Health Systems & Reform最新文献_第7页

Pay-for-Performance Debate: Not Seeing the Forest for the Trees. 绩效薪酬之争：只见树木不见森林。

IF 1.9 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1302902

Agnès Soucat, Elina Dale, Inke Mathauer, Joseph Kutzin

引用次数: 0

Why Performance-Based Financing in Chad Failed to Emerge on the National Policy Agenda. 为什么乍得基于绩效的融资未能出现在国家政策议程上。

IF 1.9 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1280115

Joël Arthur Kiendrébéogo, Zubin Cyrus Shroff, Abdramane Berthé, Lamoudi Yonli, Mahamat Béchir, Bruno Meessen

{"title":"Why Performance-Based Financing in Chad Failed to Emerge on the National Policy Agenda.","authors":"Joël Arthur Kiendrébéogo, Zubin Cyrus Shroff, Abdramane Berthé, Lamoudi Yonli, Mahamat Béchir, Bruno Meessen","doi":"10.1080/23288604.2017.1280115","DOIUrl":"10.1080/23288604.2017.1280115","url":null,"abstract":"Abstract-Supported by the World Bank (WB), Chad implemented a performance-based financing (PBF) scheme as a pilot, from October 2011 to May 2013. However, despite promising results and the government's stated commitment to ensure its continuation after the World Bank's departure, PBF failed to come onto the national policy agenda. This article aims to explain why this was the case, an especially interesting question given that several factors were favorable for project continuation. Data for this case study were collected through literature review and key informant interviews. We applied Kingdon's agenda setting theory to explain this failure. We found that though the potential of PBF to address challenges facing the Chadian health system was confirmed by internal and external evaluations of the pilot, it failed to move from the governmental agenda to the decision agenda. The main reason was a lack of dedicated policy entrepreneurs, resulting in a weak actual ownership of the policy by national authorities and key stakeholders. We tried to understand why such policy entrepreneurs failed to emerge.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"33 1","pages":"80-90"},"PeriodicalIF":1.9,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76307376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transferring the Purchasing Role from International to National Organizations During the Scale-Up Phase of Performance-Based Financing in Cameroon 在喀麦隆绩效融资扩大阶段，将采购角色从国际组织转移到国家组织

IF 4.1 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1291218

I. Sieleunou, Anne-Marie Turcotte-Tremblay, H. Yumo, Estelle Kouokam, Jean-Claude Taptué Fotso, Denise Magne Tamga, V. Ridde

{"title":"Transferring the Purchasing Role from International to National Organizations During the Scale-Up Phase of Performance-Based Financing in Cameroon","authors":"I. Sieleunou, Anne-Marie Turcotte-Tremblay, H. Yumo, Estelle Kouokam, Jean-Claude Taptué Fotso, Denise Magne Tamga, V. Ridde","doi":"10.1080/23288604.2017.1291218","DOIUrl":"https://doi.org/10.1080/23288604.2017.1291218","url":null,"abstract":"Abstract—The World Bank and the government of Cameroon launched a performance-based financing (PBF) program in Cameroon in 2011. To ensure its rapid implementation, the performance purchasing role was sub-contracted to a consultancy firm and a nongovernmental organization, both international. However, since the early stage, it was agreed upon that this role would later be transferred to a national entity. This explanatory case study aims at analyzing the process of this transfer using Dolowitz and Marsh's framework. We performed a document review and interviews with various stakeholders (n = 33) and then conducted thematic analysis of interview recordings. Sustainability, ownership, and integration of the PBF intervention into the health system emerged as the main reasons for the transfer. The different aspects of transfer from international entities to a national body consisted of (1) the decision-making power, (2) the “soft” elements (e.g., ideas, expertise), and (3) the “hard” elements (e.g., computers, vehicles). Factors facilitating the transfer included the fact that it was planned from the start and the modification of the legal status of the national organization that became responsible for strategic purchasing. Other factors hindered the transfer, such as the lack of a legal act clarifying the conditions of the transfer and the lack of posttransition support agreements. The Cameroonian experience suggests that key components of a successful transfer of PBF functions from international to national organizations may include clear guidelines, co-ownership and planning of the transition by all parties, and posttransition support to new actors.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"1 1","pages":"104 - 91"},"PeriodicalIF":4.1,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73177635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Taking Results-Based Financing from Scheme to System. 从计划到系统实行基于结果的融资。

IF 1.9 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1302903

Zubin Cyrus Shroff, Nhan Tran, Bruno Meessen, Maryam Bigdeli, Abdul Ghaffar

引用次数: 0

From Scheme to System (Part 1): Notes on Conceptual and Methodological Innovations in the Multicountry Research Program on Scaling Up Results-Based Financing in Health Systems. 从计划到系统（第1部分）：关于扩大卫生系统基于结果的融资的多国研究计划概念和方法创新的说明。

