, multiple modalities of health financing, and inadequate multisectoral collaborations were also found to be key features of fragmentation. Several approaches were found to be instrumental in fostering synergies within the global health agenda. These included strong political and technical leadership within the government, transparent coordination, and engagement of stakeholders in the process of priority setting and annual resource mapping. Furthermore, harmonization and alignment of the national strategic plan with international commitments, joint financial arrangements with stakeholders and standing partnership platforms facilitated efforts for synergy. Conclusions Ethiopia has implemented multiple approaches to overcome fragmentation. Such synergistic efforts of the primary global health agendas have made significant contributions to the improvement of the country’s health indicators and may promote sustained functionality of the health system.


2019 ◽  
Vol 4 (5) ◽  
pp. e001786 ◽  
Author(s):  
Marta Schaaf ◽  
Emily Maistrellis ◽  
Hana Thomas ◽  
Bergen Cooper

During his first week in office, US President Donald J Trump issued a presidential memorandum to reinstate and broaden the reach of the Mexico City policy. The Mexico City policy (which was in place from 1985–1993, 1999–2000 and 2001–2009) barred foreign non-governmental organisations (NGOs) that received US government family planning (FP) assistance from using US funds or their own funds for performing, providing counselling, referring or advocating for safe abortions as a method of FP. The renamed policy, Protecting Life in Global Health Assistance (PLGHA), expands the Mexico City policy by applying it to most US global health assistance. Thus, foreign NGOs receiving US global health assistance of nearly any type must agree to the policy, regardless of whether they work in reproductive health. This article summarises academic and grey literature on the impact of previous iterations of the Mexico City policy, and initial research on impacts of the expanded policy. It builds on this analysis to propose a hypothesis regarding the potential impact of PLGHA on health systems. Because PLGHA applies to much more funding than it did in its previous iterations, and because health services have generally become more integrated in the past decade, we hypothesise that the health systems impacts of PLGHA could be significant. We present this hypothesis as a tool that may be useful to others’ and to our own research on the impact of PLGHA and similar exogenous overseas development assistance policy changes.


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