IF 1.9 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1303561

Bruno Meessen, Zubin Cyrus Shroff, Por Ir, Maryam Bigdeli

{"title":"From Scheme to System (Part 1): Notes on Conceptual and Methodological Innovations in the Multicountry Research Program on Scaling Up Results-Based Financing in Health Systems.","authors":"Bruno Meessen, Zubin Cyrus Shroff, Por Ir, Maryam Bigdeli","doi":"10.1080/23288604.2017.1303561","DOIUrl":"10.1080/23288604.2017.1303561","url":null,"abstract":"Abstract-This article presents conceptual and methodological developments made in analyzing the scale up of results-based financing (RBF) as part of a multicountry research program supported by the Alliance for Health Policy and Systems Research. Following a brief overview of the research process, the article proposes a new five-dimensional conceptualization of scale-up (population coverage, service coverage, health system integration, cross-sectoral diffusion, and knowledge expansion) to capture various facets of RBF scale-up. It also presents how Walt and Gilson's health policy triangle framework was modified to identify the enablers and barriers to scale-up in the country case studies included in this research program. The article then puts forth a four-phase model of scale-up, including phases of generation, adoption, institutionalization, and expansion, developed for the purpose of this research program. The article concludes by providing some lessons learned on the use of the methods and theoretical frameworks developed for this multicountry research program.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"65 1","pages":"129-136"},"PeriodicalIF":1.9,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77457094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

From Scheme to System (Part 2): Findings from Ten Countries on the Policy Evolution of Results-Based Financing in Health Systems. 从计划到系统（第二部分）：十个国家关于卫生系统基于结果的融资政策演变的调查结果。

IF 1.9 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1304190

Zubin Cyrus Shroff, Maryam Bigdeli, Bruno Meessen

{"title":"From Scheme to System (Part 2): Findings from Ten Countries on the Policy Evolution of Results-Based Financing in Health Systems.","authors":"Zubin Cyrus Shroff, Maryam Bigdeli, Bruno Meessen","doi":"10.1080/23288604.2017.1304190","DOIUrl":"10.1080/23288604.2017.1304190","url":null,"abstract":"Abstract- This article presents the enablers and barriers to the scaling-up of results-based financing (RBF) programs. It draws on the Alliance for Health Policy and Systems Research's multicountry program of research Taking Results Based Financing From Scheme to System, which compared the scale-up of RBF interventions over four phases-generation, adoption, institutionalization, and expansion-across ten countries. Comparing country experiences reveals broad lessons on scale up of RBF for each of the scale-up phases. Though the coming together of global, national, and regional contextual factors was key to the development of pilot projects, national factors were important to scale up these pilots to national programs, including a political context favoring results and transparency, the presence of enabling policies and institutions, and the presence of policy entrepreneurs at the national level. The third transition, from program to policy, was enabled by the availability of domestic financial resources, legislative and financing arrangements to enhance health facility autonomy, and technical and political leadership within and beyond the Ministry of Health. The article provides lessons learned on RBF policy evolution, emphasizing the importance of phase-specific groups of actors, the need to tailor advocacy messages to enable scale-up, the influence of political feasibility on policy content, and policy processes to build national ownership and enable health system strengthening.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"71 1","pages":"137-147"},"PeriodicalIF":1.9,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83948367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia. 在全国范围内扩大基于成果的初级卫生保健筹资：亚美尼亚的案例。

IF 1.9 3区医学

Health Systems & Reform Pub Date : 2017-04-03 DOI: 10.1080/23288604.2017.1291394

Varduhi Petrosyan, Dzovinar Melkom Melkomian, Akaki Zoidze, Zubin Cyrus Shroff

{"title":"National Scale-Up of Results-Based Financing in Primary Health Care: The Case of Armenia.","authors":"Varduhi Petrosyan, Dzovinar Melkom Melkomian, Akaki Zoidze, Zubin Cyrus Shroff","doi":"10.1080/23288604.2017.1291394","DOIUrl":"10.1080/23288604.2017.1291394","url":null,"abstract":"Abstract-Results-based financing (RBF) has been integrated into the national health care financing system of Armenia covering all primary health care (PHC) facilities in the country. The RBF program contributed to a substantial increase in the utilization of PHC services and improved provider performance. Based on document and literature review and key informant interviews and focus group discussions, this article describes the successful scale-up and integration of RBF into Armenia's primary health care system throughout the period 2000-2015. The article shows how an interaction of contextual factors, actors, and processes contributed to the successful scale-up and integration of RBF into Armenia's primary health care system. Though international agencies, in this case the United States Agency for International Development (USAID), had a significant influence on the introduction and initial design of the RBF scheme, an important enabler was a well-sequenced reform process that included the most politically important stakeholders, including the State Health Agency. Embedding of RBF in national regulatory frameworks and the provision of funds from the national budget were also key contributors to success. Finally, an important enabler to the subsequent scale-up and integration of RBF into the PHC system was its introduction as part of a larger reform of the primary health care system.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"83 1 Pt 2 1","pages":"117-128"},"PeriodicalIF":1.9,"publicationDate":"2017-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74602799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors Driving Changes in the Design, Implementation, and Scaling-Up of the Contracting of Health Services in Rural Cambodia, 1997–2015 1997-2015年推动柬埔寨农村卫生服务承包设计、实施和扩大的因素

IF 4.1 3区医学

Health Systems & Reform Pub Date : 2017-03-01 DOI: 10.1080/23288604.2017.1291217

K. Khim, P. Ir, P. Annear

{"title":"Factors Driving Changes in the Design, Implementation, and Scaling-Up of the Contracting of Health Services in Rural Cambodia, 1997–2015","authors":"K. Khim, P. Ir, P. Annear","doi":"10.1080/23288604.2017.1291217","DOIUrl":"https://doi.org/10.1080/23288604.2017.1291217","url":null,"abstract":"Abstract—Contracting approaches have been used in various forms to improve the delivery of public health services in low- and middle-income countries. Cambodia has embarked on a public-sector reform that includes a model of internal contracting of health care through the Ministry of Health, supported by incentive payments for staff and facilities. Contracting for health care in Cambodia has evolved through three phases during 1997–2015, each with particular design features, arrangements, and structures; different levels of involvement of local and international stakeholders; and modifications based on evidence from operational research. Based on a review of published and gray literature and interviews with 29 local and international key informants, we identify national ownership, financial sustainability, and the need to strengthen service delivery institutions as the major forces that have shaped contracting in Cambodia, culminating in the move to internal contracting arrangements for public health care delivery. There remains a need to strengthen contracting governance arrangements.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"6 1","pages":"105 - 116"},"PeriodicalIF":4.1,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83973230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

How Labor Laws Can Transform Health Systems: The Case of Saudi Arabia 劳动法如何改变医疗系统:以沙特阿拉伯为例

IF 4.1 3区医学

Health Systems & Reform Pub Date : 2017-01-02 DOI: 10.1080/23288604.2016.1272982

Yagoub Al-Mazrou, Taghreed Al-Ghaith, A. Yazbeck, T. Rabie

{"title":"How Labor Laws Can Transform Health Systems: The Case of Saudi Arabia","authors":"Yagoub Al-Mazrou, Taghreed Al-Ghaith, A. Yazbeck, T. Rabie","doi":"10.1080/23288604.2016.1272982","DOIUrl":"https://doi.org/10.1080/23288604.2016.1272982","url":null,"abstract":"Abstract—In 1999, the Kingdom of Saudi Arabia enacted a law that compels private employers to cover non-Saudi employees with health insurance. In the 16 years that followed, the health sector in the Kingdom has seen a dramatic shift in how services are provided and paid for, and the change continues at an accelerated speed. Based on interviews with 12 large private sector providers in Riyadh, Jeddah, and Khobar, we found that a labor law enacted in 1999 led to rapid expansion of the insured population, both expatriates and Saudis, which led to a drastic change in how hospitals and other facilities are paid, and considerable more consistency in revenue stream. This article describes how the 1999 labor law, combined with other market conditions and public incentives, led to unprecedented growth in private sector capacity and how the insurance system changed the labor market for health care providers and put more pressure on physicians to engage in dual job holding in both the public and private sectors. The Kingdom later introduced another labor program, known as Nitaqat, designed to implement the Saudization initiative that started in 2011, which put pressure on all private companies to hire Saudi nationals. The interviews with large private health providers found the Nitaqat program to be the largest barrier to the growth of the sector. The Kingdom presents a striking case of how the health sector can be drastically impacted by laws and policies outside the sector and how health systems and reforms can, and should, take into account the whole range of policy instruments available to a country.","PeriodicalId":46168,"journal":{"name":"Health Systems & Reform","volume":"38 1","pages":"26 - 33"},"PeriodicalIF":4.1,"publicationDate":"2017-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91179461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Health Sector Reform in the Middle East and North Africa: Prospects and Experiences 中东和北非卫生部门改革:前景和经验

IF 4.1 3区医学

Health Systems & Reform Pub Date : 2017-01-02 DOI: 10.1080/23288604.2016.1272984

A. Yazbeck, T. Rabie, Aaka Pande

引用次数: 17